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LEARNING OBJECTIVES
Upon completion of this chapter, the student should be able to demonstrate the following competencies and proficiencies concerning rehabilitation of the hip, thigh, and groin:
Have a basic knowledge and understanding of hip anatomy
Understand the normal arthrokinematics and osteokinematics of the hip joint
Understand the normal biomechanics of the hip joint
Recognize the pathomechanics and its relation to dysfunction at the hip joint
Have a general understanding of common hip joint pathology
Have a general understanding of surgical procedures used to address hip joint pathology
Design a rehabilitation plan with the understanding of surgical precautions for the hip
Implement a rehabilitation plan including proper stretching, strengthening, proprioception, and exercise technique in accordance with principles of basic exercise
Perform manual treatment techniques including basic stretching, joint mobilization, and soft tissue mobilization
Demonstrate and educate athlete on a comprehensive home exercise program
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Injuries to the hip region are common in all athletic populations. Injuries to this area can be divided into three specific groupings: hip joint pathology, thigh injury, and groin dysfunction. The hip region is a common referral site for pain originating in other areas such as the lumbar spine, sacroiliac (SI) joint, pelvis, and knee.1–4 This can make treating hip pain difficult, especially when the pain has a gradual onset or is chronic in nature. The hips and pelvis must be able to withstand constant and demanding loads. This is true not only when you are playing sports, but also while doing daily activities. The hips have to be able to transmit, absorb, and produce large forces during activity. The anatomical make-up of the hip makes it a very stable joint but does not prevent it from sustaining injury. Fractures, sprains, strains, and labral tears are only a few of the injuries that occur at the hip joint. Injuries to the hip are not the most common joint injury, but they can be a significant problem when they do occur.1–4 Many hip problems can be attributed to muscle imbalances, poor flexibility, or restricted mobility. Determining the underlying cause of hip pain is the key to treating the hip and any other injury. This chapter will review the anatomy, normal biomechanics, pathomechanics, common injuries of the hip, and rehabilitation techniques to address these conditions.
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The bony anatomy of the hip is composed of the femur and the acetabulum of the pelvis (Fig. 17-1). The femur, the longest, largest, and strongest bone in the body, serves a significant role in weight-bearing for the lower extremity.5,6 The strength of the femur is essential for both mobility and support during locomotion.
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The acetabulum is formed by the three bones of the pelvis: ...