Lecture 8 Flashcards
Plica
-piece of fibrous tissue extending from the joint capsule that is supposed to reabsorb during development
-can sometimes mimic a meniscus injury
Key structures of hip and pelvis
-iliac crest
-anterior superior iliac spine
-anterior inferior iliac spine
-posterior iliac spine
-ischial tuberosity
-pubic symphysis
-hip joint and articular cartilage `
External obliques origin
-outer surface of ribs 5-12
External obliques insertion
-inferiorly onto anterior 1/2 of iliac crest and medially onto linea alna
External obliques action
-trunk rotation
-flexion
-side bending
-compresses abdominal viscera
What are the hip flexors
-psoas
-iliacus
-sartorius
-pectineus
-tensor fascia latae
Origin of rectus femoris
-AIIS
What is the only quad muscle that does hip flexion
-rectus femoris
What is the common insertion of all quad muscles
-via quad tendon into patella
What are the adductors
-pectineus
-adductor longus
-adductor magnus
-adductor brevis
-gracilis
Origin of sartorius
-ASIS
Insertion of sartorius
-medial aspect of proximal tibia
Acetabular labrum
-fibrous cartilage
-rims the acetabulum
-deepens the socket
-increases stability of joint
Blood supply of labrum
-base that attaches to bone has some capacity to heal from blood supply to bone
-free edge has limited blood supply so doesnt heal well
What is a hip pointer
-contusion of the iliac crest
-periosteum has lots of sensory nerves
Hip pointer MOI
-blunt trauma to iliac crest
Hip pointer signs and symptoms
-severe pain with trunk flexion, rotation, side bending or hip flexion
-bruising and swelling over iliac crest
-muscle spasm
Other structures affected in hip pointer
-external obliques
-TFL
Extra symptoms of hip pointer
-pain with forced exhalation
-pain with bowel movement
Acute management of hip pointer
-PIER
-lymph drainage to settle spasm
-donut pad for RTP
Acetabular labral tears MOI
-acute plant and twist
-hyperabduction
-overuse and degeneration
Acetabular labral tears signs and symptoms
-pain
-clicking/catching
-decreased hip ROM
-audible pop/sensation
Special test for acetabular labral tear
-scouring test
C sign for acetabular labral tear
-if someone cups this area it may be because they have this injury
Acute management of acetabular labral tear
-ice
-rest
-pain management
-correct mechanics
-proprioception
-refer for surgery if conservative treatment isnt working
Scouring test pros and cons
-highly sensitive
-lacks specificity
What can scouring test look for
-hip labrum tears
-capsulitis
-osteochondral defects
-acetabular defects
-osteoarthritis
-avascular necrosis
-femoral acetabular impingement syndrome
What is femoral acetabular impingement syndrome
-irregular shape of one or both joint surfaces leading to labrum/cartilage tears
ITB friction syndrome MOI
-ITB friction over lateral femoral condyle 2 degrees to biomech causes
-overuse condition from friction over lateral femoral condyle
What sports are ITB friction syndrome common in
-running or cycling
Acute management of ITB friction syndrome
-PIER
-treat inflammation
-check footwear and wear patterns
-biomech assessment
-winter walking is a common factor
Hip flexor tendonitis MOI
-overuse
-repetitive flexion
What sports are hip flexor tendonitis common in
-cyclists
-runners
-dancers
-gymnasts
Hip flexor tendonitis signs and symptoms
-pain with active and resisted hip flexion
-stretch pain with passive hip extension
-TOP affected tendon
Acute management of hip flexor tendonitis
-ice
-rest/altered activity
-correct mechanics in sport
-hip flexor wrap
Strains of the hip and thigh
-hip flexors
-quads
-hamstrings
-adductors
Hip flexor strain MOI
-forceful hip flexion
-leg caught in hip extension
Quad strain MOI
-forceful quad contraction
-hip extension with knee flexion
Hamstring strain MOI
-excessive hip flexion with extended knee
-in sprinting: eccentric hams contraction in late stance phase
Adductors strain MOI
-quick cutting
-spits type motion
Signs and symptoms of hip and thigh strains
-pull or pop sensation
-weakness
-bruising with grade 2 and 3
Acute management of hip and thigh strains
-PIER
-pressure pad
-educate
-NWB
-hip flexor wrap or adductor wrap for daily wear as needed
-effleurage/lymph drainage
Thigh contusions MOI
-blunt trauma
Thigh contusions signs and symptoms
-discoloration
-muscle weakness possible
What are thigh contusions at risk of
-myositis ossificans
Acute management of thigh contusions
-effleurage or lymph drainage
-ice
-no deep tissue massage
-donut pad
