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Pathology of Sports Injuries

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Daniel Higgs

on 25 March 2014

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Transcript of Pathology of Sports Injuries

Pathology of Sports Injuries

Learning Outcomes
Case Study 5 - Hip
Relevant hip anatomy

Biomechanics (stress and loads)

Mechanisms and structures involved

Different diagnosis

Key discussion points

Essential reading
In your groups, highlight the key aspects of the case study...
Key Aspects of the Case Study...
Amount of exercise
Location of pain
Type of pain

Key Questions
Risk Factors
A 14 year old overweight boy
attends your clinic complaining of
right hip pain and mild knee pain
. He reports the hip pain to be of an
8 week duration
and the
knee pain begun developing gradually over the last 2 weeks
. Although he does not recall any incident, he links the pain with an
increase in exercise over the last three months
trying to lose weight.

He has been jogging 3 to 4 times per week and playing badminton twice a week.
Pain sites include
anterior upper thigh around the ASIS and just below the knee.
The pain is intermittent during the day but usually
aggravated by exercise
. Occasionally he notices it becomes a
sharp pain
when playing badminton and sometimes when
getting up from a seated position
. Passive examination of the right hip shows
a reduced range flexion and bring on the sharp pain at the hip
. The client reported apprehension as his hip was
passively internally rotated
. Thomas test was
positive on right and left sides resisted knee flexion encourages symptoms.
Anatomy of the Hip
In your groups list the main....
Different ROM's
Bony points
Anatomy of the Hip


Internal Rotation

External Rotation



Range of Movements
Bony Points
Common Hip Injuries
Referred Pain
Case Study 5 - Hip
Essential Readings
Potential Diagnoses
Differential Diagnosis
Chicken nuggets are like my family
Most Common
Least Common
Not to be Missed
Superior Ramus of the Pubis
Illiac Crest
Illiac Tubercle

Greater Trochanter
Greater Sciatic Notch
Lesser Sciatic Notch
Ischial Tuberoisty
Obturator Foramen

Iliofemoral ligament:
which connects the pelvis to the femur at the front of the joint. It keeps the hip from hyper-extension.

Pubofemoral ligament:
which attaches the most forward part of the pelvis known as the pubis to the femur.

Ischiofemoral ligamen:
which attaches to the ischium (the lowest part of the pelvis) and between the two trochanters of the femur.
Hip Osteoarthritis
Hip osteoarthritis is a joint disease that mostly affects your hip joint cartilage. Articular cartilage is the hard slippery surface that covers the sections of bones that move against each other in your hip joint.
Some risk factors that increases likelihood:

Being overweight.
Previous joint injury.
Muscle weakness.
Joints stress
Poor biomechanics.
Malformed joints or a genetic defect in your joint cartilage.
(Physio Works, 2012:1)
Physio Works. (2012) Hip Arthritis (Osteoarthritis). [Online] Available from: http://physioworks.com.au/injuries-conditions-1/hip-arthritis-osteoarthritis [accessed 17 March 2014]

Pain and swelling occurring over the side of the hip
Referred pain that travels down the outside thigh and may continue down to the knee
Pain when sleeping on your side; especially the affected hip
Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car)
Pain when climbing stairs
Pain in sitting with the legs crossed
Increased pain when walking, cycling or standing for long periods of time
Trochanteric Bursitis
: The client being 14 years of age means that he may be going through the growth stages of puberty.
: Being overweight at a young age may cause stress in joints.
: The fact that the symptoms of the injury originally began 8 weeks ago and ....
Amount of exercise
: suddenly increasing the amount and intensity of exercise can have a knock on effect regarding stress of the joints, surrounding muscles and recovery rates.
Location of pain
: The area of pain that the client is experiencing are the knee (the most weight baring joint) and the hip (the second most weight baring joint).
Type of pain:
The pain the client is experiencing is a sharp pain when flexing the hip, what does this mean?
Reduction in ROM:
Reduction in hip flextion, has this occurred since the injury? why?
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