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Hip Flashcards

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1
Q

Movement analysis of hip flexion

A

Hip flexion:
• Movement occurring and joint
• Hip flexion or trunk flexion at the hip/coxal joint

  • Axis and Plane
    • Movement occurs in the sagittal plane about the frontal axis
  • Range of joint movement
    • 100-120 degrees
  • Main muscles involved
    • Prime movers: ilio-psoas, pectineus, rectus femoris.
  • Type of muscle work
    • Isotonic (dynamic); concentric muscle work where the prime mover ilio-psoas muscle shortens bringing the attachments (iliac fossa, TP T12-L4 and lesser trochanter) together resulting in movement of the associated joint and a swelling of the muscle belly. The internal force > external.
  • Range of muscle work - inner/middle/outer
    • Start in outer -> middle -> inner.
  • Muscles involved as synergists/fixators/antagonists
    • Synergist - Sartorius/TFL/pectineus/adductor longus ensures quality of movement by preventing unwanted movement in the coxal joint as well as adjacent joints
    • Fixators - Transverse Abdominus; Rectus Abdominis; Obliques; Quadratus Lumborum; Erector Spinae steadies base and stabilises the proximal attachment of ilio-psoas -stabilises the iliac fossa and TP T12-L4.
    • Antagonist - hamstrings; biceps femoris, semitendinosus, semimembranosus
• Measurement
	• Oxford scale
		○ 0 = 0 No movement
		○ 1 = Flicker of movement
		○ 2 = Full ROM w/ gravity counterbalanced
		○ 3 = Full ROM against gravity
		○ 4 = Full ROM against weak resistance
		○ 5 = full ROM against strong resistance
	• Dynamometry
  • Limiting factors
    • Soft tissue apposition of abdominals
    • Tension of hamstring antagonist
  • Other - insufficiency/reciprocal inhibition
    • Passive insufficiency of the biceps femoris when knees extended - unable to sufficiently lengthen to allow for full hip flexion. Flexion of knees will allow for full hip flexion as the biceps femoris regain length
    • Active insufficiency of the rectus femoris when the knee is extended because it is already shortened and thus suffers from active insufficiency; the action will recruit more ilio-psoas, TFL, etc.
    • Reciprocal inhibition - as ilio-psoas agonist concentrically contracts the biceps femoris antagonist will undergo reciprocal lengthening meaning it will involuntarily lengthen.
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2
Q

Movement analysis of hip extension

A

Hip extension:
• Movement occurring and joint
• Hip extension, coxal joint - synovial ball and socket joint; polyaxial capable of 3 degrees of freedom

  • Axis and Plane
    • Sagittal plane about frontal axis
  • Range of joint movement
    • 15-20 degrees
  • Main muscles involved
    • Prime mover - gluteus maximus/biceps femoris
  • Type of muscle work
    • Isotonic (dynamic) muscle work; concentric muscle work where the agonist (gluteus maximus) shortens bringing the attachments (posterior ilium, sacrum and coccyx - gluteal tuberosity, ITB) closer, resulting in a swelling of the muscle belly. Internal force > external force.

• Range of muscle work - inner/middle/outer?????

• Muscles involved as synergists/fixators/antagonists
• Synergists - Biceps Femoris (Long Head); Semitendinosus; Semimembranosus, (post) add magnus; ensure quality of movement by preventing unwanted movement in the coxal joint and adjacent joints.
• Fixators - Transverse Abdominus; Rectus Abdominus; Obliques; Quadratus Lumborum; Erector Spinae. Stabilises the base and proximal attachment of the agonist (gluteus maximus) - posterior ilium, sacrum, coccyx.
• Antagonists - iliopsoas; TFL; Rectus Femoris; Anterior Adductors (excludes inferior add magnus); Sartorius. The muscle opposing the agonist.
• Measurement
• Oxford scale:
○ 0 = No movement
○ 1 = Flicker of movement
○ 2 = Full ROM w/ gravity counterbalanced
○ 3 = Full ROM against gravity
○ 4 = Full ROM against weak resistance
○ 5 = full ROM against strong resistance
• Dynamometry

  • Limiting factors:
    • Iliofemoral lig
    • Pubofemoral lig
    • Ischiofemoral lig
    • Close packed position
  • Other - insufficiency/reciprocal inhibition
    • Active insufficiency of biceps femoris when knee flexed - unable to sufficiently shorten to allow full ROM at hip. Extension of knee allows further hip extension
    • Passive insufficiency - rectus femoris when knee extended and hip extended - unable to sufficiently shorten to allow full ROM at both joints; not as impactful as active insufficiency of the biceps femoris.
    • Reciprocal inhibition - as the biceps femoris/gluteus maximus agonist concentrically contracts the rectus femoris/ilio-psoas antagonist will undergo reciprocal lengthening; involuntary lengthen.
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3
Q

Movement analysis of hip abduction

A

Hip abduction:
• Movement occurring and joint
• Hip adduction at coxal joint - synovial ball and socket joint; poly axial capable of 3 degrees of freedom

  • Axis and Plane
    • Frontal plane about sagittal axis
  • Range of joint movement
    • 40-45 degrees
  • Main muscles involved
    • Prime mover - gluteus medius/minimus
  • Type of muscle work
    • Isotonic (dynamic); concentric muscle work of the gluteus medius/minimus that shortens bringing the attachments (posterior ilium-greater trochanter) closer leading to a swelling of the muscle belly. Internal force>external force

• Range of muscle work - inner/middle/outer???

  • Muscles involved as synergists/fixators/antagonists
    • Synergists - sartorius/TFL/piriformis (flexed thigh) ensures quality of movement by preventing unwanted movement in the coxal joint and adjacent joints
    • Fixators - rectus abdominis, internal and external obliques, quadratus lumborum, erector spinae. Stabilises base and proximal attachment (posterior ilium) of agonist.
    • Antagonists - Adductor longus/brevis/magnus. Muscle opposing agonist
• Measurement 
	• Oxford scale
		○ 0 = 0 No movement
		○ 1 = Flicker of movement
		○ 2 = Full ROM w/ gravity counterbalanced
		○ 3 = Full ROM against gravity
		○ 4 = Full ROM against weak resistance
		○ 5 = full ROM against strong resistance
	• Dynamometry
	• 
• Limiting factors
	• Iliofemoral lig -medial/inferior band
	• Pubofemoral lig
	• Tension in adductors
  • Other - insufficiency/reciprocal inhibition
    • Reciprocal inhibition - as the gluteus medius/minimus concentrically contract the adductor longus/brevis/magnus antagonist will undergo reciprocal lengthening; involuntarily lengthen
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4
Q

Movement analysis of hip Adduction

A

Hip adduction:
• Movement occurring and joint
• Hip adduction at coxal joint - synovial ball and socket joint; poly axial capable of 3 degrees of freedom

  • Axis and Plane
    • Frontal plane about sagittal axis
  • Range of joint movement
    • 15-30 degrees
  • Main muscles involved
    • Prime mover - adductor longus/brevis/magnus (superior)
  • Type of muscle work
    • Isotonic (dynamic); concentric muscle work of the adductor longus that shortens bringing the attachments (body of pubis - 2/3 linea aspera) closer leading to a swelling of the muscle belly. Internal force>external force
  • Range of muscle work - inner/middle/outer???
  • Muscles involved as synergists/fixators/antagonists
    • Synergists - ADD brevis/magnus/gracilis ensures quality of movement by preventing unwanted movement in the coxal joint and adjacent joints
    • Fixators - rectus abdominis, internal and external obliques, quadratus lumborum, erector spinae. Stabilises base and proximal attachment (pubis bodies) of agonist.
    • Antagonists - Gluteus medius/minimus. Muscle opposing agonist
• Measurement 
	• Oxford scale
		○ 0 = 0 No movement
		○ 1 = Flicker of movement
		○ 2 = Full ROM w/ gravity counterbalanced
		○ 3 = Full ROM against gravity
		○ 4 = Full ROM against weak resistance
		○ 5 = full ROM against strong resistance
	• Dynamometry
	• 
• Limiting factors
	• Iliofemoral lig - lateral/superior band
	• Ligamentum teres
	• Tension in abductors
  • Other - insufficiency/reciprocal inhibition
    • Reciprocal inhibition - as the adductor longus concentrically contract the gluteus medius/minimus antagonist will undergo reciprocal lengthening; involuntarily lengthen
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5
Q

Movement analysis of hip MR

A

Hip medial/internal rotation:
• Movement occurring and joint
• Hip MR at coxal joint - synovial ball and socket joint; poly axial capable of 3 degrees of freedom
• Axis and Plane
• Transverse plane about a vertical axis
• Range of joint movement
• 30-40 degrees
• Main muscles involved
• Prime mover - gluteus medius/minimus (ant fibres)
• Type of muscle work
• Isotonic (dynamic); concentric muscle work of the gluteus medius/minimus (ant fibres) that shorten bringing the attachments (posterior surface of ilium-greater trochanter) closer leading to a swelling of the muscle belly. Internal force>external force
• Range of muscle work - inner/middle/outer???
• Muscles involved as synergists/fixators/antagonists
• Synergists - TFL ensures quality of movement by preventing unwanted movement in the coxal joint and adjacent joints
• Fixators - rectus abdominis, internal and external obliques, quadratus lumborum, erector spinae. Stabilises base and proximal attachment (posterior surface of ilium) of agonist.
• Antagonists - Gluteus maximus, gluteus medius (post fibres), biceps femoris (long head), posterior head of adductor magnus, deep rotators of hip, sartorius. Muscle opposing agonist
• Measurement
• Oxford scale
○ 0 = 0 No movement
○ 1 = Flicker of movement
○ 2 = Full ROM w/ gravity counterbalanced
○ 3 = Full ROM against gravity
○ 4 = Full ROM against weak resistance
○ 5 = full ROM against strong resistance
• Dynamometry
•
• Limiting factors
• Ischiofemoral lig
• Posterior capsule
• Tension in lateral rotators

  • Other - insufficiency/reciprocal inhibition
    • Passive insufficiency - biceps femoris (long head)?
    • Reciprocal inhibition - as the gluteus medius/minimus (ant fibres) concentrically contract the gluteus maximus antagonist will undergo reciprocal lengthening; involuntarily lengthen
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6
Q

Movement analysis of hip LR

A

Hip lateral/external rotation:
• Movement occurring and joint
• Hip LR at coxal joint - synovial ball and socket joint; poly axial capable of 3 degrees of freedom
• Axis and Plane
• Transverse plane about a vertical axis
• Range of joint movement
• 45-60 degrees
• Main muscles involved
• Prime mover - Piriformis
• Type of muscle work
• Isotonic (dynamic); concentric muscle work of the piriformis that shorten bringing the attachments (posterior surface of ilium-greater trochanter) closer leading to a swelling of the muscle belly. Internal force>external force
• Range of muscle work - inner/middle/outer???
• Muscles involved as synergists/fixators/antagonists
• Synergists - gluteus maximus/deep lateral rotators ensures quality of movement by preventing unwanted movement in the coxal joint and adjacent joints
• Fixators - rectus abdominis, internal and external obliques, quadratus lumborum, erector spinae. Stabilises base and proximal attachment (anterior sacrum) of agonist.
• Antagonists - Gluteus medius/minimus (ant fibres)/medial rotators. Muscle opposing agonist
• Measurement
• Oxford scale
○ 0 = 0 No movement
○ 1 = Flicker of movement
○ 2 = Full ROM w/ gravity counterbalanced
○ 3 = Full ROM against gravity
○ 4 = Full ROM against weak resistance
○ 5 = full ROM against strong resistance
• Dynamometry
•
• Limiting factors
• Iliofemoral lig - lateral/superior band
• Tension in medial rotators

  • Other - insufficiency/reciprocal inhibition
    • Reciprocal inhibition - as the piriformis concentrically contract the gluteus medius/minimus (ant fibres) antagonist will undergo reciprocal lengthening; involuntarily lengthen
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Movement Analysis
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