1. Hip / Low Back

2. Hip Anatomy - Bones

3. Hip Anatomy - Ligaments

4. Hip Anatomy - Muscles Abductors –Gluteus medius –Gluteus maximus –Gluteus minimus –Sartorius –Tensor Fasciae Latae Adductors –Adductor brevis –Adductor longus –Adductor magnus –Gracilis –Pectineus –Gluteus maximus

5. Hip Anatomy - Muscles Flexors –Gluteus medius –Gluteus minimus –Iliacus –Psoas major & minor –Rectus Femoris –Sartorius –Tensor Fasciae Latae Extensors –Biceps Femoris –Gluteus maximus –Gluteus medius –Semimembranosus –Semitendinosus

6. Hip Anatomy - Muscles Internal Rotators –Adductor brevis –Adductor longus –Adductor magnus –Gluteus medius –Gluteus minimus –Semimembranosus –Semitendinosus –Tensor Fasciae Latae External Rotators –Biceps femoris –Gemellus inferior & superior –Gluteus maximus –Gluteus medius –Obturator externus & internus –Piriformis –Quadratus Femoris –Sartorius

7. Hip Injuries Piriformis Syndrome –Spasm of hypertrophy of the piriformis muscle placing pressure on the sciatic nerve –MOI: Blow to the buttock, hyperinternal rotation of femur

8. Hip Injuries Iliac Crest Contusion (Hip Pointer) –MOI: Direct blow to an unprotected ilium

9. Hip Injuries Hip Dislocation –Most hip dislocations occur when the hip is flexed and adducted with an axial force to the femur, displacing it posteriorly and causing the femoral head to be driven through the posterior capsule

10. Low Back Pain Statistics One-half of all working Americans admit to having back pain symptoms each year Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis infection, fracture or cancer. Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs. Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives (American Chiropractic Association)

11. Low Back (Lumbar) Anatomy - Bones

12. Lumbar Anatomy - Ligaments

13. Lumbar Anatomy - Muscles Rotation –Multifidis Flexion –Rectus Abdominis –External Oblique –Internal Oblique Extension –Iliocostalis –Spinalis –Longissimus Lateral Bending –Internal Oblique –External Oblique

14. Lordosis

15. Lumbar Injuries - Sciatica Inflammation of the sciatic nerve. –Causes of sciatica Disc herniation Sacroiliac joint dysfunction Scar tissue formation around the nerve root Nerve root inflammation Spinal stenosis Synovial cysts Cancerous or non-cancerous tumors

16. Lumbar Injuries – Disc Herniation They are often the result of repetitive motion (truck drivers/machine users) or due to a sudden heavy loading of the back (improper lifting)

17. Lumbar Injuries – Spondylolysis and Spondylolisthesis MOI: Pars interarticularis suffers a stress fracture secondary to repetitive stress from spinal extension

18. Lumbar Injuries – Spinal Stenosis A narrowing of the vertebral foramen where the nerve root or spinal cord pass Causes: thickened ligaments along the spinal canal, bony spurs, and enlarged joint cartilage from arthritic changes

19. Lumbar Injury Prevention Technique Proper breathing techniques Core Strength Maintain a healthy diet and weight. Remain active Avoid prolonged inactivity or bed rest. Warm up or stretch before exercising or other physical activities. Maintain proper posture. Wear comfortable, low-heeled shoes. Sleep on a mattress of medium firmness to minimize any curve in your spine. Lift with your knees, keep the object close to your body, and do not twist when lifting. Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues (American Chiropractic Association)

20. Core Strengthening

21. Question / Comments?