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Kinesiology Of Hip Joint & Pelvic Girdle
Ari Sudarsono, SST, SKM, M.Fis
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Introduction The pelvic girdle provides a sturdy foundation for the trunk and spine.
The hip joint, or acetabular femoral moveme nt like joint, performs free range of movement the shoulder joint.
The lower extremities depend on the hip joint to be relatively stable.
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Introduction The pelvic girdle provides a sturdy foundation for the trunk and spine.
The hip joint, or acetabular femoral moveme nt like joint, performs free range of movement the shoulder joint.
The lower extremities depend on the hip joint to be relatively stable.
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Pelvis A ring of bone providing articulation for the lower limbs with the trunk.
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What is the Mechanical Role of Pelvis? Pelvis Is Designed to Transfer of Weight from t
Lower Limbs
Ischial Tuberositi
By Loosing of Mobility Sacroiliac Joints
Symphysis Pubis
Additional Roles to Transfer of Weight
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What is the structure of the Sacroiliac Joint?
Synovial Joint between Illium and Sacrum. Due to the powerful ligaments in posterior Posteriorly Fibrous
Anteriorly Sinovial
The SIJs are unique in that both the structure and function of these joints change significantly from birth through adulthood
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Sacroiliac Joint
It is a C shape joint In first decade of life is smooth and flat After puberty, a central ridge in Iliac and groove on the sacral will appear
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What is the factors of Sacroiliac Joint Stability?
Line of Weight Pass Anterior to the Sacroiliac Joint Causes
Sacral Move Downward into the Pelvis The Bony Surface does Not Bear the Weight
Lower Parts Tilt Upward The Weight is Suspended by the Ligaments
Slight Wedging of the Auricular Surface Resist Rotation and Gliding Movement of Sacrum
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What is the Movement of Sacroiliac Joints?
A little Movement is Allowed by Joint Surface and Ligaments There is Slight Gliding and Rotational Movement Sacroiliac Joint movement During
Childbirth
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Nutation and Counternutation Movement
a s Joint?
e
n ca mpor ance o
acro ac
Sudden Bending Forward
Tear the Posterior Ligament
Dislocate the Joint surface
Painful Trunk Flexion Manipulation often Produce a Successful Result
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ow o we may es e accessory ovemen o Sacroiliac Joints? These Movements are Limited by the Powerful Ligaments. To Test These Movements Prone Position
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Pressure by the Heel of the Hand On the Apex of Sacrum Downward Small Rotation of the Sacrum
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Joints? Two Trabecular Systems From Sacrum to Pelvis and Then to the head of Femur
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Trabecular sysem
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What is the Symphysis Pubis?
Secondary Cartilaginous Joint. A Thin Layer of Hyaline Cartilage Cover the Bone. This Cartilage is Joined to the Opposite Cartilage by a Fibrocartilage Interpubic Disc. Two Ligaments Support the Joint: 1) Superior Pubic Ligament 2) Arcuate Pubic Ligament The anterior portion of the joint is reinforced by aponeurotic expansions from a number of muscles that cross the joint No Normally Movement Pathology:
Slipping of one pubic to other (Osteitis Pubis)
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The aponeurotic extensions of the muscles crossing the anterior aspect of the symphysis pubis
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Bones The head of the femur connects with the cup-shaped acetabulum of the pelvic girdle.
Bony landmarks, the greater and lesser trochanter, provide attachments for many muscles spanning from the pelvic bones and even the vertebrae anteriorly.
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Bones (cont.) The pelvic girdle consists of the right and left pelvic bone joined together posteriorly by the sacrum; inferior to the sacrum is the coccyx.
The pelvic bones consist of three bones: the ilium, the ischium, and the pubis.
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Bones (cont.)
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Bones (cont.)
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Bones (cont.)
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Bones (cont.) Additional important bony landmarks include the ischial tuberosity of the posterior ischium and the linea aspera on the posterior femur.
Anterolaterally, Gerdy’s tubercle provides the insertion point for the iliotibial tract.
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Name the landmarks Iliac crest
Anterior spine
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Name the landmarks 1.
2.
3.
Acetabulu m Sciatic notch Ischial tuberosity
1 2
3
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Joints The pelvic bones join in the front to form the symphysis pubis, an amphiarthrodial joint.
The sacrum is located between two bones and form the sacroiliac joint made up of strong ligaments.
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Joints (cont.) The hip joint is classified as an enarthrodial-type joint with a dense ligamentous capsule.
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Joints (cont.)
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Joints (cont.)
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The Hip Joint Type: Synovial (Ball & Socket) Articular Surfaces: head of femur & acetabulum
rt cu ar sur aces: - ceta u um as: - C- shaped articular surface = lunate surface, Acetabular fossa, - Acetabular notch -----► converted into acetabular foramen by transverse ligament of the acetabulum - - Labrum acetabulare deepens the acetabular cavity. - 2- Head of femur
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Capsule & Synovial Membrane:
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Ligaments: 1- Ilio-femoral lig.: Yshaped, strong, attached between AIIS and both ends of trochantric line. Prevents hyperextension. 2- Pubo-femoral lig.:Triangular in shape, supports the inferomedial part of the joint, attached between iliopubic eminence and the capsule. Prevents hyperabduction. 3- Iscio-femoral lig.: from ischium to the back of the capsule. It becomes tense in medial rotation. 4- round ligament of the head of femur: Inside the joint, between head of femur to acetabular
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Relations of the hip joint:
Anteriorly:
Pectineus, Iliopsoas, RF (straight head), femoral vessels.
Laterally:
Tensor fascia latae, gluteus minimus & medius.
Posteriorly:
Piriformis, obturator internus, 2 gemelli, quadratus femoris, sciatic nerve.
Above:
RF (reflected head), gluteus minimus.
Below:
Obturator externus.
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Stability of the hip joint: The hip joint is very stable joint due to: 1- The head of femur fits accurately to the acetablum. 2- The three strong ligaments outside the capsule. 3- The surrounding strong muscles. Hip dislocation is usually posterior as in car accidents. It occurs with no fracture of the acetabulum (if the hip is flexed and adducted) or with fracture acetabulum (if the hip is flexed and abducted). The sciatic nerve may be injured in posterior hip
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Blood supply to the head of femur:
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Blood supply to acetabular fossa and ligament of the head of femur:
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X-Ray of the hip joint:
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MRI of the hip joint:
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Movements
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Movements (cont.)
What is the Pelvic Motions? •open
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kinematic chain motions •anterior tilt： ASIS moves anteriorly and inferiorly •posterior tilt ： ASIS moves posteriorly and superiorly •lateral tilt to the left/right ： one ASIS is higher than the other (Pelvic list during Gait) •Lateral forward and Backward displacement
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Movements (cont.)
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Movements (cont.)
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Muscles
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Muscles (cont.) The hip flexor iliopsoas muscle is composed of the iliacus, the psoas major, and the psoas minor.
The posterior gluteal region contain the gluteal maximus, gluteus medius, and gluteus minimus.
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Muscles (cont.) The deep six lateral rotators are the piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris.
The tensor fasciae latae attaches anteriorly and laterally to abduct and flex the hip.
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Muscles (cont.) The thigh has three compartments. The anterior compartment houses the quadriceps; the rectus femoris and the knee extenders vastus medialis, vastus intermedius, and vastus lateralis.
The sartorius runs superficial to the quadriceps.
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Muscles (cont.) The posterior compartment contains the hamstrings consisting of the biceps femoris, the semitendinosus, and the semimembranosus.
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Muscles (cont.) The medial compartment contains the adductor group of adductor brevis, adductor longus, adductor magnus, pectineus, and gracilis.
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Muscles (cont.)
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Muscles (cont.)
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Muscles (cont.)
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Muscles (cont.)
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Muscles (cont.)
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Nerves The hip and pelvic girdle muscles are all innervated from the lumbar plexus and sacral plexus known as the lumbosacral plexus.
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Nerves (cont.) The femoral nerve innervates the anterior muscles of the thigh and provides sensation to the anterior and lateral thigh and medial leg and foot.
The obturator nerve innervates the adductor as well as the obturator externus and sensation to the medial thigh .
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Nerves (cont.) The sciatic nerve is composed of the tibial nerve and common peroneal nerves.
The sciatic nerve tibial division innervates the hamstrings and adductor magnus. Both nerves continue down the lower extremity to function the muscles of the leg and foot.
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Nerves (cont.)
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Nerves (cont.)
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior Iliopsoas
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Iliopsoas
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Sartorius
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Sartorius
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Rectus Femoris
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Rectus Femoris
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Tensor Fasciae Latae
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Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont.) Tensor Fasciae Latae
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior Gluteus Maximus
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior Posterior (cont.) Gluteus Maximus
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior Posterior (cont.) Gluteus Medius
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior Posterior (cont.) Gluteus Medius
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont.) Gluteus Minimus
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont.) Gluteus Minimus
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont.) Lateral Rotators
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont.) Lateral Rotators
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Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont.) Hamstrings
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The hamstrings provide hip extension and knee flexion. (Diterangkan di Kinesiologi Lutut)
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Individual Muscles of the Medial Thigh Adductor Brevis
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Individual Muscles of the Medial Thigh (cont.) Adductor Brevis
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Individual Muscles of the Medial Thigh (cont.) Adductor Longus
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Individual Muscles of the Medial Thigh (cont.) Adductor Longus
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Individual Muscles of the Medial Thigh (cont.) Adductor Magnus
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Individual Muscles of the Medial Thigh (cont.) Adductor Magnus
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Individual Muscles of the Medial Thigh (cont.) Pectineus
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Individual Muscles of the Medial Thigh (cont.) Pectineus
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Individual Muscles of the Medial Thigh (cont.) Gracilis
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Individual Muscles of the Medial Thigh (cont.) Gracilis
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Chapter Summary The bones, joints, movements, muscles, and nerves of the hip joint and pelvic girdle are explored in this chapter.
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Chapter Summary (cont.)
Individual muscles of the hip joint and pelvic girdle are reviewed in depth with regard to palpation, origin, insertion, action, and innervation.
Each muscle includes information with clinical notes, muscle specifics, clinical flexibility and strengthening.
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Chapter Review
The Chapter Review is divided into true and false, short answers, and multiple choice questions.
The questions are designed for the students to test their knowledge.
Worksheets are at the end of the text as an aid for learning.
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Explore and Practice
Students should utilize the questions and charts at the end of the chapter to help focus on the content of the chapter.
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Iliopsoas Muscle Transverse pelvic rotation contralaterally Flexion of hip
Manual of
External rotation of femur
when ipsilateral femur is stabilized
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Rectus Femoris Muscle
Flexion of hip Extension of knee
Anterior pelvic rotation
Manual of
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Sartorius Muscle Flexion of hip Flexion of knee External rotation of thigh as it flexes hip & knee
Abduction of hip
Anterior pelvic rotation
Manual of
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Adductor Brevis Muscle Adduction of hip
External rotation as it adducts hip
Assists in flexion of hip
Manual of
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Adductor Longus Muscle Adduction of hip
Assists in flexion of hip
Manual of
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Adductor Magnus Muscle Adduction of hip External rotation as hip adducts
Extension of hip
Manual of
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Gracilis Muscle Adduction of hip Weak flexion of knee
Internal rotation of hip
Assists with flexion of hip
Manual of
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Semitendinosus Muscle Flexion of knee Extension of hip Internal rotation of hip
Internal rotation of flexed knee
Posterior pelvic rotation
Manual of
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Semimembranosus Muscle Flexion of knee Extension of hip Internal rotation of hip Internal rotation of flexed knee
Posterior pelvic rotation
Manual of
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Biceps Femoris Muscle Flexion of knee Extension of hip External rotation of hip External rotation of flexed knee
Posterior pelvic rotation
Manual of
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Gluteus Maximus Muscle Extensio n of hip External rotation of hip Upper fibers assist in abduction Lower fibers assist in adduction Posterior pelvic rotation
Manual of
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Gluteus Medius Muscle
Abduction of hip Internal rotation & flexion (anterior fibers)
External rotation & extension (posterior fibers)
Manual of
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Tensor Fasciae Latae Muscle Abduction of hip Flexion of hip
Tendency to rotate hip internally as it flexes
Anterior pelvic rotation
Manual of
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Six Deep Lateral Rotator Muscles Piriformis, Gemellus superior, Gemellus inferior, Obturator externus, Obturator internus, Quadratus femoris
External rotation of hip
Manual of
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