1 Injuries to the Hip and Pelvis

2Anatomy

3Anatomy  Function of the pelvis  attachment of lower extremities  protection of internal organs  muscular attachment  birth process  Joints (other than hip)  sacroiliac & pubic symphysis

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6 Anatomy Review

7Anatomy  Anterior muscles  psoas major & minor  iliacus  pectineus  Adductors - magnus, longus, brevis  gracilis  tensor fascia latae  Quadriceps - vastus muscles, rectus femoris

8  Skeletal injuries  fractures of the pelvis  great force required  not common in sports  may occur in sports such as ice hockey, pole-vault, or football  in adolescent -- serious  Signs/symptoms:  abnormal pain in pelvic region  swelling at the injury site  pain elicited when iliac crests are pressed together  injury to internal organ(s) may be associated with this injury  First Aid:  treat for shock & internal bleeding  monitor vital signs  arrange for transportation to a medical facility on a spine board -- elevated at the feet

9  Skeletal injuries  hip pointer  common injury to the anterior/superior region of the pelvis  caused by a direct blow such as from a helmet  extremely painful  Signs/symptoms:  swelling at the site of injury  discoloration at site of injury  walk with slight limp  coughing, sneezing, laughing may be painful

10  First Aid:  immediately apply ice  rest (avoid activities that involve the lower extremities)  if severe, crutches may be necessary  Long-term care  protect the area from additional trauma with some type of padding with hard-shell covering

11  Skeletal injuries  Osteitis Pubis  results from constant stress on the pubic symphysis  long distance runners, basketball players, any athlete experiencing repetitive loading of this area is vulnerable  Signs/symptoms:  localized pain over the pubic symphysis  vague pain in the lower abdominal region  groin pain with no history of injury to that area  First Aid:  overuse injury -- as such, first aid is not a factor responds well to rest, ice, and anti-inflammatory med.  refer to a physician

12  Skeletal injuries  dislocated hip  rare in sports  may occur in contact/collision sports  can occur from a violent collision such as seen in tackle football or ice hockey  hip is in flexion and force is applied through the femur  Signs/symptoms:  most dislocations are posterior -- pain and loss of movement are common  swelling with palpable defect  knee on the involved leg is angled towards the other leg  treat for shock, immobilize the athlete and contact EMS, apply ice and compression, monitor distal pulse

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14  Skeletal injuries  avulsion fractures  bone fragment is torn away with tendon attached  uncommon but can occur -- ischial tuberosity and pubis are likely sites of this injury  sports that involve sprint running, such as football  Signs/symptoms:  pain & swelling at site of injury  inability to use the muscle group involved due to avulsion  point tenderness over injury  snapping or popping at the time of injury  First Aid:  immediately apply ice  immobilize and use crutches  refer to a physician

15  Soft tissue injuries  hernias  protrusion of viscera through abdominal wall  inguinal more common in males  femoral more common in females  seek the advice of a physician regarding surgical options  nerve problems  most problems are related to direct contact  often involves the sciatic nerve with radiating pain  may be related to root impingement resulting from lumbar strain  refer to a physician

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