Thigh and Hip Flashcards
whats the only muscle that crosses the hip?
rectus femoris. (extends knee and flexes hip)
muscle that crosses knee?
hamstrings (flexes knee and extends the hip)
Quadriceps contusion MOI
direct crushing force to quadriceps
acute single moi
extent of force and degree of ______ influences depth and functional disruption
thigh relaxation (braced/prepared for impact vs someone more relaxed injury is worse)
signs and symptoms of quadricep contusion 2 things
pain with temporary loss of function
early swelling with palpable painful region
Quad contusion management:
-POLICE
-ongoing use of ice/compression until rom increases
whats essential for management of quad contusion?
Early pain free ROM and loading in a pain free range are essential
Early management of quad contusion:
- cryotherapy with gentle stretching
-transition to heat
-tensor to compression ADL
Quad contusion return 2 play management:
-be able to return 2 play
-protection via equipment
-ongoing management of effusion and muscle tightness likely necessary
Quadriceps muscle strain MOI most common:
overstretching if quadriceps at knee (flexion) and hip (extension)
another less common MOI of quad muscle strain:
-forceful abrupt activation of quad in a compromised position
Quad muscle strain sign and symptoms:
pain, point tenderness, spasm
Quad muscle strain sign and symptoms loss of function:
knee flexion, hip extension,hip flexion and knee extension strength
GRADE 1 quad muscle strain sign and symptom: 5 things
1.tightness in front of thigh
2.Near normal gait and mobility
3.Limited swelling
4.mild discomfort during palpation
5.some discomfort with isolated quadricep contraction
GRADE 2 quad muscle strain sign and symptom: 4 things
1.antalgic gait (limited ROM @ knee and pain)
2.swelling (firm with bogginess)
3.Pain on palpation, possible defect in muscle
4. resisted knee extension and hip flexion will reproduce pain with moderate strength
GRADE 3 quad muscle strain sign and symptom:
-can’t weight bear
-lots of pain palpation
-unable to perform active knee extension
-pain with resisted knee extension and hip flexion
-isometric contractions may produce defect or bulge in muscle
-rect fem feel deformity
management of grade 1 quad strain:
wrapped during ADL and activity to reduce discomfort
management of grade 2 quad strain:
ice and compression during acute phase with gradual increase in pain free knee ROM as pain and hesitation subsides
management of grade 3 quad strain:
crutch use for 7-14 with compression
quad muscle strain rehab progression
isometric at multiple ranges
concentric only bilateral strengthening
concentric eccentric loading
eccentric overloading
plyometric/maximal effort
hamstring muscle strain MOI:
-hamstring and quad contract together
-dynamic change in role from hip extender to knee flexor
-fatigue posture, lack of flexibility and strength imbalances
hamstring strain is a
intrinsic non contact injury
hamstring strain most often occurs _________ or __________
mid muscle belly, or closer to orgin
Grade 1 hamstring muscle strain sign and symptoms:
-soreness during movement and point tenderness
Grade 2 hamstring muscle strain sign and symptoms:
-sharp snap and tear sensation
-severe pain
- loss of function
-bruising and deformity
Grade 3 hamstring muscle strain sign and symptoms:
rupturing of tendinous junction or muscular tissue
major hemorrhage
palpable deficit
hamstring muscle strain management:
similar to quad muscle strain
______ is essential to reduce likelihood of repeat hamstring injuries
eccentric strengthening
groin injuries are vulnerable to injury because
because of demands of both dynamic force production and trunk stability
anterior pelvic tilt
lordosis
posterior pelvic tilt
flatback
Trendelenburgs test: what are we looking for?
Illiac crest on non stance leg should be higher when standing on one leg
Trendelenburgs test is positive when
stance leg is higher indicating weak ab ductors (glute medius) of stance leg
adductor strain MOI:
twisting motion at trunk/pelvis with hip external rotation or excessive ab duction
sign and symptoms adductor strain:
-sudden pull or tear during active movement
-produces pain and considerable weakness
-limitations with other movements @ hip and trunk
adductor strain management:
police, determine exact muscle or muscles involves
reducing aggravating movements is crticial
restrict _______ until near complete pain free in adductor strain
dynamic excercise
trochanteric bursitis:
inflammation where glute med insert or the IT band passes over trochanter
sign and symptoms of trochanteric bursitis:
complaint of pain in lateral hip may radiate down leg
palpation reveals tenderness over lateral aspect of greater trochanter
redness and swelling around greater trochanter
trochanteric bursitis management:
POLICE
NSAIDS
-protection for collison/contact sports
-manage soft tissue/biomechanics for chronic
Hip labral tear: MOI
occurs due to repetitve movements resulting in degeneration or breakdown of labrum
can also occur due to hip dislocation
signs and symptoms of labral tear:
-asymptomatic
-present with clicking,locking,stifness, and limited ROM
-pain in groin and hip
-positive hip scour position
Hip scour:
test to help individual see what positions they should stay out of
Labral tear management:
-focus on hip ROM, strength and stability
-avoid painful movements and ranges
sciatica/piriformis syndrome:
hip and gluteal pain
many potential causes
sciatica/piriformis is most commonly due to
tight piriformis
sciatica/piriformis signs and symptoms:
patient reports deep pain in gluteal/hip region without low back pain
pain can radiate ti back of thigh, lateral calf and foot
sciatica/piriformis management:
-rest and manual therapy
-stretching exercises and self-myofascial release
-addressing biomechanic imbalancw
snapping hip:
habitual movement and postures can lead to certain muscles around the hip to have tension that causes compression
possible sources of snapping hip from:
-IT band over greater trochanter
-illiopsoas tendon moving over iliopectineal eminence
snapping hip signs and symptoms:
-complain of snapping
-snapping with pain and disability upon each snap
management of snapping hip:
-decrease pain and inflammation
-ice,NSAIDS
-focused soft tissue release for restrictive muscle groups
lliac contusion (hip pointer): MOI
direct blow often to an unpadded area
signs and symptoms of lliac contusion (hip pointer):
pain and muscle spasm
-mobility impairment
management lliac contusion (hip pointer):
police, xray examination
often very delayed to return
extra care and attention given
athletic pubalgia MOI:
chronic pain to pubic region caused by repetitive stress to pubic symphysis from kicking, twisting or cutting.
athletic pubalgia is the ___ of forces
shearning forces transmitted through pubic symphysis to insertion of rectus abdominus, hip adductors,and conjoined tendon
athletic pubalgia sign and symptoms
-no presence of hernia
-sharp pain that radiates into aadductors and pubic bone/pubic ramus
-point tenderness on pubic tubercle
in athletic pubalgia pain is increased with what ROM
-Resisted hip flexion
-internal rotation
-abdominal contraction
-resisted hip adduction
athletic pubalgia what is most effective for management?
phsysican referal to sport med doc
athletic pubalgia strengthening of what muscles is essential?
trunk stabilizers, hip flexors, and adductors
medical treatment of athletic pubalgia may involve
cortizone or injection, or tightening of pelvic wall
