Hip Treatment Flashcards
Physiologic Mobs for the HIP Final/Practical
Physiologic Mobs for the HIP
HIP Ext, Hip, Flex, Hip rotations in supine
Hip Ir/ER
Scouring/Quadrant
Accessory Mobs
Longitudinal Distraction Lateral Distraction Inferior Glide Anterior Glide Medial Glide
Mobilization with movement
Flexion
Internal Rotation
Soft Tissue Mobilization
Psoas
Piriformis
Acute Phase Intervention PRICEMEM
Protection Rice Ice Compression Elevation Manual Therapy Early Motion Medication
GOALS: Protection of injury site – Restoration of pain-free ROM (entire kinetic chain) – Improve pt comfort by decr. p! & inflammation – Retard muscle atrophy – Decr. detrimental effects of immob. & activity restriction – Maintain general fitness – Independence with HEP
INTERVENTION: Functional Phase
Attain full ROM (pain free) Restore normal joint kinematics Improve muscle strength to WNL Improve neuromuscular control Restore normal muscle force couple relationships
Grades 1-2 Hip Flexion
Treats pain in EXT
Pt: Position supine with hip/knee flexed
PT Position: gripping post area of distal femur popliteal fossa and balancing lower leg on forearm or shoulder
Directions: perform movement of flex, flex + ADD, flex + ABD (can block with pillow)
Physiologic Hip Extension
Grades I & II
• Treats: pain in flex
• Pt position: supine with legs extended
• PT position: gripping the med & lat side of
distal femur
• Directions: slightly flex & ext hip using table as
a block
Hip Rotations in Supine
Grade I & II
Grades I-II
• Treats: pain
• Pt position: supine with femur over PT’s thigh
• PT position: head hand over distal femur; foot
hand over prox tibia
• Directions: gently rotate thigh med & lat
IR/ER in prone
Grades III & IV
• Treats: facilitates incr in IR/ER ROM
• Pt position: prone with involved knee flexed 90°
• PT position: head hand gripping ankle; foot hand
stabilizing under knee
• Directions: IR: using arm of foot hand as block,
move leg in direction of IR; ER: reaching from
contralateral side, move leg in direction of ER
Scouring/Quadrant Grades III & IV 3 patterns. 1. Radiant 2. Angular 3. Rounded (curved)
Grades III-IV
• Treats: flex, ADD, with or without IR/ER
• Pt position: supine
• Directions: flex & adduct hip to near end of
ROM; move pt’s knee forward into > flex &
add to barrier – leg can be moved in arc of
motion to barrier or perpendicularly into &
away from the barrier
Compression not needed at first. Add compression after you find if not compressive force causes pain or not. Compressive force not needed of pain without compression
Longitudinal Distraction
Grades I
Treats: pain control
pt. position: supine with pillow under the knees
PT position gripping distal femur
Directions: pull thigh inferiorly (not much movement will be visible)
**Traction force can also be appllied to the ankle to obtain a more global distraction
Lateral Distraction
Grades III & IV
Treats: general mobility, general capsule stretch
Lateral Distraction Method 1
Pt. Position: supine with hip/knee flexed 90’
PT position Method: with shoulder against the lateral side of the pt’s knee, grip around the prox thigh medially take up soft tissue slack and pull back
Lateral distraction Method 2
Pt position: supine with hip/knee flexed 90’
PT position: with belt
both hands on lateral side of patients knee, belt placed around PT’s pelvis and pt’s proximal thigh
Directions with belt: use pelvis to lean back with body weight while using hands to stabilize LE
