Hip Flashcards
Normal Ranges of Motion
Hip Flexion: 140
Hip Extension: 20
Hip Abduction: 50
Hip Adduction: 30
Hip External Rotation: 30
Hip Internal Rotation: 40
PROM End Range Feels
Palpation Structures
-Iliac Crest (Edge of index finger)
-ASIS (Thumb pad)
-Greater trochanter of femur (Index finger pad)
-Ischial tuberosity
-PSIS (While lying prom, thumb pad)
-Sacroiliac joint (Middle finger pads)
-Proximal hamstring tendon (While lying prone, flex knee slightly while holding onto ankle, follow hamstring belly upwards to proximal hamstring tendon into ischial tuberosity)
-Rectus femoris tendon (Lying supine, contract quad by extending knee slightly holding onto ankle, follow centre quad to rectus femoris proximally
-Gluteals (While lying prone, With fingertip pads)
-Adductors (Supine, mid range or neutral feel medial thigh for adductors)
-Iliopsoas tendon (Lying supine, hip and knee flexed holding under knee, find tendon medial to ASIS
Hip Flexion
-Lying supine with straight leg or knee flexion
AROM: “Can you bring your knee up towards your shoulder as far as you can”
PROM: Grab backside ankle and lateral knee, bring to flexion to end range
RROM: Hip at 90 degrees knee flexed, stabilize same pelvis, other hand above knee and ask them to resist against hand
Hip Extension
-Lying prone, legs straight OR knees bent
AROM: “Keeping your pelvis on the table, can you bring your heel up to the ceiling?”
PROM: Hug distal thigh, other hand stabilize same hip and pull up
RROM: Stabilize pelvis and push down on hamstring as they resist
Hip Adduction
-Lying supine, client hugs opposite shin to chest
AROM: “Can you bring your leg across your body to the opposite side of the table as far as you can”
PROM: Grab outside of straight leg ankle and pull across
RROM: One hand stabilizes opposite hip, other hand at medial side of straight leg knee, ask them to meet resistance
Hip Abduction
-Lying supine with both legs straight extended
AROM: “Keeping both of your hips on the table, bring your leg off of the table towards me as far as you can”
PROM: Stabilize same hip, Grab medial side of ankle of straight leg ankle and pull out off table
RROM: One hand stabilizes opposite hip, other hand at lateral side of straight leg knee, ask them to meet resistance
Hip External Rotation
-Lying supine with knee bent at 90 degrees; can also do from prone
AROM: “Can you bring the inside of your foot to to opposite wall as far as you can”
PROM: One hand on medial knee, one hand grasp foot, rotate hip by pushing inwards
RROM: stabilize same side knee, put hand on medial side ankle, ask to resist hand
Hip Internal Rotation
-Lying supine with knee bent at 90 degrees
AROM: “Can you bring the inside of your foot to the same side wall as far as you can”
PROM: One hand on lateral knee, one hand grasp foot, rotate hip by pulling
RROM: stabilize same side thigh, put hand on lateral side ankle, ask to resist hand
MMT: Comparing RECTUS FEMORIS to ILIOPSOAS
RECTUS FEMORIS
Lying supine
Straight leg hip flexion, stabilize opposite ASIS
Push down resistance below knee of flexed leg
Hold for 5 seconds; note quality of strength
ILIOPSOAS:
Lying supine
Knee flexion 90 degrees and Hip flexion
Hand stabilize same side ASIS
Push resistance above knee on thigh
Hold for 5 seconds; note quality of strength
Functional Movement: PSIS in relation to sacrum
Left thumb Palpate Iliac crest into PSIS
Right thumb mid sacrum
“Can you bring your right knee up to hip length and back down?”
Get patient feedback, note feel, observe movement of PSIS in relation to sacrum
Palpate PSIS bilaterally
“Keeping feet flat and knees straight, can you slowly bend over and bring your hands to the floor and back up?”
Observe PSIS relation to each other and to sacrum
Functional Movement: Squat
“Feet shoulder width apart in a comfortable position, can you bend down into a squat to the best of your ability”
Lateral view:
-Note Sacrum and L-SPine
-Angle of sacrum and angle of lumbar in hip flexion
-Note depth and quality of movement
Anterior view:
-Look for side to side weight shifts
-Look for Abduction/Adduction
Functional Movement: SL Squat
“Standing on your right leg, can you extend your left leg in front of you and squat as low and comfortable as you can”
Anterior view:
-Shift in hips
-Abduction/Adduction compensation
-Balance
Lateral view:
-Forward lean, rounding lumbar
-Angle of sacrum
-Amount of depth/hip flexion in degrees
Posterior view:
-Weight shifts
-Spine angle
MMT: Glutes vs Hamstring
GLUTES
Lying prone, bend knee
Stabilize same hip
Lift thigh off bed and resist above knee
HAMSTRING
Lying prone, straight leg
Stabilize same hip
Lift entire leg off bed and resist at ankle
