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At the completion of this chapter, the reader will be able to:

  1. Describe the hip joint complex’s joint anatomy, ligaments, muscles, and blood and nerve supply.

  2. Describe the biomechanics of the hip joint, including the open- and close-packed positions, normal and abnormal joint barriers, force couples, and the static and dynamic stabilizers of the joint.

  3. Describe the purpose and components of the examination of the hip joint.

  4. Perform a comprehensive examination of the hip joint, including palpation of the articular and soft tissue structures, specific passive mobility, passive articular mobility tests, and stability stress tests.

  5. Evaluate the total examination data to establish a diagnosis.

  6. Describe the relationship between muscle imbalance and the functional performance of the hip.

  7. Summarize the various causes of hip dysfunction.

  8. Develop self-reliant intervention strategies based on clinical findings and established goals.

  9. Develop a working hypothesis.

  10. Describe and demonstrate intervention strategies and techniques based on clinical findings and established goals.

  11. Evaluate the intervention’s effectiveness to progress or modify an intervention.

  12. Plan an effective home program and instruct the patient in the same.



The structure and design of the hip allow for both mobility and stability, the latter of which is particularly important for weight bearing and ambulation. The center of gravity is located at the second sacral vertebral level in the human body, several segments above and medial to the femoral head. Control of the body mass from such a distant fulcrum requires the generation of significant counterbalancing forces and the joint’s ability to sustain both high compression and tensile strains. Thus, a major function of the hip joint is to provide a pathway for transmitting forces between the pelvis and the lower extremities. Thus, the entire pelvic complex should be considered when evaluating and treating individuals presenting with hip region symptoms using the concept of regional interdependence.


The hip articulation is a synovial joint formed by the femur head inferiorly and the acetabulum of the pelvic bone superiorly (Fig. 19-1). This articulation is classified as an unmodified ovoid (or ball and socket) joint. Although similar to the shoulder joint, the hip joint differs because the former has a deeper acetabular socket and acts as a weight-bearing joint with a smaller total arc of motion.


The bones of the lower extremity. (Reproduced with permission from Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. 2nd ed. New York, NY: McGraw Hill; 2019.)

Bony Anatomy

Normal hip joint growth and development occur because of a genetically determined balance of growth of the acetabulum and the presence of a strategically located spherical femoral head.

More commonly referred to as the innominate bone, each of the two os ...

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