NETWORK FITNESS FACTS THE HIP

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1 NETWORK FITNESS FACTS THE HIP The Hip Joint ANATOMY OF THE HIP The hip bones are divided into 5 areas, which are: Image: hwkb17_042.jpg The hip joint is a synovial joint, known as a ball and socket joint. The head of the femur bone articulated with the socket of the pelvis known as the acetabulum. The socket is deeper and the ligaments around it much thicker than the shoulder joint, therefore the hip joint is a much more stable joint. Movements at the hip joint include flexion and extension, abduction and adduction, internal rotation and external rotation. The sacrum is a bone at the base of the vertebral column that is created by the fusion of 4 vertebrae. It attaches to the ilium on the sides. It also provides a point of muscle attachment for back muscles. The coccyx (also called the tail bone) is a small vestigial bone that attaches to the base of the sacrum. It is created from the fusion of 4 small vertebrae. The ilium is the largest area of the hip bones. It consists of 2 large broad plates, one on each side, which serve to support the internal organs, and to provide attachment for muscles of the back, sides, and buttocks. The hip joint of the femur is part of the ilium. The ischium consists of 2 broad curves of bone, one on each side, which lie below the ilium, and are attached to the pubis in the front and the ilium in the back. The ischium serves as a place of attachment for muscles. When a person's butt hurts from sitting on a hard surface, it is the result of the sharp ischium pressing on the buttocks. The pubis is the front-most area of the hip bones. It attaches to the ilium on the sides and the ischium on the bottom. It provides structural support, and serves as a place of attachment for the muscles of the inner thigh. Seven different kinds of movements are possible in the hip joint: Flexion and extension on or from the spine or on or from the thigh Abduction and adduction of the femur Internal (medial) and external (lateral) rotation of the pelvis, thigh or spine Circumduction of the femur or pelvis A synovial joint that can produce movement in more than one axis is called a multiaxial joint

2 MUSCLES OF THE HIP Hip Flexors Psoas (major & minor) Iliacus Rectus Femoris Sartorius TFl Pectineus Adductor group These 2 muscles attach from the lumbar spine and pelvis on the femur bone. They are strong pulley muscles in flexing the hip. These muscles are always overworked in the classical dancer, and frequently become very sore particularly following growth spurts. A tight, shortened hip flexor will increase a lumbar lordosis. Image: Hip Extensors Gluteus Maximus Hamstrings The Gluteus Maximus is a large outermost bottom muscle which extends the hip. A weak gluteus maximus will load the low back muscles and the hamstrings muscles leading to overuse injuries The Hamstrings are 3 muscles (semimembranosus, semitendonosus and biceps femoris) which help the gluteus maximus to extend the hip. They also flex the knee. Image: c39xmagumpw/s320/hamstrings.gif Hip Abductors Gluteus Medius TFL Gluteus Minimus Gluteus Maximus The Gluteus Medius takes the leg away from the body in a parallel leg position. They also are very important for maintaining hip external rotation & lateral pelvic stability. Weak Gluteus Medius muscles will load the lower back muscles and adductor muscles, again increasing the risk of tendonitis around the hip. Furthermore, balance in any single leg work will be compromised. Image: Page 2

3 MUSCLES OF THE HIP Hip Adductors Adductor Magnus Adductor Brevis Adductor Longus Pectineus Gracilis There are 5 adductor muscles which control movement of the leg back into body and aid in pelvic stability. The adductors (particularly adductor magnus) will help the inner quadriceps muscle activate and maintain good patella (knee cap) position and tracking reducing the risk of knee pain (patello-femoral pain). Image: Adductors-muscles.jpg Image: Adductors-muscles.jpg Hip External Rotators Quadratus Femoris Piriformis Obturator Externus Obturator Internus Inferior Gemelli Superior Gemmelli Also: Gluteus maximus Sartorius Bicep femoris Gluteus medius Image: Hip Internal Rotators Gluteus minimus TFL Gluteus Medius Semitendinosus Semimembranosus These deep, low butt muscles are situated closest to the hip joint. They are responsible for turning the leg outwards, therefore essential for classical dance, rock climbing, roller blading. Inactivation of these deep muscles will cause loading of the glut maximus or glut medius to perform the externally rotation. It will reduce pelvic stability. Tight and short internal rotators may be a factor in poor leg alignment and patello-femoral pain A pigeon toed posture will tighten these muscles Image: Page 3

4 PROTOCOLS FOR RANGE OF MOTION TESTS FOR THE HIP Muscle Group and Testing Position Hip Flexors Thomas Test Supine on bench, sacrum on edge Neutral spine One knee bent to chest, other leg relaxed down Measure angle of leg relative to horizontal i.e. +20º, 0º, -20º Example of a good result Image: Australian Fitness Network Note: if leg pulls laterally = tight ITB See the Video Presentation The Thomas Test in this Topic. Hamstrings Muscle Group & Testing Procedure Whole body supine on bench or lay on floor Neutral spine, legs extended Lift one leg keeping knee straight and foot relaxed - ensure no movement of pelvis Check for first area of tension and measure angle from the horizontal Note: if felt in calf, tight sciatic nerve - DO NOT push or stretch this Short hip flexor Image: Australian Fitness Network Sit and Reach Test Combines lumbar, gluteal, hamstring and calf muscle flexibility as well as neural tension See the Video Presentation Range of Movement - Hamstring Test in this Topic. Images: testing_flexibility.jpg Page 4

5 PROTOCOLS FOR HIP STABILITY AND MUSCLE STRENGTH Test & Procedure Single Leg Stance - Lateral Pelvic Stability Stand on one leg to test glut medius strength. Good result = pelvis stays even Bad result = opposite pelvis hitches or drops (Trendelenberg) Note areas of poor stability (ASIS level and leg alignment - hip, knee, ankle) ADD: small knee bend or hop to increase difficulty Image: AFPprinter/ /461_f1.gif Quadriceps - Squats Client stands against the wall with feet a comfortable distance from the wall (record this distance for test retest consistency) Ask them to squat down so that thigh is parallel to the ground and hold for as long as they can If they can t squat down that far, have them do what is comfortable and measure the distance from the ground. Ideal target 2 minutes Hip Flexors Image: 20Ch4_img_4m.jpg Seated on a bench/chair Lift knee against resistance (ensure lifting straight) and rate as follows: Normal resists strong pressure Good can hold against firm pressure Weak cannot hold leg against gravity Image: AFPprinter/ /2109_f4.jpg Page 5