Kinesiology 2: Hip Joint Pathomechanics

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Questions and Answers

What is the role of the anterior portion of the muscle when the hip is extended?

It maintains hip stability.

It acts as a lateral rotator of the hip.

It primarily flexes the hip joint.

It is a medial rotator of the hip. (correct)

How does the rotation moment arm of this muscle compare to that of the gluteus medius?

It has a similar rotation moment arm.

It does not have a rotation moment arm.

It has a smaller rotation moment arm.

It has a larger rotation moment arm. (correct)

What function does the posterior portion of the muscle serve?

It primarily extends the hip joint.

It acts as a medial rotator of the hip.

It serves as an abductor of the hip.

It functions as a lateral rotator. (correct)

Which of the following statements is true regarding the muscle mentioned?

Its anterior portion has a larger medial rotation moment arm than that of the gluteus medius. Signup and view all the answers

Which action does the posterior portion of the muscle NOT perform?

Medial rotation of the hip. Signup and view all the answers

What is a primary functional role of the adductors of the hip?

To stabilize the pelvis during weight shifting Signup and view all the answers

In which range do the middle and posterior segments have smaller adduction moment arms?

Hip flexion Signup and view all the answers

Which statement about the adductors of the hip is incorrect?

They have larger moment arms in all ranges of motion. Signup and view all the answers

Which of the following functions is not typically associated with the hip adductors?

Hip flexion and extension Signup and view all the answers

How do the middle and posterior segments of the hip adductors function during movement?

They have variable moment arms in different ranges of hip flexion. Signup and view all the answers

What is the primary function of the adductor brevis muscle?

Hip adduction Signup and view all the answers

How does the position of hip flexion affect the adductor brevis's ability to function?

It enhances hip adduction. Signup and view all the answers

Which statement is true regarding the adductor brevis muscle's moment arms?

It has a significant adduction moment arm. Signup and view all the answers

Which surgical procedure has been associated with reported injuries?

Laparoscopic prostatectomy Signup and view all the answers

What would likely happen if the adductor brevis was weakened?

Decreased ability to adduct the hip. Signup and view all the answers

In which of the following activities would the adductor brevis be mainly engaged?

Crossing legs while sitting. Signup and view all the answers

Which of the following types of delivery has a rare association with certain injuries?

Vaginal delivery Signup and view all the answers

What type of prostatectomy is mentioned in association with reported injuries?

Laparoscopic prostatectomy Signup and view all the answers

Which of these surgical methods is least likely to be associated with reported injuries according to the information?

Traditional hysterectomy Signup and view all the answers

What is the commonality between laparoscopic and endoscopic surgeries mentioned?

Both can lead to reported injuries. Signup and view all the answers

What effect does tightness of the iliacus have on hip extension range of motion (ROM)?

Reduces hip extension ROM Signup and view all the answers

What postural change occurs in individuals with tight iliacus muscles while standing?

Anterior pelvic tilt Signup and view all the answers

Which spinal position is accentuated as a result of iliacus tightness causing anterior pelvic tilt?

Hyperextension of the lumbar spine Signup and view all the answers

How does iliacus tightness influence a person's ability to maintain vision of the horizon?

It may lead to a compensatory posture Signup and view all the answers

In a standing position, which condition is most likely to occur as a result of iliacus tightness?

Increased lumbar lordosis Signup and view all the answers

What is the primary cause of the gluteus maximus lurch gait pattern?

Weakness of the gluteus maximus muscle Signup and view all the answers

During which part of the gait cycle does the lurch primarily occur?

Before heel contact Signup and view all the answers

How is the trunk positioned in a gluteus maximus lurch?

In a rapid hyperextended position Signup and view all the answers

What effect does gluteus maximus weakness have on gait mechanics?

Causes an exaggerated trunk movement Signup and view all the answers

What is NOT a characteristic of the gluteus maximus lurch?

Occurs only during running Signup and view all the answers

Study Notes

Instructor Information

Instructor: Karim Ghuiba
Title: Lecturer of Physical Therapy
Affiliation: Cairo-Galala University
Additional Qualification: Doctor of Physical Therapy
Location: New York, USA
Date of Presentation: 10/9/2024

Kinesiology 2 - Fall 2024

Course: Kinesiology 2
Institution: Galala University
Semester: Fall 2024

Lecture (2): Pathomechanics of the Hip Joint

Topic: Pathomechanics of the hip joint
Focus: Detailed study of the hip joint, including muscles and their functions.

Hip Joint Muscles

Psoas Major:
- Small moment arm for flexion but large PCSA.
- Center of mass (HAT) posterior, applying extension moment.
- Flexion moment to counteract extension.
- Better aligned for applying compressive loads to the lumbar spine.
- Contributes to low back pain during hip flexion
Iliacus:
- Large muscle with PCSA equal to or greater than psoas major.
- Primary hip flexor.
- Together with psoas major = iliopsoas muscle.
- EMG activity during sit-ups and curl-ups.
- Supports hip in standing, preventing HAT weight hyperextension.
- Weakness decreases hip flexion strength.
- Similar functional effects as weakness of psoas major.
Psoas Minor:
- Often grouped with hip flexors but has no attachment on femur.
- Considered a trunk muscle.
- Reported absent in about 40% of the population.
- When present, its actions are not isolated.
- Smaller and weaker than psoas major.
Gluteus Maximus:
- Large muscle with large PCSA.
- Primary extensor of the hip.
- Active in trunk hyperextension from prone position.
- Active during stair climbing, wall squats, and mini-squats.
- More activity during extension from the extended/hyperextended position.
- Strength is important for hip extension and lateral rotation.
- Weakness results in decreased strength of hip extension and lateral rotation (and a "gluteus maximus lurch") in walking.
Gluteus Medius:
- Abducts the hip.
- May medially rotate the hip (anterior fibers) or laterally rotate (posterior fibers).
Gluteus Minimus:
- Another strong abductor, smaller than the gluteus medius.
- Anterior part as medial rotator.
- Posterior part as lateral rotator.
- Attached to the hip joint capsule and helps protect from impingement during abduction.
Hip Adductors (Pectineus, Adductor Brevis, Adductor Longus, & Adductor Magnus):
- Stabilizes pelvis and hip during weight shifting in gait.
- Active during squats/lifting/swinging (e.g., walking, running).
- Weakness causes gait instability and an abducted gait .
- Tightness is relatively common in sedentary individuals and those on bed rest..

Hip Actions

Flexion
Extension
Adduction
Abduction
Medial Rotation
Lateral Rotation

Effects of Weakness

Psoas Major weakness: decreased hip flexion strength, difficulty with tasks like lifting a limb in and out of the bathtub or climbing stairs. Loss of muscle bulk potentially linked to age-related declines like decreased balance and difficulty climbing stairs.
Iliacus weakness: decreased hip flexion strength, similar functional effects as psoas weakness.
Gluteus Maximus weakness: Decreased hip extension and lateral rotation strength; gait pattern changes.
Gluteus Medius/Minimus weakness: Reduced hip abduction, likely influencing weight-bearing activities requiring single-limb support (gait).
Adductor weakness: Gait instability, abducted gait.

Effects of Tightness

Psoas major tightness: restricts hip extension ROM, limits trunk side-bending flexibility, results in increased lumbar lordosis in standing posture.
Iliacus tightness: reduces hip extension ROM, results in anterior pelvic tilt and hyperextension of the lumbar spine.
Gluteus maximus tightness: limits hip ROM in flexion and possibly adduction
Abductor Muscle tightness: reduces ROM in adduction, possibly lateral rotation; may be seen in individuals with arthritis .

Terminology

PCSA (Physiological Cross-Sectional Area): measure of muscle size

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Description

Explore the pathomechanics of the hip joint in this detailed quiz. Focus on the muscles involved, particularly the Psoas Major and Iliacus, and their functions during hip movement. Perfect for students of Kinesiology studying the intricacies of hip mechanics.