Lab Class 6

Learning Objectives

By the end of this lab class:

  • You will be able to carry out a basic hip assessment.

Basic Assessment of the Hip

Welcome to lab class 6!

In this lab class you will learn how AROM, PROM, and Resisted Isometric Testing is performed for all possible movements of the hip joint.
Keep in mind that AROM is performed by the patient himself, so you will have to instruct your patient properly.
Besides judging the range of motion, you are looking for pain during a movement as well as compensations in other joints.

In this video you will learn how AROM is performed for all possible movements of the hip joint:

After AROM, you will want to passively assess the range of motion of the hip, meaning without muscle activation of your patient.
It is crucial that you look for compensations during the movements and that you fixate properly.
Doing so, you will receive exact information on how many degrees your patient can move in the hip joint into certain direction and you will be able to assess the correct end-feel.

In this video, you will learn how PROM is performed for all possible movements of the hip joint:

When a joint is inflamed, a limitation in range of motion is usally present and follows a specific pattern.
The capsular pattern for the hip joint is flexion, abduction and internal rotation (in varying order).

The normal values for hip range of motion are:

Bildschirmfoto 2015-09-24 um 13.02.50

After you have assessed active and passive range of motion you would continue with resisted isometric muscle testing:

 

Case study
Tom Smith, a 35 year old male is an enthusiastic runner. In 4 weeks he wants to participate at the Amsterdam Marathon that always takes every year in October.
However he has been experiencing pain on the lateral side of his knee for a couple of weeks now. The pain started gradually and usually gets worse during a running session.
But Tom isn´t the type of guy that takes a break just because of little aches here and there. Nonetheless, he is worried that his knee pain will keep him from completing the marathon.
In the first session with his physio, Tom reports a snapping or popping sound at the knee. The lateral side of the knee shows slight signs of inflammation.
PSC scores takes by the physio are: Running > 20min: 4/10, walking upstairs: 3/10, walking downstairs: 2/10.

 

Tasks:

1) Get together with a classmate and practice basic testing for the hip.

2) Tom's physio found out that his condition is related to muscles tightness und muscular weakness.
Which muscles do you expect to be tight in his case and which muscles do you expect to be weak?
Hint: Base your reasoning on anatomy!

Preparation for next week:

1) Brush up on the (bony) anatomy of the hip joint!

2) According to Janda there are tonic and phasic muscles in the human body.
Find out what this means and which muscles belong to which group!