What makes up the hip
Coxa
Iliofemoral joint
What are the characteristics of the hip joint
Deep acetabulum Thick capsule Synovial joint Ball and Socket Three degrees of freedom
What are the 3 degrees of freedom at the hip joint?
Flexion/Extension
Abduction/Adduction
Internal/External Rotation
What are the points of reference on the anterior side?
Iliac Crest: Hands on hips
ASIS: distal and slightly medial; hip bones
Greater Trochanter
What are the points of reference on the posterior side?
Iliac Crest: Hands on hips
PSIS: Dimples
What is expected AROM for hip flexion
100-120
Position for hip flexion
Supine
Start with knee extended and hip at neutral
What is the test motion for hip flexion
Bend knee and lift thigh off table toward chest
End feel for hip flexion
Soft, with firm tension at end
Axis for hip flexion
Lateral aspect of hip joint
Use greater trochanter as landmark
Stationary arm for hip flexion
Midline of pelvis or trunk
Movable arm for hip flexion
Femur
Substitutions of hip flexion
Lumbar extension
Tilting pelvis
Make sure they don’t lift the other leg
Expected AROM for hip extension
20-30
Position for hip extension
Prone
Start with knees extended
Hips at neutral
Test motion for hip extension
Raise leg off table
Maintain knee extension
End feel to hip extension
Firm because of the iliofemoral ligament
Axis for hip extension
Lateral aspect of the hip joint
Greater trochanter as landmark
Stationary (proximal) arm for hip extension
Midline of pelvis or trunk
Movable (distal) arm for hip extension
Midline of of femur
Substitutions for hip extension
Pelvis lifting off map
Make sure to keep leg straight
Watch for rolling
AROM for hip abduction
40
Position for hip abduction
Supine
Start with hip in neutral and knee extended
Test motion for hip abduction
Slide hip to the side
Do not allow lateral rotation or hip flexion
At the end when pelvis tries to laterally tilt or rotate
End feel for hip abduction
Firm
Axis for hip abduction
ASIS
Stationary arm for hip abduction
Imaginary line between the two ASIS
Movable arm for hip abduction
Midline of the femur
Substitutions for hip abduction
Lateral rotation or hip flexion
AROM for hip adduction
20
Position for hip adduction
Supine
Knees extended
Hip being tested is 0
Abduct the contralateral leg
Test motion for hip adduction
Slide leg medially
Maintain extension of knee
End when pelvis begins to tilt or rotate
End feel for hip adduction
Firm
Axis for hip adduction
ASIS
Stationary arm of hip adduction
Imaginary line between the two ASIS
Movable arm of hip adduction
Midline of femur
Substitutions for hip adduction
Watch for tilting of the pelvis
AROM for hip medial rotation (internal)
40-45
Test position for hip medial rotation (internal)
Subject seated
Knee flexed to 90
Hip at 90
Test motion for hip medial rotation (internal)
Swing leg to lateral side
End feel for hip medial rotation (internal)
Firm
Axis for hip medial rotation (internal)
Anterior patella
Stationary arm for hip medial rotation (internal)
Perpendicular to floor
Or parallel to supporting surface
Movable arm for hip medial rotation (internal)
Midline of lower leg
AROM for hip lateral rotation (external)
45-50 slightly more than internal
Test position for hip lateral rotation (external)
Seated
Knee at 90
Hip at 90
Test motion for hip lateral rotation (external)
Swing leg in
End feel for hip lateral rotation (external)
Firm
Axis for hip lateral rotation (external)
Anterior patella
Stationary arm of hip lateral rotation (external)
Perpendicular to floor
Or parallel to supporting surface
Movable arm for hip lateral rotation (external)
Midline of lower leg
How would you measure hip rotation (medial/internal or lateral/external) on an amputee?
Mark the stump with a marker