Lab - Hip/ Groin Injuries Flashcards
Groin strain - mscs affected?
Iliopsoas
Rectus Femoris
Adductors
Groin Strain MOI?
trauma
Overuse
Sudden acceleration/ deceleration
Sudden Rotation
Management of a groin strain?
POLICE
NSAID’s
Later on physic
Gentle Stretch
Gentle Active Assisted ROM
IFC
Tensor wrap (Hip spica)
Core Shorts
Trochanter Bursitis?
Inflammation at site where glute med inserts or TFL passes over greater trochanter
Test glute med strength (resisted abd)
Test TFL/ IT band tightness
MOI of Trochanteric Bursitis?
LLD
msc imbalance
faulty running form
training errors
Foot biomechanics
S&S of Trochanteric Bursitis?
- Tender on Palpation (TOP) over greater trochanter
- Pain over lateral hip - may radiate to knee
- possible limp
Management of Trochanteric Bursitis?
PRICE
NSAID’s
Physio
Progressive exercises for abd and ER
MOI of Hip Sprains?
Violent twist
Impact force
Foot planted w/ twist
S&S of Hip sprain?
No circumduction of thigh
Pain in hip
Rotation increase pain
Management of Hip sprain?
x-rays
Doc referral
POLICE
NSAID’s
Dislocated hip facts?
Rare
Can be anterior or posterior
S&S of hip DL?
High pain + spasms w/ mvm
Leg is held in guarded position (flex/ add/ IR)
Management of Hip DL?
EAP
treat for shock
Complications w/ Hip DL?
Sciatic nerve. palsy
Disrupts blood flow to femur –> avascular necrosis
Osteoarthritis later in life
Avascular necrosis?
Head of femur die due to decreased blood supply
Causes of AvNc?
- disolocation/ fracture
- ETOH use
- Steroids
- Blood coagulation DOs
- Increased pressure w/in bone
S&S of AvNc?
Pain w/ weight bearing
Increased w/ AROM, PROM, RROM
Gradual pain onset
Management of AvNc?
Doc referral
xray, MRI, CT scan
Surgery
What is Legg-Calve-Perthes disease (LCP)?
avascular necrosis of femoral head = bone dies and flattens
Kids age 4-10
Boys > girls
Or Osteochondrosis
S&S of Legg-Calve-Perthes disease?
Groin pain –> abdomen +/- knee pain and limping
Management of Legg-Calve-Perthes disease?
Doc referral
- if treated in time, head of femur can reossify and revascularize
- If not treated early enough, head of femur can be poorly shaped and lead to OA later
What is Slipped Capital Femoral Epiphysis (SCFE)?
The head of the femur slips down posteriorly off the femoral neck at the growth plate
- Boys>girls
10-17
Tall/ thin or obese
Sometimes during rapid growth period
S&S of a Slipped Capital Femoral Epiphysis (SCFE)?
Groin pain
Decreased hip abduction, flex, IR
Limp
Management of a Slipped Capital Femoral Epiphysis (SCFE)?
Doc referral
- minor slip = rest, nonwb to prevent further
- Major displacement = corrective surgery
What is snapping hip Syndrome?
Habitual mvm that causes msc imbalances
girls > boys
Stability decreases due to loose ligs. and capsule and/ or adductors
Hear/ feel snap when balanced on 1 leg
Management of snapping hip Syndrome?
Stretch what’s tight and strengthen what’s weak
Physio
What is a Hip Pointer?
Contusion
Trauma to iliac crest (fall or blow)
B/c of improperly protected Iliac crest
S&S of a Hip Pointer?
TOP
Pain w/ use of abdominal mscs
Management of a Hip Pointer?
POLICE
Dr. -> xray to rule out fracture
Physio
What is Osteitis Pubis?
Inflammation of the pubic symphysis
Repetitive strain of msc attachment into bone
S&S of Osteitis Pubis?
Pain in groin/ pubis symphysis
TOP over pubic tubercle
Pain w/ sit-ups, running, squats
Management of Osteitis Pubis?
POLICE
Dr. referral to rule out hernia or stress #
What is Athletic Pubalgia (Sports Hernia)?
Sudden explosive force on the pelvis from opposite msc groups results in a tear
Inguinal area pain
Pain at attachment of internal/ external obliques, rectus abdominus, and transverse abdominus (conjoint tendon)
S&S of Athletic Pubalgia (Sports Hernia)?
Burning/ sharp. localized pain in inguinal area -> radiates to adductors and testicles
TOP over pubic tubercle
Management of Athletic Pubalgia (Sports Hernia)?
Physio
Dr. referral –> potential surgery
Pelvic Stress #?
Potential sites include the
- Inferior pubic ramus
- femoral neck
- subtrochanteric area of femur
S&S of Pelvic Stress #?
Groin pain
Radiating ache into thigh
Persistent pain/ night pain
Unable to do single leg stand
Management of Pelvic Stress #?
Dr. referral
xray, bone scan
Rest (2-5 months)
What is an Apophysis?
Bony outgrowth where msc attaches
3 Common Areas
- ischial tuberosisty (hamstrings)
- AIIS ((rectus femoris)
- ASIS (sartorius)
MOI for Avulsion #?
Usually sudden acceleration or deceleration
S&S of Pelvic Avulsion
- sudden , sharp localized pain at specific site
- Resisted msc testing = lots of pain due to pull on attachment site
Management of Pelvic Avulsion #?
POLICE
Dr. referral
xray
NWB for 6-8 weeks
Need full healing
Use pool
Painfree/ gentle stretching
