The Hip

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The Hip
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• Femur
• Circumduction
• Acetabulum
• Iliofemoral
• External rotation
• Abduction
• Pubis
• Pubofemoral

• Flexion
• Ilium
• Extension
• Ischiofemoral
• Ischium
• Adduction
• Internal rotation

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The Hip

• Anatomy
• Injuries
• Evaluation
• Rehabilitation

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Anatomy

• Bones
• Ligaments
• Muscles

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Bones of the hip joint

• Femur- The ball part of this bone connects to the
  other three bones to comprise the hip joint.
• Ilium-This is the largest area of the hip bones.
  It consists of 2 large broad plates, one on each
  side, which serve to support the internal organs,
  and to provide attachment for muscles of the
  back, sides, and buttocks.
• Ischium-The ischium consists of 2 broad curves of
  bone, one on each side, which lie below the
  ilium, and are attached to the pubis in the front
  and the ilium in the back. The ischium serves as
  a place of attachment for muscles.
• Pubis-The pubis is the front-most area of the hip
  bones. It attaches to the ilium on the sides and
  the ischium on the bottom. It provides structural
  support, and serves as a place of attachment for
  the muscles of the inner thigh.
• The ilium, ischium, and pubis come together and
  form a cup-like shape that the head of the femur
  fits into. This cup is called the acetabulum.

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Ligaments

• The iliofemoral ligament attaches the pelvis to
  the femur. It prevents excessive extension of the
  hip.
• The pubofemoral ligament attaches the pubis bone
  of the pelvis to the femur.
• The posterior of the hip joint capsule is
  reinforced by the ischiofemoral ligament that
  attaches from the ischial part of the acetabular
  rim to the femur.

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Motions of the hip

• Flexion and extension
• Abduction and adduction
• Internal and external rotation
• Circumduction

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Muscles of the hip

• Flexor group
• Extensor group
• Lateral rotators
• Internal rotators
• Abductors
• Adductors

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Injuries

• Hip flexor strain
• Groin strain
• Hip pointer
• Hip dislocation
• Myositis Ossificans
• ITB syndrome

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Hip Flexor strain
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Hip flexor strain
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Hip pointer

• A hip pointer is an injury is to the iliac crest,
  the bony prominence that can be felt along the
  waist line. When someone sustains a hip pointer
  injury, the bone and overlying muscle can be
  bruised.

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Hip pointer
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Groin strain
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Hip dislocation

• It requires substantial force to pop the
  thighbone out of its socket. But that's just what
  happens in a hip dislocation.
• In nine out of ten hip dislocations, the head of
  the thighbone is pushed out and back (posterior
  dislocation). This leaves the hip in a fixed
  position, bent and twisted in towards the middle
  of the body. If the thighbone slips out and
  forward (anterior dislocation), the hip will be
  only slightly bent and the leg will twist out and
  away from the middle of the body.

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Hip dislocation
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Hip dislocation
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Hip dislocation
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Hip dislocation
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Myositis Ossificans

• Myositis ossificans is an unusual condition that
  often occurs in athletes who sustain a blunt
  injury that causes deep tissue bleeding.
• The soft-tissues that were injured in the
  traumatic event initially develops a hematoma,
  and subsequently develop the myositis ossificans.
  
• The word myositis ossificans means that bone
  forms within the muscle, and this occurs at the
  site of the hematoma.

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Myositis Ossificans
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ITB syndrome
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ITB syndrome

• Iliotibial band syndrome is due to inflammation
  of the iliotibial band, a thick band of fibrous
  tissue that runs down the outside of the leg.
• The iliotibial band begins at the hip and extends
  to the outer side of the shin bone (tibia) just
  below the knee joint.
• The band functions in coordination with several
  of the thigh muscles to provide stability to the
  outside of the knee joint.

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Stress Fracture
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Legg-Calve'-Perthes Disease

• LCPD is of unknown origin. It is known that bone
  death occurs in the ball of the hip due to an
  interruption in blood flow.
• The age of diagnosis is usually between 2 and 12
  years old, with the average age of 6.
• Most of these children are very active and often
  very athletic.

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Legg-Calve'-Perthes Disease

• The first symptoms characterized in LCPD are
  usually a limp and perhaps pain in the hip,
  groin, or knee (known as a referred pain). Often
  you will first notice limping during your child's
  active play. They usually cannot tell you an
  instance when they hurt themselves.

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Legg-Calve'-Perthes Disease
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Avulsion Fracture

• Causes This injury is caused by sports where you
  must start and stop running very quickly, such as
  football, soccer, and basketball. Weight lifting
  can also cause this injury. Teenagers whose bones
  are still growing are more likely to have this
  injury.
• Signs and Symptoms You may have sudden pain and
  feel a "pop" in your hip or groin. You may have
  trouble moving your hip and leg. The pain is
  often worse when the area is touched.

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Avulsion Fracture
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Snapping Hip

• The snapping sensation results from the movement
  of a muscle or tendon over a bony structure.
• ITB-When the hip is straight, the band is behind
  the trochanter. When the hip bends, the band
  moves over the trochanter so that it is in front
  of it.
• Sartorius-As you bend the hip, the tendon shifts
  across the head of the thighbone when you
  straighten the hip, the tendon moves back to the
  side of the thighbone. This back-and-forth motion
  across the head of the thighbone causes the
  snapping.