Due to its location, design, and function, the hip joint transmits truly impressive loads, both tensile and compressive. Loads of up to eight times body weight have been demonstrated in the hip joint during jogging, with potentially greater loads present during vigorous athletic competition.1 In addition to providing stability, the hip joint permits a great deal of mobility. Any imbalance between these two variables can leave the hip joint and surrounding tissues prone to soft tissue injuries, impingement syndromes, and joint dysfunction.
The hip joint consists of the articulation between the femoral head and the horseshoe shaped articulating surface of the pelvic acetabulum.
The acetabulum is formed from three bones: the ilium, ischium, and pubis.
A number of structures about the hip are uniquely adapted to transfer forces:
- Labrum: The acetabular labrum deepens the acetabulum and increases articular congruence.
- Ligaments: The major ligaments of the pelvis and hip are known to be the strongest in the body and are well adapted to the forces transferred between the spine and the lower extremities.
- Muscles (Table 8-1): The abdominal musculature and the erector muscles of the spine provide further stabilization of the hip region and must be considered in conditions that affect pelvic tilt and the hip joint.
Table 8-1 Muscles Acting Across the Hip Joint ||Download (.pdf)
Table 8-1 Muscles Acting Across the Hip Joint
|Adductor brevis||External aspect of the body and inferior ramus of the pubis||By an aponeurosis to the line from the greater trochanter of the linea aspera of the femur||Obturator nerve, L3|
|Adductor longus||Pubic crest and symphysis||By an aponeurosis to the middle third of the linea aspera of the femur||Obturator nerve, L3|
|Adductor magnus||Inferior ramus of pubis, ramus of ischium and the inferolateral aspect of the ischial tuberosity||By an aponeurosis to the linea aspera and adductor tubercle of the femur||Obturator nerve and tibial portion of the sciatic nerve, L2–L4|
|Biceps femoris (long head)||Arises from the sacrotuberous ligament and posterior aspect of the ischial tuberosity||By way of a tendon, on the lateral aspect of the head of the fibula, the lateral condyle of the tibial tuberosity, the lateral collateral ligament, and the deep fascia of the leg||Tibial portion of the sciatic nerve, S1|
|Gemelli (superior and inferior)||Superior-dorsal surface of the spine of the ischium, inferior-upper part of the tuberosity of the ischium.||Superior and inferior-medial surface of the greater trochanter||Sacral plexus, L5–S1|
|Gluteus maximus||Posterior gluteal line of the ilium, iliac crest, aponeurosis of the erector spinae, dorsal surface of the lower part of the sacrum, side of the coccyx, sacrotuberous ligament, and intermuscular fascia||Iliotibial tract of the fascia latae, gluteal tuberosity of the femur||Inferior gluteal nerve, S1–S2|
|Gluteus medius||Outer surface of the ilium ...|