Anatomy and Injuries

The hip is the most stable joint in the body. It is surrounded by muscle on all sides and has a very big range of motion.BONESThere are two main parts to the hip• Femur- which holds the ball in the ball and socket joint and the,•Pelvis- which has the socket•The socket is made of three joined bones: -ilium, ishium, and pubis

Anatomy of Hip and Pelvis

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Anatomy of the Hip, Pelvis, and Thigh Notes

Hip Joint Synovial ball and socket joint, is the articulation or

point of contact between the femur and the pelvis-the head of the femur fits into the cup shaped acetabulum

Acetabulum (hip socket) very deep and covered by thick ligament structures witch provide stability

Femur (longest bone in body) and pelvis are connected by thick strong ligaments 2 muscle groups are the quadriceps and hamstrings

The hip muscles include the most powerful muscles in the body. Hip flexor group witch includes the rectus femoris, sartorius and iliopsoas, flexes the thigh. Ham strings and gluteus maximums extend the thigh

Primary groin muscles include the gracilis, adductor magnus, adductor longus and pectineus

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Anatomy of Hip and Pelvis Continued

The hip is made of four groups of muscles

Adductor muscles: consist of the pectinus, adductor brevis, adductor longus, and the adductor magnus. These muscles are all responsible for the function of adducting the hip

Abductor muscles: consist of the gluteus medius and the gluteus minimus. These muscles abduct and internally rotate the hip

The flexors muscles: consist of the psoas, iliacus, and the rectus femoris. These muscles are responsible for the flexion of the hip

The Extensor muscles: consist of the biceps femoris, semitendonosis, semimembranosis and the gluteus maximus. These muscles are responsible for extending the hip

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Found on the Inside

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Found on the Anterior side

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Found on the Lateral Hip

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Found on Posterior Aspect

Preventing Hip, Pelvis, and Thigh Injuries

The hip is a very stable joint, therefore the athletic trainer won’t see many sprains ligaments or dislocations in this area, they will see many muscular strain related injuries.

Proper flexibility training and stretching prior to vigorous exercise or activity is warranted

Many sports expose the thigh to contact therefore the athletes must wear proper equipment.

Contact type injuries also can occur at the iliac crest (the point of the hip) because the area has little natural protection.

Proper strength training is very important because the muscles around the hip and lower torso region are considered the core region, proper strength in these muscles is necessary for normal balance and stability.

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Injuries Muscle and tendon injuries

Thigh strains are common injuries to the hip flexor, extensor and groin muscles

strains should be treated with PRICE and wrapped with a supportive elastic bandage. Moderate and severe strains should be referred to a physician. Rehabilitation will focus on re- gaining strengths and rang of motion and enhancing flexibilities before returning to play.

Bone Injuries Pelvic fractures are not common but can occur

when excessive stress is placed on the bone tissue.

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Injuries Continued

Bone injuries continued Athletics-related fractures of the hip, pelvis

and femur often occur as a result of an avulsion (the tendon pulling away the bone), disruption of the epiphysis (damage to the growth plate), stress, or trauma to the femur.

Avulsions Avulsion fractures occur as a result of forceful

muscle contractions that literally pull the bone away at the site where the tendon attaches.

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Injuries Continued

Growth Plate fractures Epiphysis fractures occur at the growth plates of

bones especially at the Capital femoral epiphysis which is where the neck of the femur joins the head.

This injury is the most common hip disorder in active children between the ages of ten and fifteen. The head of the femur slips off the neck. This problem causes pain In the groin, hip, and knee. When a athletic trainer suspects this condition the athlete should be referred to a physician because the treatment includes stopping the slippage and helping to close the growth plate with a surgery.

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Stress Fractures Femoral stress fractures although uncommon

do occur in running oriented athletes. Stress fractures are caused by repetitive stress, typically as a result of the force of the pounding of the lower extremity while running. This pounding can cause the femur to bend slightly, one side of the bones is compressed while the other side is stretch. When bone tissue is repeatedly stressed small hairline fractures can develop, causing a great deal of pain and discomfort. Rest and a alternative activity such as aquatic therapy can reduce the stress to the fracture site so it can heal

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Injuries Continued

Femur fracturesCharacterized by severe pain and loss of

function as well as internal bleeding, swelling, or tearing of muscles, tendons, nerves, and arteries. Typically the athlete cant move the leg. A femur fracture often causes the leg to externally rotate. Treatment includes a mobilization and a hospital. Often a traction splint that gently pulls the femur, which helps reduce leg pain and spasm is used.

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Injuries Continued

Hip dislocations Extreme stress causes a dislocation. Most

dislocations occur posterior and usually accompany other trauma such as a fracture. Severe damage can occur because of its nerve and vascular structures. An athlete with this will be in extreme pain and their leg is often internally rotated. An ambulance should be called quickly and transported to hospital. Only a physician should reduce the dislocation. Rehabilitation begins with the establishment of normal range of motion and strength, learning how to walk normally as this can be a very long process.

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Hip and Thigh Muscle Contusions This is a very common injury especially in

contact sports for example: contact sports such as football can cause

a thigh contusion Although many bruises suffered in athletics

are minor, thigh contusions can cause disability. In some cases it can cause tissue tearing and extensive bleeding

If not managed appropriately, serious thigh contusions can cause a condition known as Myositis Ossificans Which is the formation of bone tissue

within the muscle Bone tissue is not as extensible as muscle

tissue. Disability and loss of function are typical consequences

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Treating a Thigh Contusion

When treating a thigh contusion it is important to proceed with PRICE, the knee should be flexed when the ice is applied.

The ATC may put a athlete into a hinge knee immobilizer with the knee locked into flexion, which helps limit the total loss of flexibility.

With moderate to severe contusions, the athlete may be placed on crutches to release stress on the area and be referred to a physician.

Active rest, use of ice, and gentle stretching will help to restore mobility.

Ultra sound is often used to aid in the reabsorbing of the blood that collects internally. An ATC must be certain to place a protective pad in the place of the contusion to prevent a second contusion. If that happens…. Risks of Myositis Ossificans may occur.

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FYI Legg-Calve’ Perthes Disease

In some children and teens who are still growing, a disruption of blood flow to the head of the femur causes the tissue at the head of the femur to die, a condition knows as Legg-Calve’ Perthes Disease.

Typical signs and symptoms of this problem inlcude groin or knee pain and walking with a limp.

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Any Questions???

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