chapter 5 - hip & pelvis pt 1

degrees of movement in hip joint

- 0 to 130 degrees of flexion - 0 to 30 degrees of extension - 0 to 35 degrees of abduction - 0 to 30 degrees of adduction - 0 to 45 degrees of internal rotation - 0 to 50 degrees of external rotation

posteriorly, sacrum is between the

- 2 pelvic bones & forms the sacroiliac joints - strong ligaments unite these bones to form rigid, slightly movable joints

sacrum

- extension of spinal column with 5 fused vertebrae - extending inferiorly is the coccyx

jogging & running result in

- faster movements & greater ROM

in kicking, pelvic rotation results in a

- greater distance or more speed to the kick

ball & socket joint

- head of femur connecting with acetabulum of pelvic girdle

lateral pelvic rotation accomplished by

- hip abduction, hip adduction, &/or lumbar lateral flexion

posterior pelvic rotation accomplished by

- hip extension and/or lumbar flexion

anterior pelvic rotation accomplished by

- hip flexion and/or lumbar extension

right transverse (clockwise) pelvic rotation & left transverse (counterclockwise) pelvic rotation occurs in

- horizontal or transverse plane of motion

left lateral pelvic rotation

- in frontal plane left pelvis moves inferiorly in relation to right pelvis - either left pelvis rotates downward or right pelvis rotates upward - left lateral tilt

right lateral pelvic rotation

- in frontal plane right pelvis moves inferiorly in relation to left pelvis - either right pelvis rotates downward or left pelvis rotates upward - right lateral tilt

left transverse pelvic rotation

- in horizontal plane pelvis rotates to body's left - right iliac crest moves anteriorly in relation to left iliac crest, which moves posteriorly

right transverse pelvic rotation

- in horizontal plane pelvis rotates to body's right - left iliac crest moves anteriorly in relation to right iliac crest, which moves posteriorly

patella

- insertion for all 4 quadriceps muscles

posterior pelvic rotation

- posterior movement of upper pelvis - iliac crest tilts backward in a sagittal plane - posterior tilt - upward rotation

anteriorly, two pelvic bones join to form

- pubic symphysis (amphiarthrodial)

pelvic girdle

- r & l pelvic bone joined together posteriorly by sacrum - divided into 3 areas - pelvic bones are ilium, ischium, & pubis

hip joint (acetabular femoral)

- relatively stable due to: bony architecture, strong ligaments, & large supportive muscles - functions in weight bearing & locomotion - enhanced significantly by its wide ROM - ability to run, cross-over cut, side-step cut, jump, & many other directional changes

left transverse pelvic rotation accomplished by

- right hip external rotation, left hip internal rotation, &/or right lumbar rotation - vice versa for right TPR

hip external rotation

- rotary movement of femur laterally around its longitudinal axis away from midline - lateral rotation

hip internal rotation

- rotary movement of femur medially around its longitudinal axis toward midline - medial rotation

anterior & posterior pelvic rotation occurs in

- sagittal plane (mediolateral axis)

ischial tuberosity

- serves as the proximal attachment site of the hamstrings muscle group & adductor magnus among other lower extremity muscles

body part that moves most will be the part least stabilized

- standing on both feet & contracting hip flexors, the trunk & pelvis rotate anteriorly - lying supine & contracting hip flexors, the thighs move forward into flexion on the stable pelvis

pelvic rotation increases

- the length of stride in running

origin for 3 knee extensors

- three vasti muscles of quadriceps: anteriorly - hip adductors: linea aspera

ilium

- upper two fifths - attachment site for a number of large muscles - anterior superior iliac spine (ASIS) - anterior inferior iliac spine (AIIS) - iliac crest, iliac fossa - posterior superior inferior spine

body movements usually involve

- entire pelvic girdle & hip joints - large & heavy bones covered by thick, heavy muscles

ischium

- posterior & lower two fifths - most inferior aspect of the pelvis - ischial tuberosity - ischial ramus

acetabulum is lined with a labrum to

- enhance stability & provide some shock absorption

pubis

- anterior & lower one fifth - located anterior and medial to the ASIS - pubic crest - pectineal line - pubic tubercle - inferior pubic ramus - pubic symphysis

anterior pelvic rotation

- anterior movement of upper pelvis - iliac crest tilts forward in a sagittal plane - anterior tilt - downward rotation

teres ligament of acetabulofemoral joint

- attaches from deep in acetabulum to a depression in femoral head - slightly limits adduction

in walking or running (gait)

- called contralateral pelvic drop - if on right foot, left pelvis drops (vice-versa)

acetabulum

- deep hemispherical cup-shaped socket - contains the head of the femur - acetabular fossa - acetabular labrum

muscles involved in hip & pelvic girdle motions depend on

- direction of movement and position of body

hip extensor muscles used

- eccentrically: pelvis & trunk move downward on the femur (controlled) - concentrically: trunk is raised on femur (rising to standing position)

proximal tibia or fibula

- insertion for remainder of hip muscles - sartorius, gracilis, & semitendinosus: upper anteromedialtibial surface just below medial condyle after crossing knee posteromedially - semimembranosus: posteromedially on medial tibialcondyle - biceps femoris: laterally, primarily on fibula head with some fibers attaching on lateral tibial condyle - iliotibial tract of TFL: anterolaterally on Gerdy's tubercle of tibia

proximal thigh

- insertion for short muscles of hip - gluteal muscles & most of the six deep external rotators: greater trochanter - iliopsoas: lesser trochanter

right & left lateral pelvic rotation occurs in

- lateral or frontal plane

iliofemoral or Y ligament of acetabulofemoral joint

- located anteriorly - prevents hyperextension

pubofemoral ligament of acetabulofemoral joint

- located anteromedially & inferiorly - limits excessive extension & abduction

ischiofemoral ligament of acetabulofemoral joint

- located posteriorly, - extends from ischium to trochanteric fossa of femur - limits internal rotation

femur

- longest & strongest bone in body - head of the femur - femoral neck - femoral shaft - greater trochanter - lesser trochanter

acetabulofemoral joint

- most mobile joint of body (except glenohumeral) - multiaxial arrangement - bony architecture provides stability - relatively few hip joint subluxations & dislocations - enarthrodial-type joint - reinforced by extremely strong & dense ligamentous capsule, especially anteriorly

in downward phase of knee-bend exercise

- movement at hips & knees is flexion - hip & knee extensors involvement in eccentric contraction

hip diagonal abduction

- movement of femur in a diagonal plane away from midline of body

hip diagonal adduction

- movement of femur in a diagonal plane toward midline of body

hip horizontal abduction

- movement of femur in a horizontal or transverse plane away from pelvis

hip horizontal adduction

- movement of femur in a horizontal or transverse plane toward pelvis

hip abduction

- movement of femur laterally to side away from midline

hip adduction

- movement of femur medially toward midline

hip flexion

- movement of femur straight anteriorly toward pelvis

hip extension

- movement of the femur straight posteriorly away from the pelvis - sometimes referred to as hyperextension

hip flexor muscles used in

- moving thighs up toward trunk

seven two-joint muscles have

- one action at hip & another at knee

lateral pelvis

- origin for hip abductors - gluteus medius & minimus: just below iliac crest

medial pelvis

- origin for hip adductors - adductor magnus, adductor longus, adductor brevis, pectineus, & gracilis: pubis & its inferior ramus

posterior pelvis

- origin for hip extensors - gluteus maximus: posterior iliac crest & posterior sacrum & coccyx

posteroinferiorly pelvis

- origin for hip extensors - hamstrings: ischial tuberosity

anterior pelvis

- origin for hip flexors - tensor fasciae latae: anterior iliac crest - sartorius: anterior superior iliac spine - rectus femoris: anterior inferior iliac spine

in walking, hip flexion & extension occur with

- pelvic girdle rotation, forward in hip flexion, & backward in hip extension