Hip and Pelvis

Pelvis and Hip

Stable base!

supports for head, arms and trunk (HAT)

supplies proximal stability

pelvis = interface between LE and spine

absorbs force from UE and ascending force from LE

central point for body sym!

Sacrum

triangle shaped

located between 5th lumbar vertebrae and coccyx

5 sacral vertebrae

Pelvis

2 hip bones, 3 distinct portions

Pubic Symphysis (anterior)

fibrocartilaginous disk that provides direct connection of 2 hip bones

Acetabulum

where ilium, ischium, and pubis meet and form the socket for head of femur

Bony Landmarks of Pelvis

Iliac Crest

Anterior Superior iliac spine (ASIS)

Posterior superior iliac spine (PSIS)

Greater Sciatic notch

Ischial tuberosity

Iliac Crest

rounded edge superior border

Anterior Superior Iliac Spine (ASIS)

most anterior point

Posterior Superior Iliac Spine (PSIS)

most posterior point of iliac crest

Greater sciatic notch

where blood vessels and nerves come through

Ischial tuberosity

prime point for contact with seating surface

femur

longest bone in body

angle of inclination, important for stability!

120-130 angle

Joints of pelvis and hip

sacroiliac joint

hip joint

• absorbs and transfer forces

Sacroiliac Joint (SI)

stabilizes pelvis under strain of opposing forces

type: synovial joint

Hip Joint

ball and socket

triaxial

movements: flexion, extension, abduction, adduction, external and internal rotation

Ligaments of Hip Joint

Iliofemoral ligament, pubofemoral ligament, ischiofemoral ligament

round ligament

Iliofemoral, ischiofemoral, and pubofemoral ligaments

are ligaments that provide stability to the hip joint by connecting the femur to the pelvis and restricting excessive motion

round ligament ( ligament capitis femoris)

direct support to the femoral head within the acetabulum

Ankylosing Spondylitis

inflammatory condition in spine

fuses skeletal structures

begins in SI joint and progresses into vertebrae

significant mobility limitations of spine and pain

Pelvic Floor (diaphragm)

inferior muscular wall of pelvic cavity that supports pelvic organs and maintains continence

Hip Flexors

iliopsoas muscles: psoas major, iliacus

PRIME flexors of hip

flex trunk

tilt pelvis anteriorly

Iliopsoas

hip flexion

Gluteus maximus

largest gluteal muscle

hip extension, hyperextension, lateral(external) rotation

high force demands, running/climbing

Hamstrings

a 2 joint muscle, crosses hip and knee

Hip abductors

gluteus medius and minimus

tensor fasciae latae

Gluteus Medius and Minimus

grouped together as lesser gluteal muscles

abduct the hip

Hip Extensors

gluteus maximus

hamstrings

Tensor Fascia Latae

a supportive layer of fascia

located on lateral thigh that helps stabilize the hip and knee during activity

connects to IT band

Iliotibial (IT) Band syndrome

overuse

repetitive strain

runners and cyclists

causes on friction between connective tissue and bony prominence causes pain and inflammation

Hip Adductors

adductor magnus

adductor longus

adductor brevis

pectineus

gracilis

span the inferior aspect of pelvis and medial femur

Hip Rotators

Piriformis

Quadratus femoris

obturator internus

obturator externus gemellus superior

gemellus inferior

span posterior sacrum to lateral femur

lie deep to glute max

Sciatica

tightness of piriformis or pressure on back of leg when seated can compress the nerve

sensory innervation of lower leg

pain and paresthesia in legs

posterior pelvic tilt

backward rotation of pelvis

flattens lumbar spine

increases thoracic flexion

Anterior pelvic tilt

forward rotation of pelvis

increase lumbar lordosis

increases extension of upper trunk

Pelvic tilt

refers to the orientation of the pelvis in a sagittal plane, which can be either anterior or posterior. This affects the curvature of the lumbar spine and overall posture.

Pelvic Obliquity

is a condition where the pelvis is tilted in the frontal plane, resulting in uneven hip heights. It can lead to an imbalance in the spine and affect posture

Pelvic Rotation

transverse plane position

rotation of one side of pelvis is anterior or posterior

functional mobility

transitioning and/or transferring body from one place to another

navigating an environment (walking, running, using a wheelchair)

Bowel, bladder, and sexual function Incontinence

loss of control of bowels or bladder

results of pelvic floor weakness

Stress incontinence

abdominal pressure increases from bodily function

causes involuntary leaking of urine or feces

Urge incontinence

inability to control the bladder or bowels until appropriate

proximal hip fractures

femoral neck fracture

intertrochanteric fracture

Total hip arthroplasty (THA)

replaces both the femoral head and the acetabulum

Hemiarthoplasty

replaces only the femoral head