Basic Athletic Training Chapter 8 Hip and Pelvis

Chapter Objectives Name the anatomy of the hip and pelvis Identify the components of an injury evaluation format Compare the common injuries associated with the hip and pelvis Demonstrate the protocol for a rehabilitation program to the hip and pelvis Describe the preventive/supportive techniques and protective devices for the hip and pelvis

Anatomy The arrangement of bones, ligaments, muscles, and tendons make the hip the strongest joint in the body The hip joint is a ball and socket The bones of the hip and pelvic region provide the structure to transfer weight The largest group of muscles in the hip and pelvic region includes the gluteal muscles

Hip and Pelvis Anatomy Bones Ligaments Muscles and tendons and their functions Anatomical planes Range of motion—hip Range of motion—torso Dermatomes Myotomes

Evaluation Format (H)istory Mechanism of injury (How did it happen?) Location of pain (Where does it hurt?) Sensations experienced (Did you hear a pop or snap?) Previous injury (Have you injured this anatomical structure before?) (O)bservation—compare the uninjured to the injured lower extremity and look for bleeding, deformity, swelling, discoloration, scars, and other signs of trauma

Evaluation Format (P)alpation—the physical inspection of an injury. Palpate the anatomical structures/joints above and below the injured site, then palpate affected area. Using bilateral comparison, these items should be palpated: Neurological (motor and sensory) Circulation (pulse and capillary refill) Anatomical structures (palpate) Fracture test (palpation, compression, and distraction)

Evaluation Format (S)pecial Tests—look for joint instability, disability, and pain. Assess disability in the following areas: Joint stability Muscle/tendon Accessory anatomical structures Inflammatory conditions Range of motion (active, assistive, passive, and resistive) Pain or weakness in the affected area

Conditions that Indicate an Athlete Should be Referred for Physician Evaluation Gross deformity Significant pain Increased swelling Circulation or neurological impairment Joint instability Suspected fracture or dislocation Persistent pain in hip and pelvis area Noticeable and palpable deficit in the muscle or tendon Abnormal sensations such as clicking, popping, grating, or weakness Any doubt regarding the severity or nature of the injury

Common Injuries Injury to the coccyx Hip strains Trochanteric bursitis Trauma to the genitalia Hip pointer Hip dislocation Osteitis pubis Youth hip injuries

Musculoskeletal Disorders Athlete pubalgia Contusion of the thigh Fracture (pelvis or femur) Iliotibial band syndrome Osteitis pubis Piriformis syndrome Sprain Tendinitis

Rehabilitation Included in any rehabilitation protocol is: Range of motion exercises Resistive exercises Cardiovascular/fitness activities Sport-specific activities Return to competition guidelines Full range of motion Strength, power, and endurance are proportional to the athlete’s size and sport No pain during running, jumping, or agility movements No loss of function

Preventive/Supportive Techniques Wrapping techniques for support Hamstrings wrap Quadriceps wrap Hip flexor wrap Hip adductor wrap Taping techniques for the hip and pelvis Hip pointer Low back Rib

Protective Devices Athletic supporter with cup Back brace Low back brace/support Rib protector Thigh sleeve Sport-specific pads Sports compression girdle

Questions ?