Thigh, Hip, Groin, Pelvis Flashcards
(30 cards)
where does the quad insert?
in a common tendon to the proximal patella
which is the only quad muscle to cross the hip?
rectus femoris
hamstrings cross the knee joint anteriorly or posteriorly?
do they all cross the hip?
posteriorly
all but the short head of the biceps
bi-articulate (two joint) muscles produce forces depending upon what?
the position of the knee and the hip
*most of the muscles that cross at the hip also cross at the knee, hence, bi-articulate.
Hip flexor strains impact what?
the position of the knee
where are muscles most commonly injured?
the hip and pelvis
injuries are disabling and difficult to distinguish because there are lots of muscles that attach to this region
How do we do an assessment of the hip?
History
Observation
Assessment
History= any neural pain? is it shooting? heading down? the farther away from the back we get the more concerned we are..as it localizes we are stoked
Observation= Gait (running/walk)
Assessment = flex/ext, abd/add, internal/external rotation
Who is more likely to have a disc herniate?
Young people because there is more goo in their discs
How do we do injury prevention for this body area?
Protective equipment: thigh pads, girdles, cups, praces,
Shoes- cushoning
Physical conditioning: muscular strength, balance, flexibility!!!!!!! endurance
What are the potential acute injuries? (6)
Contusions Myositis ossificans (when you don't treat contusions properly) Strains (quad, ham, add, hip flex) Sprains (RARE-hip) Fractures (femor hip disolcation
What are the potential chronic/overuse injuries?
Femoral stress fracture
Quad contusions:
ET
SS
M
happens when esposed to blunt trauma causing muscular compression (tissue tears)
the extent of force and amt of thigh relaxation determines damage done
localized pain bleding swelling temprary loss of f(n)- weakness in extending or flexing knee graded 1-4 superficial or deep
RICE in knee flexion (72 hours, decrease chance of myositis ossificans), protect w crutches and NSAIDs
ROM and stretching
Protect with RTP (padding w tape job)
No massage or heat with acute onset—- only during rehab
What is a grade 1 contusion?
mild hemorrhaging, little to no pain, no swell, mild pt tenderness, no ROM probs
wrap and put back in
what is a grade 2 contusion?
mild pain, mild swell, mild to mod hemorrhaging, mild pt t, mild diability (>90 knee flexion), limping
no more play
what is a grade 3 contusion
moderate pain, moderate swelling, moderately disabled (> 45 but <90 degrees of knee flexion)
obvious limbing
no more play
What is a grade 4 contusion?
Severe pain, severe swelling, severe disability (<45 degrees of knee flexion)
POTENTIAL MUSCLE HERNIATION
obvious limb/ cannot weight bear
Myositis Ossificans
et
ss
man
formation of ectopic bone following direct blow, repeated blunt trauma,
or improper care of thigh contusion
pain, weakness, swelling, point tenderness, decreased ROM and function
X ray will show deposits 2-6 weeks following
Manage conservatively (regain ROM) Physician referral make them wear compression shorts
Hip Pointer Contusion
et
ss
man
direct blow to iliac crest
pain, spasm, swelling, transitory paralysis of soft structures
decreased rotation of truck, OR decreased thigh/hip flexion
the obliques and the glut med insert here therefore it’s super debilitating
RICE 48hrs, ice massage, protect for RTP
physician referral to rule out fracture
What is a first degree strain?
limited swelling and tightness near normal gait mild pt tenderness and discomfort during palpation soreness during movement <20% of fibers are torn
A second degree strain?
pain and swelling noted on palpation may note palpable divot pain with resisted muscle testing limping muscle spasm <70% of fibers torn
A third degree strain?
Ruturing tendinous or muscular tissue major hemorrhage and edema major disability and loss of function pain and palpable defect or mass >70% of fibers torn
Quadriceps Strain
et
ss
man
Sudden stretch or violent forceful contraction of the hip and knee into flexion or knee flexion with hip extension
SHARP: pain, spasm, swelling and delayed bruising, loss of function, decreased ROM and strength of extensors
RICE, crutches and wrap, later use of sleeve,
Progress to pain free ROM, isometrics (bc muscles don’t change length) and stretching
May require 12 wks RTP
Hip flexor strain
et
ss
man
Sudden overstretch into hyerextension (can be from rec fem or soas)
Pain, swelling, delayed bruising, disability: decreased ROM and extensor strength.
RICE, crutches, hip wrap
Hamstring Strain
et
ss
man
most common most debilitating
Eccentric load in hip flexion and knee extension
sudden explosive contraction or direction change or accel/decel
other factors include: fature, posture, leg length discrep, imbalances, hamstring dominance (no butt), muscle tighness
Pain, swelling, delayed bruising, spasm, loss of range and fn,
RICE, crutch and wrap
conservitive treatment with gradual ROM and strengthening
