Pelvic Girdle Overview

1. Attaches at the lower limbs to the axial skeleton at the hip joint
   • Called the bony pelvis or the pelvic girdle
   • Transmits the weight of the upper body to the lower limbs
   • Supports visceral organs of the pelvis

Bones

1. Hip bone/ Coxal (2) (trail guide p. 276-279)
   • Formed by the fusion of the illium, ischium and pubic bone
   • Articulates with the head of the femur at the Acetabulum (the socket)
   • It fuses anteriorly at the pubic symphysis and forms the sacroiliac joint with the sacrum posteriorly
   • The Coxal bones, the sacrum, and the coccyx bones form the bony pelvis
2. Sacrum (trail guide p. 277-280)
   • Forms the most inferior portion of the spine
   • Connects with the posterior illium creating the sacroiliac joint
3. Coccyx (trail guide p. 277-280)
   • Fused small vertebrae at the distal end of the scrum, “tailbone”

Muscles

1. Rules of thumb about the actions of the hips
   • Anterior muscles: Flex the hip and extend the leg at the knee
   • Posterior muscles: Extend the hip and flex the leg at the knee
   • Adductor muscles: adduct the hip, close the leg
   • Abductor muscles: abduct the hip, open the leg
   • Rotators: Medially and laterally rotate the hip
2. Movements of the body
   • Flexion: Bends a joint/brings bones closer together
   • Extension: Opens a joint/ straightens the joint
   • Adduction: brings the limb closer to the midline
   • Abduction: taking the limb away from midline
   • Medial &l Lateral Rotation: turning of a head or ball inside of the socket
   • Circumduction: Combination of flexion, extension, adduction, and abduction to create a cone shaped movement, only occurs at the hip and shoulder
3. Abbreviations
   • O – Origin: the anchor, where a muscle attaches to a bone that does not move
   • I – Insertion: the point where a muscle attaches to a bone that moves during contraction
   • A – Action: the movement caused by contraction of a muscle
   • P – Palpation: Where the muscle can be felt by touch
   • TrP- Trigger Point: pattern of trigger point referral
4. Gluteal Group
   • Gluteus Maximus
   • Gluteus Medius
   • Gluteus Minimus
5. Quadratus Lumborum
6. Hamstring Group
   • Bicep Femoris
   • Semitendinosus
   • Semimembranosus
7. Lateral Rotators of the Hip
   • Piriformis
   • Quadratus Femoris
   • Obturator Internus
   • Obturator Externus
   • Gemellus Superior
   • Gemellus Interior

Ligaments

1. Iliolumbar: Located between transverse processes of L4-5 and the Iliac crest
2. Inguinal: Superficial band between the ASIS and pubic tubercle
3. Sacrotuberous: Between ischial tuberosity and edge of sacrum
4. Sacroiliac: superficial to sacroiliac joint

Bony Landmarks

1. ASIS: Anterior Superior Iliac Spine
2. PSIS: Posterior Superior Iliac Spine
3. Pubis: Interior bones of the pelvis, connected by the pubis symphysis
4. Ischial Tuberosity: Inferior and posterior prominence of Ischium, attachment site for hamstring muscles

Pathology

1. Charley Horse (Hematoma Formation)
   • Muscle contusion with bleeding into the tissues
   • Occurs with sever, prolonged pain
   • Can take up to three weeks to heal
   • Frequently experienced in contact sports
2. Muscle Strain (Pulls or Pulled Muscle)
   • Involves muscle or tendon tearing
   • Usually results from athletes not warming up properly, then extending or over extending a joint
   • Common in athletes who’s sport involves running/sprinting/jumping
   • Can take three to six weeks to heal with proper treatment and rehabilitation
3. Ligament Sprain
   • Tears in the fibers of a ligament
   • Can be mild to severe
   • Severe sprains are also called ruptures
   • Rupture: complete tearing of the ligament fibers
   • Recognized by inflammation, redness, discoloration, heat, swelling and pain
   • Not as common as muscle strains, but much more serious and take much longer to heal
   • Heals in 8-12 weeks with proper treatment and rehabilitation

The Illiotibial tract/band isn’t covered until week three, but it is important to note as several of this week’s muscles have attachments to it.