LeLeLectureLecture 4

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Kinesiology&Physical Education
EDKP 330
David J Pearsall

Of Hip Joint (structures) 2/20/2013 6:08:00 PM Hip joint  Head of humerus sits in pocket called “acetabulum”  Triaxial joint- 3 planes of motion Hip bones  Innominate (one half) o Ilium, ishcium pubis  All 3 form the acetabulum  Proximal femur o Head is 2/3 sphere (vs humerus which is 1/3 sphere)  Shape made by articular cartilage  Thickest in middle, thinner on outer edges  Completely covers head except for posterior portion to allow for ligament attachement  2 halves (innominate sides) together = boney pelvis Hip Muscles  Large/strong o Some cross hip joint and lumbar spine o Some cross hip joint and knee  Hip abductors o Gluteus medius & minimus  Help keep pelvis level  resist GRF Hip joint cartilage  Labrum o Fibrocartilaginous ring o Function: deepens acetabulum  Increased stabilization  Increased articulation b/w head of humerus and acetabulum  more support throughout ROM o Tear is hard to diagnose Hip joint ligaments  Iliofemoral, pubofemoral, ischiofemoral o Restict movement to make sure hip is stabilized o Very strong o Reinforce hip joint ANTERIORLY Mobility vs stability  Greater hip stability but less mobility when compared to shoulder joint  good, need more motion in shoulder than in hip but need more stabilization in hip than in shoulder (faces greater loads) o Greater boney congruency (due to labrum)  More surface for articulation  Humerus: 1/3 sphere vs femur: 2/3 sphere o More support by ligament/capsule  Due to fibrous attachement o 3 degrees of freedom  triaxial joint  Movement limitations are caused by o Ligaments o Muscles o combination Of Hip joint 2/20/2013 6:08:00 PM ROM  sagittal: anterior/posterior direction  frontal: o abduction- taking hip away (move leg laterally) o adduction- bringing him in (move leg medially) Pelvic tilts  Anterior tilt  hip flexion (anterior aspect of pelvis is now closer to femur) o Causes lumbar extension  Posterior tilt  hip extension (anterior aspect of pelvis is now further from femur) o Causes lumbar flexion Kinematics o  Hip flexion of at least 120  Abduction and external rotation of at least 20 o o o Walking around 30-40 of movement o Tying shoe ~124 o o o Squatting ~ 122 Restricted ROM  Hip replacememtn (arthroplasty) for arthritis/trauma (fracture) o Most likely to have a hip dislocation  Restrictied ROM after hip replacement o No hip flexion past 90 o  Issue for tying shoes, sitting on a toilet, squatting to pick up something  No extremes of rotation  No adduction past midline o Ensures hip does not dislocate Note: dysplasia- hip doesn’t form right Arthritis: inflammatory condition that is associated with joint pain, stiffness and swelling  Adaptive equipment o Cane, special shoes, toilet seat with handle bars so you can lower yourself, something that puts on socks for you Pelvic-hip & Spine-hip interaction  Posterior hip rotation- “tucking tail between your legs” o Causes your lumbar spine to flex while hip is in extension  Anteiror rotation- hip bone forward o Flexing lumbar spine and hip Note: extension of the back is when it is arched backwards  think back handspring = extension Flexion of the back is when you have it curved (sucking in gut to spine)  Feel whether or not your lower back arches (extension) or curves (flexion)  Hip hike o Left hip up (adducted)  Right hip is abducted  Rotate forward o On right side: right hip is rotated externally (laterally) while left side is rotated internally (medially) Of Hip 2/20/2013 6:08:00 PM 0% = heel strike most of the movement during walking is generated by the hip and associated muscles Adduction- you are now standing on one leg as you swing your leg remember: forward rotation of hip = external rotation  as you bring your leg forward, you begin to internally rotate hip Trendelenburg Gait/gluteus medius lurch  Weakness in hip abductors (gluteus medius/minimus) often due to pain in the hip from disease (hip osteoarthritis)  Standing on affected leg o Pelvis on unsupporting side drops  Cane can help prevent this  Typically abductors prevent the drop from occuring o Compensate by leaning upper body and trunk over affected leg (lateral displacement)  Weakness on the right, lean to the right  This causes the GRF to move closer to the hip, decreasing the lever arm  don’t require as much work from muscles  Forces o F m F *dw/ w m •decrease dw •decrease demand on abductor muscles (Fm) o F m F *dw/ w m 2/20/2013 6:08:00 PM Angles of inclination (angle b/w neck & shaft of femur) o  Typically ~125  Conditions o o Coxa Valga (>125 )  Changes loading in the hip  Moves lateral= less area of articulation within capsule = increased joint stress  Increased risk of degredation of acetabulum  Limb is lengthened  More compressive loads on neck- less bending Note: think LATERAL movement of angle  vaLga  Reduced effectiveness of abductors o o Coxa Vara (<125 )  Femoral head is more superior in acetabulum  Decreased angle b/w neck and femur  Shortens limb  Greater trochanter moved medially  Increased effectiveness of abductors  Reduction of joint reaction forces 
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