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Osteokinematics andArthrokinematics of the Hip
N a t io n a l F i t n e s s C e n t e rK o , K w a n g J u n
I n t r o d u c t io n
The hip is the articulation between the large sphericalhead of the Femur and the deep socket provided by theacetabulum of the pelvic(ball-socket joint).The hemoral head is stabilized by a deep socket that issurrounded by an extensive set of capsular ligaments.Many large forceful muscles provide the necessarytorques needed to propel the body up ward and forward.
OSTEOLOGY
Innominte- Ilium- Pubis- Ischium
OSTEOLOGY
Acetabulum- SocketIlium and Ischium : 80%, Pubis : 20%
OSTEOLOGY
FemurThe femur is the longest andstrongest bone of the humanbody.(powerful action of muscles,
long stride length duringwalking)The femur neck reducing of bonyimpingement against the pelvisThe femur bows slightly whensubjected to body weight.This bowing allows the femur tobear a greater load than if thefemur were perfectly straight
OSTEOLOGY
Stress D istributionD eformations
200 kg
· Femur
ARTHROLOGY
Functional Anatomy ofthe Hip Joint- ball-in-socket joint- Extensive ligamentsand large musclesmaintain the femoralhead securely in theacetabulum
ACETABULAR ALIGNMENT
Center-Edge Angle- 35-40�Acetabular Anteversion Angle- Normal angle of about 20�exposes part of the anterior side of thefemoral head
Angle of Inclination
· The angle within the frontal plane between the femoralneck and the medial side of the femoral shaft
Torsion Angle· The relative rotation(angle) that exists between the shaftand neck of the femur
· “In-toeing” is a walking pattern with exaggerated posturingof hip internal rotation
CAPSULE AND LIGAMENT OF THE HIP
Ligamentum teres
Iliofemoralligament(Y- ligament)
Pubofemoral
Ischiofemoral
Femoral on Pelvic Osteokinematics
Rotation of the Femur in the SagittalPlane.Flexion80 with knee extended)�- Hamstrings and gracilis muscles.s and gracilis muscles.
120 with knee fully flexed)�120 with knee fully flexed)�-Inferior fiv-Inferior fivers of ischiofemoral
ligament .-Inferior capsule.Extension20 of extension(with knee�
Femoral on Pelvic Osteokinematics
Rotation of the Femur in the FrontalPlane
Abduction : 40�-Puhofemoral ligament, inferiororal ligament, inferiorcapsule,capsule,adductor and hamstring muscles.adductor and hamstring muscles.
Adduction : 25�Adduction : 25�-Superior fibers of ischiofemoral-Superior fibers of ischiofemoral
Femoral on Pelvic Osteokinematics
Rotation of the Femur in theHorizontal al Plane
Internal Rotation : 35�Ischiofemoral ligament, externalrotatormuscles(e.g., piriformis)
External Rotation : 45 Latera� l fasciculus
of iliofemoralligament iliotibial band and
Pelvic on Femoral Osteokinematics
Ipsi-directionalLumbopelvic Rhythm- Trunk flexion
Contra-directionalLumbopelvic Rhythm.- Trunk extension
Pelvic on Femoral Osteokinematics
Flexion (anterior pelvic tilt) : 30Extension (posterior pelvic tilt)�
: 15�Abduction : 30 Adduction : 25��Internal rotation : 15 External�rotation : 15�
MUSCLE AND JOINT INTERACTION
Innervation to Muscles- Lumbar plexus
Femoral nerve(L2-L4)- innervate most hip flexors
and all knee extensors.
Obturator nerve(L2-L4)- innervate hip adductormuscles.
MUSCLE AND JOINT INTERACTION
Innervation to Muscles- Sacral Plexus
Sciatic nerve(L4-S3)
Muscular Function at the Hip
Hip Flexor MusclesPrimaryIliopsoasTensor fasciae lataeSartoriusRectus femorisAdductor longusPectineus
SecondaryAdductor brevisGracilisGluteus minimus(anterior fibers)
Muscular Function at the Hip
Hip Extensor MusclesPrimaryGluteus maximusBiceps femoris(long head)SemitendinosusSemimembranosusAdductor magnus(posterior head)
SecondaryGluteus medius(posterior fibers)
Muscular Function at the Hip
Sagittal Plane
Flexors : solid lines
Extensors : dashedlines
Muscular Function at the Hip
Overall function of the Hip Flexors.Anterior Pelvic TiltPerformed by a force-couple between thehip flexors and low-back extensormuscles.
Overall function of the Hip Extensor.Posterior Pelvic TiltPerformed by a force-couple between thehip extensors and trunk muscles.
Muscular Function at the Hip
Hip Adductor MusclesPrimaryAdductor longusAdductor brevisPectineusGracilisAdductor magnus(both heads)
SecondaryBiceps femoris(long head)Quadratus femorisGluteus maximus(lower fibers)
Muscular Function at the Hip
Hip Abductior MusclesPrimaryGluteus mediusGluteus minimusTensor fasciae latae
SecondaryPirifomisSartorius
Muscular Function at the Hip
Frontal Plane
Abductors : solidlines
Adductors : dashedlines
Muscular Function at the HipHip External Rotatior MusclesPrimaryGluteus MaximusPirifomisObturator intermusGemellus superiorGemellus inferiorQuadratus femorisSartorius
SecondaryGluteus medius(posterior fibers)Gluteus minimus(posterior fibers)Obturator extermusBiceps femoris(long head)
Muscular Function at the Hip
Hip Internal Rotator MusclesSecondaryGluteus minimus(anterior fibers)Gluteus medius(anterior fibers)Tensor fasciae lataeAdductor longusAdductor brevisPectineusSemitendinosusSemimembranosus
Muscular Function at the Hip
External rotators : solidlines
Internal rotators : dashedlines
Reference- Donald, A. N. Kinesiology of the Musculoskeletal System. Mosby. 2002 .- Kapandji, I. A. Physiologie Articulaire. Maloine. 1996.- Hall & Brody. Therapeutic Exercise: Moving Toward Funcion, 2nd Ed. LippincottWilliams and Wilkins. 2005.
