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The Hip Joint The Hip Joint

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The Hip Joint The Hip Joint Powered By Docstoc
					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
Anterior Tilt
 Direction          Injuries               Cures

Anterior Tilt 1.) Low back pain      A) Abdominal
              2.) hamstring strain      muscle
              3.) knee problems         strengthening
                                     B) Stretching and
                                        strengthening of
                                        gluteal muscles,
                                        hip external
                                        rotators, hip
                                        flexors, and
                                        hamstrings
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   A. Stretching and
               syndrome                  strengthening of
               2.) low back pain --      hip adductors,
               usually one sided         abductors,
               3.) adductor strains      extensors, and
                                         ext. rotator
               4.) lateral hip pain      muscles.
                                      B. Others (look for
                                         leg length
                                         difference,
                                         overpronation in
                                         one foot, etc.
  Lateral Tilt                           and consider
                                         orthotics to
                                         correct.)
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 Chain
   An 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 Chain
  An 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             I               O
      Raise
      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

				
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posted:1/25/2012
language:English
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