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Audio Graphics Project Presentation

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Audio Graphics Project Presentation

  1. 1. Evaluation of the Hip http://goanimate.com/movie/0Zj8aAyXhs64?utm_source=linkshare&uid=0UiX0JZuuMVs
  2. 2. Bony Hip Anatomy Review
  3. 3. Muscular Hip Anatomy Review
  4. 4. Real Life Scenario: <ul><li>Your soccer athlete walks into the training room. He is complaining of pain in his left hip. He says he was at shooting practice and felt a pop and had immediate pain. </li></ul><ul><li>What do you do? </li></ul>
  5. 5. Hip Evaluation <ul><li>Visual Observation: </li></ul><ul><ul><li>Obvious deformity </li></ul></ul><ul><ul><li>Patterns of Swelling </li></ul></ul><ul><ul><li>Gait </li></ul></ul><ul><ul><li>Pelvic Obliquity </li></ul></ul>
  6. 6. Hip Evlauation <ul><li>MOI </li></ul><ul><ul><li>How did the injury occur? </li></ul></ul><ul><ul><li>Was there a direct blow to the hip? </li></ul></ul><ul><ul><li>Did you twist in a funny way? </li></ul></ul><ul><li>History: </li></ul><ul><ul><li>Have you ever injured it before? </li></ul></ul><ul><ul><li>How long ago did you injure it? </li></ul></ul><ul><ul><li>Did you hear or feel any ‘pops’ or ‘cracks’? </li></ul></ul><ul><ul><li>Have you had any previous evaluations or treatments? </li></ul></ul>
  7. 7. Hip Evaluation <ul><li>Palpation: </li></ul><ul><ul><li>Palpate all bony and soft tissue anatomy for: </li></ul></ul><ul><ul><ul><li>Point tenderness </li></ul></ul></ul><ul><ul><ul><li>Swelling </li></ul></ul></ul><ul><ul><ul><li>Crepitus </li></ul></ul></ul><ul><ul><ul><li>Temperature </li></ul></ul></ul><ul><ul><ul><li>Deformity </li></ul></ul></ul><ul><ul><li>Ensure </li></ul></ul><ul><ul><li>neurovascular </li></ul></ul><ul><ul><li>exam is intact </li></ul></ul>
  8. 8. Hip Evaluation <ul><li>Palpation (cont’d) </li></ul><ul><ul><li>Bony palpations: </li></ul></ul><ul><ul><ul><li>ASIS </li></ul></ul></ul><ul><ul><ul><li>Iliac crest </li></ul></ul></ul><ul><ul><ul><li>Greater Trochanter </li></ul></ul></ul><ul><ul><ul><li>Ischial Tuberosity </li></ul></ul></ul><ul><ul><ul><li>SI Joint </li></ul></ul></ul><ul><ul><ul><li>Lumbar Vertebrae </li></ul></ul></ul><ul><ul><li>Soft Tissue Palpations </li></ul></ul><ul><ul><ul><li>TFL </li></ul></ul></ul><ul><ul><ul><li>Trochantric bursa </li></ul></ul></ul><ul><ul><ul><li>Sartorious </li></ul></ul></ul><ul><ul><ul><li>Adductors </li></ul></ul></ul><ul><ul><ul><li>Inguinal lymph nodes </li></ul></ul></ul><ul><ul><ul><li>Gluteus Max. & Med. </li></ul></ul></ul><ul><ul><ul><li>Sciatic nerve </li></ul></ul></ul><ul><ul><ul><li>Quadriceps </li></ul></ul></ul><ul><ul><ul><li>Hamstrings </li></ul></ul></ul>
  9. 9. ROM & Strength Testing <ul><li>ROM should be tested: </li></ul><ul><ul><li>Passively </li></ul></ul><ul><ul><li>Actively </li></ul></ul><ul><ul><li>Resistively </li></ul></ul><ul><ul><ul><li>Concentric </li></ul></ul></ul><ul><ul><ul><li>Eccentric </li></ul></ul></ul><ul><li>Measure with a Goniometer </li></ul><ul><li>Compare Bilaterally </li></ul><ul><li>Observe Muscle Tone </li></ul>
  10. 10. Special Tests: <ul><li>Trendelenburg Test: </li></ul><ul><li>Positive Finding: </li></ul><ul><ul><li>When the pelvis on the unsupported side drops noticeably lower then the supported side </li></ul></ul><ul><ul><li>Indicates Gluteus Medius weakness on the supported side </li></ul></ul>
  11. 11. Special Tests: <ul><li>Ober’s Test </li></ul><ul><li>Positive finding: </li></ul><ul><ul><li>Inability of the leg to adduct and touch the table is indicative of IT Band tightness </li></ul></ul>
  12. 12. Special Tests <ul><li>Thomas Test </li></ul><ul><li>Positive finding: </li></ul><ul><ul><li>Lack of hip extension with knee flexion greater than 45 degrees is indicative of iliopsoas tightness </li></ul></ul><ul><ul><li>Full hip extension with knee flexion less than 45 degrees is indicative of rectus femoris tightness </li></ul></ul>
  13. 13. Special Tests: FABER/Patrick Test: <ul><li>Positive Finding: </li></ul><ul><ul><li>When involved lower extremity does not abduct below the level of the non-involved side. </li></ul></ul><ul><ul><li>Indicative of iliopsoas tightness, sacroiliac dysfunction, or hip joint abnormalities. </li></ul></ul><ul><li>Note: FABER is an acronym describing : </li></ul><ul><ul><li>F=Flexion </li></ul></ul><ul><ul><li>AB=Abducation </li></ul></ul><ul><ul><li>ER=External Rotation </li></ul></ul>
  14. 14. Special Tests <ul><li>Positive Finding: </li></ul><ul><ul><li>Pain or apprehension </li></ul></ul><ul><ul><li>Indicative of hip joint pathology such as: arthritis, osteochondral defects, avascular necrosis, or acetabular labrum defects </li></ul></ul>Hip Scouring/Quadrant Test
  15. 15. Manual Muscle Tests: <ul><li>Hip Flexors </li></ul>
  16. 16. Manual Muscle Tests <ul><li>Hip Extensors </li></ul>
  17. 17. Manual Muscle Tests <ul><li>Hip Abductors </li></ul>
  18. 18. Manual Muscle Tests <ul><li>Hip Adductors </li></ul>
  19. 19. Practice!!!
  20. 20. Questions?

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