hip Flashcards
neural origin
Steps:
1. Ask patient to do painful movement and flexion
2. Then physio puts head of patient looking forward if it stops hurting during flexion = hip
If flex increases symptoms = neural
If extension decreases symptoms = neural
hip origin supine examination for flexion
pain in flexion
1. For anterior pelvic rotation:
1. Patient lays on their back
1. Put leg on your shoulder
1. Put one hand on their posterior superior iliac spine
1. The other hand on their iliac crest
1. Rotate hip anteriorly : flexion
If symptoms increase = hip problem
hip origin supine examination in extension
posterior pelvic rotation: pain in extension
1. Patient lays on their back
1. Put leg on your shoulder
1. Put R hand on their posterior superior iliac spine
1. L hand directly on their anterior superior iliac spine / iliac crest
1. Rotate hip posteriorly
If symptoms decrease = hip problem
hip origin bidepal examination
- Patient stands up
- Physio puts one hand around the front of their hip holding their EIAS
- Other hand pinching the sacroiliac joint so that there is no movement
- Patient does painful extension movement with hands crossed in their chest with their head a little back
- While extension they bend one knee and then the other knee → because this decreases stress on the hip
If symptoms decrease = hip problem
hip origin prone examination
- Patient lays on their stomach
- Depending on leg physio stands on OPPOSITE SIDE
- One hand by the knee anteriorly - end of femur
- One hand on the femur below the gluteal line
- Patient performs extension of hip - one leg up
- Physio performs PA
If symptoms increase = hip problem
Lumbar back origin bipedal hypothesis:
- Patient stands up and does painful extension
- Put one hand around their anterior hip (waist) and hold hand in their iliac crest for no movement
- Do PA with every lumbar vertebrae
- When pain increases more on one vertebrae than you know which one it is and know that it is not hip origin
lumbar back origin prone examination
- Patient lays on their stomach
- Depending on leg physio stands on OPPOSITE SIDE
- One hand on the lower limb - end of femur (knee)
- Other hand on spinous process of lumbar vertebrates
- During hip extension perform PA on lx spinae
- This increases stress on Lx vertebrates
If pain increases = lumbar hypothesis
sacroiliac joint hypothesis origin prone test
- Patient lays on their stomach
- Depending on leg physio stands on OPPOSITE SIDE
- One hand on the lower limb
- One hand on the sacrum
- Physio performs PA on sacrum while patient does hip extension
- This increases stress on SIJ
If pain increases = SIJ problem
Accessory movement: medial & lateral transversal gliding neutral position
- for checking joint mobility and capsule
- lateral glide
Accessory movement: AP gliding
- for int/ ext rotation
- anterior / posterior joint
Accessory movement: longitudinal gliding
- taking the femur out of the capsule
- for ligament laxity, capsule restriction
Accessory movement: medial & lateral transversal gliding flexed hip
rotate and pull it
accesory movement: AP gliding flexed hip position
- put leg under patients leg
- keep paients leg at 90 degrees
- put hand on top of your knee and under the knee of the patient as buffer
- put hand on tibia and push down
- AP
scooping test
- hip mobilization test
1. create flexion with bent knee as much as possible (knee to chest)
2. move in circular manner multiple times (4-5)
3. add a little bit of compression if pain is not too strong
3. reasses movement and pain after technique
aim: increase ROM and decrease pain
thomas test - steps, muscles involved
- patient lies on the end of the table md raises one leg in flared hip position
- drop the leg and do the same with other leg
- do multiple times and compair both sides
- the side that is more horizontal and less elevated is tighter
muscles involved:
* rectus femoris = knee extension
* TFL (enscofaciallate) = hip abd, leg abd
* psoas = hip flexion, hip elevation
piriformis test
- lays prone position
- 90 degree flexed knee
- patient drops legs outwards (internal hip rotation)
- compare both sides –> side that is closer to midline of body has less ROM of internal hip rotation
joint flexion of hip degrees
120-140
joint extension of hip degrees
20-30
joint abduction of hip degrees
outwards
45-50
joint adduction of hip degrees
inwards
20
joint IR of hip degrees
IR of hip = outwards roation of leg
30
joint ER of hip degrees
EX of hip = IR of leg
50
goniometer flexion
- Patient lays on back with goniometer on the greater trochanter, goniometer =90
- Patient flexes knee towards chest
- Move goniometer with leg and measure
degrees = 120-140
goniometer extension
- Patient lays on stomach with goniometer on greater trochanter = 90 degrees
- Patient extends leg upwards keeping it straight
- Goniometer moves with leg and measure
degrees= 20-30
gonimeter abduction
Patient lays on back goniometer on ASIS of hip and leg = 90 degrees
Patient moves leg outwards
Goniometer moves = 45-50
goniometer adduction
- Patient lays on back with legs in neutral position goniometer on the ASIS of hip and leg = 90
- Patient moves leg inwards
= 20-30 deg
gonometer ER
- Patient sits with their back straight and feet dangling
- Goniometer over the center of the ball and socket joint = 90 degrees
- Patient moves leg inwards FOR ER OF HIP
- Goniometer measures movement
= 35
gonometer IR
- Patient sits with their back straight and feet dangling
- Goniometer over the center of the ball and socket joint = 90 degrees
- Patient moves leg outwards FOR IR OF HIP
- Goniometer measures movement
= 45 deg
