The Thigh and Hip MusclesThe Thigh and Hip MusclesAnatomy, Injuries and AssessmentAnatomy, Injuries and Assessment

Sports Medicine Camp

Quadriceps Muscles

• Vastus Medialis• Vastus Intermedius• Vastus Lateralis• Rectus Femoris

Ely’s Test or Prone Knee Bend

• Rectus Femoris tightness– Athlete prone– Passive knee flexion– Positive test indicated by hip flexion

Quadriceps MMT

• Manual Muscle Test– Athlete seated– Examiner apply resistance at lower leg

Rectus Femoris Strain• Mechanism of Injury

– Sudden stretch– Sudden contraction

• Signs and Symptoms– Pain– Point tenderness– Spasm– Loss of function– Deformity

• Treatment– RICE– NSAIDS– Modalities– Stretching– Strengthening

Thigh Contusion

Hamstrings Muscles

• Medial side– Semitendinosus– Semimembranosus

• Lateral side– Biceps Femoris Long Head– Biceps Femoris Short head

Hamstrings MMT• Medial hamstrings

– Semitendinosus– Semimembranosus– Internally rotate tibia – (foot points in)

• Lateral Hamstring– Biceps Femoris– Externally rotate tibia – (foot points out)

Hamstring Strains• Mechanism of Injury

– Unknown– 1st Theory

• Hamstrings contract same time as quadriceps• Deficiency in complementary action of opposing muscles

– 2nd Theory • Quick change of function from

– Role as knee stabilizer– To– Hip extensor

– Possible reasons• Muscle fatigue• Faulty posture• Leg length discrepancy• Tight hamstrings• Improper form• Imbalance of strength between hamstrings• Hamstring strength ratio to quads normal 60 - 70 %

Hamstring Strains

• 1st Degree injury– Muscle soreness during

movement• Due to muscle spasm rather

then tearing of tissue• Fewer then 20% fibers torn

– Point tenderness– Stiffness after cool down

• 2nd Degree injury– Partial tear– Fewer then 70% fibers torn– Sudden snap or tear of muscle– Severe pain– Loss of function

Hamstring Strains

• 3rd Degree injury– Rupture of tendon – Tear of > 70% fibers– Severe swelling– Tenderness– Loss of function– Discoloration– Palpable mass or gap

Hamstring Strains– Treatment

• Grade 2 & 3– Extremely conservative

• RICE – Grade 2: 24 - 48 hrs.– Grade 3: 48 - 72 hrs.

• Stretching• Strengthening

– Emphasize eccentric exercise

– Complications• Recurrent as result of

– Inelastic fibrous scar tissue

Hip Flexors– Iliopsoas

• Psoas Major• Psoas Minor• Iliacus – MMT

Thomas Test

– Normal length of hip flexors– With low back flat – Posterior thigh touches table– Knee flexes approximately 80°– The pelvis is in 10 ° posterior tilt

– Abnormal length of hip flexors– With low back flat – Posterior thigh does not touch

table– Knee flexes < 80°

Hip Flexor Support

Adductor Muscles• Adductor Magnus• Adductor Longus• Adductor Brevis• Pectineus• Gracilis

• MMT Adduction• Athlete sidelying• Examiner supports top leg• Give resistance above knee joint

8-4

Adductor Support

21-34

Hip Pointer• Mechanism of injury

– Direct impact

• Signs and Symptoms– One of the most handicapping injuries– Immediate pain– Muscle spasm– Transitory paralysis – Inability to

• rotate trunk• Flex thigh

– Discoloration– Swelling

• Treatment– PRICE

• Bed rest as needed• Crutches as needed

– ROM exercises– Strength exercises– Severe cases MD referral