Hip assessment and treatment

Question 1

What is the most important combination of movements to restore gait?

Answer 1

Extension abduction and medial rotation

Question 2

What is the position the patient is in to test Glut Max strength?

Answer 2

In prone + hip extension + lateral rotation with knee flexed

Question 3

What is the position the patient is in to test hamstrings strength?

Answer 3

Resist hip extension with or without knee flexion in hip flexion

Question 4

What is the position the patient is in to test TFL strength?

Answer 4

Hip flexion abduction and medial rotation

Question 5

What is the position the patient is in to test Glut Med posterior fibers strength?

Answer 5

Hip abduction/ extension/ lateral rotation

Question 6

What is the position the patient is in to test Iliopsoas strength?

Answer 6

Hip flexion
Abduction
Lateral rotation
Sitting or lying

Question 7

What is the position the patient is in to test Rectus Femoris strength?

Answer 7

Hip flexion

Knee extension with hip and knee flexed

Question 8

What is the position the patient is in to test Pectineus strength?

Answer 8

Hip flexion and adduction in sitting

e.g. crossing legs

Question 9

What is the position the patient is in to test adductor L and B strength?

Answer 9

Hip adduction in supine or side lying

Question 10

What is the position the patient is in to test medial and lateral rotators strength?

Answer 10

test in flexion and extension
or
0 and 90 degrees of hip flexion

Question 11

When is considered a positive test for the SLR?

Answer 11

It is considered a positive test when pain/ change in sensation is felt within the first 30 degrees

Question 12

What does the prone knee bending test evaluate?

Answer 12

It stretches the femoral nerve and tests for upper lumbar disc herniations

Question 13

What position is the femoral neck in when someone is pigeon toed?

Answer 13

Anteversion

Question 14

What position is the femoral neck in when someone is duck footed?

Answer 14

Retroversion

Question 15

What is the most common problem at the hip?

Answer 15

Osteoarthrosis: the process of degeneration

Question 16

Describe Primary OA.

Answer 16

The cartilage wears away because one spot is taking more than its share of load. This may be due to joint alignment and decreased ROM.

Question 17

Why is OA so common in the hip?

Answer 17

Obesity and increased weight bearing

Question 18

Hip joint has 2 compressive load peaks during walking, what are they? How does DJD affect this?

Answer 18

One in midstance and the other later at push off
DJD causes tight capsule and therefore slack is taken up sooner in extn and the 1st and 2nd loads are simultaneous which cause wearing and cartilage failure.

Question 19

A person comes in with slight decrease in ROM in their hip. The hip is the stiffest in the morning and evening. It is achy pain at night. They also are experiencing LBP. What is the most likely diagnosis and what is the treatment?

Answer 19

Early OA

Education: avoid compressive loads and keep moving, lose weight
Manual therapy: Passive stretches, quadrants, tractions, large amplitude oscillations
Exercise: Lumbar stabilization exercises before hip strengthening or stretching. Gluteal strengthening. NWB aerobic exercise
Other: SWD, walking sticks

Question 20

What is Anterior Femoral Glide Syndrome?

Answer 20

Femoral head is in the anterior part of the joint.
Capsule is stretched out
Posterior muscles are weak or stretched
Femoral Acetabular impingement

Question 21

What is a common history for people with AFGS?

Answer 21

They often have a history of running or dancing

Excessive stretching into extension and lateral rotation

Question 22

Symptoms of AFGS.

Answer 22

Groin pain especially with hip flexion

Question 23

What are the muscle imbalances associated with AFGS?

Answer 23

TFL dominant over psoas
Psoas lengthened and weak
TFL dominant over post glut med
Hams dominant over glut max