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