Hip conditions Flashcards
Intra-articular hip problems
Femoral acetabular impingement
Microinstability
Dysplasia
Osteoarthritis
Stress fracture
Extra-articular hip problems
Greater trochanteric pain syndrome (GTPS)
Proximal hamstring
Iliopsoas injuries
Adductor injuries
Athletic pubalgia/core injuries (combined pathology)
Piriformis syndrome
Femoral Neck Stress Fractures Conservative management of confirmed FNSFs requires immediate what
weight bearing restriction in order to prevent further fracture progression or compromised bony stability
for Femoral Neck Stress Fractures Conservative how long to WB restrictions normally last
6 to 8 weeks
Up to 14 weeks in slower-healing cases
Caution with what kind of activities with FNSF
supine and side-lying because they may place tensile forces on the femoral neck
when can activity be progressed from NWB in FNSF’s
progressed when there is radiographic evidence of fracture union and related improvement in functional activity tolerance
Uncomplicated compression side FNSFs fractures can typically return to running and athletic activity around
12 weeks
Complicated, and slow-healing cases have reported return-to-sport time frames up to
28 weeks
what muscle should be emphasized in FNSF pt
Gluteus medius
due to the effect of this muscle on frontal plane hip and pelvic stabilization
what is a key component in return to sport and late stage rehab for FNSF
determining the tissues tolerance to increased loading
increased endurance
motor control in a more demanding eviroment
GTPS Rehabilitation currently
strengthening and motor control to minimize compressive forces and excessive friction at the trochanteric region
strengthening in GTPS
Graded and progressive strengthening
Motor control in GTPS
Minimize valgus collapse
Minimize Trendelenburg tendencies
GTPS Patient should avoid
Sitting with legs crossed
Leaning towards one side in standing
Crossing legs while standing
GTPS -Supine positioning with legs in slight adduction is recommended
in those with severe symptoms as there is no or very low compression of gluteal tendons.
GTPS - Side lying with the affected leg on top has been shown to
to create high levels of compression in the trochanteric region.
This position should be modified to include a pillow between knees to reduce adduction of thigh, decreasing amount of compression.
what is the main concern with proximal hamstring injury
Re-injury is primary concern
Early treatment with proximal hamstring injury
Protect scar development while avoiding adhesion development: rest/modification , PROM
Manual therapy: commonly utilized as acuity decreases, weak evidence
Minimize atrophy: submaximal isometrics, AROM
Proximal Hamstring Injury Criteria for progression from early treatment
Full PROM and AROM of hip and knee
Symmetrical gait pattern
Tolerance to therapeutic activities
