Podcast
Questions and Answers
Which muscle is considered the primary internal rotator at 90 degrees of hip flexion?
Which muscle is considered the primary internal rotator at 90 degrees of hip flexion?
- Tensor fasciae latae (correct)
- Adductor longus
- Glute med
- Piriformis
Which condition is most likely to result from weakness or impaired coordination of the hip muscles?
Which condition is most likely to result from weakness or impaired coordination of the hip muscles?
- Patellar tendonitis
- Iliotibial band syndrome
- Anterior knee pain (correct)
- Achilles tendinopathy
Which statement is true regarding the hip's external rotators?
Which statement is true regarding the hip's external rotators?
- The sartorius is the primary external rotator.
- The primary external rotators include Glute max and the Deep 6. (correct)
- Glute med posterior fibers are considered primary external rotators.
- Obturator externus is the main contributor to external rotation.
What is the biomechanical relationship between hip dysfunction and knee problems?
What is the biomechanical relationship between hip dysfunction and knee problems?
What effect does anterior pelvic tilt have on hip range of motion?
What effect does anterior pelvic tilt have on hip range of motion?
Which muscle is primarily responsible for producing an anterior pelvic tilt?
Which muscle is primarily responsible for producing an anterior pelvic tilt?
What is the typical functional range of motion for stair descent at the hip?
What is the typical functional range of motion for stair descent at the hip?
Which hip muscles are considered primary hip extensors?
Which hip muscles are considered primary hip extensors?
What motion occurs at the hip during the initial phase of a squat?
What motion occurs at the hip during the initial phase of a squat?
In lower crossed syndrome, which of the following muscle groups is typically weak?
In lower crossed syndrome, which of the following muscle groups is typically weak?
What is the purpose of goniometry techniques in assessing hip motion?
What is the purpose of goniometry techniques in assessing hip motion?
Which of the following statements about hip abductors is true?
Which of the following statements about hip abductors is true?
During hip flexion, what is the pattern of capsular restriction at the hip?
During hip flexion, what is the pattern of capsular restriction at the hip?
What movement at the hip joint is primarily associated with anterior pelvic tilt?
What movement at the hip joint is primarily associated with anterior pelvic tilt?
Which of the following muscles is primarily responsible for hip adduction?
Which of the following muscles is primarily responsible for hip adduction?
In which plane does abduction and adduction of the hip occur?
In which plane does abduction and adduction of the hip occur?
Which ligament provides anterior support to the hip joint?
Which ligament provides anterior support to the hip joint?
What is the axis of rotation for hip flexion and extension?
What is the axis of rotation for hip flexion and extension?
Lower Crossed Syndrome typically involves tightness in which of the following muscle groups?
Lower Crossed Syndrome typically involves tightness in which of the following muscle groups?
What type of joint is the hip categorized as?
What type of joint is the hip categorized as?
During goniometry for measuring hip internal and external rotation, which axis is utilized?
During goniometry for measuring hip internal and external rotation, which axis is utilized?
The acetabulum is primarily formed by which three bones?
The acetabulum is primarily formed by which three bones?
What is the function of the acetabular notch?
What is the function of the acetabular notch?
Flashcards
End-feel (soft)
End-feel (soft)
A soft sensation when movement stops, typically due to soft tissue.
End-feel (firm)
End-feel (firm)
A firm sensation when movement stops, typically due to bone-on-bone contact or joint capsule.
Hip Flexion ROM (Walking)
Hip Flexion ROM (Walking)
30 degrees flexion to 10 degrees extension while walking.
Hip Flexors Muscle Group
Hip Flexors Muscle Group
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Hip Extensors Muscles
Hip Extensors Muscles
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Hip Abductors Muscle Group
Hip Abductors Muscle Group
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Hip Adductors Muscle Group
Hip Adductors Muscle Group
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Capsular Pattern (Hip)
Capsular Pattern (Hip)
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Hip Joint Structure
Hip Joint Structure
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Acetabulum
Acetabulum
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Hip Joint Stability
Hip Joint Stability
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Pelvic Tilt and ROM
Pelvic Tilt and ROM
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Lower Crossed Syndrome
Lower Crossed Syndrome
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Goniometry
Goniometry
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Hip Joint ROM Axes
Hip Joint ROM Axes
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Ligamentous Support (Hip)
Ligamentous Support (Hip)
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Transverse Ligament
Transverse Ligament
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Hip Flexion
Hip Flexion
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Hip Internal Rotation
Hip Internal Rotation
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Hip External Rotation
Hip External Rotation
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Regional Interdependence
Regional Interdependence
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Hip Dysfunction
Hip Dysfunction
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Anterior Knee Pain
Anterior Knee Pain
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Study Notes
Hip Examination
- Examiner: Rebecca Pinkus, PT, DPT, NCS, PT8311
- Contributors: Jolene Walsh, PT, MPT; Keith Cole, PT, DPT, PhD, MBiomedEd; Joseph Signorino, PT, DPT, OCS, FAAOMPT; Dhinu Jayaseelan, DPT, OCS, FAAOMPT
- University: The George Washington University
- Reference: https://paindoctor.com/conditions/hip-pain/
Objectives
- Discuss relevant subjective questions specific to hip pathology
- Discuss relevant anatomy related to physical examination of the hip
- Describe typical goniometric and muscle testing technique for the hip region
- Present various clinical presentations of hip dysfunction that may be more likely based on appropriate examination techniques
Subjective Intake
- Include both family and individual information
- Medical History: HTN/CAD, cholesterol, DM
- Symptoms: Quality (burning, aching, stabbing, shooting, stiffness), instability, deep/superficial location
- Symptoms Including Aggravating/Alleviating Factors: Sitting, sitting durations, squatting, and 24-hour pain pattern (AM/day/night)
- Common Complaints: Joint sounds (clicking, crepitus)
Importance of Subjective History
- Hip can be the primary source of pain; localized or referred
- Hip structures refer pain to other areas
- Possible Referred Pain: Lumbar and/or Thoracic Spine, Pubic symphysis, pelvic girdle pain, visceral (appendix, renal), GU (ureter, bladder), hernia
Where is the Pain?
- Table 1: Frequency of pain referral to buttock, thigh, groin, leg, knee, and foot
- Anatomic Region: Buttock, thigh (anterior, lateral, posterior, medial), groin, leg (lateral, posterior, anterior, medial), foot, knee
- Percentage of Patients with Pain: Data represented in a table for each anatomical region
Referred Pain Regions
- Diagram showing referred pain from various internal organs to the hip/buttock area
- Organs include: liver and gallbladder, lung and diaphragm, heart, stomach, pancreas, ovary (female), colon, kidney, ureter, urinary bladder
Primary Functions
- Support the weight of head, arms, trunk in static and dynamic postures
- Pathway for transmission of forces between the pelvis and lower extremities
The Hip
- Very (very) stable joint
- Acetabulum: Faces laterally, inferiorly, and anteriorly
- Femur: Longest bone in the body; wide diameter
ROM
- Ball and socket" joint: Circumduction joint
- Range of Motion (ROM): Flexion, extension, abduction, adduction, external rotation, internal rotation, Axis of rotation (frontal, sagittal, longitudinal)
- Muscle groups: Gluteal, adductors, iliopsoas, lateral/external rotators
Acetabulum
- Combined ilium, ischium, pubis
- Not a complete circle
- Acetabular notch (inferior) and transverse ligament complete the circle
- Labrum ("O" ring)
- 70% of the femoral head articulates with acetabulum
Ligamentous Support
- Posterior: Ischiofemoral
- Anterior: Iliofemoral, pubofemoral
Pelvic Tilt and Hip ROM
- Diagram showing neutral pelvis, anterior pelvic tilt, and posterior pelvic tilt, along with associated hip range of motion
Posture
- Lower Crossed Syndrome: Defined by Vladimir Janda (1928-2002)
- Diagram showing tight erector spinae, weak abdominal, weak gluteus maximus, and tight iliopsoas
Proximal Contribution to Distal Pathology
- Hip dysfunction may be linked biomechanically to knee and/or foot problems
- Treatment approach is regional interdependence
- Clinical Example (Anterior knee pain): Weakness/impaired coordination or timing of hip abductors/external rotators, increased dynamic genu valgum (femoral adduction + internal rotation), increased lateral compression, medial tension
Clinical Case: Hip Osteoarthritis
- History:
- Patient is generally older ( > 60 years)
- Groin pain, lateral hip pain, knee pain
- High frequency, associated with L-spine DJD
- Morning hip stiffness ( < 60 minutes)
- Functional Loss:
Research Report: Development of a Clinical Prediction Rule
- 5 variables:
- Self-reported squatting as an aggravating factor
- Active hip flexion causing lateral hip pain
- Scour with adduction creates lateral hip or groin pain
- Active hip extension causes pain
- Passive hip internal rotation less than or equal to 25 degrees
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Description
This quiz covers essential aspects of hip examination, including subjective assessments, anatomy, and examination techniques. Participants will explore common clinical presentations related to hip dysfunction and the appropriate goniometric and muscle testing methods. Understanding these concepts is crucial for effective physical therapy practice.
