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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