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Anatomy & Injuries to the Thigh, Hip and Pelvis

Anatomy & Injuries to the Thigh, Hip and Pelvis. SP Sports Medicine John Hardin Instructor. General Information about the pelvis. This area of body is strong and stable Great demand placed on this part of body—”core” Functions: support the spine & trunk

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Anatomy & Injuries to the Thigh, Hip and Pelvis

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  1. Anatomy & Injuries to the Thigh, Hip and Pelvis SP Sports Medicine John Hardin Instructor

  2. General Information about the pelvis • This area of body is strong and stable • Great demand placed on this part of body—”core” • Functions: • support the spine & trunk • Transfer weight to lower extremities • Place for muscle attachment of thigh and trunk • Protect organs of pelvic region

  3. Anatomy • Bones • Muscles • Ligaments

  4. Bones • Femur • Head, neck, greater trochanter, lesser trochanter, shaft, medial & lateral condyle and epicondyles • Pelvis • Ilium: iliac crest, ASIS, AIIS, PSIS • Ishcium: ischial tuberosity • Pubis: Pubic symphysis • Acetabulum

  5. Bones-the anterior femur

  6. The posterior femur

  7. The pelvis

  8. Muscles • Hip Flexors: • Iliacus & psoas major= Iliopsoas • Rectus femoris • Sartorius • Hip Extensors: • Hamstrings-biceps femoris, semitendinosus, semimembranosus • Gluteus maximus

  9. Muscles • Knee flexors: • Hamstrings, gastrocnemius • Knee extensors: • Quadriceps—rectus femoris, vastuslateralis, vastusmedialis, vastusintermedius

  10. Muscles

  11. Muscles

  12. Muscles

  13. Muscles • Hip Adductors: • Adductor magnus, adductor longus, adductor brevis, gracilis, pectineus • Hip Abductors: • Gluteus medius, tensor fascia latae

  14. Muscles

  15. Muscles

  16. Muscles • Hip Internal rotators: • Tensor fascia latae, gluteus minimus • Hip External rotators: • Gluteus maximus, gluteus medius, piriformis

  17. Ligaments • Thickening of joint capsule allows for very stable joint • Iliofemoral • Ischiofemoral • pubofemoral • LigamentumTeres • Also called the round ligament • Attaches head of femur into acetabulum allowing blood supply to that area

  18. Ligaments

  19. Preventing injuries to thigh/hip • Flexibility training and stretching • Strength training • Proper protective equipment

  20. Common Injuries • Strains • Sprains • Contusions • Fractures • Dislocations

  21. Strains • Quads • Hamstrings • Groin (adductors) • Hip flexors • Gluteals

  22. Strains • Mxn: • sudden strong contraction of muscle(s) • overstretching of muscle(s) • Muscle strength imbalance

  23. Strains-hamstring

  24. Strains- groin

  25. Strains • S/S: pain/discomfort • POT • Bleeding causing discoloration (after 1-2 days) • Loss of function • Muscle spasm • deformity

  26. Strains • TX: RICE • modify/restrict activity • crutches if necessary • Medical referral if necessary • Restore normal ROM flexibility and strength using various modalities as needed

  27. Strains • Complications: • recurrent strains due to “inelasticity of scar tissue” especially at that same site • Excess buildup of scar tissue

  28. Strains-quad after the fact

  29. Strains-quad

  30. Strains-hamstring

  31. Strains-hamstring

  32. Hamstring strain treatment

  33. Hamstring avulsion

  34. Contusions • Quadriceps • Hip pointer

  35. Quadriceps Contusion • Mxn: • direct blow to relaxed thigh compressing the musculature again the femur

  36. Quadriceps Contusion • S/S: • Pain • POT • Bleeding into the muscle • Swelling • Temporary loss of function

  37. Quad contusion • Tx: RICE w/ knee flexed • Crutches if necessary • Restore normal ROM, flexibility & strength • Ultrasound • Heat • Medical referral if needed

  38. Quad contusion • Complication: • Myositisossificans—formation of bony tissue within the muscle • Very painful • Greatly restricts ROM mainly flexion • Caused by: • severe blow that is not properly cares for • Repeated blows to same area

  39. MyositisOssificans

  40. Hip Pointer • Mxn: • direct blow to the iliac crest and/or ASIS

  41. S/S: • Pain • Spasm • Bleeding in the area—discloration • Temporary loss of motion • Unable to rotate trunk or flex hip without pain

  42. Hip Pointer

  43. Hip Pointer • Tx: • RICE • Bed rest if necessary • Medical referral if necessary • Return to activity when pain if gone and motion is restored

  44. Fractures-Avulsion • Most common at ASIS or IschialTuberosity • Mxn: forceful contraction of muscle

  45. Avulsion Fractures • S/S: • Extreme pain with movement & weight bearing • POT (either over the ASIS or Ischial tub.) • Bleeding/discoloration

  46. Avulsion • TX: • Ice • crutches • Medical referral for x-ray

  47. Fractures- femur • Occurs most often in the shaft of the femur • Mxn: • great force-direct or indirect- placed on the femur

  48. Femur Fractures • S/S: • Pain • POT • Deformity w/ thigh externally rotated, shortened • Loss of motion/function • Swelling due to internal bleeding • Muscle spasms • Muscle lacerations

  49. Femur fractures • Can be life threatening—fatty tissue and bone marrow can get into the blood stream and cause a blood clot

  50. Femur Fracture • Tx: • Call 911 • Don’t move the athlete • Hare traction splint • Check for distal pulse • Control any external bleeding • Treat for shock

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