Care & PreventionChapter

Hip & Pelvis

AnatomyAnatomy

The arrangement of bones, ligaments, muscles, and tendons make the hip the strongest joint

in the body.

AnatomyAnatomy

The hip joint is a ball and socket joint.

• Note the femoral head of the femur sits in the socket of the hip.

AnatomyAnatomy

There two fused vertebrae known as the:• Sacrum• coccyx

AnatomyAnatomy

Groin & torso muscles are involved in supporting and moving the trunk, upper, and lower

extremities.

AnatomyAnatomy

The hip and pelvis are supported by the following ligaments:

• Ligamentum teres• Transverse acetabular

• Iliofemoral• Pubofemoral

• Inguinal

AnatomyAnatomy

The bones of the hip and pelvic region provide the structure to transfer weight between the

torso and the lower extremities.

Important Muscle groups:• Gluteal Muscles (Largest)

– Gluteus Medius– Gluteus Minimus– Gluteus Maximus

Assist in hip extension, internal rotation, external rotation abduction

• Hip Flexors:– Iliopsoas– Sartorius– Pectineus– Rectus Femoris

• Hip Adductors:– Adductor Longus– Adductor Brevis– Adductor Magnus– Gracilis

AnatomyAnatomy

QuadricepsHip Flexion

HamstringsHip Extension

Dermatome: the sensory distribution of a nerve root, which produces feeling in a certain area.Myotome: A single nerve root that produces movement in an area.

AnatomyAnatomy

Other Structures:• Fat Pads – Specialized soft tissue for weight bearing and absorbing impact.• Bursa – Synovial sacs generally located over bony prominences through the body.

Bones• Femur• Pelvis (Illium, Ischium, Pubis)• Sacrum• Coccyx

Pelvic Girdle – the bony ring of the 2 innominate bones, the sacrum and the coccyx

MusclesAlthough all important a few stand out:• Gluteus Maximus – extension & adduction of hip• Gluteus Medius – abduction & external rotation of hip

• Gluteus Minimus – abduction & internal rotation of hip• Tensor Fascia Latae: flexion & internal rotation of hip• Adductor (Longus/Brevis/Magnus) - adduction & flexion of the knee

Muscles cont.Hamstrings:

Biceps Femoris – Flexion of knee / external rotation of leg

Semimembranosus – Flexion of knee/internal rotation of leg

Semitendinosus – Flexion of knee/internal rotation of legQuadriceps:

Rectus Femoris – Extension of knee / flexion of hip

Vastus Medialis / Vastus Lateralis / Vastus IntermediusExtension of knee

Anatomical PlanesAnatomical Planes

Sagittal Plane – bisecting body into right and left halves

Frontal Planes - bisecting body into front & back halves

Transverse Planes - bisecting body into upper & lower halves

Range of Motion - HipRange of Motion - HipAdduction – moving leg toward the midline in the

frontal planeAbduction – moving leg away from the midline of

body in frontal planeFlexion – decreasing angle between anterior thigh

& abdomen through the sagittal planeExtension – increasing the angle between anterior

thigh and abdomen through the sagittal planeInternal Rotation – rotation of femur toward the

midlineExternal Rotation – rotation of femur away the

midline

Range of Motion - TORSORange of Motion - TORSO

Flexion – moving the torso forward through the sagittal plane

Extension – moving the torso backward through the sagittal plane

Lateral Flexion – moving the torso laterally (side to side) in the frontal plane

Rotation – rotating the torso in the transverse plane

VocabularyVocabulary

Dermatome: a segment of the skin that is innervated by a spinal nerve

Innervated: nerve stimulation (usually of a muscle

Both terms are used when inferring about the nerve innervations of the body

Common InjuriesCommon Injuries

Injuries to the coccyx:Coccyx – A 4 fused vertebrae on the lower end

of the spine.• AKA – Tail Bone

Area can be bruised by falling or struck by a hard surface

• Severe trauma can cause fracture of dislocation

Treatment – Protection, rest, ice

Common InjuriesCommon Injuries

Hip Strains • Commonly occur when the joint received

violent twisting motion of the torso accompanied by stationary/fixed feet

Evaluating – have athletes perform various ROM (flexion, extension, adductions, abduction, circumduction)

Hip Pointer• Some muscles that control trunk movement

attach to the iliac crest.• Due to limited natural protection, injuries to

the iliac crest result from direct blow, (contusion) and can disable an athlete.– Immediate pain & swelling may of may not be present initially.

Trauma to the genitalia• Result from direct blow or testicular torsion

– Causes excruciating pain and temporary disability• Same physiological tissue reaction as contusions to

other body parts– Hemorrhaging, fluid effusion, and muscle spasm

• 1 method to relieve this spasm is to have the athlete lie on the ground and flex thighs to chest. Loosen clothing, Ice, & see physician.

• Can occur to a female as well

Trochanteric Bursitis• Occurs at the bursa at the gluteus

medius/iliotibial band insertion at greater trochanter.

• Running technique should be examined• Common in dance

Hip Dislocation• Should be handled by emergency personnel• In most cases the athlete will be lying on their

backs with the injured extremity flexed and externally rotated.

• Injury caused by abnormal stress to the joint.

– Can dislocate either anteriorly or posteriorly

Hip Dislocation cont.• The head of the femur could permanently

damage nerves and blood supply*These athletes need to be transported.

Science Word MapScience Word Map

• Athlete Publgia• Iliotibial Bans Syndrome• Osteitis Pubis• Piriformis Sysndrome

RehabilitationRehabilitation

Sending an athlete back to competition before healing is complete leaves the player

susceptible to further injury.

The best way to determine when healing is complete is by the absence of pain during

stressful activity.

Followed by Full pain free ROM

RehabilitationRehabilitation

Before the return to competition the following guidelines must be met:

• Full Range of Motion• Strength, Power, and endurance are

proportional to the athlete’s size, and sport• No pain during running, jumping, or cutting

RehabilitationRehabilitation

Before the beginning of any rehabilitation exercise program, the athletic trainer should

consult with all members of the sports medicine team.

Establish an individual program tailored for each athlete and their injury.

RehabilitationRehabilitationInclude in any Rehabilitation Protocol are the

following:Range of Motion Exercise

Resistance ExerciseCardiovascular/Fitness Activities

(Walking, stairs, climbing, running, swimming, cycling)

Sport Specific Activities

(jumping, figure eights, Swimming, Jumping Rope)