The Groin And Pelvis: Exam 3 Flashcards
How do the hip and pelvis move?
Multiple planes and through muscle function and gait
What type of joint is the hip?
Ball and socket
Does the hip have high or low stability?
High
What is the most common structure in the hip and pelvis region?
Muscles
Obersvation of hip and pelvis
- symmetry of hips and pelvis tilt
- lower limb alignment
- pelvic landmarks
- standing on one leg
- ambulation
Lordosis
Sway back
Pelvis landmarks
- ASIS
- PSIS
- iliac crest
What should you look for hen asking patient to stand on one leg?
Pubic symphysis or drop on one side
Functional evaluation special tests for the hip and pelvis
- ROM and strength
- hip adduction, abduction, flexion, extension, internal and external rotation
Selective tissue testing
- hip flexor tightness
- sacroiliac joint
- iliotibilal band tightness
- gluteus medius weakness
How does adductor or hip flexor strain (groin) happen?
Running, jumping, twisting with hip external rotation or severe stretch
Symptoms of groin strain
- sudden twinge or tearing during active movement
- produces pain weakness and internal hemorrhaging
Management of groin strain
- rice and NSAIDs for 48-72 hours
- rest is critical
- ROM once pain free
How hip sprains happen
Unusual movement exceeding normal ROM may result in damage
Symptoms or sprains
- signs of acute injury and inability to circumduct hip
- pain in hip region with hip rotation increasing pain
Management of hip sprain
- x-ray or MRI to rule out fx
- RICE, NSAIDs
- ROM and PRE once pain free
What causes a hip Labral tear?
Repetitive movements such as running or pivoting, resulting in degeneration or breakdown of labrum
Can hip labral tear be acute?
Yes
Symptoms of hip labral tear
- clicking, locking, stiffness, slipping
- limited ROM
- Diffuse pain thru groin and hip
Management of hip labral tear
- hip ROM, strength, stability
- avoid painful movement
When is surgery required in hip labral tear?
About 4 weeks
What causes a hip pointer?
Contusion of iliac crest/ abdominal musculature and results from a direct blow
Symptoms of hip pointer
- pain
- loss of function
Management of hip pointer
- RICE 48 hours
- NSAIDs
- ic massage
- ultrasound
- ***steroid injection occasionally
How long is recovery for hip pointer?
1-3 weeks
Where is osteitis pubis most seen?
Distance runners, soccer, football, wrestling
What causes osteitis pubis?
Repetitive stress on pubic symphysis and adjacent muscles
Symptoms of osteitis pubis
- chronic pain and inflammation of groin
- point tenderness on pubic tubercle
- acute case may be the result of bicycle seat
Management of osteitis pubis
- rest
- NSAIDs
- gradual return to activity
- steroidal injection possible
Athletic pubalgia
Chronic pain in pubic region
What causes athletic pubalgia?
Repetitive stress to pubic symphysis from kicking, twisting, or cutting
Symptoms of athletic pubalgia
- no hernia
- point tenderness
- pain increased with resisted hip flexion, internal rotation, abdominal contraction, resisted hip adduction
Management of athletic pubalgia
- conservative treatment (rarely effective)
- massage
- stretching after 1 week
- aggressive treatment involves cortisone injection or tightening of pelvic wall surgically
