The Developing Hip

Question 1

What is the purpose of the hip?

Answer 1

• force transference for locomotion (stability)
• mobility

Question 2

What are at odds with each other in the hip joint?

Answer 2

• congruent surface => slippery for mobility
• stable => lots of ligaments + muscle attachments

=> both mean the hip has to be a ball and socket joint

Question 3

What are the main movements of the hip and what allows for the extra movements?

Answer 3

• flexion/extension are the main movements
• neck of femur makes the hip more moveable, functional and efficient

Question 4

What does the neck shaft angle of the femur allow?

Answer 4

• brings feet together + centre of gravity closer together

Question 5

What happens as we develop in the femur from a baby to an adult?

Answer 5

• born => no neck shaft angle => normal anteversion
• babies start to walk on tip toes + pigeon toed due to tight iliofemoral ligament + duck bottom to hold hip together
• as baby pulls up, iliolumbar (mm at this point) ligament creates tension in hip capsule => externally rotates limbs
• babies who are unwell in early life + cannot walk early => no external rotation (femur in anteversion)
• low lumbar area integrates with low lumbar sphincters => if anteversion => no bladder control until later life
• sponylolythesis in later life has been linked to children with bladder control issues when younger (up to 6-7 years is unusual to continue nocturnal urination) => don’t make a big deal of it

Question 6

Why is the iliofemoral ligament required?

Answer 6

• force transference

Question 7

Which type of tissues should be used for walking?

Answer 7

• non-metabolically active tissues e.g. ligaments, tendons, fascia

Question 8

What happens with hip dysplasia?

Answer 8

• more mm in use => less efficient

Question 9

How much extension is there at the hip?

Answer 9

• 17-18 degrees

Question 10

How is hip extension controlled?

Answer 10

• iliofemoral ligament

Question 11

What does hip extension also do?

Answer 11

• brings the lumbar spine into lordosis

Question 12

What happens as the leg swings forward?

Answer 12

• innominate tilts posteriorly => removes lordosis

Question 13

What movement do the ligaments of the hip limit?

Answer 13

• rotation

Question 14

What happens as the leg swings forwards?

Answer 14

• femur internally rotates 35 degrees + tension in front of joint => efficient

Question 15

How much flexion is there in the hip?

Answer 15

• 120 => needed for stairs

Question 16

What happens if there is change to the hip function?

Answer 16

• tissues above/below change

Question 17

What happens with hip OA?

Answer 17

• negative -2 degrees extension => flexed flexed deformity