Common Hip Soft Tissue injuries Flashcards
Trochanteric Bursitis: mechanism of injury
- insidious
- repeated hip flexion/extension
- IR/ER
- compression
trochanteric bursitis
- also called trochanteric pain syndrome
- bursa is found over GT and under IT band
- Could also be a gluteus medius tear
Signs and symptoms of trochanteric bursitis
- deep ache (local)
- no active limitations
- pain ascending stairs
- resisted EXT/ER
- may disturbe sleep
- AVN can minmic this
- IT band tightness
Interventions for trochanteric bursitis
- avoidance of aggravating activity
- Ice, gentle stretch, iontophoresis
- restore gluteal and tensor strength/flexability balance
- trochanteric osteotomy
hip pointer: mechanism and what it is
- direct trauma
- pain associated with trauma to anterior hip
Hip pointer
signs and symptoms
- tender to palpation
- aggravated by running, coughing, sneeze, trunk movements
Interventions for hip pointer
- rest
- ice
- gentle stretching
- protective padding
How is a muscule injuried
- strong contraction
- blunt trauma
- overstretched
- overuse
Signs and symptoms of a muscule strain
- Grade 1: mild symptoms & RI strong and painful
- Grade 2: moderate symptoms & RI are weak and painful
- Grade 3: weak and painless (torn)
Interventions for muscule strains
- initially: PRICE
- Strengthen: isometric
- Stretch: to return to resting length not over stretching
Common hip muscle strains
- adductor strain
- iliopsoas strain
- Hip flexor
- hmastring
- gluteus medius
When are the adductors active during gait
- loading reposne into initial swing
When is iliopsoas active during gait
intial swing = concentrically
mid stance into preswing = eccentrically
When are the hamstrings active during gait
and how can you differiate which hamstring
- mid swing to initial contact = eccentrically
- intiail contact to loading response: counter hip flexor moment
- differentiate by toes in = semis and toes out = biceps femoris
Gluteus medius
activity in gait cycle
- will see + trendelemberg
- works throughout stance esp. SLS
Athletic pubalgia aka sports hernia
- strain: abdominal muscules or adductrs muscles
- weak abs can set you up for overstressing adductors and vice versa
Mechanism of injury for athletic pubalgia
- vigorous trunk twisting with foot planted
exam: athletic pubalgia
- resisted trunk flexion
- resisted hip adduction
- no bulge
- MRI, bone scan
Interventions for athletic pubalgia
- rest
- flexibility
- strengthening
- surgery: repair tear or inguinal neurctomy (if inguinal nerve is irritated)
Prognosis
athletic pubalgia
- return to activity 6-12 weeks
- may progress to inguinal hernia with content bulge
Signs and symptoms of acetabular labral tears
- anterior hip/groin pain
- posterior hip pain less frequent
- greater in women with history of dysplasia
- catching/clicking
- diagnosis of exclusion (rule out soft tissue, DJD, back etc)
Provocation tests
acetabular labrum tears
- anterior flex, ER, abdu –> ext, IR, add
- posterior: ext, ER, abd –> flexion IR and add
- Compression (axial)
- painful SLR (rectus femoris attahces to superior labrum
- (+) FABERS
- confirm with MRI with arthrography
Acetabular labrum tears intervention
- avoid knee hyperextnesion
- surgery: repair and debride, cartilage regeneration procedures
