Hip Study Guide

Pelvis and femur Fracture

Def - A break in the bone caused by high repetitive impact activity

MOI - Direct blow to leg or pelvis; Quick increase in activity; Fall from great height

Hamstring, Quad, Hip Flexor, & Groin Strains

Def - Acute injury to the muscles on the medial side of the thigh caused by overstretching

MOI - Sudden change in direction (explosive); Overuse; Sudden impact

Hamstring and quadriceps Contusions

Def - A bruise on the quadriceps

MOI - Direct blow to the thigh; trauma to muscle

Dislocations/Subluxations

Def - Separation of two bones at a joint

MOI - Outside forces pushing bones out of place; Strong force that tears ligaments

Myositis Ossificans

Def - Formation of bone tissue in the muscle

MOI - Direct blow to the muscle; Repetitive trauma; Strained muscle

Iliac Crest Contusions

Def - A bruise to the bone that’s located on the side of the hip (also known as the Illiac Crest)

MOI - Direct blow to the Illiac Crest

Trochanteric Bursitis

Def - Inflammation in the sac of fluid (known as the bursa)

MOI - Direct blow/trauma to the bursa (side of the hip); Falling on hip; Overuse

IT Band Syndrome

Def - Swelling/Irritation of the iliotibial band tendon

MOI - Running on a slope (for a long time); Difference in leg length; poor foot-wear

Pelvis and femur Stress Fractures

Def - Cracks in the bone from repetitive strain to the pelvis

MOI - Repetitive trauma; Ramped up intensity of activity; Overuse

Thomas Test

Used to test for tight hip flexors

How to perform Thomas test

Have patient lay on their back with their but hanging off the edge of the table

Have patient flex and hold one knee

If the patient’s resting leg rises (not at 90 degrees) then Hip Flexors are tight

Trendelenburg Test

Used to test for weak gluteal muscles

How to perform Trendelenburg

Have patient stand

Direct patient to stand on one leg

The leg that is not standing; observe for a drop in the hip

If hip drop is visible then the hip muscles are weak

Long sit test

Used to test for discrepancy and rotation of the pelvis

How to perform Long sit test

Have patient lay on their back with both legs laying straight

Compare both malleoli

If one is shorter than the other then you have a positive test result

Hip Scouring Test

Used to test for defect in the articular cartilage of femur or acetabulum (space where femur head is inserted)

How to perform Hip Scouring Test

Have the patient lie on their back

Flex one leg towards them

Have one hand on the knee and the other on the foot

Put pressure on them and rotate the leg

Positive test result should cause pain

Sacroiliac Compression and Distraction

Tests for sacroiliac pathology

How to perform SI Compression

With patient laying to the side and edge of the table, make sure knees are bent

Press on the side of their hips

Positive result if pain is present

How to perform SI Distraction

With patient laying on their back, make sure the legs are straight

With place hands on opposite sides of the hip (X-Shape) and push

Positive result indicates pain

Obers Test

Used to test for IT Band Syndrome

How to perform Obers Test

With patient laying on the side, place top leg behind the bottom leg

A positive result indicates that the leg stays up and doesn’t go down

Normal ROM for Hip Flexion

120-140

Normal ROM for Hip Extension

10-20

Normal ROM for Hip Abduction

30-50

Normal ROM for Hip Adduction

20-30

Normal ROM for Hip Internal Rotation (→)

30-45

Normal ROM for Hip External Rotation (<--)

40-50

Trendelenburg Gait

Def - Abnormal gait caused by weak gluteal muscles

MOI - Unilateral hip weakness; nerve damage (mostly hip weakness)

Ataxic Gait

Def - ATAXIA is a degenerative disease of the nervous system consisting of lack of voluntary muscles

MOI - Damage to the brain that involves coordination; Stroke; Cerebral Palsy

Short Leg Gait

Def - a condition where one leg is shorter than the other

MOI - Damage to the growth plate; little leg disorder; trauma to bone

Steppage Gait (a.k.a Drop Foot)

Def - Inability to lift the foot; due to weakness of dorsiflexors

MOI - Nerve damage; muscle atrophy; dorsiflexor weakness

Gluteus Maximus Gait

Def - A backwards lean caused by weak gluteus maximus muscles

MOI - Weakness in gluteus muscles

Parkinsonian Gait

Def - Brain disorder (Parkinson’s) that causes uncontrollable movement, shaking, stiffness, and unbalance (feet shuffling)

MOI - Parkinsons; Bradykinesia

Psoatic Limp Gait

Def - Part of LCPD; part of a group of disorders called osteochondrosis which weakens the psoas major muscle causing exaggerated trunk and pelvic movement.

MOI - Caused by…; weakness or sensory stimulation decrease in reflex activity of the psoas muscles

Stiff Knee/Hip Gait

Def - Decreased knee flexion during the swing phase

MOI - Knee Hyperextension; menisci injury; sudden movement/twisting

Gait Cycle Phases

Stane Phase and Swing Phase

Percentage of Stance Phase

60%

Percentage of swing Phase

40%