Hip / Low Back

Hip Anatomy - Bones

Hip Anatomy - Ligaments

Hip Anatomy - Muscles

• Abductors– Gluteus medius– Gluteus maximus– Gluteus minimus– Sartorius– Tensor Fasciae Latae

• Adductors– Adductor brevis– Adductor longus– Adductor magnus– Gracilis– Pectineus– Gluteus maximus

Hip Anatomy - Muscles

• Flexors– Gluteus medius– Gluteus minimus– Iliacus– Psoas major & minor– Rectus Femoris– Sartorius– Tensor Fasciae Latae

• Extensors– Biceps Femoris– Gluteus maximus– Gluteus medius– Semimembranosus– Semitendinosus

Hip Anatomy - Muscles• Internal Rotators

– Adductor brevis– Adductor longus– Adductor magnus– Gluteus medius– Gluteus minimus– Semimembranosus– Semitendinosus– Tensor Fasciae Latae

• External Rotators– Biceps femoris– Gemellus inferior & superior– Gluteus maximus– Gluteus medius– Obturator externus & internus– Piriformis– Quadratus Femoris– Sartorius

Hip Injuries

• Piriformis Syndrome– Spasm of hypertrophy

of the piriformis muscle placing pressure on the sciatic nerve

– MOI: Blow to the buttock, hyperinternal rotation of femur

Hip Injuries

• Iliac Crest Contusion (Hip Pointer)– MOI: Direct blow to an unprotected ilium

Hip Injuries

• Hip Dislocation– Most hip dislocations occur when the hip is

flexed and adducted with an axial force to the femur, displacing it posteriorly and causing the femoral head to be driven through the posterior capsule

Low Back Pain Statistics• One-half of all working Americans admit to having back pain symptoms each year• Back pain is one of the most common reasons for missed work. In fact, back pain is the second

most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

• Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis infection, fracture or cancer.

• Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.

• Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives

• (American Chiropractic Association)

Low Back (Lumbar) Anatomy - Bones

Lumbar Anatomy - Ligaments

Lumbar Anatomy - Muscles

• Rotation– Multifidis

• Flexion– Rectus Abdominis– External Oblique– Internal Oblique

• Extension– Iliocostalis– Spinalis– Longissimus

• Lateral Bending– Internal Oblique– External Oblique

Lordosis

Lumbar Injuries - Sciatica

• Inflammation of the sciatic nerve.– Causes of sciatica

• Disc herniation• Sacroiliac joint dysfunction• Scar tissue formation around the nerve

root• Nerve root inflammation• Spinal stenosis• Synovial cysts• Cancerous or non-cancerous tumors

Lumbar Injuries – Disc Herniation

They are often the result of repetitive motion (truck drivers/machine users) or due to a sudden heavy loading of the back (improper lifting)

Lumbar Injuries – Spondylolysis and Spondylolisthesis

• MOI: Pars interarticularis suffers a stress fracture secondary to repetitive stress from spinal extension

Lumbar Injuries – Spinal Stenosis

• A narrowing of the vertebral foramen where the nerve root or spinal cord pass

• Causes: thickened ligaments along the spinal canal, bony spurs, and enlarged joint cartilage from arthritic changes

Lumbar Injury Prevention• Technique• Proper breathing techniques• Core Strength• Maintain a healthy diet and weight.• Remain active• Avoid prolonged inactivity or bed rest.• Warm up or stretch before exercising or other physical activities.• Maintain proper posture.• Wear comfortable, low-heeled shoes.• Sleep on a mattress of medium firmness to minimize any curve in your

spine.• Lift with your knees, keep the object close to your body, and do not twist

when lifting.• Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient

deprivation to spinal tissues• (American Chiropractic Association)

Core Strengthening

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