1. Hip – Thigh – Pelvis Injury Evaluation

2. History

3. -Mechanism of Injury (MOI):
-Majority of injuries to hip are chronic or overuse injuries
-Acute MOI:
-Direct blow to iliac crest, quadriceps or hamstrings
-Falling on buttocks
-Gradual increase in pain- may be due to tendinitis or femoral stress fx
-Extreme amount of force needed to dislocate hip or fracture the Femur
-Hip pain most frequently felt on anterior or medial aspect of hip & into groin; may be referred to knee or back

4. Inspection

5. -Check for alterations in gait pattern
-Look for signs of trauma around iliac crest, in soft tissues (many structures in the hip are deep & show no obvious signs of trauma)
-Measurement of leg length discrepancy:
3 Types of Leg Length Discrepancy
1. Functional (due to rotation of the pelvis): Compare level of ASIS & Greater Trochanter to distance from the floor (Standing)
2. True (actual anatomical discrepancy): Measure from ASIS to Medial Malleolus (lying)
3. Apparent (caused by muscle contracture): Measure from umbilicus (belly button) to Medial Malleolus (lying)

6. Palpation

7. Medial Structures:
-Adductor Muscle Group
-Gracilis
-Pubic Tubercle

8. Pubic Tubercle – front of pubic region

9. Anterior Structures -Iliac Crest -Sartorius -Rectus Femoris
-ASIS, AIIS
-Iliac Crest
-Sartorius
-Rectus Femoris

10. ASIS – where your pants should sit; most prominent bump on anterior side

11. Iliac Crest – superior to ASIS; sides of hips

12. Lateral Structures: -Iliac Crest -Greater Trochanter
-Gluteus Medius (palpate in hip abduction)
-Tensor Fascia Latae

13. Greater Trochanter – lie on side and it is the “bump” on the outside of the hip

14. Posterior Structures:
-PSIS
-Gluteus Maximus
-Hamstrings
-Ischial Tuberosity

15. PSIS – dimples in your low back; below L5 vertebrae; lateral to sacrum

16. Ischial tuberosity – “butt bones”; “sitting bones”; go inferior from greater trochanter; origin of hamstrings

17. Functional Tests

18. Range of Motion:
Abduction, Adduction, Flexion, Extension, Circumduction,
Internal Rotation, & External Rotation

19. -Active ROM -Passive ROM -Resistive ROM -Athlete performs the action
-Trainer performs the action, athlete is relaxed
-Resistive ROM
-Trainer applies resistance as athlete performs the action

20. Stress Tests:
These tests check individual structures to determine injuries

21. Thomas Test: -Tests for Hip Flexor Tightness
-+ Test result: Involved knee rests at less than 90 degrees of flexion (Rectus Femoris)
-+ Test result: Involved leg rises off
the table (Iliopsoas)

23. Trendelenburg Test: -Tests for weakness of the gluteal muscles
-+ Test result: Pelvis lowers on non-weightbearing side

25. Hip Scouring Test: -+ Test Result: Pain
-Tests for defect in the articular cartilage of femur or acetabulum
-+ Test Result: Pain

27. Long Sit Test:
-Tests for leg-length discrepancy and rotation of the pelvis
-+Test result: Medial Malleolus of 1 leg is shorter or longer
than the other
-If malleolus goes short to long = Posterior rotation
-If malleolus goes long to short = Anterior rotation

29. Sacroiliac Compression:
-Tests for sacroiliac pathology
-+ Test result: Pain

31. Sacroiliac Distraction:
-Tests for sacroiliac pathology
-+ Test result: Pain