1. Chapter 10
The Hip and Pelvis

2. Bones of the Pelvis Pelvic Bone: A Coccyx: L
Pubic Symphysis: A1 Acetabulum: R
Sacrum: J Sacroiliac Joint: K

3. Bones of the Pelvis The pelvic bone Is split into 3 parts: Ileum: O
Ischium: P
Pubis: Q

4. Pelvic Bone
Each bone has different processes that tendons and ligaments attach to:
Acetabulum: R
Anterior Superior Iliac Spine (ASIS): O2
Iliac Crest: O3
Posterior Superior Iliac Spine (PSIS): O4
Ischial Spine: P1
Ischial Tuberosity: P3
Obturator Foramen: Q5

5. ROM of the Hip Joint Adduction Abduction Flexion Extension
Internal Rotation
External Rotation
Torso Flexion
Torso Extension
Lateral Flexion
Circumduction

6. Gluteus Maximus (E posterior diagram)
Origin: posterior gluteal line of the ilium, and posterior surface of the sacrum and coccyx
Insertion: On the femur and the Iliotibial Band
Action

7. Gluteus Medius Origin: Outer surface of the posterior ilium
Insertion: Lateral surface of the greater trochanter of the femur
Action

8. Gluteus Minimus Origin: Outer surface of the posterior ilium
Insertion: Anterior surface of the greater trochanter of the femur
Action

9. Tensor Fascia Latae C: anterior diagram
Origin: Anterior portion of the iliac crest and the ASIS
Insertion: Iliotibial band of the fascia latae
Action

10. Iliacus B: Anterior Diagram Origin: Iliac crest and fossa
Insertion: Lesser trochanter of the femur
Action

11. Psoas Major and Psoas Minor
Major: A (anterior)
Origin: Transverse processes and bodies of the last thoracic vertebrae and all of the lumbar vertebrae
Insertion: Lesser trochanter of the femur
Action
Minor: c (anterior)
Origin: same
Insertion: same

12. Sartorius D: Anterior diagram C: Posterior diagram
Origin: ASIS, most anterior point of the ilium
Insertion: Upper part of the medial surface of the tibia, medial to tibial tuberosity
Action

13. Pectineus M (anterior) Origin: Pubic bone
Insertion: Medial aspect of the upper 1/3 of the femur
Action

14. Adductor Muscle Group Anterior Diagram Adductor Longus: J
Origin: Anterior surface of the pubis near pubic symphysis
Insertion: middle third of the medial portion of the linea aspera (posterior aspect of femur)
Action
Adductor Longus – Origin – Anterior surface of the pubis near pubic symphysis.
Insertion – middle third of the medial portion of the linea aspera (posterior aspect of femur).
Action – adduct the hip

15. Adductor Muscle Group cont.
Adductor Brevis:
Origin: Outer surface of inferior ramus of pubis
Insertion: proximal half of the linea aspera
Action
Adductor Magnus: I
Origin: Inferior pubic ramus, ramus of the ischium, and the ischial tuberosity
Insertion: linea aspera and medial condyle of the femur

16. Gracilis L: anterior diagram D: posterior diagram
Origin: Inferior half of the symphysis pubis
Insertion: medial surface of the tibia, distal to condyle
Action
Origin – Inferior half of the symphysis pubis
Insertion – medial surface of the tibia, distal to condyle.
Action – adducts hip, flexes knee, and medially rotates knee.

17. Piriformis Labeled on posterior diagram
Origin: Anterior surface of the sacrum
Insertion: Superior border of the greater trochanter of the femur
Action
Origin – Anterior surface of the sacrum
Insertion – Superior border of the greater trochanter of the femur.
Action – lateral rotation of thigh; assists in extension and abduction of the thigh.

18. Quadratus Femoris J: posterior diagram Origin: Ischial tuberosity
Insertion: shaft of femur just below the greater trochanter
Action
Origin – Ischial tuberosity
Insertion – shaft of femur just below the greater trochanter
Action – lateral rotation of the thigh.

19. Hamstrings **Will NOT need to label on quiz!** Biceps Femoris
Knee flexion
Hip extension
Semitendinosus
Semimembranosus
Biceps Femoris – Origin – Ischial tuberosity and back of femur
Insertion – head of fibula and lateral condyle of tibia
Action – knee flexion and hip extension
Semitendinosus – Origin – Ischial tuberosity
Insertion – Upper medial surface of the tibial shaft
Semimembranosus – Origin – Ischial tuberosity
Insertion – posterior aspect of medial condyle of tibia (upper inside part of tibia)
Action – knee flexion and hip extension.

20. Quadriceps Group **Will NOT need to label on quiz!** Rectus Femoris
Knee extension
Hip flexion
Vastus Lateralis
Knee flexion
Vastus Intermedius
Vastus Medialis
Rectus Femoris – Origin – ASIS of Ilium above acetabulum.
Insertion – via patellar tendon to tibial tuberosity
Function – Knee extension and hip flexion (ex. In combination, when kicking a ball)
Vastus Lateralis – Origin – Upper half of the shaft of the femur
Function – Knee extension
Vastus Intermedius – (deep, under rectus femoris) Origin – Upper half of the shaft of the femur
Vastus Medialis – Origin – Upper half of the shaft of the femur

21. Muscle Groups of the Hip
Hip flexors
Psoas Major
Psoas Minor
Iliacus
Rectus Femoris
Tensor Fascia Latae
Sartorius
Hip Extensors
Gluteus Maximus
Biceps Femoris
Semimembranosus
Semitendinosus
Piriformis
Hip Adductors
Adductor Longus
Adductor Magnus
Adductor Brevis
Gracilis
Pectineus
Hip Abductors
Gluteus Medius
Piriformis
Sartorius
Tensor Fascia Latae/IT Band

22. Muscles Groups of the Hip
Internal Rotators
Gluteus medius
Tensor Fascia Latae
Gracilis
External Rotators
Gluteus maximus
Piriformis
Quadratus Femoris
Sartorius

23. Common Injuries Injury to the coccyx Hip strains Trochanteric Bursitis
Testicular Contusion
Hip Pointer
Hip Dislocation
Thigh Contusion
Myositis Ossificans
Pelvic Fracture
Femur Fracture
Iliotibial Band Syndrome
Osteitis Pubis
Piriformis Syndrome

24. Coccyx Injury Cause: usually from a fall on a hard surface.
Can result in a contusion, dislocation, or fracture.
X-ray illustrates a dislocated coccyx.
Treat with PRICE and refer to physician if dislocation or fracture suspected.

25. Hip Strains Stretching or tearing of tendon or muscle in the hip.
Usually caused from a violent twisting motion at the joint.
Treat with PRICE and ROM exercises.
Refer to a physician if a complete tear is suspected.

26. Trochanteric Bursitis
Occurs at the gluteus medius/IT band insertion at the greater trochanter of the femur.
CAUSE: poor form or hip misalignment
Running form should be evaluated.
Treat with heat if a chronic condition; acute conditions treat with PRICE.
May be treated with a cortisone injection.

27. Testicular Contusion Results from a direct blow to the groin region.
Can cause hemorrhaging, swelling, and muscle spasm.
Treat by laying athlete on back and raise thighs to chest.
Apply ice.
Refer to physician if necessary.

28. Hip Pointer Caused by a direct blow to the iliac crest.
Extremely painful because of the lack of natural protection for iliac crest.
Apply padding to prevent further injury.

29. Hip Dislocation
Extremity will normally be found flexed and internally rotated.
Medical emergency.
Extreme amount of stress on the joint is the cause.
May also have a femoral fracture.
Transport by ambulance immediately!!!

30. Thigh Contusions Caused by direct blow, usually to quadriceps muscles.
Treat with PRICES.
Can lead to further complications if not treated properly.

31. Myositis Ossificans
Caused by a severe blow to the thigh, or repeated blows to the thigh.
Myositis = inflammation of the muscle
Ossificans = ossification (formation of bone) of tissue.
Bone forms in the muscle and is very painful.
Treat with ice, compression wrap, and flexion to help relieve pain and prevent myositis ossificans formation.

32. Pelvic Fracture Caused by external force.
X-ray illustrates a “crushed” pelvis.
Medical emergency.
Transport by ambulance immediately!!!
Splint in position found with backboard and full leg splint if possible

33. Femur Fracture Most common fracture in older adults after a fall.
Neck of femur is the weakest part of the bone.
Often mistaken for a dislocation.
Medical emergency!
Surgically repaired with rods and screws.

34. Iliotibial Band Friction Syndrome
Inflammation of the Iliotibial Band.
Causes: Excessive pronation, leg length discrepancy, bowed legs, and lateral pelvic tilt.
May lead to patellar subluxation.

35. Osteitis Pubis
Osteitis pubis is a noninfectious inflammation of the pubis symphysis causing varying degrees of lower abdominal and pelvic pain.
Occurs most often in soccer players and distance runners.

36. Piriformis Syndrome
A condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve.
Often misdiagnosed.
Piriformis massage to relieve tension.