Hip/Thigh Flashcards
(38 cards)
What could be the possible causes of groin pain? (13)
•Muscle strain - thigh or rectus abdominus
Referred pain from L-spine or SI
- Osteitis pubis / pubic symphysitis
- Trochanteric bursitis / Gluteal tendinopathy
- Obturator nerve entrapmentIliopsoas strain
- Stress fracture of the femoral neck
- Athletic Pubalgia / Sports hernia
- Labral tear / FAI
- Avulsion fracture
- Slipped capital femoral epiphysis
- Legg-Calve’ Perthes disease
- Bursitis
What is the most common MSK cause of chronic groin pain?
An adductor muscle strain
Which muscle is most frequently involved in an adductor muscle strain?
Adductor longus
What are the clinical signs/symptoms of an adductor muscle strain?
localized pain (i.e. muscle belly, musculoskeletal junction, origin on pubic bone), tender to palpation, pain with resisted adduction, and pain with passive stretch
How do you manage an acute adductor muscle strain?
Imaging to rule out avulsion fracture, PRICE (elastic wrap or compression shorts), NSAID’s, pain free ROM, progressive stretching and strengthening, and then sport specific training
What is a hip pointer and what muscle is it commonly over?
It’s a contusion to the iliac crest, commonly over the TFL with associated hematoma
Describe the Grades I-III of a Hip Pointer.
- Grade I: normal gait and posture, slight pain with palpation, little or no swelling, and full trunk ROM
- Grade II: athlete flexed to side of injury, gait abnormal, debilitating pain and tenderness, return to activity 5-14 days
- Grade III: sever pain and swelling, gait is slow and deliberate, sever tilt to side of injury, trunk ROM is limited in all directions, return in 14-21 days
What is the most common type of Snapping Hip Syndrome?
ITB snapping over greater trochanter (i.e. external)
What are the less two common types of Snapping Hip Syndrome?
(1) Iliopsoas tendon over iliopectineal eminence
(2) Iliofemoral ligament over femoral head
What else can cause Snapping Hip Syndrome instead of a tendon or a ligament?
loose bodies (inter-articular), subluxation of the hip, or labrum
What are the interventions for treating Snapping Hip Syndrome?
stretching, strengthening, training modifications, and surgery
What would a patient usually report when they have a femoral neck stress fracture?
They have gradual onset of groin pain that increases with activity and is better with rest
What is the difference between tension-type and compression-type femoral neck stress fractures?
tension-type = fractures of the superior aspect of the femoral neck
compression-type = fractures on the inferior aspect of the femoral neck
Why does a tension-type femoral neck stress fracture have a poorer prognosis than a compression-type?
It has the possibility of advancing to full fracture with potential to compromise blood supply to femoral head
What other injuries is Femoroacetabular Impingement (FAI) associated with?
cartilage damage, labral tears, early hip arthritis, hyperlaxity, sports hernias, and LBP
What occurs with movement in FAI?
Abnormal contact between the femoral head and acetabular rim occurs with hip flexion, adduction, and IR with impingement of the anterior-superior labrum occurring
What are the signs and symptoms of symptomatic acetabular labrum tear?
anterior groin pain worse with prolonged periods of standing, sitting, and walking
A combination of what 2 hip movements causes the greatest strain on the labrum?
flexion and adduction
What is the “crossover sign” or “figure of 8”?
A sign that indicates acetabular retroversion/pincer type FAI
What does the alpha angle measure?
It measures the extent to which the femoral head deviates from spherical (cam type FAI)
What might rehab for FAI include?
ROM/modalities (i.e. ice, compression), muscle restoration with dynamic hip control, core/gluteal muscles, and muscle balance (lumbar-pelvic-hip complex)
What portion of the labrum tears most frequently?
The anterosuperior part
In what athletes are labral tears more common?
Those who perform twisting and pivoting in flexed, weight bearing positions (repetitive microtrauma)
How do you differentiate a traumatic avulsion from apophysitis?
Apophysitis = typically low grade inflammatory pain that comes on over time (may not even prevent participation in activity)
Traumatic Avulsion = fragment of bone pulled away at ligamentous or tendinous attachment due to a sudden violent muscle contraction
