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THE HIP JOINT

THE HIP JOINT

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THE HIP JOINT

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  1. THE HIP JOINT

  2. Muscles of the Hip

  3. Gluteus Maximus • O: lower posterior iliac crest and posterior surface of the sacrum • I: gluteal tuberosity (upper, posterior aspect of the femur) & I.T. band • Actions: • Extension of the hip • External rotation of the hip • Lower fibers (below the center of motion) assist in adduction

  4. Extension

  5. Gluteus Maximus • Produces hip extension beyond 15 degrees; not used extensively during walking • Strongly used during running, hopping, skipping, and jumping • Best isolated with the knee flexed to reduce hip extension from the hamstrings 40 degrees

  6. Gluteus Medius • O: outer surface of the ilium just below the crest • I: greater trochanter • Actions: • Abduction of the hip • Anterior fibers: Internal rotation, • Posterior fibers: External rotation.

  7. Gluteus Minimus • O: outer surface of the ilium beneath the gluteus medius • I: greater trochanter of the femur • Actions • Abduction of the hip • Internal rotation

  8. Gluteus Medius and Minimus • During walking these muscles abduct (or hold up) the free leg, preventing it from sagging. • Both are important in transferring weight from one leg to the other (e.g. running, hopping, skipping, etc.) • Their effectiveness decreases with age.

  9. Biceps Femoris • Lateral side • Origin: • 1.) Long head - ischial tuberosity; • 2.) Short head - lower half of the linea aspera • Insertion: Head of the fibula • Action: • Extension of hip • External rotation of the hip (and knee) • (Flexion of knee)

  10. Biceps Femoris • One of the hamstring muscles (semitendinosus and semimembranosus) • A two-joint muscle which is a powerful hip extensor unless the knees are flexed • Isolated during leg curls with some external rotation of the hip and knee. This “lines up” the origin and insertion.

  11. Semitendinosus • Medial side; superficial • Origin: Ischial tuberosity • Insertion: Medial surface of proximal end of the tibia • Action: • Extension of the hip • Internal rotation of the hip (and knee) • Flexion of the knee

  12. Semimembranosus • Medial side, deeper than semitendonosus • Origin: Ischial tuberosity • Insertion: Medial surface of the tibia • Action: • Extension of the hip • Internal rotation of the hip (and knee) • Flexion of the knee

  13. Semitendinosus & Semimembranosus • Two-joint muscles • Used in ordinary walking for hip extension • Best exercised with knee flexion exercises (leg curls) with the hip and knee internally rotated • Help to medially stabilize knee

  14. Tensor Fasciae Latae • O: iliac crest • I: iliotibial (I.T.) band • Actions: • Flexion of the hip • Internal rotation • Abduction of the hip

  15. Tensor Fasciae Latae • Prevents external rotation at the hip is flexed Stretching Strengthening

  16. Tensor Fascia Latae (Anterior View)

  17. Iliopsoas • Origins: • iliac fossa • vertebral bodies of the last thorasic and lumbar vertebrae • I: lesser trochanter of the femur • Actions: • Flexion of the hip • External rotation

  18. Iliopsoas • Strong hip flexor muscle • Raises legs off the floor from the supine position. • Pulls anteriorly on the lower lumbar vertebrae • May aggravate lower back problems • Abdominal muscles can prevent lumbar strain • Used during complete sit-ups and straight leg sit-ups. • Stretching this muscle requires hyper-extension of the hip.

  19. Pectineous • O: pubic crest or ramus • I: below the linea aspera • Actions • Flexion • Adduction • Internal rotation

  20. Tensor Fasciae Latae Pectineus

  21. Adductor Brevis • Origin: Inferior ramus of pubis • Insertion: Pectineal line (linea aspera) • Actions: • Adduction • External rotation

  22. Adductor Longus • Below the adductor brevis • O: front of the pubis just below its crest • I: middle third of the linea aspera • Actions: • Adduction • Flexion

  23. Adductor Magnus • Located posterior to the longus • O: edge of the pubic crest and ischial tuberosity • I: linea aspera • Actions: • Adduction • External rotation

  24. Gracilis • O: pubic crest • I: medial condyle of tibia • Actions: • Adduction at the hip • Internal rotation • [Flexion at the knee]

  25. Adductor Muscles • Adductor Brevis • Adductor Longus • Adductor Magnus • Gracilis • Not heavily used in ordinary movements • Horse back riding, the breaststroke kick in swimming

  26. Sartorius • Origin: Anterior-superior spine of the ilium • Insertion: Anterior medial condyle of the tibia (behind the medial condyle) • Action: • Flexion of hip • External rotation of the hip • [Flexion of the knee]

  27. Sartorius • Longest muscle in the body • It is a two-joint muscle; hip flexion and knee flexion • It is weak when both actions take place at the same time.

  28. Rectus Femoris • Two joint muscle; most superficial • Origin: anterior-inferior iliac spine of the ilium • Insertion: top of the patella and patellar ligament to the tibial tuberosity • Actions: • Flexion of the hip [Extension of the knee]

  29. Rectus Femoris • A two-joint muscle: hip flexion and knee extension • Powerful knee extension when the hip is extended but weaker when the hip is flexed. • The gluteus maximus and the hamstring muscles will extend the hip making the rectus femoris stronger during knee extension

  30. Hip Rotator Muscles • ANTERIOR • Obturator Externus Anterior

  31. Hip Rotator Muscles • POSTERIOR • Piriformis • Gemellus superior • Obturator internus Gemellus inferior • Quadratus femoris Posterior

  32. Hip Rotator Muscles Posterior Posterior

  33. Hip Rotator Muscles Posterior Anterior

  34. Six Hip Rotator Muscles • Common action is External Rotation • Powerful external rotation of the hip is required to throw a baseball, swing a bat or golf club. • The sciatic nerve passes just inferior to the piriformis therefore a tight piriformis muscle my contribute to compression on the sciatic nerve.

  35. Review

  36. Name the action at her hip Abduction

  37. Name the action at his right hip Flexion

  38. Name the actions at her hip Extension, Abduction & External Rotation

  39. Name the two action at his right hip Extension and External Rotation

  40. Name the action at his hip Flexion

  41. Name the actions at his hip Flexion and External Rotation and Abduction

  42. Name the actions at his hip Flexion and Adduction

  43. 3. The Femur 1. 2. 1 = 2 = 3 = 4 = 5 = 6 = 7 = Head Neck Greater trochanter Lesser trochanter Linea Aspera Medial condyle Lateral condyle 4. 5. 6. 7.