Hip Lecture Flashcards by Maria Benjamin

stabilizing muscles

deep rotators

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the body’s ability to react and control movement. Goal to provide DYNAMIC STABILITY.

If they don’t have this, the body will take the path of least resistance

NMSK Control

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to have neuromuscular control, you need

proprioception
kinesthesia

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squat has the most force:
open chain leg extension has the most force:

squat: in deepest position

open chain: at the end range of extension

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acetabulum is oriented?
femur is oriented?

acetabulum: anterior, inferior, lateral

femur: anterior; superior; medially

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angle of inclination

normal
coxa vara
coxa valga

normal: 125

coxa vara: <110
coxa valga: >140

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acetabulum labrum functions

deepen the socket
shock absorption, lubrication, pressure distribution
add a partial vaccum that adds stability (negative pressure)

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what ligaments help reinforce the strong capsule?

iliofemoral
pubofemoral
ischiofemoral

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hip flexion
hip extension

flexion: 120; 90 (if knee ext)
extension: 10-30 degrees ; less w/ knee flexion (RF, TFL)

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abduction
adduction

ABD: 45-50
ADD: 20-30

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what limits abduction?
what limits adduction?

ABD: gracilis

ADD: TFL and ITB

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hip closed pack

extension
abduction
IR

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open pack posiiton

flexion
abduction
ER

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hip functional ROM for gait?

30 flexion
10 ext
5 abd/add and MR/LR

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activities requirieng more flexion from hip

squat, sitting, stairs, putting on pants/shoes, crouching

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if the opposite side of the pelvis hikes, stance hip ____.
if the opposite side of pelvis drops, stance hip ____.

abducts

adducts

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lateral pelvic shift in bilateral stance:

adduction on shift side
abduction on opposite side

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anterior (forward) pelvic rotation produces ____rotation on the stance hip

posterior rotation produces hip ____ rotation on the stance hip

anterior; medial rotation
posterior; lateral rotation

describe forward bending (pelvifemroal motion)

 Head and upper trunk initiates flexion, pelvis shifts posteriorly
 Trunk continues to forward bend, controlled by extensors
 Once vertebral segments are at end range, pelvis rotates forward/anteriorly tilts
 Pelvis continues to rotate forward until full muscle length is reached

the LOG at the hip creates

an extensor moment counterbalanced by ligaments/iliopsoas tension

TFL function

flexion
abduciton
MR

what group of mm can help flex the hip from extended position?

hip ADDuctors

(pectineus, adductor longus/magnus, gracilis)
gracilis (can help flex hip if knee is extended)

what muscles help adduct the hip when leg is in ER and ABD?

biceps femoris long head
glute max
QF
Obturator externus

T/F there are no primary medial rotators;
anteriro glut med, min, TFL, adductors all help medially rotate

True

what muscle is a primary compensator?

TFL- Because it will flex hip as you try to isolate abduction

T/F glute med is a primary external rotator

FALSE- that's why we don't like clamshells because it's not targetting external rotation like we think.

primary hip lateral rotators

glute max OI AND OE gemelli S and I QF Piriformis (neutral or less than 90 hip)

when is bursa painful?

with compression

when does tendon cause pain?

contracted or resisted or pulled tx: isometric

when does peritendon cause pain?

stretch or in the LONGEST position (quadricep tendon: most pain w/ end range knee flexion) TX: massage

preferred MMT position for iliposoas

supine > sitting

how to target the hamstring groups more specifically

semis (medial) - IR the tibia biceps (lateral) - ER the tibia

dominant muscles (weak muscles)

TFL & AGM (PGM & glut min) TFL (iliopsoas) Hip adductors (abductors) Hamstrings as hip extensors (Glut Max) Hamstrings as knee extensors in closed chain (Quads) Biceps femoris in LR (piriformis & LRs) Medial hams (Biceps femoris)

PAILS/RAILS Benefits

* Bypass the stretch reflex * Creates cortical mapping * Increase neural drive to the tissue * Cause a cellular adaptation in the tissue * Increase blood flow to both the PAILS and RAILs tissue

when does hip IR occur?

when extending towards 0 degrees from a flexed position - Flexed 60-100 degrees

true function of hip IR

Drives force into the ground

hip pain with mobility deficits CPG

1. insidious onset, first w/ WB 2. mod anterior / lateral hip pain during WB 3. morning stiffness <1 hr in duration after wakening 4. Hip IR ROM less than 24 degrees 5. IR and hip flexion 15 degrees less than nonpainful side 6. increased hip pain associated with passive hip IR

Hip OA CPR

1. squatting aggravates 2. hip flexion AROM causes lateral hip pain 3. scour test with adduction causes lateral hip or groin pain 4. active hip extension causes pain 5. passive IR less than or equal 25

cam impingement more prevalent in

males (younger)

Pincer impingement more common in

middle-aged, active women

Usually between 4-8 years old (male)  Child tends to be shorter  Deformity of the femoral head  Usually treated conservatively. If surgery is indicated, may involve femoral osteotomy

legg-calve-perthes disease

 Usually between 10-15 years old  Child tends to be overweight  Displacement of the femoral neck  Usually treated surgically- internal fixation

SCFE

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