Lower Extremity: Hip OPC

Hip

Articulation of the femoral head to the acetabulum within the innominate

Thigh

Region from the informal ligament to the knee

Leg

Distance between the knee to the ankle mortise

Ilium, Ischium, & Pubic Bones

The innominate bones is formed from the fusion of

Tightens

The hip capsule ____ in extension and internal rotation

Loose

The hip capsule becomes ______ in flexion and external rotation (more prone to injury)

Labrum

Fibrocartilaginous ring that deepens the acetabulum and makes the joint more stable

Flexion/Extension

This happens in the Transverse axis

Internal/External Rotation

This happens in the Functional/Longitudinal axis

Abduction/Adduction

This happens in the A/P axis

Quadriceps Angle (Q-angle)

Formed by intersection of tibial longitudinal axis and a vertical line constructed from the ASIS to the middle of the patella

Coxa Valga

Increase in angle of inclination

Coxa Vara

Decrease in angle of inclination

Genu Vara

Decrease in Q-angle

Genu Valga

Increase in Q-angle

Quadriceps Femoris

Flexes thigh, extends knee, 10% of hip flexors

Psoas/Iliopsoas

Flexes hip, sidebends lumbar spine, 90% of hip flexors

Gluteus Maximus

Extends & laterally rotates thigh, 90% of hip extensors

Hamstrings

Extends thigh & knee flexion, 10% of hip extensors

Tensor Fascia Lata (TFL)

Flexes, internally rotates, abductor

Gluteus Medius

Medially rotates thigh, abductor

Pectineus, Gracilis, & 3 “adductor” muscles

Moves pubic bone inferiorly, Adductors

Piriformis

Abducts, External Rotator

Gluteus Medius & Gluteus Minimus

Internal Rotators

Iliopsoas Syndrome

Hypertonicity, Back/hip pain, Groin pain, from sitting long periods or athlete

Piriformis Syndrome

Sciatic nerve entrapment at ischial tuberosity, from sitting long periods, gluteal pain and down leg

Tight/Restricted

Motion restriction in flexion means hip extensors are

Hip Dysfunction

Minor motions of hip affected

Pathology Restriction

Motion restriction with an extremely hard end feel

Physiologic Restriction

Motion restriction with a more elastic end feel

Osteoarthritis of Pelvis

One sided achy pain in groin and possibly lateral thigh and buttocks, worse with standing after sitting & at the end of the day

Slipped Capital Femoral Epiphysis (SCFE)

Displacement of (this is in name) from the femoral neck through the physeal plate, can be classified as stable or unstable, primarily in male overweight adolescents

Developmental Dysplasia of the Hip (DDH)

Abnormal acetabulum development in newborn, hip instability/dislocation, failure to treat can lead to disability, pain, and accelerated OA

Ortolani

Relocating maneuver for DDH

Barlow

Dislocating maneuver for DDH

Pavlik Harness & Spica Cast

Treatments for DDH