The Hip

Hip Characteristics The Hip is a ball and socket joint like the

shoulder, but because it is me stable it has less motion than the shoulder.

Hip Characteristics The hip is a triaxial joint meaning that it

moves in all three planes. Flexion/extension/hyperextension Abduction/adduction Internal and external rotation Which motion is each

plan in???

Hip Characteristics Hip consists of 3 bones, one of which has

3 parts. Sacrum Coccyx Pelvis

Illium Ischium Pubis

Hip Characteristics The pelvis

articulates with the sacrum on the posterior side of the hip

The pelvis articulates with the two pubic portions of the pelvis on the anterior side of the hip.

Hip Characteristics The pelvic girdle

articulates with the femur at the head of the femur and the acetabulum of the pelvic girdle.

Hip Landmarks First part of

the pelvis is the Illium. The fan

shaped illium makes up the superior portion of the hip bone

Hip Landmarks Illica Fossa- large smooth concave on the

anterior surface of the illium Illiac Crest- superior part of the illium that

you can touch.

Hip Landmarks The Illica Crest runs from the anterior

superior illiac spine ASIS to the posterior superior illiac spine PSIS.

You can palpate these easily

Hip Landmarks There is also a posterior inferior and

anterior inferior illiac spine that are just below the ASIS and PSIS. There muscles that attach to each.

Hip Landmarks The Ischium is the posterior inferior

portion of the pelvic bone.

Hip Landmarks Ramus- inferior/medial part. It is

attachment site for adductor magnus, and obturator muscles

Hip Landmarks Ischial tuberosity is rough blunt projection

of the inferior ischium, it is the part that you bear weight on when you sit.

Hip Landmarks The pubis form the anterior inferior

portion of the pelvis.

Hip Landmarks The symphysis

pubis is a cartilaginous joint connecting the bodies of the two pubic bones at the anterior midline.

Hip Landmarks Superior and Inferior ramus are above

and below the symphysis pubis. Attachment for various muscles.

Hip Landmarks Acetabulum is the concave socket that

the femoral head fits into. It is made up of the all three pelvic bones.

Hip Landmarks Obterator foramen- a large opening made

up of the bodies and rami of the ischium and pubis through which passes blood vessels and nerves.

Hip Landmarks Femur is the longest and strongest bone

in the body. A person’s height is roughly 4x the length of their femur.

Hip Landmarks Head is the rounded

portion covered with articular cartilage

The Neck is the narrower portion between the head and the trochanters.

Hip Landmarks Greater Trochanter is the large projection

located laterally between the neck of the femur and the body. Provides attachments for glute medius and minimus.

Hip Landmarks Lesser trochanter- smaller projection

located medially and posterior and just distal to the greater trochanger. Attachment for the iliopsoas.

Hip Landmarks Medial and Lateral Condyle- distal medial

and lateral end of the femur. Medial and Lateral Epicondyle- projection

proximal to the condyle

Hip Landmarks-Linea Aspera- prominent

longitudinal ridge running most of the posterior femur length.

Hip Landmarks Tibial Tuberosity is the large projection on

the tibia at the proximal end where the patellar tendon attaches.

Hip Structures There are 3 main ligaments in the hip

joint. They attach from the rim of the acetabulum to the femoral neck. They are in a spiral fashion and allow flexion and restrict hyperextension.

Hip Structures Acetabular Labrum helps increase the

depth of the labrum, it is fibrocartilage like the meniscus.

Hip Structures Iliotibial band- is the very long tendinous

portion of the tensor fascia latae muscle. It runs from the anterior iliac crest to the lateral tibia. The gluteus maximus has tendons that are attached to it.

Hip injuresIliotibial band syndrome-

overuse injury causing lateral knee pain. Repeated friction of the band sliding over the lateral femoral epicondyle, caused by tight muscles, or worn down shoes

Hip Injuries Trochanteric bursitis- result of either

acute trauma or overuse. Tight glute muscles and Iliotibial band can create overuse among runners and bikers.

Hip Injuries Hamstring Strain “pulled hamstring”-

most common muscle problem in body, often recurrent and a result of overload, or moving the muscle too fast.

Hip Injuries Hip Pointer/Iliac crest contusion- due to a

direct blow to the iliac crest.

Hip Muscles Iliopsoas Muscles-

actually two muscles with separate proximal attachments, and a common distal attachment. Prime hip flexor muscle.

Hip Muscles Sartorius – longest

muscle in the body. It is also called the tailor muscle and it has many actions, when combined they are most powerful.

Hip Muscles Adductor Longus- most superficial of the

adductor muscles, it can be palpated most easily due to the long tendon in the medial anterior groin.

Hip Muscles Adductor Magnus- largest, most massive

and deepest of the adductor muscles. It is a very strong adductor muscle.

Hip Muscles Gracilis- the only hip

flexor that is a two joint muscle. It starts at the pubic symphysis, and attaches to the proximal medial tibia and assists with knee flexion.

Hip Muscles Gluteus Maximus- large, quadrilateral

shaped muscle located on the superficial buttocks. Posterior hip muscle that is a very strong hip extensor.

Hip Muscles Gluteus Medius- Triangular shaped

muscle like the deltoid. It spans the hip laterally and is a primary adductor muscle.

Hip Muscles Piriformis- This is one of the deep rotator

muscles of the hip, it goes from the sacrum to the greater trochanter of the femur. It laterally or externally rotates the hip.

Hip Muscles Tensor Fascia Latae-

short muscle with a long tendinous attachment. It starts at ASIS and attaches to the IT band. It is a hip adductor and is most powerful in a bit of hip flexion.