Hip & Pelvis
Hip Joint
Between Acetabulum (Pelvis) & Head of Femur
Ball and Socket Joint Weight Bearing
Acetabulum
• Formed from Ilium, Ischium, and Pubis
• Oriented laterally, anteriorly, inferiorly
• Acetabular Rim
• Acetabular Notch
Netter
453
Femur
Head
Neck
Greater Trochanter
Lesser Trochanter
Intertrochanteric Line
Intertrochanteric Crest
Netter
453
Femoral Neck AnglesCoronal Plane
Normal Coxa Valga Coxa Vara
125 > Normal < Normal
Femoral Neck AnglesHorizontal Plane
Normal 15° anterior
Anteversion
> 15° anterior
Toe-In Posture
Retroversion
< 15° anterior
Toe-Out Posture
Joint Capsule
Netter
454
Acetabular Labrum
Transverse Acetabular Ligament
Ligamentum Teres
Capsular Ligaments
Accessory Ligaments
Accessory Ligaments
Netter
454
Anterior – limit extension &
external rotation– Iliofemoral Ligament (Y)– Pubofemoral Ligament
Posterior– Ischiofemoral Ligament
Movements of the
Hip & Pelvis
Movement at the Hip Flexion Extension Abduction Adduction Internal Rotation External Rotation Circumduction
Movement of the Pelvis
Anterior Rotation (AS Ilium, +X)
Posterior Rotation (PI Ilium, - X)
Lateral Flexion (High or Low Ilium
– (+ or - Z)
Rotation (+ or - Y)
Determining APICompare angle between PSIS & ASIS to horizontal
Posture - Pelvis ( X)
Anterior & Posterior Rotation
Angle of Pelvic Inclination (API)
Males = 0° to 5° anterior
Females = 5° to 10° anterior
Combined Movements Movement of the Pelvis at the end
range of Hip movement– Due to ligamentous attachments
Movements of the Pelvis and Lumbar Spine with a Fixed Femur (standing)
Effects of Contracture/Shortening of muscles on Posture and Movement
Hip Flexion
Anatomy of
Movement
186
End Range of Hip Flexion - Effects on Pelvis & Lumbar Spine
Posterior Rotation of Pelvis
Decreased Lumbar Lordosis
Anatomy of
Movement
206
Muscles that Flex the Hip
Iliopsoas
Rectus Femoris
Tensor Fascia Lata (TFL)
Sartorius
Anatomy of
Movement
231
Major Hip Flexor Iliopsoas Proximal Attachments– Psoas Major - Lumbar
vertebral bodies & discs– Iliacus - Entire internal iliac
fossa Distal Attachment– Common tendon attaches to
lesser trochanter of femur
Netter
462
Other Hip Flexors
458 Rectus Femoris– AIIS to patella (via
quadriceps tendon)
Sartorius– ASIS to Pes Anserine
insertion (Tibia)
Tensor Fascia Lata– ASIS to Iliotibial Band
fascia
Netter
458
Action of Hip Flexors with Femur fixed
Anterior rotation of Pelvis
Increased Lumbar Lordosis
Anatomy of
Movement
214
Effects of Contracture of Hip Flexors on Posture & Movement
Anteriorly Rotated Pelvis• Sagittal Plane
• +X rotation (anterior ilium)
Increased Lumbar Lordosis
Limited Hip Extension
Hip Extension
Anatomy of
Movement
187
End Range of Hip Extension - Effects on Pelvis & Lumbar Spine
Anterior Rotation of Pelvis
Increased Lumbar Lordosis
Anatomy of
Movement
222
Muscles that Extend the Hip
Gluteus Maximus
Hamstrings– Biceps Femoris– Semimembranosus– Semitendinosus
Anatomy of
Movement
231
Hip Extensors Gluteus Maximus– Medial Attachments - Medial Ilium,
Lateral Sacrum, Sacrotuberous Ligament
– Lateral Attachments - Posterior shaft of Proximal Femur, Iliotibial Band
– Also externally rotates hip Netter
461
Hip Extensors Hamstrings Attach proximally on
Ischial Tuberosity Distal Attachments
– Biceps Femoris (lateral on fibular Head)
– Semimembranosus & Semitendinosus (medial on tibia)
Netter
461 & 468
Action of Hip Extensors with Femur fixed
Posterior rotation of Pelvis
Decreased Lumbar Lordosis
Anatomy of
Movement
222
Effects of Contracture of Hip Extensors on Posture
Posteriorly rotated pelvis
Indirectly causes Lumbar Hypolordosis
Limited Hip flexion (with knee extended - Hamstrings)
Hip Abduction
Anatomy of
Movement
188
Position of Femur
Femur must be externally rotated for full abduction
Internal Rotation External
Rotation
Anatomy of
Movement
188
End Range of Hip Abduction - Effects on Pelvis & Lumbar Spine
Contralateral Lateral Flexion of Pelvis
Ipsilateral Lateral Flexion of Lumbar Spine
Anatomy of
Movement
188
Hip Abductors
Gluteus Medius
Gluteus Minimus
Tensor Fascia Lata
Gluteus Maximus
Anatomy of
Movement
231
Hip Abductors - Attachments
Gluteus Medius– Upper part of External Iliac
Fossa to Lateral aspect of Greater Trochanter
Gluteus Minimus– Lower part of External Iliac
Fossa to Lateral aspect of Greater Trochanter
Netter
469
Tensor Fascia Lata
ASIS to Iliotibial Band
Actions - Abduction, Flexion & Internal Rotation
Netter
460
Anatomy of
Movement
227
Action of Hip Abductors with Fixed Femur Ipsilateral
lateral flexion of pelvis
Stabilization of Pelvis during stance on one leg
Anatomy of
Movement
227 & 229
Effects of Contracture of Hip Abductors on Posture
Low ilium (ipsilateral lateral flexion of pelvis)
Limits adduction (widened stance)
May limit flexion or extension of hip
Weakness of Hip Abductors
Weakness causes contralateral lateral flexion of Pelvis during stance on one leg
Trendelenberg Test
Adduction of the Hip
Anatomy of
Movement
187
Hip Adductors
Pectineus
Adductor Longus
Adductor Brevis
Adductor Magnus
Gracilis
Anatomy of
Movement
232
External Rotation of the Hip
Anatomy of
Movement
189
Hip External Rotators Gluteus Maximus
– Medial Attachments - Medial Ilium, Lateral Sacrum, Sacrotuberous Ligament
– Lateral Attachments - Posterior shaft of Proximal Femur, Iliotibial Band
– Also extends hip Netter
461
Hip External Rotators
Piriformis– Anterior sacrum to greater trochanter
Short External Rotators– Gemelli– Obturators– Quadratus Femoris
Netter
469
Internal Rotation of the Hip
Anatomy of
Movement
189
Internal Rotators
Tensor Fascia Lata
Anterior fibers of Gluteus Medius and Gluteus Minimus
Netter
460