The Hip Joint

Exercises and Injuries

Pelvis Abnormalities

To appreciate the abnormalities that may occur, picture a box around the pelvis.

The two most common situations are: 1.the pelvis is tilted forward (anterior

tilt); slightly rotate the box forward 2.one side of the pelvis is lower than

the other (lateral tilt); slightly tip the box to one side.

Each of these abnormalities has its own specific range of problems and sometimes both can occur.

How would weak hamstrings, and tight hip flexor muscles affect the lower back?

Anterior Tilt

Anterior Tilt

Anterior Tilt

How can this excessive anterior tilt be corrected?

Anterior Tilt

Direction Injuries Cures

Anterior Tilt 1.) Low back pain2.) hamstring strain3.) knee problems

A) Abdominal muscle strengthening

B) Stretching and strengthening of gluteal muscles, hip external rotators, hip flexors, and hamstrings

Anterior Tilt

Lateral Tilt

Which group of muscles would be stronger in the left leg with permanent left lateral tilt?

Name the muscles

Left Lateral Tilt

Lateral Tilt

Contracting what group of muscles will limit the amount of left anterior tilt while walking?

Name the muscles.

Direction Injuries Cures

Lateral Tilt  1.) iliotibial band syndrome2.) low back pain -- usually one sided3.) adductor strains4.) lateral hip pain

A. Stretching and strengthening of hip adductors, abductors, extensors, and ext. rotator muscles.

B. Others (look for leg length difference, overpronation in one foot, etc. and consider orthotics to correct.)

Lateral Tilt

Exercises for the Hip Joint

Good ExRx

Qustionable Bodybuilding

Terminology

Compound An exercise that involves two or more joint

movements.

Isolated An exercise that involves just one discernible

joint movement.

Terminology

Closed ChainAn exercise in which the end segment of the exercised limb is fixed, or the end is supporting the weight. Most compound exercises are closed chain movements.

Open ChainAn exercise in which the end segment of the exercised limb is not fixed, or the end is not supporting the weight. Most isolated exercise are open chain movements.

Gluteus Maximus

Compound/Isolated Open/Closed

Squats C C

Deadlift C C

Lunge C O

Step up C O

Leg Press C O

Gluteus Maximus – Squats

Gluteus Maximus – Dead Lift

Gluteus Maximus – Lunge

Gluteus Maximus – Step Up

Gluteus Maximus – Leg Press

Hip Abductors/Adductors

Compound/Isolated Open/Closed

Cable I O

Seated I O

Lever I O

Hip Abductors – Cable

Hip Abductors – Seated

Hip Abductors – Lever

Hip Adductors – Seated

Hip Adductors – Lever

Hip Flexors

Compound/Isolated Open/Closed

Leg Raise

I O

Lever I O

Hip Flexors – Leg Raise

Hip Flexors – Lever

Stretching

Opposite action of the muscle For example, to stretch a hip extensor muscle,

perform hip flexion.

Gluteus Maximus - Stretching

Abductors - Stretching

Abductors (IT Band) - Stretching

Hip Flexors - Stretching

HIP INJURIES

GROIN INJURIES

Pathology

Twisting, running, jumping Muscles most often

involved: Adductor longus Iliopsoas Gracilis Sartorius

HIP POINTER

A hip pointer is a contusion to the iliac crest, the surrounding soft tissue structures, or the greater trochanter of the femur.

Typically, the injury is caused by a direct blow or fall. Hip pointer injuries occur most commonly in contact

sports (eg, football, hockey), but they can also occur in noncontact sports (eg, volleyball) as a result of a fall onto the hip or side.

Pain and tenderness in this region can limit an athlete's participation in sports.

Hip Pointer

HIP DISLOCATION

Dislocation

Any traumatic hip dislocation requires immediate treatment, ideally within six hours or less.

This is because a traumatic hip dislocation interrupts the normal blood circulation to the top of the femur, depriving the bone of its vital oxygen supply.

Unless the dislocated hip is reduced (replaced in its socket) promptly, and normal circulation is restored within the hip joint, there can be permanent damage to the head of the femur. This permanent damage is called avascular necrosis.

Dislocation

January 13, 1991, Bo Jackson partially dislocated his hip, tearing the blood vessels to the neck and head of the femur.

X-rays revealed a small fracture to the posterior of the hip socket.

Four weeks later, scans of the joint showed the beginning of vascular necrosis, in which the bone cells die because of deficient blood supply, and chondrolysis, in which cartilage degenerates.

Eventually Jackson would require a total hip replacement which relieves him of pain and allows him full range of motion.

HIP REPLACEMENT SURGERY

Causes

1. Osteoarthritis is perhaps the most common cause for hip replacement surgery.

2. Avascular necrosis is another cause of degeneration of the hip joint.

Causes

3. Abnormalities of hip joint function resulting from fractures of the hip and some types of hip conditions that appear in childhood can also lead to degeneration many years after an injury.

Surgery

Parts

Acetabular component – metal shell with plastic inner socket

Femoral component – metal stem with a metal or ceramic head

Types

Cemented – epoxy cement holds metal to bone

Types

Uncemented – mesh allows bone to grow into the prothesis

Operation

Removing the femoral head

Dislocate the hip joint Cut femoral neck with power saw

Reaming the Acetabulum

Power drill and special reamer remove the cartilage Bone is formed to fit the metal shell

Inserting the Acetabular Component

Cemented Uncemented

Preparing Femoral Canal

Inserting the Femoral Stem

Attaching the Femoral Head

Completed