Lab 5: Hip Exam and Intervention Flashcards
if you move your back and your hip hurts
if you move your hip and your back hurts
back issue
hip issue
if LBP is related to the hip pain
treat the LBP first (treat PROXIMALLY)
When you were a child…
do you remember if you were ever braced? had any surgeries? any dysplasia?
hip questions to ask
any clicking/popping/locking that’s painful?
(older) any morning stiffness? does it get better or worse as you move?
any recent surgery?
after pt performs a double limb squat and it’s positive (compensatory patterns, etc.), PT will:
confrim hip joint dysfunction by measuring ROM (goni)
functional tests
double limb squat
SLS
SL SQUAT
Trendelenberg (CL hip drop)
have pt demo any additional activities that typcially increas SX
hip flexion and extension AROM
F: 110-120
E: 10-15
hip Ab and ADD
ABD: 30-50
ADD: 25-30
hip IR and ER
IR: 30-40
ER: 40-60
Hip ROM needed for functional task
SLIDE 22 MEMORIZE!!
MMT of the hip:
start in supine with neutral pelvis. progress to sidelying or prone as needed.
do overpressure for WNL AROM, do PROM when AROM is not WNL.
joint play assessment
- long axis distraction
- lateral traction
- postero-inferior glide
- anterior glide
long axis distraction target tissue
overall capsule
assess 3x for hypomobility / pain
posterior inferior glide target tissue
inferior/posterior capsule
“down and out” force
anterior glide
modified prone (for lumbar pain) or prone
target anterior capsule
hand right below isch tubs
position of the hip in joint play assessment
open pack!
30 flexion
30 abd
slight ER
labral pathology tests (progressive)
- impingement
- hip quadrant
- hip scour
- fitzgeral test
- FABER / Patrick
GM tear/weakness tests
trendelenberg
MMT for glut med / PGM
which test is testing for FAI?
impingement test: FADIR
(PROM; + with increased hip / groin pain)
what is the hip quadrant test
“FADIR to FABER”
also tests for a FAI
+ test: ROS at hip with groin or clicking sensation
hip scour test tests for:
FAI, Labral tear, Acetabular dysfunction
describe the hip scour test
PT moves leg from combination of
flexion/add/IR
to
flexion/abd/ER
WITH A COMPRESSIVE FORCE
(+) test if sx occur
fitzgeral test is for
anterior labral tear
describe the fitzgerald test
PT passively moves hip from
full FABER
to
adduction, IR, and extension (below table)
(+) test is pain with or without clicking sound
this tests for impingement, SIJ dysfunction, or capsular tightness
FABER/Patrick
T/F: anterior pain during FABER/Patrick test indicates SIJ dysfunction
FALSE (SIJ will only be posterior pelvis/buttock pain)
hip will most likely be anterior hip pain, but can still be posterior.
recap: list the progressive hip impingement exams in order
- impingement (FADIR)
- hip quadrant (FADIR –> FABER)
- Scour (forceful)
- Fitzgerald (ant labral tear –> FABER to add, ir, and extension)
- FABER/Patrick
which test is looking for femoral anteversion/retroversion?
Craig’s Test
when do you measure ROM during the Craig’s test?
when the greater trochanter is parallel to the examining table
what is normal (aka anteversion)?
what is excessive anteversion?
what is retroversion?
normal: 10-15
anteversion: >15
retroversion: <10
if you suspect a hip or femur fracture
perform patellar-pubic percussion test
(+) test = diminished sound on involved side
ALTMAN’S criteria for Hip OA
- hip pain
- morning stiffness up to 60 min
- > 50 y/o
- painful IR
- IR <15 degrees
