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Chapter 13 Hip, Pelvis, and Thigh Injuries

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Presentation on theme: "Chapter 13 Hip, Pelvis, and Thigh Injuries"— Presentation transcript:

1 Chapter 13 Hip, Pelvis, and Thigh Injuries

2 The Hip, Pelvis, and Thigh
Includes some of the strongest muscles in the body. Subjected to tremendous demands. Extremely vulnerable to injuries that can sideline a player for an extensive period of time

3 Anatomy of the Hip and Pelvis
The hip joint is a ball-and-socket joint that allows motion and provides stability needed to bear body weight The socket area, which is inside the pelvis, is called the acetabulum. The ball part of this joint is the top of the leg bone (head). It joins with the acetabulum to form the hip joint.

4 Anatomy of the Thigh Bones The femur
Designed to permit maximum mobility and support during movement Longest and strongest bone in the body Extends from the hip to the knee The head of femur articulates with the pelvis to form the hip joint


6 Anatomy of the Thigh Pelvis Ilium Ischium Pubis

7 Muscles of the Hip Most powerful in the body Hip Flexors
Rectus femoris Sartorius Iliopsoas Psoas major Psoas minor iliacus

8 Muscles of the Hip Hip Extensors Hamstrings Gluteus maximus
Biceps femoris Vastus lateralis Vastus medialis Gluteus maximus

9 Muscles of the Hip Abductors Gluteus medius Gluteus minimus
Tensor fascia latae

10 Muscles of the Hip/Thigh
Medial Thigh Muscles (Groin) Primary function: adduction Gracilis Adductor magnus Adductor brevis Adductor longus Pectineus

11 Thigh Injuries Very few sprained ligaments or dislocations in this area Proper flexibility and strength prevents most hip injuries Proper equipment also important

12 Thigh Injuries Quadriceps Contusion Symptoms & Signs
Caused by sharp blow to thigh Severe impact from relaxed thigh (muscle to femur) Extent of force and degree of thigh relaxation determines depth of injury Feels like a muscle bruise Produces intense pain and weakness Grades depending on severity of injury

13 Thigh Injuries Management RICE
Use elastic bandage for pressure and support in the quadriceps area Constant stretching of quadriceps muscle Do not exercise if pain is still occurring Begin slowly with swimming, jogging, etc...

14 Thigh Injuries Myositis Ossificans (bone growth in muscle)
Symptoms & Signs Pain, muscle weakness, soreness, swelling, decreased muscle function, ROM Caused by multiple blows to the muscle area A single severe blow Improper care of a contusion Management PRICE Do not ignore quadriceps contusions Remove surgically after one year

15 Thigh Injuries Quadriceps & Hamstring Strains Symptoms & Signs
Pain, discomfort, point tenderness, spasms, soreness Grade 1 = mostly spasms, grade 3 = rupture of tendon/muscle tissues Strains tend to reoccur because of scar tissue that forms during the healing process Management PRICE, NSAIDS, analgesics Cryotherapy Preventative – stretch, warm up, use proper form

16 Thigh Injuries Stress Fractures and Femur Fractures
Symptoms & Signs Stress fracture – femur bends slightly, pain and discomfort from pounding of lower extremity (running) Femur Fracture – severe pain, loss of function, internal bleeding, swelling Management for stress fracture: Rest An alternative activity -Management for femur fracture: Immobilization, once at hospital traction splint may be used to pull femur and reduce pain

17 Femur Fractures

18 Anatomy of the Hip and Pelvis
Bones Ilium Broad, flaring portion of hip bone Crest of the pelvis Pubis Lower, posterior part of hip bone Ischium Helps to form the hip


20 Hip injuries Hip Pointer Injury to the iliac crest
Can be as minimal as contusion or as major as an avulsion fracture Can be very painful and debilitating

21 Hip Injuries/Conditions
Legg-Calve-Perthes Disease A disruption of blood flow to the head of the femur The 'ball' of the 'ball and socket' joint dies Usually is seen in children 2 to12 years of age, five times more common in boys than girls Characterized by extreme pain in groin and knee area, or walking with limp

22 Hip Injuries Dislocation of hip – Femur pops out of the socket (acetabulum) Causes Athletic injuries Car accidents Severe falls Signs & Symptoms Extreme pain Leg is often internally rotated Possible loss of feeling in foot or leg due to nerve damage X-Ray or position of leg usually determines this injury



25 Hip Injuries - Dislocation
Management Call ambulance immediately, hospital will relocate hip Months of rehab needed – very long process Begin with normal ROM and strength May need to learn how to walk again

26 Hip injuries - Snapping Hip
The snapping hip – The IT band snaps over the greater trochanter hip stability becomes lessened and ligaments and adductor muscles become less stable. - Causes Habitual movements that predispose muscles around the hip to become imbalanced Greater range of motion of hip abduction Dancers, gymnasts, hurdlers – structurally narrow pelvic width Signs & Symptoms Snapping occurs when balancing on one leg Pain and inflammation with the snapping

27 Hip snapping

28 Hip injuries – Hip snapping
Management Cryotherapy Ultrasound to stretch tight muscles and strengthen weak muscles in the hip region Resume activity when the pain subsides

29 Slipped Capital Femoral Epiphysis
The head of the femur slips off of the neck or shifts position Found mostly in boys between who are tall & thin or obese May be related to the effects of a growth hormone Signs & Symptoms Pain in the groin, limping Hip and knee pain during passive and active motion


31 Avascular Necrosis Temporary or permanent loss of the blood supply to the proximal femur. - Causes Without blood, the bone tissue dies and causes a collapse of the joint surface. Use of steroids can cause AVN - Signs and Symptoms No symptoms in the early stages Joint pain, at first during activity, then during rest Osteoarthritis may develop after a period of time

32 Avascular Necrosis Management
See physician for an MRI, X-ray, or CT scan Electrical stimulation, ROM exercises, reduce weight bearing activity Surgery will eventually be required to repair the joint

33 Groin Strains and Avulsions

34 Groin Strains Groin strains usually involve the adductor group (especially adductor longus) Causes Running, jumping, or twisting with external rotation Sports that require stretching of the hip Rapid changes in speed or direction (soccer) Signs & Symptoms Complete rupture of the muscles that attach the pelvis bone to the femur bone. Pain, weakness, and internal hemorrhage A sudden twinge or feeling of tearing

35 Groin Strains Management
RICE, NSAIDs, anagelsics for 48 – 72 hours after injury occurs Rest Daily whirlpool therapy or cryotherapy Ultrasound Gradual stretching to restore ROM Protective spica bandages can be worn or Sawa groin & thigh braces

36 Hip, Thigh, and Groin Stretches

37 Hip, Thigh, and Groin Stretches

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