Insertion:
Hip MMt page 2
Origin:
· Tensor fasciae latae: iliac crest and anterior superior iliac spine
Insertion:
· Tensor fasciae latae: iliotibial band
Nerve Innervation:
· Tensor fasciae latae: superior gluteal
Patient
Position:
· Patient lying on side, hip is flexed to 45° and lying across the limb underneath it, the foot should be resting on the table.
Therapist and Patient Instructions:
· Resistance is given on the thigh just above the knee in a downward direction. The stabilizing hand is placed on the crest of the ilium. Ask the patient to, “lift his/her leg and don’t let me push it down.”
Patient
Position:
· Patient should be sitting on the table with both legs completely supported on the table. The patient can lean backwards if comfortable.
Therapist and Patient Instructions:
· The therapist should have one hand holding the leg up slightly under the ankle to reduce friction. The other hand should be palpating the tensor fasciae latae where it inserts into the iliotibial band. Have the patient to try and slide their leg out to the side.
Origin:
· Adductor magnus: ischial tuberosity and inferior ramus of pubis
· Adductor brevis: body and inferior ramus of pubis
· Adductor longus: anterior crest of pubis
· Pectineus: pectineal line of pubis
· Gracilis: body and inferior ramus of pubis
Insertion:
· Adductor magnus: linea aspera and adductor tubercle on medial condyle of the femur.
· Adductor brevis: linea aspera of femur
· Adductor longus: linea aspera of femur
·
Pectineus: posterior femur
· Gracilis: tibia (shaft distal to condyle)
Nerve Innervation:
· Adductor magnus: obturator and tibial
· Adductor brevis: obturator
· Adductor longus: obturator
· Pectineus: femoral and obturator
· Gracilis: obturator
Patient
Position:
· Patient should be lying on his/her side with the limb being tested resting on the table. The therapist will support the limb not being tested.
Therapist and Patient Instructions:
· Standing behind the patient place the resistance hand on the medial thigh just above the knee. Resistance is given in a downward direction. Ask the patient to, “Lift your bottom leg up to your top leg, don’t let me push it down.”
Patient
Position:
· Supine with the limb not being tested slightly abducted.
Therapist and Patient Instructions:
· Using one hand support the ankle and hold the leg slightly off the table to decrease friction. Use the other hand to palpate the adductors on the medial proximal thigh while the patient tries to move their leg in toward the other one.
Obturator internus, obturator externus, gemellae superior, gemellae inferior, piriformis, quadratus femoris, gluteus maximus (posterior)
Origin:
· Obturator externus: ischium and obturator foramen of pubis
·
Obturator internus: inferior ramus of pubis, inferior ramus of ischium, and obturator
foramen internal side and membrane
·
Quadratus femoris: ischial tuberosity
·
Piriformis: anterior sacrum, sciatic notch of ilium, and sacrotuberous ligament
·
Gemellae superior: spine of ischium
·
Gemellae inferior: ischial tuberosity
·
Gluteus maximus: posterior gluteal line of ilium, posterior sacrum, posterior coccyx,
and sacrotuberous ligament.
Insertion:
·
Obturator externus: trochanteric fossa of femur
·
Obturator internus: greater trochanter of femur
·
Quadratus femoris: quadrate tubercle of femur
·
Piriformis: greater trochanter of femur
·
Gemellus superior: greater trochanter of femur
·
Gemellus inferior: greater trochanter of femur
·
Gluteus maximus: gluteal tuberosity of femur and iliotibial band
Nerve
Innervation:
·
Obturator externus: obturator
·
Obturator internus: ischiadic plexus
·
Quadratus femoris: ischiadic plexus
·
Piriformis: ischiadic plexus
·
Gemellus superior: L5 and S1
·
Gemellus inferior: L5 and S1
·
Gluteus maximus: inferior gluteal
Patient
Position:
·
Sitting
with legs dangling off the table. The
patient can place hands on the table for support and balance.
The patient should externally rotate at the hip.
Therapist
and Patient Instructions:
·
The
therapist should place one hand on the lateral aspect of the knee and the other
hand just above the medial malleolus. The
resistance will be inward at the knee and outward at the ankle to create a sort
of rotary resistance. The patient
should be in the end position for testing. End Positioning means that the patient is trying to hold the
movement at the end of the ROM. Ask the patient to, “bring your leg inward toward your
other leg, don’t let me turn your leg out.”
Patient
Position:
·
Patient
should be supine with the test limb internally rotated.
Therapist
and Patient Instruction:
·
While
palpating the external rotators ask the patient to try and roll their leg out.
Origin:
·
Gluteus minimus: outer surface between the anterior and inferior gluteal lines of the
ilium and the greater sciatic notch.
·
Gluteus medius: outer surface between the crest and posterior gluteal line of the ilium.
·
Tensor fasciae latae: iliac crest and anterior superior iliac spine
Insertion:
·
Gluteus minimus: greater trochanter of the femur
·
Gluteus medius: greater trochanter of the femur
·
Tensor fasciae latae: iliotibial band
Nerve
Innervation:
·
Gluteus minimus: superior gluteal
·
Gluteus medius: superior gluteal
·
Tensor fasciae latae: superior gluteal
Patient
Position:
·
Sitting,
hands can be placed on the table for support.
Leg should be internally rotated at the hip.
Therapist
and Patient Instructions:
·
The
therapist should place one hand on the medial aspect of the knee and the other
hand just above the lateral malleolus. Resistance
will be in an outward direction at the knee and in an inward direction at the
ankle to create a rotary resistance. The patient should be in the end position for testing.
Ask the patient to, “move your leg outward, don’t let me pull it back
in.”
Patient
Position:
·
Supine
with the limb being tested in external rotation.
Therapist
and Patient Position:
·
Palpate
the internal rotators and ask the patient to try and roll their leg in toward
their other leg.