© 2007 mcgraw-hill higher education. all rights reserved. the thigh, hip, groin, and pelvis pe 236...

© 2007 McGraw-Hill Higher Education. All rights reserved.

The Thigh, Hip, Groin, and Pelvis

PE 236Amber Giacomazzi, MS, ATC



Prevention of Thigh Injuries

• Thigh must have ____________, ___________, and ________ to withstand _______

• ____________________ may aid in muscle preparation for activity

• _____________ can also help in preventing injuries– ____________________– ____________________


Recognition and Management of Thigh Injuries

• Quadriceps Contusions– Cause of Injury

• Constantly exposed to _______________

– Signs and Symptoms• Pain, ______________, ______________ of affected

muscles• ___________ and ________________ are vital –

increases ____________ and prevents _____________


• Treatment– _________________– Crutches for more

severe cases– Isometric quadriceps

contractions should begin as soon as tolerated

– _________________ _________________ _________________

– Padding may be worn for additional protection upon return to play


• Myositis Ossificans– Cause of Injury

• _________________________________________ _______________

– Signs and Symptoms• X-ray shows ___________________ following

injury• Pain, weakness, swelling, decreased ROM• _____________ and __________________

– Treatment• Treatment must be _______________• May require __________________ and _______

_____ (after one year - remove too early and it may come back)

• If condition is recurrent it may indicate problem with ___________


• Quadriceps Strain– Cause of Injury

• ____________ when athlete falls on _______ or experiences _______________

• Associated with _________________________________

– Signs and Symptoms• ___________ causes fewer symptoms than ___________• Pain, point tenderness, spasm, loss of function and little

discoloration• ____________ may leave athlete w/ little _________ and

____________ but with some ____________

– Treatment• Rest, ice and compression to control internal bleeding• ________________________ • Neoprene sleeve may provide some added support


• Hamstring Strains– Cause of Injury

• Multiple theories of injury– ________________________________– Change in role from ________________________– _________________________________________

_________________________________________

– Signs and Symptoms• __________________________________• Capillary hemorrhage, pain, ______________ and

_________________________– Grade 1 - __________________ and point tenderness – Grade 2 - ___________________________________

___________________________________________


– Signs of Injury (continued)– Grade 3 - __________ of tendinous or muscular tissue,

involving _________________ , ______ , loss of function, _________, __________________

– Treatment• RICE • ____________ until soreness has subsided• ______________ and ______________ should be

avoided initially


• Acute Femoral Fractures– Cause of Injury

• Generally involving shaft and requiring great force• Occurs in ___________ due to _______and

________________– Signs and Symptoms

• Shock, pain, swelling, deformity– Must be aware of ______________ and ______________

• ___________________– Treatment

• Treat for shock, ______________, ____________ _______ , reduce following X-ray

• Secure immediate emergency assistance and medical referral


• Femoral Stress Fractures– Cause of Injury

• __________• Females who are ___________ are more vulnerable

to stress fx– Signs and Symptoms

• ____________________• X-ray or _________ will reveal fracture• Commonly seen in ______________

– Treatment• __________________________• ROM and PRE exercises are carried out w/ pain free

ROM• ______, ________________


Recognition and Management of Specific Hip, Groin, and Pelvic

Injuries• Groin Strain

– Cause of Injury • One of the more difficult problems to diagnose• Often seen in ____________ due to __________ and

________________• Occurs from running , jumping, twisting w/ hip

___________ or ____________

– Signs and Symptoms• Sudden twinge or tearing during active movement• Produce _____ , ________, and __________________


• Groin Strain (continued)– Treatment

• RICE, NSAID’s and analgesics for ___________• Determine _________ or _______________• ______________• Restore normal _____ and ________ -- ________

________________• Refer to physician if severe groin pain is

experienced


• Sprains of the Hip Joint– Cause of Injury

• Result of ___________ due to ______________• Force from opponent/object or ______________

____________________________

– Signs and Symptoms• Signs of acute injury is the inability to __________ hip• Pain in hip region, w/ hip rotation ________________

– Treatment• X-rays or MRI should be performed to rule out fx• RICE, NSAID’s and analgesics• Depending on severity, ___________________• _______ and _____ are delayed until hip is pain free


• Piriformis Syndrome– Cause of Condition

• Compression of __________; irritation due to ________ or ______ of muscle

• May mimic ___________

– Signs and Symptoms• Pain, __________ and ___________– may extend ________ and

__________• Pain may increase following periods of _______, ___________,

walking or running

– Treatment• _____________________• NSAID’s may be prescribed• __________________________ will be prescribed• Corticosteroid injection may also be suggested• Surgery is sometimes an option as well


• Dislocated Hip– Cause of Injury

• ________________________• Result of traumatic force directed along the long axis of the femur

– Signs and Symptoms• ___________________________________• Palpation reveals displaced femoral head, _______________• Serious pathology

– _____________________________________

– Treatment• Immediate medical care (__________________ may be

compromised)• Prepare for shock• 2 weeks immobilization and crutch use for at least one month


Hip Problems in Adolescent Athletes

• Legg Calve’-Perthes Disease (Coxa Plana)– Cause of Condition

• ________________ of the femoral head in child ages 4-10• Articular cartilage becomes ____________________

– Signs and Symptoms• Pain in ______that can be referred to the abdomen or knee• ___________________• Varying onsets and may exhibit _______________


•Legg-Calve’-Perthes Disease

– Treatment• Bed rest to reduce chance of chronic condition• ___________________________• Early treatment and ______________________

_______________

– Complication• If not treated early, will result in ill-shaping and

________________ in later life


• Slipped Capital Femoral Epiphysis

– Cause of Condition• Epiphysis slips from femoral head in _______________ due to

weakness in _______________• May occur during periods of elevated growth

– Signs and Symptoms• Pain in _________ that comes on over weeks or months• Hip and knee pain during ________ and ________ motion;

limitations of _________, ________, ____________ and a limp

– Treatment• W/ minor slippage, ________________________________

____________________• Major displacement requires surgery• If undetected or surgery fails severe problems will result


• Iliac Crest Contusion (hip pointer)– Cause of Injury

• Contusion of ________ or _______________• Result of direct blow

– Signs of Injury• Pain, spasm, and transitory paralysis of soft structures• __________________ or _________________ due to pain

– Care• ______________________________• Bed rest 1-2 days in severe cases• Referral must be made, X-ray• ____________ should be used upon return to minimize chance

of added injury

Recognition and Management of Injuries to the Pelvis


• Osteitis Pubis– Cause of Injury

• Seen in ______________• Repetitive stress on ______________ and _______

___________

– Signs and Symptoms• Chronic pain and inflammation of groin• _______________________• Pain w/ __________, ______________

– Treatment• Rest, NSAID’s and gradual return

to activity


• Acute Fracture of Pelvis– Cause of Injury

• Result of ________________________

– Signs and Symptoms • Severe pain, loss of function, shock

– Treatment• ______________________• Refer to physician• Seriousness of injury dependent on

______________ and ______________________


• Stress Fractures– Cause of injury

• Repetitive abnormal overused forces – Signs and Symptoms

• ______________________________________ ______________________________________

• Discomfort increases with activity and subsides during rest

– Treatment• Refer to physician for assessment and X-ray• Rest for _________________


• Avulsion Fractures– Cause of Injury

• Avulsions seen in sports w/ sudden accelerations and decelerations

• Pulling of tendon away and off of bony insertion• Common sites include ____________, _________

_________________, ____________________– Signs and Symptoms

• Sudden localized pain w/ limited movement• Pain, swelling, point tenderness

– Treatment• ________________________________________


Assessment of the Thigh• History

– Mechanism of injury?

• Observation– ____________________– ____________________________– _____________________


• Palpation– Soft tissue of the thigh (anterior, posterior,

medial, lateral) should be palpated for pain and tenderness

– Bony palpation should also be performed to locate areas of pain/discomfort

– Utilize palpation to assess body symmetry


• Special Tests– ______________

• Test for hip contractures

– ______________• Test for hip

extensor tightness• Can also be used to

assess __________ ________________


• Special Tests– ________________

______• Test for weakness in

the gluteus medius muscle on the ___________

– _____________• Test for ITB

tightness

© 2007 mcgraw-hill higher education. all rights reserved. the thigh, hip, groin, and pelvis pe 236...

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