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What are the concave/convex bony partners of the hip?
- acetabulum= concave
- head of femur= convex
What way is the glide if the head of the femur is moving into flexion?
What way is the glide if the head of the femur is moving into extension?
What way is the glide if the head of the femur is moving into abduction?
What way is the glide if the head of the femur is moving into adduction?
What way is the glide if the head of the femur is moving into IR?
What way is the glide if the head of the femur is moving into ER?
What is the normal angle of inclination between the axis of the femoral neck and the shaft of the femur?
If the angle of inclination is greater than 125, what is it called?
If the angle of inclination is less than 125, what is it called?
What is unilateral coxa valga associated with?
relatively longer leg on that side and associated genu varum
What is unilateral coxa vara associated with?
relatively shorter leg with associated genu valgum on that side
Where does compensation with vara/valga usually occur?
pelvis, foot, ankle
What is the normal range for the angle of torsion of the neck of the femur?
8-25 degrees....normal angle 12
What is in increase of the angle of torsion called, and which way will the femur rotate?
head of femur moves more anterior
What is a decrease int he angle of torsion called, and which way does the femur rotate?
head of femur moves more posterior
What does anteversion often result in?
genu valgum, pes planus (flat feet)
unilateral anteversion ususally results in a relatively shorter leg on that side with compensation in the position of the pelvis
What does retroversion often result in?
genu varum, pes cavus (arched feet)
unilateral retroversion often results in relatively longer leg on that side with compensation in the position of the pelvis
What pelvic tilt results in hip flexion and increased lumbar spine extension (hyperextension)?
What pelvic tilt results in hip extension and lumbar spine flexion?
What happens during pelvic shifting (often seen with relaxed/slouched postures)?
when standing, a forward translatory shifting of the pelvis results in extension of the hip and extension of the lumbar spinal segments
compensatory posterior shifting of thorax and upper lumbar spine with increased flexion of the spinal segments
With a lateral pelvic tilt, what happens to the hip thats elevated/lowered?
- elevated (hip hiking) theres adduction
- lowered (hip drop) theres abduction
When standing with a lateral pelvic tilt, which way does the lumbar spine flex?
toward the side of the elevated pelvis
convexity goes toward the lowered side
What muscles may cause a lateral pelvic tilt?
- erector spinae on the side of the elevated pelvis
- reverse muscle pull of the gluteus medius and minimus on the side of the lowered pelvis
What is the resting position of the hip?
- 30 flexion
- 30 abduction
- 20 ER
What is the closed packed position of the hip?
max extension, abduction, IR
What is the capsular pattern of the hip?
With tight hip mm./jts, where are bearing forces/mvmt transmitted?
spine rather than absorbed in the pelvis
What will tight hip extensors cause?
- increased lumbar flexion when the thigh is flexed
- when sitting, posterior pelvic tilt occurs
What do tight hip flexors cause?
increased lumbar extension as the thigh extends
What will tight hip adductors cause?
lateral pelvic tilt opposite and SB of the trunk toward the side of tightness when weight bearing
What will unilateral short leg cause?
lateral pelvic tilting (drop to short side) and SB of the trunk away from the short side (convexity of lateral lumbar curve toward side of short leg)
leads to functional/possible structural scoliosis
What are some possible causes of unilateral short leg?
unilateral LE asymmetry such as flat foot, genu valgum, coxa vara, tight hip mm., anterior rotated innominate bone, poor standing posture, asymetry in bone growth
What can sciatic nerve entrapment cause?
sensory changes along the lateral and posterior portion of the leg and dorsal and plantar surface of the foot
forms in post pelvis (L4-S3), and leaves pelvis across the lower edge of greater sciatic notch, then passes deep to piriformis
What may cause osteoarthritis?
aging, jt trauma, repetitive abnormal stresses, disease
will be articular cartilage degeneration
What is the trendelenburg test?
evaluates strength of gluteus medius
- pt stands on one leg
- (+) if the pelvis dips on the NWB leg
- weakness in the gluteus medius on the supporting side (stance leg)
What is the true leg length discrepancy?
- measure distance from the ASIS to the medial malleoli of the ankles
- (+) if distance is unequal
- one leg shorter
What is apparent leg length discrepancy?
- measure from umbilicus to medial malleoli of ankle
- (+) if distance is unequal
- pelvis obliquity from adduction or flexion deformity of the hip jt
What is the Ober test for contracture of the iliotibial band?
- pt lies on side with involved leg on top
- bring the leg up an over the other leg (abduct, flex knee, extend back)
- slowly lower leg keeping the thigh in extension and knee in flexion
- (+) if thigh remains abducted
- contracture of fascia lata or IT band
What is the Thomas test for contracture of the hip flexors?
- pt sits on end of table, then lays back with legs hanging off
- bring one knee toward chest, extend other hip
- (+) if thigh come sup off table during opposite leg flexion
- hip flexor tightness/contracture