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Chapter 9 the Hip Joint and Pelvic Girdle

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The Hip Joint and Pelvic Girdle • Hip joint (acetabular femoral) – relatively stable due to • bony architecture Chapter 9 • strong ligaments • large supportive muscles The Hip Joint and Pelvic Girdle – functions in weight bearing & locomotion • enhanced significantly by its wide range of Manual of Structural Kinesiology motion • ability to run, cross-over cut, side-step cut, R.T. Floyd, EdD, ATC, CSCS jump, & many other directional changes © 2007 McGraw-Hill Higher Education. All rights reserved. 9-1 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-2 Bones Bones • Ball & socket joint – Sacrum – Head of femur connecting • extension of spinal column with acetabulum of pelvic with 5 fused vertebrae girdle • extending inferiorly is the coccyx – Pelvic girdle • Pelvic bone - divided into 3 • right & left pelvic bone areas joined together posteriorly by sacrum – Upper two fifths = ilium • pelvic bones are ilium, – Posterior & lower two fifths = ischium, & pubis ischium – Femur – Anterior & lower one fifth = pubis • longest bone in body © 2007 McGraw-Hill Higher Education. All rights reserved. 9-3 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-4 Bones Bones • Bony landmarks • Bony landmarks – Anterior pelvis - origin – Lateral pelvis - for hip flexors origin for hip • tensor fasciae latae - abductors anterior iliac crest • gluteus medius & • sartorius - anterior minimus - just superior iliac spine below iliac crest • rectus femoris - anterior inferior iliac spine © 2007 McGraw-Hill Higher Education. All rights reserved. 9-5 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-6 1 Bones Bones • Bony landmarks • Bony landmarks – Medially - origin for – Posteriorly – origin for hip hip adductors extensors • adductor magnus, • gluteus maximus - adductor longus, posterior iliac crest & adductor brevis, posterior sacrum & coccyx pectineus, & gracilis - – Posteroinferiorly - origin pubis & its inferior for hip extensors ramus • hamstrings - ischial tuberosity © 2007 McGraw-Hill Higher Education. All rights reserved. 9-7 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-8 Bones Bones • Bony landmarks • Bony landmarks – Proximal thigh - insertion for short – Patella – insertion for all 4 muscles of hip quadriceps muscles • gluteal muscles & most of the six deep external rotators - greater – Proximal tibia or fibula – insertion trochanter for remainder of hip muscles • iliopsoas - lesser trochanter • sartorius, gracilis, & semitendinosus - upper anteromedial tibial surface – Proximal thigh - origin for 3 knee just below medial condyle after extensors crossing knee posteromedially • three vasti muscles of quadriceps – • semimembranosus - posteromedially anteriorly on medial tibial condyle • hip adductors - linea aspera © 2007 McGraw-Hill Higher Education. All rights reserved. 9-9 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-10 Bones Joints • Bony landmarks • Anteriorly – Proximal tibia or fibula – insertion – Two pelvic bones join to form for remainder of hip muscles symphysis pubis, amphiarthrodial • biceps femoris – laterally, primarily on fibula head with some fibers • Posteriorly attaching on lateral tibial condyle – Sacrum is between the 2 pelvic • iliotibial tract of tensor fasciae latae – bones & forms the sacroiliac anterolaterally on Gerdy’s tubercle of joints tibia – Strong ligaments unite these bones to form rigid, slightly movable joints © 2007 McGraw-Hill Higher Education. All rights reserved. 9-11 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-12 2 Joints Joints • Large & heavy bones covered by thick, • Jogging & running result in faster heavy muscles movements & greater range of • Very minimal oscillating-type movements movement occur in sacroiliac joints, as in walking • Pelvic rotation increases the length of • Body movements usually involve entire stride in running; in kicking it results in a pelvic girdle & hip joints greater distance or more speed to the • In walking, hip flexion & extension occur kick with pelvic girdle rotation, forward in hip flexion & backward in hip extension © 2007 McGraw-Hill Higher Education. All rights reserved. 9-13 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-14 Joints Joints • Acetabulofemoral joint - most mobile • Acetabulofemoral joint joints of body (except glenohumeral) – Iliofemoral or Y – Multiaxial arrangement ligament – located – Bony architecture provides stability anteriorly, prevents hyperextension • relatively few hip joint subluxations & dislocations – Pubofemoral ligament - – Enarthrodial-type joint located anteromedially & inferiorly, limits – Femoral head inserting into acetabulum excessive extension & – Reinforced by extremely strong & dense abduction ligamentous capsule, especially anteriorly © 2007 McGraw-Hill Higher Education. All rights reserved. 9-15 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-16 Joints Joints • Acetabulofemoral joint • Some disagreement – Teres ligament - attaches about exact possible from deep in acetabulum to a range of each depression in femoral head, slightly limits adduction movement in hip joint – Ischiofemoral ligament – – 0 to 130 degrees of located posteriorly, extends flexion from ischium to trochanteric – 0 to 30 degrees of fossa of femur, limits internal rotation extension © 2007 McGraw-Hill Higher Education. All rights reserved. 9-17 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-18 3 Joints Joints – 0 to 35 degrees of abduction – 0 to 45 degrees of internal rotation – 0 to 30 degrees of adduction – 0 to 50 degrees of external rotation © 2007 McGraw-Hill Higher Education. All rights reserved. 9-19 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-20 Joints Joints Motions accompanying pelvic rotation • Pelvic girdle moves back & forth within Pelvic Rotation Lumbar Spine Right Hip Left Hip 3 planes for a total of 6 different Motion Motion Motion movements Anterior rotation Extension Flexion Flexion – All pelvic girdle rotation results from motion Posterior rotation Flexion Extension Extension Right lateral Right lateral at one or more locations Adduction Abduction rotation flexion • right hip Left lateral rotation Left lateral flexion Abduction Adduction • left hip Right transverse Left transverse Internal External • lumbar spine rotation rotation rotation rotation Left transverse Right transverse External Internal rotation rotation rotation rotation © 2007 McGraw-Hill Higher Education. All rights reserved. 9-21 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-22 Movements Movements • Anterior & posterior pelvic rotation • Hip flexion – sagittal or anteroposterior plane – movement of femur straight anteriorly toward • Right & left lateral rotation pelvis – lateral or frontal plane • Hip extension • Right transverse (clockwise) rotation & – movement of the femur left transverse (counterclockwise) straight posteriorly away rotation from the pelvis; sometimes referred to as – horizontal or transverse plane of motion hyperextension © 2007 McGraw-Hill Higher Education. All rights reserved. 9-23 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-24 4 Movements Movements • Hip abduction • Hip external rotation – movement of femur – rotary movement of femur laterally to side away from laterally around its midline longitudinal axis away from midline; lateral rotation • Hip adduction • Hip internal rotation – movement of femur – rotary movement of femur medially toward midline medially around its longitudinal axis toward to midline; medial rotation © 2007 McGraw-Hill Higher Education. All rights reserved. 9-25 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-26 Movements Movements • Hip diagonal abduction • Anterior pelvic rotation – movement of femur in a – anterior movement of upper diagonal plane away from pelvis; iliac crest tilts forward in midline of body a sagittal plane; anterior tilt • Hip diagonal adduction • Posterior pelvic rotation – movement of femur in a – posterior movement of upper diagonal plane toward pelvis; iliac crest tilts backward midline of body in a sagittal plane; posterior tilt © 2007 McGraw-Hill Higher Education. All rights reserved. 9-27 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-28 Movements Movements • Left lateral pelvic rotation • Left transverse pelvic rotation – in frontal plane left pelvis moves inferiorly – in horizontal plane pelvis rotates to in relation to right pelvis; either left pelvis body's left; right iliac crest moves rotates downward or right pelvis rotates anteriorly in relation to left iliac upward; left lateral tilt crest, which moves posteriorly • Right lateral pelvic rotation • Right transverse pelvic rotation – in frontal plane right pelvis moves inferiorly – in horizontal plane pelvis rotates to in relation to left pelvis; either right pelvis body's right; left iliac crest moves rotates downward or left pelvis rotates anteriorly in relation to right iliac upward; right lateral tilt crest, which moves posteriorly © 2007 McGraw-Hill Higher Education. All rights reserved. 9-29 © 2007 McGraw-Hill Higher Education. All rights reserved. 9-30 5 Muscles Muscles • Seven two-joint muscles have one action • Muscles involved in hip & pelvic girdle at hip & another at knee motions depend largely on direction of movement and position of body in relation to earth & gravitational forces • Body part that moves most will be the part least stabilized – Standing on both feet & contracting hip flexors, the trunk & pelvis rotate anteriorly – Lying
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