What is the angel of the femur in the transverse plane?
Which direction is the head of the femur angled>
slightly ant, inf and medially
Do female anatomical differences increase risk of any type of injury?
which hip ligaments contribute to stability of the hip?
iliofemoral ligament (Y ligament) checks hiphyperext; pubofemoral ligament checks abd and ext
Normal ROM for hip flexion
Normal ROM for hip ext
Normal ROM for hip abd
Normal ROM for hip add
Normal ROM for hip ER
Normal ROM for IR
Name the hip flexors:
iliopsoas, rectus femoris, tensor fascia latae, sartorious, pectineus, adductor brevis, adductor longus, and oblique fibers of adductor magnus
Name the hip extensors crossing the hip joint:
Glut max, bicep femoris, semimembranous, semitendinous
Name the hip abd crossing the hip joint:
glut med, glut min, tensor fascia latae, upper fibers of glut max
Name the hip add crossing the hip joint:
adductor magnus, adductor longus, adductor brevis, pectinus, gracilis
Name the hip ER crossing the hip joint:
obturator externus, obturator internus, quadratus femoris, piriformis, gemellus superior, gemellus inferior, gluteus maximus, sartorius, and biceps femoris
Name the hip IR crossing the hip joint:
Gluteus min, tensor fascia latae, ant fibers of glut med, semitendinous and semimembranousis
What is inversion of muscle action
muscles that cross a joint with 3 degrees of freedom may have alternate or even opposite actions than their classically described actions
What happens to hip strength with OA?
abd and flexion decrease significantly, and ext also decreases with B hip OA
Describe blood supply to the femoral head:
main supply is the extracapsular ring from the medial femoral circumflex artery, followed by ascending cervical branches, and very little from artery of ligamentum teres
Describe the trochanteric bursa:
1.) between glut max and med tendon 2.) glut max and greater trochanter 3.) glut med and greater trochanter; other bursa can form from excessive friction
Functional ROM of hip:
90 degrees flexion, 20 abd, and IR/ER from 0/20
How are muscle strains classified?
Grade 1: little tissue disruption, low grade inflammatory, strength testing produces pain no weakness, no loss of ROM, grade2: some disruption of muscle fibers but not complete, strength ROM decreased pain significant grade 3: complete rupture loss of strength, palpable or visible defect may be present
MOI for glut med strain?
running producing a seesaw motion, but can occur in swimmers as well; typically tender just above the greater trochanter and painful with resisted abd (which bursitis is not)
What is bald trochanter?
rupture and retraction of the glut med and min tendons; Tx use a cane, NSAIDs, and possible surgery
How do groin pulls occur?
most commonly the adductor longus with quick acceleration or direction changes typically because of a lack of strengthening (abd to add ratio) and stretching of the adductors other factors are previous injury and lack of experience
Tx for groin pull?
8-12 wk of strengthening of the adductors with focus on the eccentrics resistive exercise, balance training, core strengthening and sport specific movements (stretching, massage, and modalities are not supported)
When is surgery necessary for a groin pull?
If symptoms persist after 6 months
What is a sports hernia
overuse syndrome with rectus abdominus insertion, internal obliquis insertion, or the external oblique muscle aponeurosis
What is the most frequently strained muscle in the body?
Are quad strains common?
No, but can happen with rapid deceleration