Hip Flashcards
(46 cards)
what are the most common mobility impairments in hip pts
flexion/IR/abd
common flexibility impairments
tight hip flexors (stress on spine/knee)
tight ADD and hamstrings
what causes medial collapse?
decreased strength of hip ABD/EXT/ER
Common M imbalance impairments related to hip
short tfl
dominance of TFL over glute med
dom. of TFL over iliopsoas
dom of hamstrings over glute max
Common M control impairments related to hip
poor hip control in WB position (squat or unilateral squat)
hyperext/swayback posture and ANT hip
movement training is KEY
most common hip pain in older adults
hip pain associated with OA
RF for hip OA
age, developmental disorders, previous hip injury, reduced ROM (IR), osteophytes, lower socioeconomic status, higher bone mass and BMI
describe the natural hx of OA
-Decrease in joint space
-Shortening of capsule
-Flattening of femoral head
-Osteophytic growth
common impairments/clinical presentation hip OA
Hip pain (anterior or lateral) and stiffness –worse with WB
Impaired mobility (flexion, IR, ABD, extension)
Impaired m performance (ABD, ext, ER)
Impaired balance
Impaired gait pattern
Activity limitations and participation restrictions (STS, prolonged walking)
Clinical criteria for OA dx
(adults > 50)
mod anterior or lat hip pain
morning stiffness ( <1 hr after walking)
Hip IR <24 degrees OR hip IR + flexion 15 degrees less than non-painful side
Increased hip pain with passive IR
Hip school
Hip dysfunction/pain can improve and does not always get worse it is NOT automatic downhill from here
S/S associated with mvmt and physical exam is best way to dx hip OA
Treatment should start with non-pharm interventions
Not too much, not too little activity
Seek help b4 overwhelmed
** Hip school vs control group = greater reduction in pain and activity limitation
most common hamstring strain
long head biceps femoris
hamstring strain RF
modifiable: fascicle length/stiffness
non-modifiable: >23 yrs, previous HIS, ACL injury, calf strains, other knee/ankle lig injuries
common impairments with ham strain
pain and localized tenderness
impaired mob (active knee ext test)
impaired flexibility (pain w stretching)
impaired m performance (pain)
gait deviations (terminal swing, short stride length, and MSW–clear foot) activity limitations
what does evidence say about pain free vs pain threshold rehab
-Did not accelerate RTP
-Strength = greater knee flexor strength in pain-threshold group
-BFLH fascicle length = greater in pain-threshold group
what does evidence say about adding eccentric exercise to strengthening program (hamstring)
- Adding ecc strengthening exsc to a conventional program = sig reduced RTP
- Important for PREVENTION
(Nordic Hamstring exsc reduced HIS by 50% , Depends on exsc compliance, Performed after training and on days b4 rest)
**Lengthening Exsc had quicker return to play than conventional protocol
what does evidence say about progressive agility and trunk stabilization (hamstring)
- Reinjury rates lower for PATS (hamstring is important as a hip stabilizer in all trunk stabilization exsc)
- RTP no diff
what helps RTP for hamstring injuries?
eccentrics
what helps reduce reinjury for hamstring injury?
PATS: progressive agility and trunk stabilization
pt education recommendation for FAI
avoid positions that create impingment (end range flexion, IR, sometimes ABD)
pt education recommendation for instability
avoid activities that place repetitive strain on passive restorations of hip (forced ext and rot loading)
pt education activity modification
movement pattern and hip alignment should be assessed with all activities. other examples include higher seats (avoid excessive hip flexion) and AD with gait to unload
common pattern in FAI
decreased IR and increased ER
decreased flexion and abduction
clinical presentation of FAI
hip groin pain (ant>post)
c/o clicking, locking catching or stiff
slight decrease ROM (flexion and IR)
f>m
avg 2-4 yrs duration
+ hip impingment tests (FADIR)
pain with walking, standing, sitting
