Movement and massage therapy III. theory – Week 6.
Hip additional movements, examinations, tests, therapeutic options.
1
Pelvic (os pelvis)
The left and right hip bones (innominate bones, pelvic bones) are two irregularly shaped bones that form part
of the pelvic girdle – the bony structure that attaches the axial skeleton to the lower limbs.
The hip bones have three main articulations
• Sacroiliac joint – articulation with the sacrum.
• Pubic symphysis – articulation between the left and right hip bones.
• Hip joint – articulation with the head of femur.
Art. Sacroiliaca
• The sacrum has an "L" shaped surface covered with hyaline cartilage and os ilium fibrous cartilage
• Adjustment to shear forces
• Joint case very tight
• Your tape device is very strong mainly in the back (dorsally).
• Tight joint between the sacral facial auricularis of sacrum and pelvic bone
Structure of the Pelvic Girdle
The bony pelvis consists of the two hip bones (also known as innominate or pelvic bones), the
sacrum and the coccyx.
There are four articulations within the pelvis:
• Sacroiliac joints (x2) – between the ilium of the hip bones, and the sacrum
• Sacrococcygeal symphysis – between the sacrum and the coccyx.
• Pubic symphysis – between the pubis bodies of the two hip bones.
Ligaments attach the lateral border of the sacrum to various bony landmarks on the bony pelvis to
aid stability.
• lig. iliolumbale
• lig. sacrospinale
• lig. sacrotuberale
• membrana obturatoria
Ligaments of the pelvis
• lig. iliolumbale
• lig. sacrospinale
• lig. sacrotuberale
• membrana obturatoria
Function of the pelvis
The strong and rigid pelvis is adapted to serve
a number of roles in the human body. The main
functions being:
• Transfer of weight from the upper axial
skeleton to the lower appendicular
components of the skeleton, especially
during movement.
• Provides attachment for a number of
muscles and ligaments used in locomotion.
• Contains and protects the abdominopelvic
and pelvic viscera.
art. coxae – Hip joint
Articulation surfaces
• caput femoris
• acetabulum
Accessory parts
• labrum acetabulare
• intraarticularis ligaments
Joint Type
• ball and socket joint
Interarticular ligaments
• lig. capitis femoris
• lig. transvum acetabuli
Extraarticular ligaments
• lig. iliofemorale
• lig. pubofemorale
• lig. ischiofemorale
Extraarticular ligaments of the hip
Extraarticular ligaments
• lig. iliofemorale
• lig. pubofemorale
• lig. ischiofemorale
Flexion: iliofemorale and pubofemorale in
relax, ischiofemorale tightens - pelvic psoterior
tilt
Extension: iliofemorale and pubofemorale in
tension, preventing excessive extension.
Rotation: the anterior ligaments are tensioned in
external rotation, and the psoterior ones in
internal rotation rotation.
art. coxae – Hip joint
1. flexion – extension
Axis of the movement:
transversal axis passing through the center of caput femoris
2. abduction – adduction
Axis of the movement:
the saggital axis passing through the center of the caput femoris
3. internal rotation – external rotation
Axis of the movement:
the structural axis of the thigh (center of caput femoris - center of
fossa intercondylaris)
art. coxae – Hip joint
Accessory movements
• Flexion: when the convex surface moves sliding dorsal and distal, it rolls in
the opposite direction
• Extension: when the convex surface moves to slip ventral and distal, roll to
dorsal and proximal
• External rotation: when the convex surface moves, the head slides forward
(ventral) and rolls dorsally
• Internal rotation: slides dorsal and ventral
• Abduction: Slides distal and medial and rolls in opposite directions
• Adduction: Slides lateral and cranial and rolls in opposite directions
Closed packed position: full extension, full internal rotation, and full abduction
Open packed position: 30° flexion, 30° abduction, and slight external rotation
The left and right hip bones (innominate bones, pelvic bones) are two irregularly
shaped bones that form part of the pelvic girdle – the bony structure
that attaches the axial skeleton to the lower limbs.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
The hip bones have three main articulations
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Sacroiliac joint – articulation with the sacrum.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Pubic symphysis – articulation between the left and right hip bones.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Hip joint – articulation with the head of femur.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
The sacrum has an "L" shaped surface covered with hyaline cartilage and os ilium fibrous cartilage
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Art. Sacroiliaca: Adjustment to shear forces
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Art. Sacroiliaca: Joint case very tight
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Art. Sacroiliaca: Your tape device is very strong mainly in the back (dorsally).
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Art. Sacroiliaca: Tight joint between the sacral facial auricularis of sacrum and pelvic bone
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
The bony pelvis consists of the two hip bones
(also known as innominate or pelvic bones), the sacrum and the coccyx.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
There are four articulations within the pelvis
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Sacroiliac joints (x2) – between the ilium of the hip bones, and the sacrum
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Sacrococcygeal symphysis – between the sacrum and the coccyx.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
Pubic symphysis – between the pubis bodies of the two hip bones.
True
False
If the answer is incorrect, the square disappears! If you answer well, you can go further!
References
1) Atlas of Human Anatomy by Frank H. Netter, ISBN: 9781455704187, Publication Date: 2014-03-24
2) Big Picture: Gross Anatomy by David A. Morton; Kurt Albertine; David Morton; K. Bo Foreman,
ISBN: 9780071476720, Access Medicine
3) Human Anatomy and Physiology by Kent Van de Graaff; R. Rhees; Sidney Palmer; R Ward Rhees;
Sidney L. Palmer; Kent M. Van De Graaff, ISBN: 9780071623308 EBSCO
4) Biel A (2005). Trail Guide to the Body (2nd ed). Boulder, CO: Books of Discovery.
5) Sanzo P, MacHutchon M (2015). Length Tension Testing Book 1, Lower Quadrant: A Workbook of
Manual Therapy Techniques (2nd ed). Canada: Brush Education.
6) Travell JG, Simons DG, Simons LS (1998). Travell and Simons' Myofascial Pain and Dysfunction:
The Trigger Point Manual, Volume 1: The Lower Extremities (2nd ed). Baltimore, MD: Williams &
Wilkins.
Resources References
• Bharucha AE. Pelvic floor: anatomy and function. Neurogastroenterology & Motility. 2006
Jul;18(7):507-19.
• Mantle J, Haslam J, Barton S, Polden M. Physiotherapy in obstetrics and gynaecology.
Butterworth-Heinemann,; 2004.
• Chaurasia BD. Human Anatomy: Regional and applied dissection and clinical, Vol 2 (Lower Limb,
Abdomen & Pelvis)-.
• Sapsford R, Bullock-Saxton J, Markwell S, editors. Women's health: a textbook for
physiotherapists. WB Saunders; 1998.
• Anatomy Zone. Pelvic Floor Part 1 - The Pelvic Diaphragm - 3D Anatomy Tutorial. Available
from: [Link] [last accessed 11/04/14]
• Anatomy Zone. Pelvic Floor Part 2 - Perineal Membrane and Deep Perineal Pouch - 3D Anatomy
Tutorial. Available from: [Link] accessed 11/04/14]
References
1) Atlas of Human Anatomy by Frank H. Netter, ISBN: 9781455704187, Publication Date: 2014-03-24
2) Big Picture: Gross Anatomy by David A. Morton; Kurt Albertine; David Morton; K. Bo Foreman, ISBN: 9780071476720, Access Medicine
3) Gray H, Anatomy, descriptive and surgical, 8th edition, Philadelphia, Collins, June, 1878
4) Dougherty, C. Curr Pain Headache Rep (2014) 18: 411. [Link]
5) Morton DA, Foreman K, Albertine KH. eds. 'The Big Picture: Gross Anatomy, 2e' New York, NY: McGraw-Hill. Available Anderson BW, Al Kharazi KA. Anatomy, Head and Neck,
[Link] Island (FL): StatPearls Publishing; 2019. Available from: [Link] (accessed 8 April 2019)
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Tételsor
1. Hip additional movements
2. Hip Examinations
3. Hip Tests
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