Hip Injuries
Bones of the Pelvic Girdle
Pelvis (right and left)
Parts to know:
Sacrum
•
Pubic Symphysis
Coccyx
•
Sacroiliac Joint
Pelvis
Bones of the Pelvis
• Ilium
• Ischium
• Pubis
Parts of the Pelvis
Parts of the Pelvis to know:
•
Anterior Inferior Iliac Spine (AIIS)
•
Anterior Superior Iliac Spine (ASIS)
•
Iliac Crest
•
Posterior Superior Iliac Spine (PSIS)
•
Posterior Inferior Iliac Spine (PIIS)
•
Greater Sciatic Notch
•
Ischial Spine
•
Lesser Sciatic Notch
•
Ischial Tuberosity
•
Ramus of the Ischium
•
Pubic Tubercle
•
Superior Ramus
•
Inferior Ramus
•
Body of the Pubis
•
Obturator Foramen
•
Acetabulum
Sacrum & Coccyx
Parts to Know:
• Sacrum
• Base of the Sacrum
• Sacral Canal
• Median Sacral Crest
• Sacral Cornua
• Sacral Hiatus
• Sacral Foramen
• Ala
• Lateral Sacral Crest
• Apex of the Sacrum
• Coccyx
• Coccygeal Vertebrae
• Coccygeal Cornu
• Transverse Processes
Bones of the Hip
Pelvis
Femur
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Parts to know:
Greater Trochanter
Head of the Femur
Neck of the Femur
Lesser Trochanter
Shaft of the Femur
Linea Aspera
Lateral Condyle of the Femur
Lateral Epicondyle of the
Femur
Medial Condyle of the Femur
Medial Epicondyle of the Femur
Patellar Surface
Popliteal Surface
Intercondylar Fossa
Anterior view Posterior view
Muscles of the Hip
Rectus Femoris
• Origin
• Anterior Inferior Iliac
Spine (AIIS)
• Insertion
• Tibial Tuberosity via the
patellar tendon
• Action
• Extend the knee
• Flex the hip
Muscles of the Hip
Vastus Lateralis
•
Origin
• Lateral lip of linea aspera,
gluteal tuberosity, and
greater trochanter.
•
Insertion
• Tibial tuberosity via the
patellar tendon.
•
Action
• Extend the knee.
Muscles of the Hip
Vastus Lateralis (posterior view)
Muscles of the Hip
Vastus Intermedius
•
Origin
• Anterior and lateral
shaft of the femur.
•
Insertion
• Tibial tuberosity via
the patellar tendon.
•
Action
• Extend the knee.
Muscles of the Hip
Vastus Medialis
•
Origin
• Medial lip of the linea
aspera.
•
Insertion
• Tibial tuberosity via the
patellar tendon.
•
Action
• Extend the knee.
Muscles of the Hip
Sartorius
•
Origin
• Anterior Superior Iliac
Spine (ASIS)
•
Insertion
• Proximal, medial shaft of
the tibia at the pes
anserinus
•
Action
• Flex the hip, laterally rotate
the hip, abduct the hip, flex
the knee, medially rotate
the flexed knee
Muscles of the Hip
Sartorius (posterior view)
Muscles of the Hip
Gracilis
•
Origin
• Inferior ramus of the pubis
•
Insertion
• Proximal, medial shaft of
the tibia at pes anserinus
•
Action
• Adduct hip, medially
rotate hip, flex the knee,
medially rotate the flexed
knee
Muscles of the Hip
Gracilis (posterior view)
Muscles of the Hip
Pectineus
•
Origin
•
•
Superior ramus of the pubis.
Insertion
•
•
Pectineal line of the femur.
Action
•
Adduct the hip, medially
rotate the hip, assist to flex
the hip.
Muscles of the Hip
Adductor Longus
•
Origin
• Pubic tubercle.
•
Insertion
• Medial lip of the linea
aspera.
•
Action
• Adduct the hip, medially
rotate the hip, flex the
hip.
Muscles of the Hip
Adductor Magnus
•
Origin
• Inferior ramus of the pubis, ramus of
the ischium and ischial tuberosity.
•
Insertion
• Medial lip of the linea aspera and
adductor tubercle.
•
Action
• Adduct the hip, medially rotate the
hip, flex the hip.
• Posterior fibers of the Adductor
Magnus also help to extend the hip.
Muscles of the Hip
Adductor Magnus (posterior view)
Muscles of the Hip
Adductor Brevis
•
Origin
• Inferior ramus of the pubis.
•
Insertion
• Pectineal line and medial lip of the
linea aspera.
•
Action
• Adduct the hip, medially rotate
the hip, flex the hip.
Muscles of the Hip
Tensor Fascia Latae and the
Iliotibial Band
•
Origin
• Iliac crest, posterior to the
ASIS
•
Insertion
• Iliotibial tract (which then
inserts on the tibial
tubercle on the lateral
aspect of the proximal
tibia)
•
Action
• Flex the hip, medially rotate
the hip, abduct the hip
Muscles of the Hip
Iliacus
•
Origin
•
•
Iliac fossa.
Insertion
•
•
Lesser trochanter of the femur.
Action
•
Flex the hip, laterally rotate the
hip, flex the trunk toward the
thigh, tilt the pelvis anteriorly.
Muscles of the Hip
Psoas Major
•
Origin
•
•
Bodies and transverse processes
of lumbar vertebrae.
Insertion
•
•
Lesser trochanter of the femur.
Action
•
Flex the hip, laterally rotate the
hip, flex the trunk towards the
thigh, tilt the pelvis anteriorly,
assist in laterally flexing the
lumbar spine.
Muscles of the Hip
Psoas Minor
•
Origin
•
•
Body and transverse process of
first lumbar vertebra.
Insertion
•
•
Superior ramus of the pubis.
Action
•
Helps to create lordotic
curvature in the lumbar spine, tilt
the pelvis posteriorly.
Muscles of the Hip
Quadratus Lumborum
•
Origin
•
•
Posterior iliac crest.
Insertion
•
•
Last rib and transverse processes
of first through fourth lumbar
vertebrae.
Action
•
Laterally tilt pelvis (elevate side),
laterally flex the vertebral
column to the same side, assist in
extension of the vertebral
column, fix the last rib during
forced inhalation and exhalation.
Muscles of the Hip
Semimembranosus
•
Origin
• Ischial tuberosity.
•
Insertion
• Posterior aspect of
medial condyle of tibia.
•
Action
• Flex the knee, medially
rotate the flexed knee,
extend the hip, assist in
medially rotating the
hip, tilt the pelvis
posteriorly
Muscles of the Hip
Semitendinosus
•
Origin
• Ischial tuberosity.
•
Insertion
• Proximal, medial shaft of
the tibia at pes
anserinus.
•
Action
• Flex the knee, medially
rotate the flexed knee,
extend the hip, assist to
medially rotate the hip,
tilt the pelvis posteriorly.
Muscles of the Hip
Biceps Femoris
•
Origin
• Long head: Ischial
tuberosity.
• Short head: Lateral lip of the
linea aspera.
•
Insertion
• Head of the fibula.
•
Action
• Flex the knee, laterally
rotate the flexed knee, Long
head: extend the hip and
assist to laterally rotate the
hip, tilt the pelvis posteriorly.
Muscles of the Hip
Quadratus Femoris
• Origin
• Lateral border of the ischial
tuberosity.
• Insertion
• Intertrochanteric crest,
between the greater and
lesser trochanters.
• Action
• Laterally rotate the hip.
Muscles of the Hip
Obturator Externus
• Origin
• Rami of pubis and ischium,
obturator membrane.
• Insertion
• Trochanteric fossa of the
femur.
• Action
• Laterally rotate the hip.
Muscles of the Hip
Obturator Internus
• Origin
• Obturator membrane and
inferior surface of the
obturator foramen.
• Insertion
• Medial surface of the greater
trochanter.
• Action
• Laterally rotate the hip.
Muscles of the Hip
Inferior Gemellus
• Origin
• Ischial tuberosity.
• Insertion
• Medial surface of the greater
trochanter.
• Action
• Laterally rotate the hip.
Muscles of the Hip
Superior Gemellus
• Origin
• Ischial spine.
• Insertion
• Medial surface of the greater
trochanter.
• Action
• Laterally rotate the hip.
Muscles of the Hip
Piriformis
• Origin
• Anterior surface of sacrum.
• Insertion
• Superior aspect of the
greater trochanter.
• Action
• Laterally rotate the hip and
abduct the hip when the hip
is flexed.
Muscles of the Hip
Gluteus Minimus
• Origin
• Gluteal surface of the ilium
between the anterior and
inferior gluteal lines.
• Insertion
• Anterior aspect of the
greater trochanter.
• Action
• Abduct the hip, medially
rotate the hip, and flex the
hip.
Muscles of the Hip
Gluteus Medius
• Origin
• Gluteal surface of the ilium, between the
posterior and anterior gluteal lines, just
below the iliac crest.
• Insertion
• Lateral aspect of the greater trochanter.
• Action
• Abduct the hip, flex the hip (anterior fibers),
medially rotate the hip (anterior fibers),
extend the hip (posterior fibers) and
laterally rotate the hip (posterior fibers).
Muscles of the Hip
Gluteus Maximus
• Origin
• Coccyx, edge of sacrum,
posterior iliac crest,
sacrotuberous and sacroiliac
ligaments.
• Insertion
• Iliotibial tract (upper fibers) and
gluteal tuberosity (lower fibers).
• Action
• Extend the hip (all fibers),
laterally rotate the hip (all
fibers), abduct the hip (all
fibers), adduct the hip (lower
fibers).
ROM of the Hip Joint
Adduction
Torso Flexion
Abduction
Torso Extension
Flexion
Lateral Flexion
Extension
Lateral Rotation
Internal Rotation
Circumduction
External Rotation
Muscle Groups of the Hip
Hip flexors
•Psoas Major
•Psoas Minor
•Iliacus
•Rectus Femoris
•Tensor Fascia Latae
•Sartorius
Hip Extensors
•Gluteus Maximus
•Biceps Femoris
•Semimembranosus
•Semitendinosus
•Piriformis
Hip Adductors
•Adductor Longus
•Adductor Magnus
•Adductor Brevis
•Gracilis
•Pectineus
Hip Abductors
•Gluteus Medius
•Gluteus Minimus
•Piriformis
Muscles Groups of the Hip
Medial Rotators
•Gluteus medius
•Gluteus Minimus
•Tensor Fascia Latae
Lateral Rotators
•Gluteus maximus
•Piriformis
•Superior Gemellus
•Inferior Gemellus
•Obturator Internus
•Obturator Externus
•Quadratus Femoris
Common Injuries
Groin strains
Myositis Ossificans
Trochanteric Bursitis
Avulsion Fractures/Apophysitis
Testicular Contusion
Osteitis Pubis
Hip Pointer (contusion)
Piriformis Syndrome
Hip Dislocation
Legg-Calve’-Perthes Disease
(Coxa Plana)
Avascular Necrosis
Femur Fracture
Thigh Contusion
Slipped Capital Femoral
Epiphysis
Groin Strain
Etiology
Groin strain
Pathology
Treatment
Trochanteric Bursitis
Etiology
Pathology
Treatment
• Injection procedure
Testicular Contusion
Etiology
Pathology
Treatment
Hip Pointer (Contusion)
Etiology
• Hip pointer
Pathology
Treatment
Hip Dislocation
Etiology
• Hip Dislocation
Pathology
Treatment
Avascular Necrosis
Etiology
Pathology
Treatment
Femur Fracture
Etiology
Pathology
Treatment
Thigh Contusion
Etiology
Pathology
Treatment
Myositis Ossificans
Etiology
Pathology
Treatment
Avulsion Fractures/Apophysitis
Etiology
Pathology
Treatment
Osteitis Pubis
Etiology
Pathology
Treatment
Piriformis Syndrome
Etiology
Pathology
Treatment
•
Piriformis
Test
•
Piriformis
Release
Legg-Calve’-Perthes Disease (Coxa
Plana)
Etiology
Pathology
Treatment
Slipped Capital Femoral Epiphysis
Etiology
Pathology
Treatment
For your quizzes:
Students should be able to:
• Identify the different parts of the bones of the
hip on a labeling quiz.
• Identify the different muscles of the hip on a
labeling quiz.
• Identify the different bones on a practical exam.
• Identify the different hip injuries and conditions
and be able to define them.