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Care and Prevention Chapter 21
Hip, Thigh, Groin, Pelvis
THIGH
Bones:
Femur

Muscles:
Quadriceps (4): - involved in knee extension & deceleration movements.
     Rectus Femoris
     Vastus Lateralis
     Vastus Medialis
     Vastus Intermedius

Hamstrings (3): - involved in knee flexion & acceleration movements
     Biceps Femoris
     Semimembranosus
     Semitendinosus

Hamstring/Quad Strain:
MOI: sudden overstretching
Important factors: poor flexibility, improper technique, fatigue, imbalance of quad-Hamstring strength
S&S: Limping, decreased ROM, decreased strength, increased muscle tone, pnt tenderness, possible ecchymosis or palpable gap.
Treatment: Ice, Compression, Stretch, NSAID

Quad Contusion:
MOI: Direct blow
S&S: Pnt tenderness, palpable knot or lump, increased muscle tone, decreased ROM, Decreased strength, Ecchymosis.
Treatment: ICE, compression, light stretching
post-acute- Ultrasound, and massage to avoid myositis ossificans(bone formation within the muscle tissue

Adductor strain: Commonly referred to as a "Groin Strain" involved the adductor muscle group: Adductor magnus, adductor longus, adductor brevis, gracilis and to an extent, the pectineus muscles.
This condition is usually positive with manual muscle testing of hip adduction. Pain with resisted hip flexion may elicit a false positive for adductor strain, but is indicative of a rectus femoris or satorius strain.


HIP

Bones:
Femur
Pelvis

Joints: Hip joint( made up of the acetabular labrum, femoral head, and greater trochanter)

Muscles:
Gluteus medius
Gluteus Minimus
Tensor fascia latae
Gluteus maximus
Iliopsoas
Sartorius - the longest muscle in the body
Adductors (longus, magnus, brevis)
Gracilis
Hamstrings
Quadriceps

Iliac Crest Contusion (hip pointer)
Contusion of illiac crest (usually ASIS)
MOI: Direct blow
S&S: mild swelling, ecchymosis, pnt tender
Treatment: Ice, pad, e-stim, ultrasound

Muscle strain (quad, illiopsoas, gracilis, sartorius adductor group)
MOI: overstretching of the muscle or tendon
S&S: swelling, ecchymosis, limited ROM, decreased strength
Treatment: Ice, light stretching, wrap, heat, strength exercises

Hip dislocation:
MOI: direct blow, or severe twisting with foot planted
S&S: deformity, loss of circulation
Treatment: check circulation, activate EMS

Trochanteric Bursitis(snapping hip syndrome)
MOI: Direct blow or repetitive jumping or running
S&S: Pain when palpating the greater trochanter, an audible and palpable snap
Treatment: Rest, ice and stretch

Ischial Bursitis:
MOI: Direct blow or sitting for a prolonged period with legs crossed or on a hard surface
S&S: tenderness over the ischial bursa
Treatment: Ice, rest, ultrasound and stretch

Slipped Capital Femoral Epiphysis
Not a true athletic injury. Occurs in pre-adolescent or adolescent athletes
MOI: growth disturbance in the capital femoral epiphysis and minor trauma
S&S: pain in the groin but may have referred pain in knee or anterior thigh, limited ROM of hip
Treatment: Refer to physician

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