2.  The hip, pelvis, and thigh contain some of the strongest muscles in the body  This area is also subjected to tremendous demands  Injuries to this area can sideline a player for long periods of time  Most injuries to this area are strains and contusions

3.  Hip joint (ball-and-socket joint) is the POC between the femur and the pelvis  Acetabulum-hip socket.  Head of femur fits here  Femur (longest bone in the body) is connected to the pelvis by thick, strong ligaments  2 muscle groups of the femur are the quads and hamstrings

4.  Since the hip is very stable, ATCs will not see a lot of sprains or dislocations  ATCs will see a lot of muscular strains  Proper flexibility training and stretching will help prevent injuries in this area  Also wearing proper padding (ex. Football) and strengthening the core region of the body will help prevent injuries

5.  Extremely stable joint  Very thick ligamentous structures and strong muscles surround the hip  This results in very few ligament injuries

6.  Thigh strains are very common, especially to the hip flexor, extensor, and groin muscles.  Theories as to why this occurs:  Many muscles in the leg cross 2 joints  Ex. Hamstrings cross the back of the hip joint (extension) and the knee joint (flexion)  Strength imbalance occurs  Stronger muscle group put excessive tension on the opposing muscle group

7.  Strains should be treated with PRICE and wrapped with supportive elastic bandage  Moderate and severe strains may need to be referred to a physician  Rehab will focus on regaining strength and range of motion and enhancing flexibility

8.  Pelvic fractures are not common but can occur if excessive stress is placed on the bone tissue  Athletic-related fractures of this area often occur as a result of an avulsion, disruption of the epiphysis, stress, or trauma to femur

9.  Avulsions (tendon pulling away the bone)  Occur as a result of forceful muscle contractions that literally pull the bone away at the site where the tendon attaches Ex. Football player continues to run aggressively forward while a defender is holding his leg **hip flexor may forcefully contract, causing a fracture

10.  Growth plate fractures  Occur at the growth plate of the bone (the neck of the femur joins the head)  Most commonly occurs between the ages of 10 and 15  Head of femur slips off the neck  Causes pain in the groin, hip, and knee  ATC would refer athlete to a physician b/c the treatment involves stopping the slippage and helping to close the growth plate through surgery

11.  Stress Fractures  Uncommon but do occur in running-oriented athletes  Caused by repetitive stress, typically from the force of pounding of the lower extremity while running  Pounding can cause the femur to bend slightly (one side is compressed while the other is stretched)  If this pounding continues, small hairline fractures can develop  Rest and an alternative activity are the treatment and rehab for this problem

12.  Femur Fractures  Stress required to fracture the femur is very extreme (due to the size of the bone)  Characterized by severe pain and loss of function, as well as internal bleeding, swelling, or tearing of muscles, tendons, nerves, and arteries  Often causes the leg to externally rotate  Initial treatment-immobilization and transportation to hospital by EMS  Often use a traction splint that gently pulls the femur (helps reduce leg pain and spasm)

13.  Hip Dislocations  Caused by extreme stress  Most occur posteriorly  Severe damage can occur because of the nerve and vascular structures  Athlete will be in extreme pain and leg will often be internally rotated  EMS called immediately for transportation to hospital  Rehab begins with establishing normal range of motion and strength  Learning how to walk normally will be necessary  Long recovery process

14.  Hip and Thigh Muscle Contusions  Deep thigh contusions are common, especially in contact sports  The more severe contusions can actually cause tissue tearing and extensive bleeding  Myositis ossificans can occur if serious contusions are not managed appropriately  Bone tissue forms within the muscle  Treatment-PRICE (knee flexed during ice applications)  Moderate to severe contusions require athlete be placed on crutches to minimize the stress to the area

15.  Hip and Thigh contusions continued…  Rehab-active rest and gentle stretching help restore mobility  Ultrasound often used to help reabsorb the blood that collects internally and to break up bony tissue deposits  ATC must place a protective pad over the contusion to prevent repeated injuries to the area

16.  Legg-Calve-Perthes Disease  Disruption of blood flow to the head of the femur causes the tissue at head of the femur to die  Typical signs and symptoms include groin or knee pain and walking with a limp  If condition is suspected, athlete should be referred to a physician right away