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Hip and Pelvis

common hip and pelvis injuries

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Hamstring strain
Groin strain
Definition

Tearing to the tendon(s) or muscle(s) located in the back of thigh made up of 3 different muscles known as the hamstrings.

Structure and Function

The hamstrings constitute 3 muscles: The biceps femoris, semitendinosus and semimembranosus muscles. The hamstrings are responsible for bending the knee and pulling the hip backward. The most common injury location is the proximal (closest to the upper body) biceps femoris at the muscle tendon junction.

Why does it occur?

Muscle imbalance, such as weak gluteals or tight iliopsoas/gastrocnemius causing increased demand on the hamstrings. Fatigue or over training i.e. long / middle distance running. Ballistic activities, sudden jumping, sprints, kicking can cause a speed of contracture likely to cause injury.

Symptoms

-Pain on stretching the hamstring
-Feeling/hearing a popping sensation at onset is common
-Actively bending the knee may cause pain, especially against resistance.

Treatment

PRICE initially. NSAIDS can be effective during the acute phase to deal with inflammation. Crutches might be required in severe cases and then weaned off ASAP. Strengthening and stretching programme post-acute phase to help rehabilitate and prevent recurrent injury.

What to avoid

-Returning to sport/activity to early
-Prolonged crutch use

Definition

Injury to the adductor muscles, most often the adductor longus in the femoral triangle. Groin strains may also involve injury to other muscles i.e. saratorius, rectus femoris, or iliopsoas.

Structure and Function

The adductor muscles are located on the inner thigh and are responsible primarily for adducting the hip (moving toward the midline of the body).

Why does it occur?

Overstretching into abduction or extension is the most common mechanism for injury. Rapid acceleration and distance running (overuse) are often reasons for this injury arising. Tight adductors can be caused by abdominal weakness as they take the role of trying to stabilise the pelvis, which may predispose them to injury.

Symptoms

-Pain felt in the groin
-Tenderness when pressing into the inner thigh
-Pain on resisted adduction or extension

Treatment

– Deep tissue massage and manual therapy to remove adhesions as tolerated. Hot and cold therapy during acute phase. PRICE and NSAID use recommended on immediate phase to tackle inflammation and manage any swelling.

What to avoid

– Ballistic activity
– End of range activity e.g. breast stroke swimming