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Download Hip, Pelvis, and Thigh Injuries
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HIP, PELVIS, AND THIGH INJURIES SOME FYI The hip, pelvis, and thigh contain some of the strongest muscles in the body This area is also subjected to tremendous demands Injuries to this area can sideline a player for long periods of time Most injuries to this area are strains and contusions ANATOMY OF THE HIP, PELVIS, AND THIGH Hip joint (ball-and-socket joint) is the POC between the femur and the pelvis Acetabulum-hip socket. Head of femur fits here Femur (longest bone in the body) is connected to the pelvis by thick, strong ligaments 2 muscle groups of the femur are the quads and hamstrings PREVENTING HIP, PELVIS, AND THIGH INJURIES Since the hip is very stable, ATCs will not see a lot of sprains or dislocations ATCs will see a lot of muscular strains Proper flexibility training and stretching will help prevent injuries in this area Also wearing proper padding (ex. Football) and strengthening the core region of the body will help prevent injuries LIGAMENT INJURIES Extremely stable joint Very thick ligamentous structures and strong muscles surround the hip This results in very few ligament injuries MUSCLE AND TENDON INJURIES Thigh strains are very common, especially to the hip flexor, extensor, and groin muscles. Theories as to why this occurs: Many muscles in the leg cross 2 joints Ex. Hamstrings cross the back of the hip joint (extension) and the knee joint (flexion) Strength imbalance occurs Stronger muscle group put excessive tension on the opposing muscle group MUSCLE AND TENDON INJURIES Strains should be treated with PRICE and wrapped with supportive elastic bandage Moderate and severe strains may need to be referred to a physician Rehab will focus on regaining strength and range of motion and enhancing flexibility BONE INJURIES Pelvic fractures are not common but can occur if excessive stress is placed on the bone tissue Athletic-related fractures of this area often occur as a result of an avulsion, disruption of the epiphysis, stress, or trauma to femur BONE INJURIES Avulsions (tendon pulling away the bone) Occur as a result of forceful muscle contractions that literally pull the bone away at the site where the tendon attaches Ex. Football player continues to run aggressively forward while a defender is holding his leg **hip flexor may forcefully contract, causing a fracture BONE INJURIES Growth plate fractures Occur at the growth plate of the bone (the neck of the femur joins the head) Most commonly occurs between the ages of 10 and 15 Head of femur slips off the neck Causes pain in the groin, hip, and knee ATC would refer athlete to a physician b/c the treatment involves stopping the slippage and helping to close the growth plate through surgery BONE INJURIES Stress Fractures Uncommon but do occur in running-oriented athletes Caused by repetitive stress, typically from the force of pounding of the lower extremity while running Pounding can cause the femur to bend slightly (one side is compressed while the other is stretched) If this pounding continues, small hairline fractures can develop Rest and an alternative activity are the treatment and rehab for this problem BONE INJURIES Femur Fractures Stress required to fracture the femur is very extreme (due to the size of the bone) Characterized by severe pain and loss of function, as well as internal bleeding, swelling, or tearing of muscles, tendons, nerves, and arteries Often causes the leg to externally rotate Initial treatment-immobilization and transportation to hospital by EMS Often use a traction splint that gently pulls the femur (helps reduce leg pain and spasm) BONE INJURIES Hip Dislocations Caused by extreme stress Most occur posteriorly Severe damage can occur because of the nerve and vascular structures Athlete will be in extreme pain and leg will often be internally rotated EMS called immediately for transportation to hospital Rehab begins with establishing normal range of motion and strength Learning how to walk normally will be necessary Long recovery process OTHER COMMON INJURIES Hip and Thigh Muscle Contusions Deep thigh contusions are common, especially in contact sports The more severe contusions can actually cause tissue tearing and extensive bleeding Myositis ossificans can occur if serious contusions are not managed appropriately Bone tissue forms within the muscle Treatment-PRICE (knee flexed during ice applications) Moderate to severe contusions require athlete be placed on crutches to minimize the stress to the area OTHER COMMON INJURIES Hip and Thigh contusions continued… Rehab-active rest and gentle stretching help restore mobility Ultrasound often used to help reabsorb the blood that collects internally and to break up bony tissue deposits ATC must place a protective pad over the contusion to prevent repeated injuries to the area OTHER COMMON INJURIES Legg-Calve-Perthes Disease Disruption of blood flow to the head of the femur causes the tissue at head of the femur to die Typical signs and symptoms include groin or knee pain and walking with a limp If condition is suspected, athlete should be referred to a physician right away
