2. Chapter 19
The Hip and Pelvis

3. Objectives 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

4. The Hip and Pelvis
The hip is one of the most stable joints in the body
Well protected and surrounded by muscle
Freely movable, ball-and-socket joint

5. The Hip and Pelvis (cont’d.)
The pelvis:
Provides attachments for various muscles that attach onto and control the lower limbs
Houses parts of the digestive and urinary tracts
Houses reproductive systems

6. The Hip and Pelvis (cont’d.)
Skeletal structure of the pelvis:
Ilium
Sacrum
Ischium
Pubis
Coccyx

7. Anterior Superior Iliac Spine
Symphisis

9. Iliopsoas
Pectineus
Rectus Femoris
Sartorius

12. Common Injuries and Conditions of the Hip and Thigh
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

15. Injuries and Conditions (cont’d.)
Hip fracture
Break of the top part of the femur where it connects to the pelvis
Symptoms: severe hip pain
Treatment: highly individualized

17. Injuries and Conditions (cont’d.)
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

19. Injuries and Conditions (cont’d.)
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

21. Animation – Hamstring Strain
Click Here to Play Hamstring Strain Animation

24. Injuries and Conditions (cont’d.)
Adductor (groin) strains
Common in sports requiring sudden sideways changes in direction
Treatment: rest, ice, and anti-inflammatory medications, adductor stretching and strengthening exercises

26. Injuries and Conditions (cont’d.)
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

28. Injuries and Conditions (cont’d.)
Quadriceps contusions
Usually caused by a direct blow to the thigh
Treatment: compression, ice (applied during the first 24 to 48 hours), and crutches

29. Injuries and Conditions (cont’d.)
Myositis ossificans
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

30. Injuries and Conditions (cont’d.)
Iliac crest contusion
Painful injury caused by a direct blow to the hip
Symptoms: extreme tenderness, swelling, and ecchymosis over the iliac crest
Treatment: ice and compression

31. Injuries and Conditions (cont’d.)
Overuse injuries
Cumulative effect of very low levels of stress
Include chronic muscle strains, stress fractures, tendonitis, snapping hip, and bursitis
Treatment: rest and exercise different body parts

32. Injuries and Conditions (cont’d.)
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

33. Conclusion
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