The Thigh and Hip Muscles

1
Sports Medicine Camp
The Thigh and Hip Muscles Anatomy, Injuries and
Assessment
2
Quadriceps Muscles

• Vastus Medialis
• Vastus Intermedius
• Vastus Lateralis
• Rectus Femoris

3
Elys Test or Prone Knee Bend

• Rectus Femoris tightness
• Athlete prone
• Passive knee flexion
• Positive test indicated by hip flexion

4
Quadriceps MMT

• Manual Muscle Test
• Athlete seated
• Examiner apply resistance at lower leg

5
Rectus Femoris Strain

• Mechanism of Injury
• Sudden stretch
• Sudden contraction
• Signs and Symptoms
• Pain
• Point tenderness
• Spasm
• Loss of function
• Deformity
• Treatment
• RICE
• NSAIDS
• Modalities
• Stretching
• Strengthening

6
Thigh Contusion
7
Hamstrings Muscles

• Lateral side
• Biceps Femoris Long Head
• Biceps Femoris Short head

• Medial side
• Semitendinosus
• Semimembranosus

8
Hamstrings MMT

• Medial hamstrings
• Semitendinosus
• Semimembranosus
• Internally rotate tibia
• (foot points in)

• Lateral Hamstring
• Biceps Femoris
• Externally rotate tibia
• (foot points out)

9
Hamstring Strains

• Mechanism of Injury
• Unknown
• 1st Theory
• Hamstrings contract same time as quadriceps
• Deficiency in complementary action of opposing
  muscles
• 2nd Theory
• Quick change of function from
• Role as knee stabilizer
• To
• Hip extensor
• Possible reasons
• Muscle fatigue
• Faulty posture
• Leg length discrepancy
• Tight hamstrings
• Improper form
• Imbalance of strength between hamstrings
• Hamstring strength ratio to quads normal 60 - 70
  

10
Hamstring Strains

• 1st Degree injury
• Muscle soreness during movement
• Due to muscle spasm rather then tearing of tissue
• Fewer then 20 fibers torn
• Point tenderness
• Stiffness after cool down

• 2nd Degree injury
• Partial tear
• Fewer then 70 fibers torn
• Sudden snap or tear of muscle
• Severe pain
• Loss of function

11
Hamstring Strains

• 3rd Degree injury
• Rupture of tendon
• Tear of gt 70 fibers
• Severe swelling
• Tenderness
• Loss of function
• Discoloration
• Palpable mass or gap

12
Hamstring Strains

• Treatment
• Grade 2 3
• Extremely conservative
• RICE
• Grade 2 24 - 48 hrs.
• Grade 3 48 - 72 hrs.
• Stretching
• Strengthening
• Emphasize eccentric exercise
• Complications
• Recurrent as result of
• Inelastic fibrous scar tissue

13
Hip Flexors

• Iliopsoas
• Psoas Major
• Psoas Minor
• Iliacus

• MMT

14
Thomas Test

• Normal length of hip flexors
• With low back flat
• Posterior thigh touches table
• Knee flexes approximately 80
• The pelvis is in 10 posterior tilt

• Abnormal length of hip flexors
• With low back flat
• Posterior thigh does not touch table
• Knee flexes lt 80

15
Hip Flexor Support
16
Adductor Muscles

• Adductor Magnus
• Adductor Longus
• Adductor Brevis
• Pectineus
• Gracilis

• MMT Adduction
• Athlete sidelying
• Examiner supports top leg
• Give resistance above knee joint

17
Adductor Support
8-4
18
Hip Pointer

• Mechanism of injury
• Direct impact
• Signs and Symptoms
• One of the most handicapping injuries
• Immediate pain
• Muscle spasm
• Transitory paralysis
• Inability to
• rotate trunk
• Flex thigh
• Discoloration
• Swelling

• Treatment
• PRICE
• Bed rest as needed
• Crutches as needed
• ROM exercises
• Strength exercises
• Severe cases MD referral

21-34