Hip Flexors and Hip Extensors

Question 1 

Which bony landmark should you palpate to identify the hip joint, and how is that landmark related to the hip joint centre? 

The hip joint is underneath approximately 3 cm beneath the midsection of the inguinal ligament. It is also about 3 cm lateral of the palpable femoral artery. The head point of the joint or femur joins together to the acetabulum that is underneath the acetabular labrum. To identify the hip joint, the primary bony landmark to palpate includes the pubic symphysis, located in the inner section of the midline. Another bony landmark is the anterior superior lilac spine and the ischial tuberosity. The physical examination must be undertaken with an individual in the standing position. Palpation and inspection at the hip are conducted either at the hyperlordosis or the pelvic obliquity (palpitated when the pelvis is tilted). 

The articulation at the pelvis together with the pelvis entails the hip joint that links the axial skeleton to the extremity underneath. These two hip bones join to make the pelvis along with the coccyx and the sacrum. All come together and are connected by the pubic symphysis. 

Question 2 

Hip flexion and hip extension are opposing joint rotations. Why are Adductor Longus, Adductor Magnus, and Gracilis able to act as both hip flexors and hip extensors? 

Adduction is all about getting back the thigh to the midline. It is achieved by the adductor muscles that comprise of the adductor gracilis, Magnus and longus. The adductor magnus, adductor gracilis, and adductor longus all have extensive hip adduction muscle moment arms. At the same time, adductor Magnus's extensor muscle arm is unappreciated. The others are majorly hip flexors. Although gracilis is longer, the other adductors, longus and magnus have the same fascicle lengths, making them able to act as both hip extensors and flexors. At the same time, as they all link at the pubis, attaching themselves to the femur length, their movements can be coordinated jointly, enabling them to act as hip flexors and hip extensors. 

Question 3 

Review activity 4a), 4b), and 4c) from lab 6. Do your test results indicate that your lab group member has better mobility of their left or right hip? Explain which test results you used to determine which hip has better mobility. 

While reaching out, she has more mobility on her left hip but could not hold onto her balance with the left leg. At the same time, she had less movement on her left while trying to reach out. While on her left leg, she could not hold onto her balance for a long time. However, she was more stable on her right leg. In essence, she has some weakness on her left side, meaning that she may have a weak hip flexor and a tight glute or hamstring muscle. While leaning on her left, she went the opposite direction tilting towards the right leg. However, when she switched to the right leg, she was forced to lean towards the supporting left leg. Her situation shows that she has reduced mobility on both hips. 

Mobility testing entails using classical osteopathy to evaluate how every spinal part is aligned for mobility in several plane directions and relation to the vertebrae below or above. For the test results, a positive Hip Quadrant test is best suited to show the likelihood of avascular necrosis, osteochondral defect, joint capsule tightness or arthritis. The test result will also show if the individual can make a complete range of movement. 

Question 4 

Lower cross syndrome means weak gluteus maximus and weak abdominals with tight erector spinae and tight iliopsoas. Review activity 4b) and 4c) from lab 6. What might movements of the pelvis and trunk during those tests indicate the person tested had a lower cross syndrome? 

The lower crossed syndrome is due to an imbalance in the muscle strength, especially in the lower segment where the hamstrings are often tight. The situations result in an interior pelvis slant and an increase in hips flexion. Tight movement of the muscles is a clear indication of the condition. A controlled and slow roll back movement on the back while lying on a bed or sitting on a table. While lying on the back, the legs are pushed down without much strain. In case the leg is lifted over the hip flexors it means the flexors of the hip are tight. The knee needs to be vertical at 80 to 90 degrees and bending should be achieved without a strain. Uninterrupted movement with one leg up and the arms folded will help determine if the individual has a lower cross syndrome. 

Question 5 

5) Review Activity 4e) in lab 6. If someone that you assessed for a Trendelenberg test failed the test, what would you suggest they do to correct their dysfunctional trunk/pelvis alignment, and why would you recommend this? 

A Trendelenburg test refers to a physical assessment which helps in evaluating a hip dysfunction. A positive Trendelenburg is an indication of hip abductor muscles weakness. Failing the test would call for taking corrective measures towards corrective their pelvis alignment or dysfunctional trunk. To correct the situation, an individual can stretch for approximately 40 to 60 seconds and repeats the same three times. The exercise needs to be pain-free and light. The individual needs to breathe in profoundly while allowing the chest and belly to expand. Using a stretch and foam roller can also help remedy the situation. Maintaining the pressure of the foam roller at specific areas for some time (approximately 30 to 60 seconds) will guarantee best stretch levels. The method is comfortable and pain-free and can be undertaken without much strain on the muscles.