© 2010 Delmar, Cengage Learning 1 © 2011 Delmar, Cengage Learning  Name at least 1 injury to the hip or pelvis that you know of. 1

The Hip and Pelvis

© 2010 Delmar, Cengage Learning 3 © 2011 Delmar, Cengage Learning  Upon completion of this chapter, you should be able to:  Explain the importance of the hip and pelvis as a support structure for the human body  Describe the skeletal structure of the hip and pelvis  List the primary muscles of the hip and pelvis  Describe common injuries associated with the hip and pelvis 3

© 2010 Delmar, Cengage Learning 4 © 2011 Delmar, Cengage Learning  The hip is one of the most stable joints in the body  strongest joint in body  Well protected and surrounded by muscle  Freely movable, ball-and-socket joint  Attachment site for these muscles:  Back  Abdomen  Hamstrings & quads  Abductors & adductors  Gluteals 4

© 2010 Delmar, Cengage Learning 5 © 2011 Delmar, Cengage Learning  The pelvis:  Transmits weight from axial skeleton to lower limbs when standing, or to ischial tuberosities when sitting  Provides attachments for various muscles that attach onto and control the lower limbs  Houses parts of the digestive and urinary tracts  Houses reproductive systems 5

© 2010 Delmar, Cengage Learning 6 © 2011 Delmar, Cengage Learning  Ilium: upper & lateral sections of pelvis  Sacrum: 5 fused vertebrae  Ischium: between ilium & pubis; bears weight of body when sitting  Pubis: to the front, below bladder  Coccyx: tailbone 6

© 2010 Delmar, Cengage Learning 7 © 2011 Delmar, Cengage Learning  Iliac crest: upper ridge of ilium  Greater sciatic notch: space through which sciatic nerve passes  Iliac fossa: concave inner surface of ilium  Obturator foramina: large openings in ischium  Symphysis: line where 2 sides of pubis are fused 7

© 2010 Delmar, Cengage Learning 8 © 2011 Delmar, Cengage Learning 8 FemaleMale FemaleMale

© 2010 Delmar, Cengage Learning 9 © 2011 Delmar, Cengage Learning  Hip flexors:  Iliopsoas  Sartorius  Pectineus  Rectus femoris  Adductor muscles:  A. longus  A. brevis  A. magnus 9

© 2010 Delmar, Cengage Learning 10 © 2011 Delmar, Cengage Learning  Hamstring muscles & glutes: aid in hip extension 10

© 2010 Delmar, Cengage Learning 11 © 2011 Delmar, Cengage Learning  Bursitis  Commonly seen in athletes who do not sufficiently stretch and warm up the outside of the hip  Symptoms: tenderness  Treatment: limiting activity, stretching exercises, and ice massage, and nonsteroidal anti-inflammatory medicines (NSAIDs) 11

© 2010 Delmar, Cengage Learning 12 © 2011 Delmar, Cengage Learning  Hip fracture  Break of the top part of the femur where it connects to the pelvis  Symptoms: severe hip pain  Treatment: highly individualized 12

© 2010 Delmar, Cengage Learning 13 © 2011 Delmar, Cengage Learning  Quadriceps and hip flexor strains  Common in sports requiring jumping, kicking, or repetitive sprinting  Treatment: icing, compression with an elastic wrap, and anti-inflammatory medications  Rehabilitation: progressive and sport specific 13

© 2010 Delmar, Cengage Learning 14 © 2011 Delmar, Cengage Learning  Hamstring strains  Mild or moderate damage in the muscle tissue  Completely tearing the muscles or separating them from connective tendons is a hamstring tear  Symptoms: sharp pain in the back of the thigh, bruising, swelling, loss of strength, and hearing a “pop”  Treatment: RICE, medication, and physical therapy and rehabilitation 14

© 2010 Delmar, Cengage Learning 15 © 2011 Delmar, Cengage Learning  Adductor (groin) strains  Common in sports requiring sudden sideways changes in direction  Treatment: rest, ice, and anti-inflammatory medications, adductor stretching and strengthening exercises 15

© 2010 Delmar, Cengage Learning 16 © 2011 Delmar, Cengage Learning  Iliotibial band syndrome  Inflammation of iliotibial band  Symptoms: irritation over the outside of the knee joint  Treatment: rule out mechanical problems or training errors, proper footwear, icing the area of pain, and stretching 16

© 2010 Delmar, Cengage Learning 17 © 2011 Delmar, Cengage Learning  Quadriceps contusions  Usually caused by a direct blow to the thigh  Treatment: compression, ice (applied during the first 24 to 48 hours), and crutches 17

© 2010 Delmar, Cengage Learning 18 © 2011 Delmar, Cengage Learning  Myositis ossificans (calcium deposit)  Usually the result of recurrent trauma to a quadricep muscle that was not properly protected after an initial injury  Symptoms: hard, painful mass in the soft tissue of the thigh and progressive loss of bending motion of the injured knee  Treatment: heat, limitation of joint motion, rehabilitative exercises within the limits of pain; surgery may be necessary 18

© 2010 Delmar, Cengage Learning 19 © 2011 Delmar, Cengage Learning  Take out one sheet of paper & list all members of this class, one name per line. (Leave plenty of room to the right of each name.) 19

© 2010 Delmar, Cengage Learning 20 © 2011 Delmar, Cengage Learning Click Here to Play Hamstring Strain Animation

© 2010 Delmar, Cengage Learning 21 © 2011 Delmar, Cengage Learning  Iliac crest contusion (“hip pointer”)  Painful injury caused by a direct blow to the hip  Symptoms: extreme tenderness, swelling, and ecchymosis over the iliac crest  Treatment: ice and compression 21

© 2010 Delmar, Cengage Learning 22 © 2011 Delmar, Cengage Learning  Overuse injuries  Cumulative effect of very low levels of stress  Include chronic muscle strains, stress fractures, tendonitis, “snapping hip” (iliopsoas tendon rolls over head of femur), and bursitis  Treatment: rest and exercise different body parts (cross-training) 22

© 2010 Delmar, Cengage Learning 23 © 2011 Delmar, Cengage Learning  Stress fractures:  Pelvis stress fractures occur most often in runners and dancers  Femur stress fractures usually occur in runners  Symptoms: chronic, ill-defined pain over the groin and thigh  Treatment: rest and nonweight-bearing endurance exercises 23

© 2010 Delmar, Cengage Learning 24 © 2011 Delmar, Cengage Learning 24 Hamstrings/Glutes Adductor (groin) Hip flexors Quadriceps Calves

© 2010 Delmar, Cengage Learning 25 © 2011 Delmar, Cengage Learning  The hip is a stable joint that is well protected and surrounded by muscle on all sides  The pelvis is made up of several flattened bones that function as a support structure  Injuries to the hip and thigh are very common in athletics 25