Observation/palpation
- ASIS, iliac crest, greater trochanter
- pubic tubercles, PSIS, ischial tuberosity
- SI joint, inguinal ligament
- femoral artery, sartorius muscle, adductor longus, sciatic n
Femoral triangle
- superiorly= inguinal ligament
- medially= adductor longus m
- laterally= sartorius m
Flexors of the hip
- iliopsoas
- sartorius
- rectus femoris
- tensor fascia lata/IT band
adductor of the hip
-adductor longus/brevis/magnus
Abductor muscles?
- gluteus medius and minimus
- tensor fascia lata/IT band
What are extensor muscles?
- gluteus maximus m
- hamstrings (biceps femoris m, semitendinosus/semimembranosus)
Osteopathic evaluation
- hip flexion/extension dysfunction
- hip external/internal rotation dysfunction
- hip abduction/adducation dysfunction
- IT band restriction
How are dysfunctions named?
Ex) Tight hamstrings
- tight hamstrings lead to decrease in hip flexion/knee extension
- restriction of hip flexion= ease of motion to extension= Hip EXTENSION dysfunction
ROM for hip
- flexion= 90 knee extended, 120-135 knee flexed
- extension= 15-30
- internal rotation= 30-40
- external rotation= 40-60
- abduction= 45-50
- adduction= 20-30
Muscles strength testing: flexion, extension, abduction, adduction
- flexion= iliopsoas m. And femoral n. (L1-L2)
- extension= gluteus maximus m. And inferior gluteal n. (L5-S2)
- abduction= gluteus medius/minimus m. And superior gluteal n. (L5-S1)
- adduction= adducator longus m. And obturator n. (L2-L4)
What is the grade scale for muscle strength testing?
0/5= no muscle contraction 1/5= barely detectable flicker/trace movement 2/5= active movement w/o gravity (doc help) 3/5= active movement against gravity 4/5= active movement against gravity and some resistance 5/5= active movement against gravity and resistance w/o signs of fatigue (normal)
What are structures and pathology in the central compartment?
- contents: labrum, ligamentum teres, articular surfaces
- pathology: labral tears, ligamentum teres tears, oseochondral defects, chondromalacia/osteoarthritis, congenital hip dysplasia, loose bodies
What is in the peripheral compartment are what are pathologies?
- contents: femoral neck, synovial lining
- pathology: loose bodies, impringment syndrome (CAM and pincer types), synovitis
What is in the lateral compartment are what are pathologies?
- contents: gluteus medius, gluteus minimus, piriformis, IT band, trochanteric bursa
- pathology: IT band syndrome, bursitis, rotator cuff tendinopathies
What is in the anterior compartment and what are pathologies?
- contents: iliopsoas insertion, iliopsoas bursae
- pathology: psoas tendonitis
