HIP Flashcards
1
Q
HIP - ROM
A
- Flexion - 80-90 (straight leg)
- Flexion - 120 (bent leg)
- Extension - 30
- Internal rotation - 40
- External rotation - 50
- Abduction - 50
- Adduction - 30
2
Q
HIP - MYOTOMES
A
- Hip flexion - L1, L2, L3 - femoral nerve
- Knee extension - L3, L4 - femoral nerve
- Knee flexion - L4, L5, S1, S2 - sciatic nerve
- Ankle dorsiflexion - L4, L5 - deep peroneal nerve
- Ankle inversion - L4, L5 - tibial nerve, deep peroneal nerve
- Ankle eversion - L5, S1 - superior peroneal nerve
- Big toe extension - L5, S1 - deep peroneal nerve
- Big toe flexion - L5, S1 - tibial nerve
3
Q
HIP - ORTHO TESTS - SCREENING
A
- SCREENING - Heel walk, toe walk, Trendelenburg’s sign
4
Q
HIP - ORTHO TEST - INSTABILITY
A
- INSTABILITY - hip telescoping
5
Q
HIP - ORTHO TEST - HIP DJD
A
- HIP DJD - Scour, FABERE
6
Q
HIP - ORTHO TEST - LUMBAR RADICULOPATHY
A
- LUMBAR RADICULOPATHY - SLR, Braggard’s test
7
Q
HIP - ORTHO TEST - HIP FLEXOR LENGTH
A
- HIP FLEXOR LENGTH - Thomas test, Gaenslen’s test, Rectus femoris contracture test
8
Q
HIP - ORTHO TEST - PIRIFORMIS SYNDROME
A
- PIRIFORMIS SYNDROME - Sign of the buttock
9
Q
HIP - JOINT TYPE
A
Synovial
- Symphysis - pubic symphysis
- Ball and socket - acetabulofemoral
10
Q
HIP - ARTICULAR SURFACES
A
- Acetabulofemoral - convex (head of femur) on concave (acetabulofemoral)
11
Q
HIP - MAIN MUSCLE ACTIONS - FLEXION
A
- FLEXION - iliopsoas, rectus femoris, sartorius
12
Q
HIP - MAIN MUSCLE ACTIONS - EXTENSION
A
- EXTENSION - gluteus maximus, hamstrings
13
Q
HIP - MAIN MUSCLE ACTIONS - ABDUCTION
A
- ABDUCTION - gluteus medius, gluteus minimus, tensor fasciae latae
14
Q
HIP - MAIN MUSCLE ACTIONS - ADDUCTION
A
- ADDUCTION - adductor Magnus, gracilis, adductor longus and brevis
15
Q
HIP - MAIN MUSCLE ACTIONS - INTERNAL ROTATION
A
- INTERNAL ROTATION - gluteus medius, gluteus minimus, tensor fasciae latae
16
Q
HIP - MAIN MUSCLE ACTIONS - EXTERNAL ROTATION
A
- EXTERNAL ROTATION - piriformis, quadrates femoris, superior and inferior gemellus, obturator internus and externus
17
Q
HIP - RESTING POSITION
A
Acetabulofemoral: 30 abduction, 30 flexion, and slight external rotation
18
Q
HIP - CLOSED PACKED POSITION
A
Acetabulofemoral: full extension, abduction and internal rotation
19
Q
HIP - NORMAL END FEEL
A
FLEXION & ADDUCTION- elastic or tissue approximation
EXTENSION & ABDUCTION - elastic/firm
STRAIGHT LEG RAISE - elastic
INTERNAL/EXTERNAL ROTATION - elastic/firm
20
Q
HIP - ABNORMAL END FEEL
A
- Bony = osteoarthritis
- Late myospasm = instability
21
Q
HIP - HIP JOINT FORCES
A
- Standing - 0.3x body weight
- Standing on one leg - 2.5x body weight
- Walking - 3x body weight
- Running - >4.5x body weight
22
Q
HIP - CONDITIONS - AVASCULAR NECROSIS
A
Hx - repetitive hip trauma, corticosteroids, alcohol, diabetes, sickle cell anaemia, atherosclerosis
S&S - pain/stiffness in hip joint, pain persists with rest, antalgic limp, limited ROM
DDx - osteoarthritis, osteoporosis, hip dislocation, femoral neck fracture
23
Q
HIP - CONDITIONS - ACETABULAR LABRAL TEAR
A
Hx - prior trauma, deep hip/groin pain, worse with full hip flexion, possible locking
S&S - audible click with motion, pain with full passive hip flexion (bent knee)
DDx - internal or external snapping hip, DJD
24
Q
HIP - CONDITIONS - HERNIA (INGUINAL OR FEMORAL)
A
Hx - M>F (9:1); prior heavy lifting with valsalva causes more pain
S&S - palpable protrusion worse with valsalva - Red flags: nausea, fever, vomiting, discolouration indicative of a strnagulated hernia = medical emergance
DDx - groin strain, testicular torsion
25
HIP - CONDITIONS - HIP DJD
Hx - groin pain worse with weight bearing or cold weather, morning stiffness
S&S - antalgic gait, +ve scour test, visible on x-rays (sclerosis, decreased joint space)
DDx - avascular necrosis
26
HIP - CONDITIONS - LEGG-CALVE PERTHES
Hx - pain in groin, medial thigh or knee (without knee pathology)
S&S - antalgic gait, decreased ROM, the hip may also refer pain down to the knee
DDx - osteoarthrosis, avascular necrosis (visible on x-ray)
27
HIP - CONDITIONS - MUSCLE STRAIN (HAMSTRING, QUADS, GROIN)
Hx - sudden onset of pain associated with muscle contraction
S&S - antalgic gait, local tenderness to palpation, decreased AROM
DDx - avulsion fracture
28
HIP - CONDITIONS - PIRIFORMIS SYNDROME
Hx - possible pain down back of leg, worse when sitting on hard surfaces
S&S - tender to palpation, +ve SLR, +ve sign of the buttock, +ve piriformis test
DDx - lumbar radiculopathy, disc herniation, lumbar sprain/strain, stenosisa
29
HIP - CONDITIONS - SEPTIC ARTHIRTIS
Hx - rapid onset of severe hip pain, prior infection possible (resp or other)
S&S - fever, mincing/painful gait, extremely limited ROM, puncture wound in skin
DDx - rheumatoid arthritis
30
HIP - CONDITIONS - SCFE
Hx - 10 - 16 years old, mild hip pain referral to medial thigh/knee; worse with activity
S&S - decreased abduction and internal rotation ROM; mild limp or awkward gait
DDx - visible on x-ray, groin strain, Legg-Calve-Perthes disease, septic arthritis
31
HIP - CONDITIONS - SNAPPING HIP
Hx - pt may feel repeatable ‘pop’ of ITB or direct trauma to greater trochanter
S&S - tender to palpation over greater trochanter, +ve Ober’s test
DDx - may causeteric bursitis
32
HIP - CONDITIONS - TROCHANTERIC BURSITIS
Hx - pt may feel ‘pop’ of ITB or direct trauma to greater trochanter
S&S - tender to palpation over greater trochanter, +ve Ober’s test
DDx - snapping hip
33
HIP - ORTHO TESTS - THOMAS TEST
- Pt supine
- Pt flexes one knee to chest while keeping the other leg straight
- Examiner observes for straight leg elevation
34
HIP - ORTHO TEST - THOMAS TEST - POSITIVE TEST
**Hip contracture, tight iliopsoas or rectus femoris**
- Elevation of the straight leg
35
HIP - ORTHO TEST - LABRAL TEAR TEST
- Pt supine
- 3 parts to test
1. Examiner applies P-A force over distal thigh and asks pt to flex hip
Rectus femoris originates from the anterior acetabulum nd if the anterior labrum is torn the pull from the contraction may cause pain
2. Pain in Gaenslen’s test position, examiner pushes hanging leg into extension
Compression of the posterior labrum may cause pain if damaged
3. Pt knee bent, examiner flexes pt hip into full flexion and internal rotation with over pressure
**SN**: 98
**SP**: 8-25
36
HIP - ORTHO TEST - LABRAL TEAR TEST - POSITIVE TEST
**Acetabular labral tear, Joint capsule impingement**
- Pain or apprehension
37
HIP - ORTHO TEST - OBER'S TEST
- Pt sidelying with affected lower extremity up
- Examiner stabilises pelvis with one hand and grasps ankle and flexes pt knee to 90, slightly abducts and extends hip
- Examiner then proceeds to internally rotate the hip (lift the ankle up)
38
HIP - ORTHO TEST - OBER'S TEST - POSITIVE TEST
**Trochanteric bursitis**
- Trochanteric pain
**Hip joint pathology**
- Hip pain
39
HIP - ORTHO TEST - MODIFIED OBER'S TEST
- Pt side lying with affected lower extremity up
- Examiner stabilises the pt pelvis and adducts affected leg behind opposite leg
- Examiner observes for pain, discomfort, ROM anf end feel
40
HIP - ORTHO TEST - MODIFIED OBER'S TEST - POSITIVE TEST
**Hip joint pathology**
- Hip pain
**Trochanteric bursitis**
- Trochanteric pain
**ITB contracture**
- Decreased ROM
41
HIP - ORTHO TEST - FABERE TEST
- Pt supine
- Examiner instructs pt to cross legs into a figure 4 position (ankle placed above contralateral knee, ipsilateral knee flexed 90, ipsilateral hip abducted and externally rotated)
- Examiner stabilises the pelvis and applies gentle downward pressure over the flexed knee
42
HIP - ORTHO TEST - FABERE TEST - POSITIVE TEST
**Hip joint pathology, severe arthritis, sprain/strain, fracture, tight hip adductors**
- Pain
- Inability to perform motion
43
HIP - ORTHO TEST - FABERE TEST - SN & SP
**SN:** 50
**SP:** 29
44
HIP - ORTHO TEST - FADIR TEST
- Pt sidelying or supine
- Hip neutral and knee flexed 60-90 degrees
- Examiner stabilises hip and passively flexes hip to 60 and internally rotates femur
45
HIP - ORTHO TEST - FADIR TEST - POSITIVE TEST
**Sciatic nerve compression, hip joint pathology, femoral acetabular impingement, hip fracture**
- Pain in sciatic/gluteal area
46
HIP - ORTHO TEST - FADIR TEST - SN & SP
**SN**: 88
**SP**: 83
47
HIP - ORTHO TEST - SCOUR TEST
- Pt supine
- Examiner flexes pt hip to 90 and flexes knee - 3 parts
1. Take pt through PROM of hip (circumduction and rotation) without compression
2. Examiner then applied mild axis compression over the femur and repeats
3. If tolerated, examiner repeats the test with more pressure
48
HIP - ORTHO TEST - SCOUR TEST - POSITIVE TEST
**Hip joint pathology, osteoarthritis, transient hip synovitis, capsulitis, labral tear, acetabular impingement syndrome, SCFE, fracture**
- Pain or crepitus
49
HIP - ORTHO TEST - SCOUR TEST - SN & SP
**SN**: 75-91
**SP**: 43
50
HIP - SNAPPING HIP SYNDROME
- A palpable or audible snapping sensation that is heard during the movement of the hip joint.
51
HIP - SNAPPING HIP SYNDROME - CAUSE
- Most commonly a result of overuse
- External snapping hip syndrome most commonly is caused by the iliotibial band snapping over the greater trochanter of the femoral head during movements such as flexion, extension, and external or internal rotation.
- Internal snapping hip is most commonly caused by the iliopsoas tendon snapping over underlying bony prominences, such as the iliopectinal eminence or the anterior aspect of the femoral head.
52
HIP - SNAPPING HIP SYNDROME - POPULATION AFFECTED
- Slightly more common in women than men
Heavy labour jobs, ballet dancers, weight lifters
liotibial band tightness, shorter muscle or tendon lengths, muscle tightness
53
HIP - SNAPPING HIP SYNDROME - CLINICAL PRESENTATION
- External SHS may also have coxa vara, fibrotic scar tissue, a prominent greater trochanter, smaller lateral pelvic width, or a past surgery for anterolateral knee instability.
- Internal SHS Ps describe a painful sensation coming from deep within the anterior groin as they move their hip from flexion into extension or external rotation.
- The snapping movement can produce an auditory clunk or click.
- Pain
- Inflammation
- Feeling like hip is dislocation
- Leg muscle weakness
- Swelling
- Difficulty standing up from a chair
54
HIP - ACQUIRED DISLOCATION OF THE HIP
- Hip dislocation is the displacement of the femur head from the acetabulum
55
HIP - ACQUIRED DISLOCATION OF THE HIP - CAUSE
- Majority from motor vehicle collisions - posterior dislocations
56
HIP - ACQUIRED DISLOCATION OF THE HIP - POPULATION AFFECTED
- More common in elderly/females
- Within 3 months of a hip replacement surgery
57
HIP - ACQUIRED DISLOCATION OF THE HIP - CLINICAL PRESENTATION
- The hip will be shortenend, in external rotation, slight flexion and adduction in the more common posterior dislocations.
58
HIP - COXA VARA
- Normal femoral neck-shaft is 160deg in adults – angle less than 120deg is called coxa vara. Can be either congenital (CCV) or acquired (ACV).
- CCV due to defect of endochondral ossification in medial part of femoral neck
When child starts to crawl or stand the femoral neck bends or develops a stress fracture
- Infancy and early childhood (CCV)
- ACV can develop at any age if the femoral neck gives way
- Limb length discrepancy, Leg is short, thigh may be bowed
- Prominent greater trochanter
- Limitation of abduction and internal rotation of the hip
59
HIP - FEMORAL ANTEVERSION
- The femur turns inwards causing the whole leg to turn in
60
HIP - FEMORAL ANTEVERSION - CAUSE
- Excessive anteversion of the femoral neck, so that the internal rotation of the hip is increased and external rotation is diminished.
61
HIP - FEMORAL ANTEVERSION - POPULATION AFFECTED
- Most evident in children 2-4
- Twice as common in girls than boys
62
HIP - FEMORAL ANTEVERSION - CLINICAL PRESENTATION
- When a child walks or runs, the feet turn inward instead of pointing straight ahead
- Usually sit on floor with knees facing each other – should be advised to sit with knees facing outwards
63
HIP - PYOGENIC ARTHRITIS
- Bacterial, viral or fungal infections - spreads through the bloodstream to a joint.
64
HIP - PYOGENIC ARTHRITIS - CAUSE
- Lining of your joints has little ability to protect itself from infection. Your body’s reaction to the infection — including inflammation that can increase pressure and reduce blood flow within the joint — contributes to the damage.
65
HIP - PYOGENIC ARTHRITIS - RISK FACTORS
- Children under 2
- Complication of joint surgery
- Diabetes mellitus
- Immunodeficiency
- Pre-existing joint disease, Rheumatoid arthritis
66
HIP - PYOGENIC ARTHRITIS - CLINICAL PRESENTATION
- Child is in pain and ill
- Hip movements resisted to total lack of ROM
- Aspiring pus from joint
- Severe joint pain, usually in just 1 joint, that started suddenly
- Swelling around a joint
- Skin around a joint has changed colour
- Pt feels generally unwell and have a high temperature or feel hot and shivery
67
HIP - RHEUMATOID ARTHRITIS
- Autoimmune disease.
- This means your immune system attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful.
68
HIP - RHEUMATOID ARTHRITIS - POPULATION AFFECTED
- Women more likely to get it than men
- Develops mainly 30-60
- 16-40 diagnosed as early onset RA
69
HIP - RHEUMATOID ARTHRITIS - CLINICAL PRESENTATION
- Usually, Pt has RA in many other joints
- Groin pain comes on subtly
- Limp common, may be as a result of knee or ankle RA too
- Wasting of buttock or thigh muscles, limb usually held in external rotation and fixed flexion
- Painful and restricted in all ROM
70
HIP - OSTEOARTHRITIS
- Most common non-traumatic disorder of the hip in the middle and late age
71
HIP - OSTEOARTHRITIS - CAUSE
- Usually no specific cause
72
HIP - OSTEOARTHRITIS - POPULATION AFFECTED
- <50
- In younger Ps (under 40) may appear as a sequel to childhood and adolescent disorders, such as coxa vera, perthes’ disease and Femoroacetabular impingement
73
HIP - OSTEOARTHRITIS - CLINICAL PRESENTATION
- Typically occurs after periods of activity
- Later becomes more constant and sometimes disturbs sleep
- Stiffness most notable after waking up
- Limp
- Limited ROM
74
HIP - FEMOROACETABULAR IMPINGEMENT
- Femoral head (ball of the hip) pinches up against the acetabulum (cup of the hip). When this happens, damage to the labrum (cartilage that surrounds the acetabulum) can occur, causing hip stiffness and pain, and can lead to arthritis.
75
HIP - FEMOROACETABULAR IMPINGEMENT - CAM
- Cam – deformity at femoral head/neck junction, an unusual degree of bony thickening causes jamming of femoral neck against front of acetabulum and abrasion of articular cartilage
76
HIP FEMOROACETABULAR IMPINGEMENT - PINCER
- Pincer – over-coverage of femoral head by anterior edge of acetabulum due to depth or retroversion of acetabular socket at a localised site. Hard acetabular margin abuts against the femoral head during movement causing degeneration of the acetabular labarum and adjacent articular cartilage
77
HIP - ILIOPECTINEAL BURSITIS
- Largest bursa in the region of the hip joint
78
HIP - ILIOPECTINEAL BURSITIS - CAUSE
- Trauma, osteoarthritis, rheumatoid arthritis, septic arthritis
79
HIP - ILIOPECTINEAL BURSITIS - CLINICAL PRESENTATION
- Pt may have radicular pain and edema from groin to anterior thigh as enlargement of the bursa can irritate or entrap the femoral nerve and vein.
80
HIP - TROCHANTERIC BURSITIS
- Inflammation of the bursa at the outside (lateral) point of the hip known as the greater trochanter
81
HIP - MERALGIA PARASTHETICA
- Disorder characterised by tingling, numbness, and burning pain in the outer side of the thigh - may intensify after walking.
82
HIP - MERALGIA PARASTHETICA - CAUSE
- Tight clothes, trauma
- Compression of the lateral femoral cutaneous nerve, a sensory nerve to the skin, as it exits the pelvis.
- Often under the inguinal ligament, which runs along your groin from your abdomen to your upper thigh.
83
HIP - MERALGIA PARASTHETICA - RISK FACTORS
- Obesity or weight gain
- Pregnancy
- Local trauma
- Diseases like diabetes
84
HIP - MERALGIA PARASTHETICA - CLINICAL PRESENTATION
- Patients may complain of pain, burning, numbness, muscle aches, coldness, lightning pain, or buzzing (like a cell phone) in their lateral or anterolateral thigh
85
HIP - PROTRUSIO ACETABULI
- Condition of the hip where there is medial displacement of the femoral head into the pelvis and the medial aspect of the femoral head lies medial to the ilioischial line.
86
HIP - PERTHES DISEASE
- Too little blood is supplied to the femoral head. Without enough blood, this bone becomes weak/dies off and fractures easily.
87
HIP - PERTHES DISEASE - POPULATION AFFECTED
- Childhood condition.
88
HIP - PERTHES DISEASE - CLINICAL PRESENTATION
- Complains of pain, starts to limp
- pain in the groin, the thigh or the knee - particularly after physical activity.
- They limp and have a restricted range of movement (stiffness) of the hip joint.
89
HIP - SLIPPED UPPER FEMORAL EPIPHYSIS
- Femoral head moves with respect to the rest of the femur.
- The head of the femur stays in the cup of the hip joint while the rest of the femur is shifted.
- If one side slips, 30% chance of other side slipping as well
90
HIP - SLIPPED UPPER FEMORAL EPIPHYSIS - CAUSE
- Trauma with an underlying abnormality
91
HIP - SLIPPED UPPER FEMORAL EPIPHYSIS - RISK FACTORS
- Obesity
- Unusually tall/rapid growth
92
HIP - THE IRRITABLE HIP
- Most common cause acute hip pain in children
- Hip joint becomes sore and inflamed.
93
HIP - THE IRRITABLE HIP - POPULATION AFFECTED
- 3-8 year olds, boys twice as likely to get it than girls
94
HIP - THE IRRITABLE HIP - CLINICAL PRESENTATION
- Pain around hip
- Often intermittent limp following activity
- Restriction of all movements with pain in all directions
- Symptoms usually last for 2-3 weeks and then go spontaneously
- Child may experience more than one episode
95
HIP - AROM - FLEXION - MUSCLES ACTIVATED
Iliopsoas
Rectus femoris
Sartorius
96
HIP - AROM - FLEXION - TISSUES STRETCHED
Gluteus maximus
Hamstrings
Sciatic nerve
97
HIP - AROM - FLEXION - TISSUES COMPRESSED
Anterior hip muscles
Anterior joint capsule
Inguinal ligament
Femoral artery
Femoral nerve
98
HIP - AROM - EXTENSION - MUSCLES ACTIVATED
Gluteus maximus
Hamstrings
99
HIP - AROM - EXTENSION - TISSUES STRETCHED
Iliopsoas
Rectus femoris
Sartorius
Anterior iliofemoral ligament and joint capsule
Femoral nerve
100
HIP - AROM - EXTENSION - TISSUES COMPRESSED
Posterior hip muscles
Posterior joint capsule
101
HIP - AROM - ABDUCTION - MUSCLES ACTIVATED
Gluteus medius
Gluteus minimus
Tensor fascia latae
102
HIP - AROM - ABDUCTION - TISSUES STRETCHED
Adductor Magnus
Gracilis
Adductor longus and brevis
Medial hip joint capsule
103
HIP - AROM - ABDUCTION - TISSUES COMPRESSED
Lateral hip structures (joint capsule, lateral acetabular labrum)
104
HIP - AROM - ADDUCTION - MUSCLES ACTIVATED
Adductor Magnus
Gracillis
Adductor brevis and longus
105
HIP - AROM - ADDUCTION - TISSUES STRETCHED
Gluteus medius and minimus
Tensor fascia latae
Iliotibial band
106
HIP - AROM - ADDUCTION - TISSUES COMPRESSED
Medial hip structures
107
HIP - AROM - EXTERNAL ROTATION - MUSCLES ACTIVATED
Piriformis
Quadratus femoris
Superior and inferior gemellus
Obturator internus and externus
108
HIP - AROM - EXTERNAL ROTATION - TISSUES STRETCHED
Tensor fascia latae
Gluteus medius and minimus
Anterior joint capsule
109
HIP - AROM - EXTERNAL ROTATION - TISSUES COMPRESSED
Posterior hip structures
110
HIP - AROM - INTERNAL ROTATION - MUSCLES ACTIVATED
Tensor fascia latae
Gluteus medius and minimus
111
HIP - AROM - INTERNAL ROTATION - TISSUES STRETCHED
Piriformis
Quadratus femoris
Superior and inferior gemellus
Obturator interns and externus
Posterior joint capsule
112
HIP - AROM - INTERNAL ROTATION - TISSUES COMPRESSED
Anterior joint capsule
113
GLUTEUS MAXIMUS - ORIGIN
Posterior iliac crest
Sacrum
Coccyx
Sacrotuberous ligament
114
GLUTEUS MAXIMUS - INSERTION
ITB
Gluteal tuberosity of femur
115
GLUTEUS MAXIMUS - ACTION
Extension and lateral rotation of hip
Abduction of hip (upper 1/3)
Adduction of hip (lower 2/3)
Posterior pelvic tilt
116
GLUTEUS MAXIMUS - INNERVATION
Inferior gluteal nerve (L5-S2)
117
GLUTEUS MAXIMUS - TRIGGER POINT REFERRAL
Adjacent to sacrum - refers pain to gluteal cleft, gluteal fold and SIJ
Superior to ischial tuberosity - refers pain to entire buttock
Medial inferior fibres - refer pain to coccyx and gluteal cleft
118
GLUTEUS MAXIMUS - STRETCH
Pull knee to chest
119
GLUTEUS MAXIMUS - STRENGTHEN
Squat
Kick back
Lunge
Step up
120
GLUTEUS MEDIUS - ORIGIN
Outer ilium (between anterior and posterior gluteal lines)
121
GLUTEUS MEDIUS - INSERTION
Greater trochanter (superior and lateral surface)
122
GLUTEUS MEDIUS - ACTION
Abduction of hip
Flexion and medial rotation of hip (anterior fibres)
Lateral rotation and extension of hip (posterior fibres)
123
GLUTEUS MEDIUS - INNERVATION
Superior gluteal nerve (L4-S1)
124
GLUTEUS MEDIUS - TRIGGER POINT REFERRAL
Near PSIS - refers pain to gluteal cleft, gluteal fold and SIJ
Mid iliac crest - refers pain to entire buttock and posterior proximal thigh
Lateral iliac crest - refer pain over sacrum, coccyx and gluteal cleft
125
GLUTEUS MEDIUS - STRETCH
Place one leg in front of other and adduct anterior thigh
126
GLUTEUS MEDIUS - STRENGTHEN
Resisted thigh abduction
Lunge
Side kicks
127
GLUTEUS MINIMUS - ORIGIN
Outer ilium (between anterior and inferior gluteal lines)
128
GLUTEUS MINIMUS - INSERTION
Greater trochanter (anterior surface)
129
GLUTEUS MINIMUS - ACTION
Abduction of hip
Medial rotation and flexion of hip (anterior fibres)
Lateral rotation and extension (posterior fibres)
130
GLUTEUS MINIMUS - INNERVATION
Superior gluteal nerve (L4-S1)
131
GLUTEUS MINIMUS - TRIGGER POINT REFERRAL
Anterior muscle - refers pain down lateral leg, thigh and medial buttock
Posterior muscle - refers pain down the posterior leg, thigh and medial buttock
132
GLUTEUS MINIMUS - STRETCH
Place one leg in front of other and adduct anterior thigh
133
GLUTEUS MINIMUS - STRENGTHEN
Resisted thigh abduction
Lunge
Side kicks
134
PIRIFORMIS - ORIGIN
Anterior sacrum
135
PIRIFORMIS - INSERTION
Greater trochanter (superiomedial surface)
136
PIRIFORMIS - ACTION
Lateral rotation of hip
Abduction of hip when thigh is flexed
137
PIRIFORMIS - INNERVATION
Nerve to piriformis (L5-S2)
138
PIRIFORMIS - TRIGGER POINT REFERRAL
Medial muscle - refers pain down posterior thigh and medial buttock
Lateral muscle - refers pain down posterior thigh and lateral buttock
139
PIRIFORMIS - STRETCH
Cross ankle of other leg over thigh and pull knee to chest
140
PIRIFORMIS - STRENGTHEN
Resisted thigh horizontal abduction with hip flexed
141
SUPERIOR GEMELLUS - ORIGIN
Ischial spine
142
INFERIOR GEMELLUS - ORIGIN
Ischial tuberosity
143
SUPERIOR AND INFERIOR GEMELLUS - INSERTION
Greater trochanter
144
SUPERIOR AND INFERIOR GEMELLUS - ACTION
External rotation of hip
Abduction of thigh when hip is flexed
145
SUPERIOR AND INFERIOR GEMELLUS - INNERVATION
Nerve to obturator internus (L5-S2)
146
SUPERIOR AND INFERIOR GEMELLUS - TRIGGER POINT REFERRAL
Gemellus superior - refers pain down posterior thigh and buttock
Gemellus inferior - refers pain down the buttock and upper posterior thigh
147
SUPERIOR AND INFERIOR GEMELLUS - STRETCH
Cross ankle of other leg over thigh and pull knee to chest
148
SUPERIOR AND INFERIOR GEMELLUS - STRENGTHEN
Resisted thigh horizontal abduction with hip flexed
149
OBTURATOR INTERNUS - ORIGIN
Obturator foramen
Obturator membrane
150
OBTURATOR INTERNUS - INSERTION
Greater trochanter
151
OBTURATOR INTERNUS - ACTION
Lateral rotation od hip
Abduction of thigh when hip is flexed
152
OBTURATOR INTERNUS - INNERVATION
Nerve to obturator internus (L5-S2)
153
OBTURATOR EXTERNUS - ORIGIN
Obturator foramen
Obturator membrane
154
OBTURATOR EXTERNUS - INSERTION
Trochanteric fossa of femur
155
OBTURATOR EXTERNUS - ACTION
External rotation of hip
156
OBTURATOR EXTERNUS - INNERVATION
Obturator nerve (L2-L4)
157
QUADRATUS FEMORIS - ORIGIN
Ischial tiberosity
158
QUADRATUS FEMORIS - INSERTION
Intertrochanteric crest of femur
159
QUADRATUS FEMORIS - ACTION
External rotation of hip
160
QUADRATUS FEMORIS - INNERVATION
Nerve to quadratus femoris (L4-S1)
161
QUADRATUS FEMORIS - TRIGGER POINT REFERRAL
Medial muscle - refers pain down buttock and upper posterior thigh
Lateral muscle - refers pain near the gluteal fold and upper posterior thigh
162
QUADRATUS FEMORIS - STRETCH
Cross ankle of other leg over thigh and pull knee to chest
163
QUADRATUS FEMORIS - STRENGTHEN
Resisted thigh horizontal abduction with hip flexed
164
PSOAS MAJOR AND MINOR - ORIGIN
TPs of L1-L5
Vertebral bodies of T12-L5
Intervening IVDs
165
PSOAS MAJOR AND MINOR - INSERTION
Lesser trochanter of femur
166
PSOAS MAJOR AND MINOR - ACTION
Flexion and external rotation of hip
Flexion and lateral flexion of spinal joints
167
PSOAS MAJOR AND MINOR - INNERVATION
Lumbar plexus ventral rami (L1-L3)
168
PSOAS MAJOR AND MINOR - TRIGGER POINT REFERRAL
Upper muscle - refers pain to posterior low back and upper medial buttock
Lower muscle - refers pain down anterior thigh and inguinal region
169
PSOAS MAJOR AND MINOR - STRETCH
While kneeling extend hip and tilt pelvis posteriorly
170
PSOAS MAJOR AND MINOR - STRENGTHEN
Resisted thigh flexion
Lying leg raise
Straight leg sit up
171
ILIACUS - ORIGIN
Inner surface of iliac fossa
Sacral ala
172
ILIACUS - INSERTION
Lesser trochanter of femur
173
ILIACUS - ACTION
Flexion and external rotation of hip joint
Anterior pelvic tilt
174
ILIACUS - INNERVATION
Femoral nerve (L2-L3)
175
ILIACUS - TRIGGER POINT REFERRAL
Refer pain to the anterior thigh and inguinal region
176
ILIACUS - STRETCH
While kneeling extend hip and tilt pelvis posteriorly
177
ILIACUS - STRENGTHEN
Resisted thigh flexion
Lying leg raise
Straight leg sit up
178
TENSOR FASCIA LATAE - ORIGIN
Anterior superior iliac spine (ASIS)
Anterior aspect of iliac crest
179
TENSOR FASCIA LATAE - INSERTION
ITB
180
TENSOR FASCIA LATAE - ACTION
Flexion, abduction and medial rotation of hip joint
Anterior pelvic tilt
Tenses ITB to support femur on tibia during standing
181
TENSOR FASCIA LATAE - INNERVATION
Superior gluteal nerve (L4-S1)
182
TENSOR FASCIA LATAE - TRIGGER POINT REFERRAL
Pain referred to hip joint and down the lateral thigh to the knee
183
TENSOR FASCIA LATAE - STRETCH
Extend, adduct and medially rotate thigh
184
TENSOR FASCIA LATAE - STRENGTHEN
Resisted abduction and flexion
Side lying leg raises
45 degree leg raises
Figure 8 in air with legs
185
PECTINEUS - ORIGIN
Pectineal line of pubis
186
PECTINEUS - INSERTION
Pectineal line of femur
187
PECTINEUS - ACTION
Adduction and flexion of hip
188
PECTINEUS - INNERVATION
Femoral nerve (L2-L3)
Obturator nerve (L2-L4)
189
PECTINEUS - TRIGGER POINT REFERRAL
Pain is referred over the groin and anterior proximal thigh
190
PECTINEUS - STRETCH
Lying supine, flex knees and touch soles of feet together and drop knees to the floor
Over pressure may be applied by hands
191
PECTINEUS - STRENGTHEN
Resisted thigh adduction
Thigh master
Leg raise (inferior leg)
192
ADDUCTOR LONGUS - ORIGIN
Anterior surface of pubis
193
ADDUCTOR LONGUS - INSERTION
Medial lip of linea aspera (proximal 1/3)
194
ADDUCTOR BREVIS - ORIGIN
Body and inferior ramus of pubis
195
ADDUCTOR BREVIS - INSERTION
Medial lip of linea aspera (middle 1/3)
196
ADDUCTOR LONGUS AND BREVIS - ACTION
Adduction and flexion of hip joint
197
ADDUCTOR LONGUS AND BREVIS - INNERVATION
Obturator nerve (L2-L4)
198
ADDUCTOR LONGUS AND BREVIS - TRIGGER POINT REFERRAL
Pain referred upward to the groin and down toward the medial knee and shin
199
ADDUCTOR LONGUS AND BREVIS - STRETCH
Seated, flex knees and touch soles of feet together
Over pressure may be applied by elbows
200
ADDUCTOR LONGUS AND BREVIS - STRENGTHEN
Resisted thigh adduction
Thigh master
Leg raise (inferior leg)
201
ADDUCTOR MAGNUS - ORIGIN
Anterior head (adductor part) - inferior pubic ramus and ischial ramus
Posterior head (hamstring part) - ischial tuberosity
202
ADDUCTOR MAGNUS - INSERTION
Anterior head - linea aspera
Posterior head - adductor tubercle of femur
203
ADDUCTOR MAGNUS - ACTION
Adduction and extension of hip
204
ADDUCTOR MAGNUS - INNERVATION
Anterior head - obturator nerve (L2-L4)
Posterior head - sciatic nerve, tibial division (L4-L5)
205
ADDUCTOR MAGNUS - TRIGGER POINT REFERRAL
Pain referred upward to the groin and down the medial thigh
206
ADDUCTOR MAGNUS - STRETCH
Seated, flex knees and touch soles of feet together
Over pressure may be applied by elbows
207
ADDUCTOR MAGNUS - STRENGTHEN
Resisted thigh adduction
Thigh master
Leg raise (inferior leg)
208
GRACILIS - ORIGIN
Body and inferior ramus of pubis
209
GRACILIS - INSERTION
Proximal anterior medial tibis (pes anserine)
210
GRACILIS - ACTION
Adduction and flexion of hip
Flexion and internal rotation of knee
211
GRACILIS - INNERVATION
Obturator nerve (L2-L4)
212
GRACILIS - TRIGGER POINT REFERRAL
Pain referred over the medial groin and thigh as far down as the knee
Pain often described as hot and stinging superficial pain
213
GRACILIS - STRETCH
Standing, abduct both thighs as if attempting to do the splits
214
GRACILIS - STRENGTHEN
Resisted thigh adduction
Thigh master
Leg raise (inferior leg)
