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EPHE 344 Athletic and Care Prevention > Hip & Groin > Flashcards

Hip & Groin Flashcards

1
Q

Sciatic nerve innervates ________

A

posterior thigh

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2
Q

Femoral nerve innervates _______

A

anterior thigh

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3
Q

obturator innervates ________

A

adductor group

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4
Q

how would you do an assessment of hip

A
  • history (any neural pain?)
  • observation (gait; walking, running)
  • assessment (flexion, extension, abduction, adduction, internal, external rotation)
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5
Q

injury prevention for hip and groin

A
  • protective equipment (thigh pads/girdles; athletic cups; neoprene braces/sleeves)
  • shoes (cushion forces)
  • physical conditioning (mm strength, endurance & flexbility)
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6
Q

true or false; hip sprains are very rare

A

true

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7
Q

potential acute hip and groin injuries

A
  • contusions
  • myositis ossificans
  • strains (quadriceps, hamstring, adductor, groin, hip flexor)
  • sprains (RARE)
  • fractures (femoral)
  • hip dislocation
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8
Q

potential chronic/overuse injuries for hip and groin

A

femoral stress fracture

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9
Q

contusions - quad - etiology

A
  • exposed to blunt trauma
  • contusions usually develop as a result of severe impact & resultant muscular compression
  • extent of force and degree of thigh relaxation determine depth and functional disruption that occurs
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10
Q

1st degree contusion

A
  • little or no pain
  • mild hemorrhaging
  • no swelling
  • mild point tenderness
  • no disability in ROM
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11
Q

2nd degree contusion

A
  • mild pain
  • mild swelling
  • mild to moderate hemorrhaging
  • mild point tenderness
  • mild disability
  • limping
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12
Q

3rd degree contusion

A
  • moderate pain
  • moderate swelling
  • moderate disability
  • obvious limping
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13
Q

4th degree contusion

A
  • severe pain
  • severe swelling
  • severe disability
  • potential mm herniation
  • obvious limp or unable to weight bear
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14
Q

S&S contusions - quad

A
  • localized pain, bleeding, swelling & temporary loss of function - weakness (extending or flexing knee) ; graded 1-4 superficial to deep
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15
Q

management of contusions - quad

A
  • POLICE
  • NSAIDS
  • ROM and stretching ex
  • protect upon return to play
  • no massage or heat initially
  • recommended during rehab
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16
Q

myositis ossificans - etiology

A
  • formation of ectopic bone following direct blow, repeated blunt trauma, or improper care of thigh contusion
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17
Q

S&S myositis ossificans

A
  • pain, weakness, swelling, point tenderness, decreased ROM & function
  • X ray shows deposits 2-6 weeks following
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18
Q

management of myositis ossificans

A
  • manage conservatively
  • regain ROM
  • physician referral
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19
Q

contusions - hip pointer - etiology

A
  • direct blow to iliac crest or abdominal musculature
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20
Q

S&S contusions - hip pointer

A
  • pain
  • spasm
  • swelling
  • transitory paralysis of soft structures
  • decreased rotation of trunk or thigh/hip flexion
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21
Q

hip pointer - contusion - management

A
  • POLICE for 48 hours
  • ice massage
  • protection upon RTP
  • may need physician referral to rule out fracture
22
Q

1st degree strain

A
  • limited swelling and tightness
  • near normal gait
  • mild point tenderness & discomfort during palpation
  • soreness during movement
  • < 20% fibers torn
23
Q

2nd degree strain

A
  • pain and swelling noted on palpation
  • may note on palpable divot
  • pain with resisted mm testing
  • limping
  • mm spasms
  • <70% of fibers torn
24
Q

3rd degree strain

A
  • rupturing tendinous or mm tissue
  • major hemorrhage & edema
  • major disability and loss of function
  • pain and palpable defect or mass
  • > 70% fibers torn
25
Q

quadriceps strain - etiology

A
  • suddens tretch, or violent forceful contraction of hip and knee into flexion or knee flexion with hip in extension
26
Q

S&S quad strain

A
  • pain
  • spasm
  • swelling and delayed bruising
  • loss of function
  • decrease ROM
  • decrease strength of extensors
27
Q

quad strain - management

A
  • POLICE
  • crutches and wrap
  • later use of sleeve
  • progress to pain free ROM, isometrics, and stretching
  • may require 12 weeks RTP
28
Q

hip flexor strain etiology

A
  • sudden overstretch into hyperextension
29
Q

S&S hip flexor strain

A
  • pain, swelling, delayed bruising and disability

- decrease ROM and extensor strength

30
Q

management hip flexor strain

A
  • POLICE
  • crutches and hip spica wrap
  • note direction of pull
31
Q

ham strain etiology

A
  • eccentric load in hip flexion and knee extension
  • sudden explosive contraction or direction change/acceleration/decceleration
  • other factors: fatigue, posture, leg length discrepancy, imbalances, ham dominance, mm tightness
32
Q

S&S ham strain

A
  • pain, swelling, delayed bruising, spasms, loss of range and function
33
Q

management - ham strain

A
  • POLICE
  • crutch
  • wrap
  • conservative treatment with gradual ROM and strengthening
34
Q

adductor strain - etiology

A
  • overstretch into abduction
  • abduction, and external rotation and hip extension
  • running, jumping, twisting w/ ER
35
Q

management - adductor strain

A
  • POLICE
  • rest is key
  • hip spica wrap
36
Q

legg-calve perthes disease

A
  • affects 10-17 / boys>girls

- disrupts circulation to femoral head -> necrosis

37
Q

Slipped capital femoral epiphysis

A
  • affects 10-17 boys > girls; idiopathic

- often those very tall and thin or obese

38
Q

S&S LCP; SCFE

A
  • groin pain associated with a trauma (25% of time) or slow onset over weeks/months as a result of stress; limited range and limp
39
Q

LCP may refer into the ______ or ______

A

abdomen or knee

40
Q

hip dislocation - etiology

A
  • rare in sports

- posterior dislocation when traumatic force applied along long axis of femur (eg., seated)

41
Q

S&S hip dislocation

A
  • flexed, adducted, and internally rotated thigh

- deformity, pain, mm spasms, neurological issues

42
Q

management hip dislocation

A
  • call 911 ; immediate medical care (blood and nerve supply may be compromised)
  • immobilization and crutch use
43
Q

femoral fracture - etiology

A
  • significant trauma; fall from height
  • direct blow
  • avascular necrosis
44
Q

S&S femoral fracture

A
  • swelling
  • pain
  • deformity (shorter appearance)
  • mm guarding
  • hip slight adduction and ER
45
Q

femoral fracture - management

A
  • call 911
  • treat for shock
  • verify neurovascular status and vitals
  • splint before moving
46
Q

femoral stress fracture - etiology

A
  • overuse (10-25% of all stress fractures)
  • endurance athletes; excessive downhill running or jumping activities
  • female athlete triad
47
Q

S&S femoral stress fracture

A
  • persistent pain in thigh/groin;
  • antalgic gait (ie., limp) which increases during activity
  • loss of glut medius stabilization
48
Q

management of femoral stress fracture

A
  • prognosis will vary depending on location (femoral neck vs shaft)
49
Q

osteitis pubus - etiology

A
  • repetitive stress on pubic symphysis and adjacent mm

- seen in distance runners, soccer, football, and wrestling

50
Q

S&S osteitis pubis

A
  • pain in groin, and pubic symphysis
  • point tenderness
  • pain with running
  • sit ups and squats pain
51
Q

management of osteitis pubis

A
  • rest, NSAID

- gradual RTP

52
Q

true or false; joint mobilization must be done passively

A

false; can be done actively

EPHE 344 Athletic and Care Prevention (17 decks)

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