Chapter 14 Injuries to the Hip and Pelvis

Anatomy Review Primary hip structures Innominate bones

Anatomy Review (cont.) Functions of the pelvis include: Attachment of lower extremities. Muscle attachments. Joints (other than hip)

Nervous System Major Nerves Femoral Sciatic Saphenous Tibial Plantar nerves (not shown)

Circulatory System Major Blood Vessels External iliac Deep profunda femoral (not shown) Popliteal Anterior tibial Dorsalis pedis

Musculature Posterior Muscles Gluteals – Deep external rotators – Hamstrings –

Musculature (cont.) Anterior Muscles

Musculature (cont.) Anterior Muscles (continued)

Common Sports Injuries: Skeletal Injuries Fractures of the Pelvis Pelvic fractures are devastating injuries. Pelvic fractures are not common in sports, because it typically takes a great deal of force to fracture the pelvis. Pelvic fractures in the adolescent can be serious.

Fractures of the Pelvis (cont.) Signs and symptoms include: Abnormal pain in pelvic region. Pain elicited when iliac crests are pressed together.

Fractures of the Pelvis (cont.) First Aid Treat for shock and internal bleeding. Arrange for transportation to a medical facility on a spine board, elevated at the feet. An athlete with _________________________ should not be allowed to return to participation before obtaining a physician’s approval.

Adolescent Pelvic Fractures Femoral Neck Stress Fracture Commonly occurs in amenorrheic athletes involved in endurance sports. Slipped Capital Femoral Epiphysis Commonly occurs in prepubescent boys, particularly tall boys who experienced recent growth spurts, overweight boys, and late- maturing boys.

Hip Pointer Hip Pointer is a common injury, involving a contusion to the anterior/superior portion of the iliac crest. Signs and symptoms include swelling, pain, and discoloration at injury site.

Hip Pointer (cont.) First Aid Apply ice immediately. In severe cases, crutches may be necessary.

Hip Pointer (cont.) Courtesy of Brent Mangus

Osteitis Pubis This injury results from constant stress and possibly some degeneration in the pubic symphysis joint. Male athletes may have testicular or scrotal pain, along with discomfort in the anterior pubic, suprapubic, or hip areas.

Osteitis Pubis (cont.) First Aid Refer to a physician. It may take 3 months to a year to recover.

Hip Dislocation Dislocated Hip Injury can occur from a violent collision such as seen in tackle football or ice hockey.

Hip Dislocation (cont.) Signs and symptoms include: First Aid Treat for shock. Immobilize the athlete and contact EMS.

Avulsion Factures of the Hip In an avulsion fracture, a bone fragment is torn away with tendon attached. Injury likely to occur while sprinting or jumping.

Avulsion Fractures of the Hip (cont.) Signs and symptoms include:

Avulsion Fractures of the Hip (cont.) First Aid Immediately apply ice. Limit athlete’s movements. Crutches may be necessary for walking.

Injuries to Male Genitalia These injuries are usually transient in nature. Wearing a protective cup is advised in collision/contact sports.

Testicular or Scrotal Contusions Signs and symptoms include: First Aid Apply ice, and allow athlete to rest lying down. Testicular torsion can occur and results in considerable discomfort. Transport to medical care facility.

Hernias A hernia is a protrusion of viscera through abdominal wall. Femoral hernia is more common in females. In a sports hernia, the posterior inguinal wall is weakened without protrusion of abdominal contents. No palpable hernia is detected, but athlete complains of pain in groin and lower abdominal areas.

Nerve Problems A common complaint is burning or tingling sensation radiating from the hip to buttocks area and going down the leg. Continuing to participate in the activity aggravates the irritation. Rest, stretching, and strengthening exercises may be helpful.

Prevention Rest is also important for the body to repair micro damages incurred by the stresses of training.