Hip&Pelvis Kines Trans

KINESIOLOGY MSC 2101-4
BSPT 2-4 | MS. AMORES | 1ST SEMESTER | FINALS | PELAYO SUAREZ CABRERA SOTO PAEZ NAVARRO RICOHERMOSO ANGELES
○ Providing a bony support for the

birth canal
LEARNING OBJECTIVES ● Kinesiological Functions:
○ Supporting and transferring the
A. Bones F. Muscles
weight of the Head and Trunk
a. Bony landmarks G. Recorded Lecture
(HAT) to the femurs and lower
B. Lines and Angles
C. Sacroiliac Joints and
extremities in standing and
Symphysis walking or to the Ischial
D. Pelvic Motions Tuberosity in sitting;
E. Joints ○ Rotating during walking to
a. Range of Motion create a rhythmic pelvic swing so
b. Ligaments a smooth translation of both the
trunk and the lower extremities
occurs; and
○ Providing a broad area for
muscular attachment
● Made-up of Anterior-Superior Ilium,
PELVIS
Posterior-Inferior Ischium, and
● Aka OS COXAE
Anterior-Inferior Pubis that joint together
● Consist of left and right INNOMINATE
to form the bony pelvis and the
bones that connect with each other
acetabulum
anteriorly at the pubic symphysis and
posterior at the sacrum
○ Innominate
■ Means ‘Nameless’
■ Not really a single named
bone but is made up of
three bones that are
fused together (Ilium,
Ischium, and Pubis)
● Organ Function: DISTINCTIVE BONY LANDMARKS
○ Provides support and protection ● Ilium - more anterior and superior of the
of viscera; and three pelvic bones that’s why it will be
felt when you put your hands on your hips
○ Iliac crest DIMPLE in the skin (Dimple of

■ The very prominent superior Venus).
bony border of the ilium ○ Posterior Inferior Iliac Spine (PIIS)
○ Iliac fossa ■ These landmark is not easily
■ Large concave inner surface palpated along with AIIS
of the ilium
■ Provides a depend large
Bony Vertebral Soft Tissue
surface area to which a
Landmarks Level (if (Muscles or
portion of the large, powerful
there are Ligaments
iliacus muscle attaches
any) attached)
○ Anterior Superior Iliac Spine (ASIS)
■ Most anterior and superior ILIAC L4 spinous Snell: Tensor Fascia
aspect of the iliac crest CREST process Latae (origin)
■ Important landmark for
assessing pelvis position, ASIS - Sartorius and Tensor
leg length, and Q-angle Fascia Latae
○ Anterior Inferior Iliac Spine (AIIS)
AIIS - Rectus Femoris
■ Serves as the proximal
attachment for the rectus PSIS S2 -
femoris muscle
○ Posterior Superior Iliac Spine (PSIS) ILIAC L5 -
■ Left and right prominences TUBERCLE
are broader and sturdier
OUTER - Houglum: Separate
under than the ASIS and feel
SURFACE the areas of
rough under the palpating
OF ILIUM attachment of the
fingers
three gluteal muscles
■ Immediately inferior to each
Snell:
PSIS is a depression this is
Gluteus maximus,
the posterior landmark for
medius, and minimus
the sacroiliac joint
(Origin)
■ The soft tissue superficial to
PSIS is OFTEN marked by a ILIAC - Iliacus
FOSSA
NOTE: CLINICAL APPLICATION

In a normally aligned pelvis, the ASIS and PSIS are
Bony Soft Tissue (Muscles or
in the same horizontal plane and the ASIS is in the
Landmarks Ligaments attached)
same vertical line or slightly posterior to the
inferior most portion of the pubis. ISCHIAL Origin of Hamstring muscles
TUBEROSITY (Long head of Biceps femoris,
● Ischium - posterior inferior bone of the semimembranosus, and
pelvis semitendinosus) and Adductor
○ Ischial Ramus Magnus
■ Not easily palpable feature
■ Extends medially from the Snell: Gemellus inferior (origin)
body of the ischium to and Adductor longus (origin) -
connect to the ramus of the medial to pubic tubercle
pubis
○ Ischial Tuberosity ISCHIAL SPINE Sacrospinous ligament
■ Most notable palpable feature
■ Located at the bone’s most Snell: Gemellus superior (origin)
inferior aspect
ISCHIAL RAMUS Adductor magnus and Some of
■ An important landmark as it
the small lateral rotators of the
is the weight-bearing
hip
prominence when sitting
○ Ischial Spine
■ Provide a firm attachment for NOTE: CLINICAL APPLICATION
the sacrospinous ligament There is a BURSA UNDERNEATH THE ISCHIAL
● Sacrospinous ligament TUBEROSITY. Inflammation of this bursa is
- a major reinforcer of known as: ISCHIAL BURSITIS/ WEAVER’S/
the sacroiliac joints TAILOR’S/ BOATMENT’S BOTTOM. Usually, this
condition is due to sitting on hard surfaces for a
prolonged period. The area of ischial tuberosity
is a common site for pressure ulcer in
wheelchair bound individuals.
● Pubis - anteroinferior portion of the pelvis ● From Combination of Innominate Bones

○ Superior and Inferior ramus (Ilium, Ischium, and Pubis)
■ Attachment sites for most of ○ Acetabulum
the hip adductor muscles ■ Aka Vinegar’s cup
● Snell: Inferior ramus ■ Cup into which the head of
of pubis - origin of the femur fits to form the
gracilis, adductor Acetabulofemoral joint (Hip
brevis, minimus, and Joint)
magnus muscles ■ Ensures that the hip joint is
○ Symphysis Pubis actually comprised of
■ Amphiarthrodial connection portions of all three pelvic
between the two pubic bones bones
anteriorly ■ Acetabulum was formed
○ Pubic Tubercle approximately by 40% of
■ Located in most medial and Ilium, 40% of Ischium,
superior aspect of the and 20% of Pubis
superior ramus (HOUGLUM); (NEUMANN)
■ Attachment of inguinal 75% of Ilium and Ischium
ligament and 25% of Pubis
○ Greater Sciatic Notch
■ It is where the sciatic nerve
Soft Tissue (Muscles or
travels through and the
Bony Landmarks Ligaments attached)
piriformis muscle spans
SUPERIOR RAMUS HIP ADDUCTOR MUSCLES across it
Snell: Pectineus (origin) ○ Obturator Foramen
■ It is where several vessels
BODY Snell: Origin of Adductor and nerve on their way to the
Longus lower extremity travels
through
INFERIOR RAMUS HIP ADDUCTOR MUSCLES
■ Formed by the Ischium and
PUBIC TUBERCLE INGUINAL LIGAMENT Pubis
because it is a lateral projection

SACRUM of the femur
● The link between the axial skeleton and ■ Increases the moment
the lower extremities arm of these muscles by
● Intimate connection with the pelvic bone deflecting their line of
through the left and right sacroiliac joints pull away from the axis of
hip motion, thereby
BONY LANDMARKS: increasing the torque
● SACRAL PROMONTORY able to be produced by
○ Sharp anterior edge of the body these muscles
○ Moves inferiorly and anteriorly ● Lesser Trochanter
during nutation; upward and ○ Located medially and inferiorly to
posteriorly during the greater trochanter
counternutation along with ● Linea Aspera
sacrum and coccyx ○ Prominent ridge running almost
the entire length of the posterior
FEMUR (PROXIMAL) femur
● Longest, largest, heaviest, and strongest ● Pectineal line
bone ○ Attachment of pectineus muscle
● Contributes to 25% of height
● Articulating partner at the hip proximally
Soft Tissue (Muscles
and with the tibia at the knees distally
Bony Landmarks or Ligaments
BONY LANDMARKS
attached)
● Greater Trochanter
○ Most palpable prominence GREATER Houglum: Gluteus medius
○ A marker used in measuring leg TROCHANTER and lateral rotator
length muscles (upper border -
○ Level with the center of the insertion of piriformis,
femoral head in normal adults gemellus superior and
○ Increases the leverage of many inferior, obturator
hip muscles (3 gluteal muscles internus)
and lateral rotators) that attach
by increasing their moment arm Snell: Lateral Surface -
● Smooth curved line connecting medial

Gluteus medius
border of femoral metaphysis with the
(insertion); Anterior
superior border of the obturator foramen
surface - Gluteus
● A BROKEN Shenton’s line is DIAGNOSTIC
minimus (insertion)
OF PATHOLOGY
LESSER Iliopsoas ○ For example, if the head of the
TROCHANTER femur is dislocated or fractured,
two lines form two arcs, which
LINEA ASPERA Some of the Adductor indicates a BROKEN LINE
muscles
Snell: Short Head Biceps

Femoris (origin)
PECTINEAL LINE Pectineus muscle
JOINTS THAT MAKE UP THE PELVIS: (7)

A. (2) Both Hips/ Acetabulofemoral/
Coxofemoral Joints
B. (1) Lumbosacral joint HILGENREINER’S LINE
C. (2) Left and Right Sacroiliac joints ● Drawn from lateral to the medial edge of
D. (1) Sacrococcygeal joint the acetabulum
E. (1) Symphysis pubis ● This line is horizontal
● Drawn between the inferior parts of ilium
● A horizontal line through the triradiate
cartilage of the acetabulum
SHENTON’S LINE
● This line is normally curved
● Drawn along the medial curved edge of
the femur and continuing upward in a
smooth arc along the inferior edge of the
pubis
● An angle formed by a horizontal line and a

PERKIN’S LINE line connecting the medial point of the
● This line is vertical sclerotic zone with the lateral center of
● Drawn through the upper outer point of the acetabulum
the acetabulum ● Normal: 30°; in newborn: 27.5°
● A vertical line (perpendicular to
Hilgenreiner’s line) from the lateral Average Values of Hilgenreiner’s Angle
margin of the ossified acetabular roof that
(Acetabular Index)
is normally tangential to the lateral Gender Newborn 6 Months 1 Year
margin of the ossification center of the Old Old
femoral head
Male 26° 20° 20°
Female 28° 22° 20°
NECK-SHAFT ANGLE
● Plane: Frontal
● Normally, at birth 150°-160° and
decreases to between 120°-135° in
FOOD FOR THOUGHT:
adults
The Hilgenreiner’s line and the Perkin’s line
● Coxa Vara - less than <120° in adult
will create a quadrant. Normally, the femoral
○ Smaller neck-shaft angle
head of the ossification center of the femoral
○ Decrease in leg length
head is at the inner distal quadrant. If it is at
○ Prone to fx
the superolateral quadrant, it may indicate hip
○ Places the limb in an adducted
dislocation
position
● Coxa Valga - angle is more than > 135°
ACETABULAR INDEX in adult
● Determined by drawing first the ○ Larger neck-shaft angle
Hilgenreiner’s line ○ Increase in leg length
● Aka Hilgenreiner’s angle ○ Prone to dislocation of hip
● The greater the slope angle, the less ○ Places the limb in an abducted
stable the femoral head in the acetabulum position
arm) of hip
abductors
● Increase limb
length
● OA - because of
increase
compressive force
from the muscle
due to the
Coxa Vara vs. Coxa Valga tendency of hip
dislocation
Coxa Vara Coxa Valga
Decrease in neck-shaft Increase in neck-shaft

angle angle
Related conditions: Related conditions:

● Prone to fracture ● Prone to hip
because of the dislocation
increase bending ● Decrease bending
force across the moment arm,
femoral neck hence, decreases
● Increase mechanical shear force across
advantage and femoral neck
moment arm of hip ● Increased
abductor, decrease functional length
functional length of of hip abductor
hip abductor muscle
● Decrease leg length ● Decrease
● Common in CP mechanical
● SCFE advantage
(decrease moment
CENTRAL-EDGE ANGLE ACETABULAR ANTEVERSION ANGLE

● Plane: FRONTAL PLANE ● Plane: TRANSVERSE PLANE
● Aka “ANGLE OF WILBERG” ● It is formed by two lines which originate
● An angle formed by two lines that at the posterior rim of the acetabulum
originate at the center of femoral head ● Reference line: EXTENDS IN AN ANTERIOR
● Reference Line: EXTEND VERTICALLY DIRECTION PARALLEL WITH SAGITTAL
● Second Line: EXTENDS TO THE LATERAL PLANE
ASPECT OF THE ACETABULUM ● Second line: EXTENDS OBLIQUELY TO THE
● Angles vary during development (although ANTERIOR MARGIN OF THE ACETABULUM
after age 5) ● Angles:
● Angles: ○ Normal: 15° to 20°
○ Suggest hip dysplasia: <20° ○ Associated with less containment
■ HIP DYSPLASIA - an of femoral head by the
abnormality in which the acetabulum: >20°
femur does not fit ■ Put significantly more
together with the pelvis stress on the hip joint,
as it should. especially when going
○ Considered normal: >25° DOWNSTAIRS, making
them more susceptible to
osteoarthritis joint
changes
○ Excessive coverage of femoral
head by the acetabulum: <15°
FLEXION EXTENSION
NELATON’S LINE
● Imaginary line drawn from ischial Primary muscles Gluteus maximus and
tuberosity of the pelvis to ASIS responsible: Iliopsoas Abdominals
Hip flexion occurs when Hip extension occurs when

the femur moves on a the femur moves on a
stable pelvis stable pelvis
*Increase of Lumbar *Person sits in a slouch

Lordosis
Anterior and Posterior pelvic tilts are motions of the

entire pelvic ring in the SAGITTAL PLANE around a
MEDIAL-LATERAL AXIS
PELVIC INCLINATION
● Plane: OBLIQUE PLANE FOOD FOR THOUGHT:
● Normal: 50° to 60° If the patient has an anteriorly tilted pelvis in
● Drawn through PSIS and foremost portion upright standing (close kinematic chain); there
of the symphysis pubis is increased hip flexion and increased lumbar
● Angle of pelvic inclination is an angle extension. The hip flexors and the lumbar
created by oblique plane intersecting with extensors are force couple and may have
the transverse plane tightness. On the other hand, the abdominal
● Alignment of the pelvis when the ASIS and muscles and hip extensors are stretched and
pubic symphysis do not align on the same weak.
vertical line
Anterior Pelvic Tilt Posterior Pelvic Tilt If the patient has posteriorly tilted pelvis,
opposite happens.
Inclines FORWARD: ASIS Inclinces BACKWARD:
moves ASIS moves
ANTERIOR-INFERIOR POSTERIOR-SUPERIOR
Associated with LUMBAR Associated with LUMBAR

ANGLE OF FEMORAL TORSION ○ Increase in hip medial rotation

● Plane: TRANSVERSE PLANE with a concomitant limitation of
● Innate medial twist of the femur hip lateral rotation motion
● Angles: ○ 25° to 45° is common in persons
○ Infancy: 40° with cerebral palsy
○ Adulthood: 10° to 20° ● RETROVERSION
● ANTEVERSION ○ Less commonly seen
○ An angle greater than normal ○ Decrease in this angle
○ Results in joint incongruence to ○ ‘Out-toeing’
produce relative instability of the ○ Lateral hip rotation, during
hip joint standing and walking
○ ‘In-toeing’
Anteverted Hip Retroverted Hip
● Medial femoral ● Lateral femoral

torsion torsion
● ROM: Increase ● ROM: increase
internal rotation external rotation
● Foot deformity: ● Foot deformity: out
in-toeing short leg toeing longer leg
ilium/innominate bone against the sacrum.

Moreover, the pelvic girdle can also move on a
● Sacroiliac joint - diarthrodial joint fixed sacrum.
(freely movable)
● Symphysis pubis - amphiarthrodial joint
(slightly movable) SACRUM MOVING AGAINST FIXED ILIA
● Sacrum moving against fixed ilia - Nutation Counternutation
counternutation, nutation
○ When the sacrum moves, it is ● Posterior pelvic ● Anterior pelvic
accompanied by a changed in tilting/torsion tilting/torsion
relative position of the two Other motions: Other motions:
innominate bones (i.e., the pelvic ● Sacral ● Sacral
girdle) in relation to the moving promontory promontory
sacrum. moves inferiorly moves superiorly
● Pelvic girdle moving on a sacrum - Pelvic & anteriorly & posteriorly
anterior pelvic tilt, posterior pelvic tilt Girdle ● Distal aspect ● Distal aspect
○ When the ilium moves against a Position of sacrum and of sacrum and
fixed sacrum, there are movement coccyx move coccyx move
happening at the sacroiliac joint posteriorly anteriorly
and at the symphysis pubis. These ● Iliac crests ● Iliac crests
joints are primarily for absorption approximate move apart
of forces. ● Ischial ● Ischial
tuberosities tuberosities
move apart approximate
There is a difference in the term
● Pelvic inlet ● Pelvic inlet
anterior/posterior pelvic tilt of the pelvic girdle
widens approximates
associated with the movement of the sacrum --
● Pelvic outlet ● Pelvic outlet
counternutation/nutation with the term anterior
approximates widens
and posterior pelvic tilt used in describing the
movement of the pelvis as one unit--meaning, Sacrotuberous Anterior sacroiliac
the sacrum moved with the rest of the pelvis. In Limits ligament ligament
anterior/post pelvic tilt with sacral movements, Sacrospinous Posterior sacroiliac
it describes the position of the ligament ligament
Whenever the hip joint is weight-bearing, the femur is

relatively fixed, and, in fact, motion of the hip joint is
produced by movement of the pelvis on the femur.
ANTERIOR AND POSTERIOR PELVIC TILT

● Motions of the entire PELVIC RING in the
SAGITTAL PLANE around a CORONAL/
FRONTAL/MEDIOLATERAL axis.
● Normal Alignment of Pelvis
○ ASIS is in HORIZONTAL line with
PSIS
LATERAL PELVIC TILT
○ ASIS is in VERTICAL line with
● A FRONTAL PLANE motion of the entire
SYMPHYSIS PUBIS
pelvis around an ANTEROPOSTERIOR axis.
● May occur in BILATERAL STANCE or in
● In a normally aligned pelvis, a
UNILATERAL STANCE if opposite limb is
HORIZONTAL LINE passes through the
NON-WEIGHT BEARING
ASIS.
● In CLOSED KINEMATIC CHAIN or in FIXED
FEMUR: (yung SOLID RED LINE ang HORIZONTAL LINE)
Anterior Pelvic Tilt Posterior Pelvic Tilt
● HIP FLEXION ● HIP EXTENSION

● ASIS moves ● SYMPHYSIS PUBIS
ANTERIORLY & moves SUPERIORLY
INFERIORLY ● SACRUM moves
● INFERIOR SACRUM CLOSER to the
moves AWAY from the FEMUR ● PELVIC DROP = one side of the pelvis
femur ● LUMBAR FLEXION DROPS
● LUMBAR EXTENSION ● PELVIC HIKE = one side of the pelvis
ELEVATES
● In LATERAL PELVIC TILT during LEFT Kapag naman binaba mo yung kanang balakang mo,
UNILATERAL STANCE: yung kaliwang balakang ay mag-a-ADDUCT, at yung
space or angle sa pagitan ng VERTICAL line ng femur
PELVIC HIKE PELVIC DROP
at HORIZONTAL line ng ASIS ay mag de-decrease.
AXIS OF LEFT HIP JOINT LEFT HIP JOINT
MOTION HIKE VS DROP (NAMING AND
REFERENCING)
HIP JOINT LEFT HIP JOINT LEFT HIP JOINT
MOTION ABDUCTS ADDUCTS
(weight-bearing) (weight-bearing) Lateral pelvic tilt is named (and should be
observed) by what is happening to the side of
MEDIAL INCREASES DECREASES the pelvis opposite to the weight-bearing hip
ANGLE in a unilateral stance. The weight-bearing hip
joint in unilateral stance will always be the
LUMBAR
axis of rotation, and the opposite side of the
FLEXION TOWARDS TOWARDS
pelvis will always be the reference side for
(always THE HIKE OPPOSITE THE
naming the movement (hike or drop).
towards the DROP
higher side)
Kapag aalamin if DROP or HIKE, ang titingnan
lagi ay ang OPPOSITE SIDE ng WEIGHT-
BEARING leg. Since ang weight-bearing leg ay
ang AXIS OF MOTION ng lateral pelvic tilt, ang
movement ng opposite side ang
magde-determine kung HIKE or DROP ang
movement.
So, kapag tumayo ka sa kaliwang paa mo at tinaas mo

yung kanang balakang, mag-a-ABDUCT yung kaliwang
balakang mo, at yung space or yung angle sa pagitan ng
VERTICAL line ng femur at HORIZONTAL line ng ASIS ay
mag i-increase.
PELVIC SHIFTING FORWARD AND BACKWARD PELVIC ROTATION

● Lateral pelvic tilt in BILATERAL stance ● Motion of the entire pelvic ring in the
● Moves in the FRONTAL PLANE transverse plane around a vertical axis.
● If both feet are on the ground and the hip and
knee of one limb are flexed, the opposite limb Although rotation can occur in bilateral stance, it
is largely the weight-bearing limb and the most commonly and more importantly occurs
terminology is the same as for a unilateral in single-limb support around the axis of the
stance. supporting or weight-bearing hip joint.
● If both limbs are weight-bearing, lateral tilt of
the pelvis will cause the pelvis to shift to one
FORWARD BACKWARD
side or the other.
● During pelvic shift, the pelvis CAN ONLY DROP HIP Medial Rotation Lateral Rotation
and NOT HIKE. MOTION on stance leg on stance leg
● WHEN THE PELVIS IS SHIFTED TO THE
RIGHT in BILATERAL STANCE: LUMBAR Rotation towards Rotation towards
○ Left side of pelvis drops MOTION side Contralateral side Ipsilateral to
○ Right hip joint is adducted to the stance leg the stance leg
○ Left hip joint is abducted
● To return to neutral position from this
pelvic shifted stance while continuing to
bear weight on both legs:
○ Right abductor and left adductor muscles
work synergistically to shorten and shift
the weight back to center. (oo, opposite. A) Forward rotation around right hip
‘Wag ka na magduda) joint; medial rotation of left hip joint
B) Backward rotation around right hip

joint; lateral rotation of left hip joint
● Pelvic rotation can occur in bilateral stance as ● Type of Joint

well as unilateral stance, as is true for lateral
pelvic tilt.
● If both feet are bearing weight and the axis of Functional Diarthrodial
motion occurs around a vertical axis through
Structural Synovial
the center of the pelvis, the terms forward
(Ball-and-Socket)
rotation and backward rotation must be used by
referencing a side. Degrees of Freedom 3 degrees
○ Forward rotation on the right and
backward rotation on the left. flexion-extension,
Motions abduction-adduction,
Ang reference for FORWARD and medial rotation-lateral
BACKWARD rotation ay ang OPPOSITE rotation
SIDE ng WEIGHT-BEARING HIP JOINT.
Ang reference ng MEDIAL and LATERAL ● Structures for Stability

rotation ay ang STANCE LEG or ○ Acetabular Labrum
WEIGHT-BEARING HIP JOINT. ■ Sphere-shaped deepening rimmed
by a strong, fibrocartilaginous
labrum which grips and stabilizes
the head of the femur
○ Acetabular Fossa
HIP JOINT
■ Establishes a partial vacuum so that
● Bony Articulation
negative atmospheric pressure
○ The hip joint is composed of the bony
helps to maintain the contact
articulation of the HEAD OF THE FEMUR and
between the two articulating
the ACETABULUM OF THE PELVIS.
partners
○ Acetabulum
○ Joint Capsule
■ Formed by the three bony components
■ A strong structure attaching to the
of the pelvis (pubis, ilium, ischium)
outer rim of the acetabulum,
■ 40% of Ilium, 40% of Ischium, and
enclosing the neck of the femur like
20% of Pubis (HOUGLUM);
a tube.
(NEUMANN) 75% of Ilium and Ischium
and 25% of Pubis
■ This thick joint capsule is strongest ○ In these positions, the ligaments are
and thickest superiorly and twisted into their most taut position.
anteriorly, lending maximum ○ The hip is one of a very few joints in
stability to the hip during the body in which the close-packed
weight-bearing. position is not also associated
○ Ligaments with the position of maximal joint
■ Iliofemoral, Pubofemoral, and congruency (Neumann).
Ischiofemoral ligaments are ○ Ang maximum contact ng bones ng hip
embedded within the capsule, joint ay hindi sa close-packed position
arising from pelvic attachments and niya.
spiraling around the femoral head
and neck to provide tremendous ● Open-packed Position
reinforcement and stability. ○ Houglum
■ All three ligaments stabilize the ■ The negative atmospheric pressure
extended hip, limiting extension and within the joint usually limits the
contributing to the ability to stand amount of joint distraction. In one
upright with minimal muscle study, a force of 45 lb was required
activity in adult cadavers to laterally
distract the joint 3 mm, but when
● Close-packed Position of the Hip the joint capsule was incised to
○ Norkin release the vacuum, the femur
■ Extension could be distracted about 8 mm
■ Slight Abduction without significant traction force.33
■ Slight Medial Rotation In adults, Arvidsson found that
○ Houglum traction forces above 90 lb are
■ Full Extension required to produce a significant
■ Medial Rotation joint separation in the open-packed
■ Abduction position.
○ Neumann ○ Neumann
■ Full Extension (20 degrees beyond ■ The hip joint surfaces fit most
neutral position) congruently in about 90 degrees of
■ Slight Internal Rotation flexion with moderate abduction
■ Slight Abduction and external rotation.
■ In this position, most of the capsule

■ and associated ligaments have HIP RANGE OF MOTION
“unraveled” to a more
FLEXION
slackened state, adding only
little passive tension to the Range 0 – 120o
joint. (AAOS)
○ Norkin
■ Articular contact between the End feel Soft
femur and the acetabulum can be
Contact b/w muscle bulk of
increased in the normal
anterior thigh & lower abdomen;
non-weight-bearing hip joint by a
Reason for the end-feel may be firm
combination of flexion,
end feel because of tension in the posterior
abduction, and slight lateral
joint capsule and/
rotation.
or gluteus maximus
○ Kaya naging open packed ang positions
na ‘to dahil ito yung most slackened Roll & glide Posterior spin
and joint, yet ito ang pinakafunctional.
At sabi nga, ang hip ay isa sa mga EXTENSION
joints na hindi close-packed position
Range 0 – 20o
ang highest articular congruency.
(AAOS)
● Capsular Patterns
○ Cyriax End feel Firm
■ Greatest loss of medial rotation and
flexion Tension in the anterior joint
■ Some loss of abduction capsule & iliofemoral ligament; to
■ Slight loss of extension a lesser extent, ischiofemoral &
■ Little or no loss of adduction and Reason for pubofemoral ligaments; tension in
lateral rotation end feel various muscles that flex the hip,
○ Kaltenborn such as the iliopsoas, sartorius,
■ Greates loss of medial rotation TFL, gracilis, adductor longus may
■ Followed by less restriction of contribute
extension, abduction, flexion, lateral
Roll & glide Anterior spin
rotation.
ABDUCTION INTERNAL ROTATION
Range 0 – 40o Range 0 – 45o

(AAOS) (AAOS)
End feel Firm End feel Firm
Tension in the inferior (medial) Tension in the posterior

joint capsule, pubofemoral joint capsule & ischiofemoral
ligament, ischiofemoral ligament, ligament; Tension in piriformis,
Reason for inferior band of iliofemoral Reason for obturator internus, obturator
end feel ligament; passive tension in the end feel externus, gemellus superior,
adductor magnus, adductor longus, gemellus inferior, quadratus
adductor brevis, pectineus, gracilis femoris, gluteus medius (posterior
may contribute fibers), gluteus maximus may
contribute
Roll & glide Superior roll, Inferior glide
Roll & glide Anterior roll, Posterior glide
ADDUCTION
EXTERNAL ROTATION
Range 0 – 20o
(AAOS) Range 0 – 45o
(AAOS)
End feel Firm
End feel Firm
Tension in the superior
(lateral) joint capsule & superior Tension in the anterior
Reason for band of the iliofemoral ligament; joint capsule, iliofemoral ligament,
end feel Tension in the gluteus medius, pubofemoral ligament; Tension in
gluteus minimus, TFL may Reason for the anterior portion of the gluteus
contribute end feel medius, gluteus minimus, adductor
magnus, adductor longus,
Roll & glide Inferior roll, Superior glide pectineus, piriformis may add
Roll & glide Posterior roll, Anterior glide

Attachment: Center of
LIGAMENTS OF THE HIP JOINT
acetabular fossa → fovea of
Attachment: AIIS & iliac Ligamentum femoral head
portion of acetabulum → teres
Iliofemoral/ “Y” intertrochanteric line Limits: Extreme limits of
ligament / adduction, flexion, ER; OR
Ligament of Limits: Hip extension adduction, extension, IR
Bigelow (hyperextension), adduction
(superior portion), ER (lateral
portion); pelvic posterior tilt
Ilio- Pubo- Ischio-
Attachment: Pubis & pubic femoral femoral femoral
portion of acetabular rim →
anterior to intertrochanteric Extension Taut
Pubofemoral fossa & neck of femur (primary Taut Taut
posteriorly limit)
Limits: Hip extension, Flexion Lax Lax Lax

abduction, ER; ipsilateral
Abduction Taut Taut
pelvic lateral tilt
(inferior (primary Taut
Attachment: Ischial portion fibers) limit)
of acetabulum rim and
Adduction Taut Neumann:
labrum posteriorly and
(superior Lax Taut
inferiorly → posterior aspect
fibers)
of femoral neck near apex of
medial greater trochanter IR Lax Lax Taut (Primary
Ischiofemoral limit)
Limits: Hip extension,
abduction, IR; hyperflexion; ER Taut Taut Lax
extreme adduction (superior
● When the ligament is taut in the extremes
fibers esp. When hip is
of the position, it means it limits the joint
flexed); ipsilateral pelvic
from having excessive movement towards
rotation
that direction.
● Plays a primary role in weight-bearing as

a stabilizer of the pelvic region
● Exerts a strong contraction in activities
such as stair climbing, running, and
jumping.
● During walking and running, it acts both
concentrically to extend the hip and
eccentrically to decelerate leg swing,
especially during running
● Its fibers run laterally from the posterior
pelvis to attach to the proximal femur
● Has numerous proximal attachments from
the posterior side of the ilium, sacrum,
coccyx, sacrotuberous and posterior
sacroiliac ligaments, and adjacent
fascia
● Attaches into the iliotibial band of the
fascia lata (along with the tensor fasciae
latae), and the gluteal tuberosity on the
MUSCLES OF THE GLUTEAL REGION:
femur
GLUTEUS MAXIMUS
● Primary Actions:
GLUTEUS MEDIUS
○ Hip Extension
● Primary Action:
○ Hip Lateral Rotation
○ Hip Abduction
● Secondary Action (Lower fibers):
● Anterior portion: Assists in hip flexion and
○ Hip Adduction
medial rotation
● Works in concert with the abdominal
● Posterior portion: Assists in hip extension
muscles as a force couple to tilt the
and lateral rotation
pelvis posteriorly
● All portions of the gluteus medius act as ● Deepest layer of the gluteal muscles
strong abductors and strong pelvic ● Smaller than the gluteus medius,
stabilizers. occupying about 20% of the total
● Provides lateral stabilization of the pelvis abductor cross-sectional area
in single-leg stance to prevent dropping of ● Two interesting additional functional
the pelvis on the opposite, non tasks:
weight-bearing side ○ Contracting to keep the folds of
● Largest of the lateral hip muscles the joint capsule from pinching
● Largest of the hip abductor muscles, ○ Applying pressure on the femoral
occupying about 60% of the total head to stabilize the femoral head
abductor cross-sectional area firmly against the acetabulum
● FOOD FOR THOUGHT: This muscle is
important in maintaining a steady pelvis TENSOR FASCIAE LATAE
during unilateral stance, and this is ● Primary Actions:
achieved by isometric contraction. ○ Hip Abduction
Weakness of this muscle results to ○ Hip Flexion
Trendelenburg sign which is the ● Secondary Action:
dropping of the pelvis CONTRALATERAL ○ Hip Medial Rotation (Neumann)
to the side of weakness upon UNILATERAL ● Offers lateral stabilization to the thigh
STANCE. and knee joint during weight-bearing
activities
GLUTEUS MINIMUS ● At the hip, the tensor fascia lata flexes,
● Primary Action: abducts, and to a small degree, medially
○ Hip Abduction rotates the thigh
● Secondary Action (Anterior Fibers): ● Referred as the “pocket muscle” - put
○ Hip Medial Rotation your hand in your pants’ side pocket and
● Synergist with the gluteus medius in hip your hand will rest on the muscle’s belly
abduction and can also medially rotate ● Assists as a knee stabilizer during
the hip weight-bearing in closed chain activities
PIRIFORMIS OBTURATOR INTERNUS

● Primary Action: ● Primary Action:
○ Hip Lateral Rotation ○ Hip Lateral Rotation
● Secondary Action: ● With the femur firmly fixed during
○ Hip Abduction standing, strong contraction of this
● Attaches proximally on the anterior muscle rotates the pelvis (and
surface of the sacrum, among the ventral superimposed trunk) relative to the
sacral femoral head
● Exiting the pelvis posteriorly through ● Force produced by the obturator internus
the greater sciatic foramen, the compresses the surfaces of the joint,
piriformis attaches to the superior aspect thereby providing an element of dynamic
of the greater trochanter foramina stability to the hip
● CLINICAL APPLICATION: Muscle spasm
or tightness of the deep lateral rotators, GEMELLUS INFERIOR
especially the piriformis, results in ● Primary Action:
tenderness in the deep gluteal region ○ Hip Lateral Rotation
with accompanying decreased ROM in hip ● Shares a common tendon with gemellus
medial rotation and irritation of the superior and obturator internus and lies
sciatic nerve, which may lead to radiating between piriformis and quadratus femoris
pain down the posterior leg
QUADRATUS FEMORIS
GEMELLUS SUPERIOR ● Primary Action:
● Primary Action: ○ Hip Lateral Rotation
○ Hip Lateral Rotation ● Secondary Action:
● Shares a common tendon with gemellus ○ Hip Adduction
inferior and obturator internus and lies ● Arises from the external side of the ischial
between the piriformis and the quadratus tuberosity and inserts on the posterior
femoris side of the proximal femur
ANTERIOR MUSCLES OF THE THIGH: ILIOPSOAS

ILIACUS ● Primary action:
● Primary Action: ○ Hip Flexion
○ Hip Flexion ○ Anterior pelvic tilt
● Together with the psoas major, it forms ● Strongest and most consistent hip flexor
the iliopsoas muscle ● Consists of the iliacus and the psoas
● The iliacus (part of the iliopsoas) assists major muscle
in lateral rotation ● Fibers of the iliacus and the psoas major
● Attaches on the iliac fossa and extreme usually fuse just anterior to the femoral
lateral edge of sacrum, just over the head
sacroiliac joint ● Only hip flexor that can produce enough
● Provide as a secondary source of stability tension to flex the hip beyond 90 degrees
to the sacroiliac articulation since it in sitting position
attaches directly into the capsule or ● With the hip abducted, the iliopsoas
margins of the sacroiliac joints assists with lateral rotation
PSOAS SARTORIUS
● Primary Action
● Primary Actions:
○ Hip Flexion
○ Hip Flexion
● Together with the iliacus, it forms the
● Secondary Action:
iliopsoas muscle
○ Hip Abduction
● Attaches along the transverse processes
○ Hip Lateral Rotation
of the last thoracic and all lumbar
● Longest muscle in the body
vertebrae, including the intervertebral
● Two-joint muscle passing on the flexor
discs
side of the knee, where it forms the pes
● The psoas (part of the iliopsoas) assists in
anserine along with the gracilis and
lateral rotation
semitendinosus tendons
● Sartorius is based on the Latin root sartor, ● Only muscle of the quadriceps group that
referring to a tailor’s position of crosses both the hip and the knee
cross-legged sitting that describes the ● Responsible for about one third of the
muscle’s combined action of hip flexion, total isometric, flexion torque at the hip
lateral rotation, and abduction. ● Strong contributor to hip flexion and
● Most effective in simultaneous hip and applies most of its force at the hip when
knee flexion especially when hip lateral the knee is flexed (e.g. climbing stairs)
rotation is added to provide foot
clearance MEDIAL MUSCLES OF THE THIGH:
○ e.g. stepping over to mount a GRACILIS
● Slender gracilis muscle (L., gracilis,
horse, motorcycle, or bicycle
slender or grace-like) is a synergist to the
other hip adductors for adduction.
PECTINEUS
● As part of the pes anserine, its strong
● Primary Actions: distal tendinous attachment onto the
○ Hip Flexion proximal medial tibia provides knee
○ Hip Adduction stability.
● Secondary Action ● The gracilis is active as hip flexor only
when the knee is extended but electrically
○ Hip Medial Rotation (Neumann)
silent when the knee is flexed.
● Belongs essentially to the adductor group
● Two-jointed muscle and not considered as
of muscles, its fibers running
primary hip flexor.
approximately parallel to those of the ● Primary Actions:
adductor longus, but it also flexes and ○ Hip adduction
medially rotates the hip
ADDUCTOR LONGUS AND BREVIS
RECTUS FEMORIS ● Secondary hip flexors
● Long strap-like muscle
● Primary Action:
● It is located by its very thick prominent
○ Hip Flexion
tendon in the anterior groin.
● Acting as both a primary hip flexor and ● It is a strong, single-joint hip adductor; its
primary knee extensor smaller synergist is the adductor brevis.
● The adductor longus is most active in late ○ Head of fibula and Lateral condyle of
stance; and the gracilis’ primary activity tibia
occurs in initial swing. ● Primary Actions:
● Primary Actions: ○ Hip extension; lateral hip rotation
○ Hip adduction ○ Knee flexion and lateral knee rotation
ADDUCTOR MAGNUS SEMITENDINOSUS

● Secondary hip flexor ● Hamstring muscles are primary hip
● Made of two portions; the medial portion extensors and contract strongly to
is a strong adductor whereas its posterior stabilize pelvis in prone trunk extension.
fibers assist in hip extension. ● Medial hamstring includes two muscles:
● Primary Action: the fusiform shaped semitendinosus and
○ Hip adduction the semimembranosus
● Proximal Attachment:
OBTURATOR EXTERNUS ○ Tuberosity of the ischium, having a
● The obturator externus lies anterior to common tendon with the long head
piriformis and quadratus femoris. of the biceps
● Because of their insertion in the posterior ● Distal Attachment:
greater trochanter region, their line of ○ Medial aspect of the tibia near the
pull is collectively posterior to the axis of knee joint, distal to the attachment
motion, so they serve as a lateral of the gracilis
rotator. ● Primary Actions:
● These rotators are considered by many to ○ Hip extension; Hip medial rotation
be the “rotator cuff ” of the hip, providing ○ Knee flexion and medial rotation
a “fine tuning” role during hip motion
SEMIMEMBRANOSUS
POSTERIOR MUSCLES OF THE THIGH: ● Proximal Attachment:
BICEPS FEMORIS ○ Ischial tuberosity
● Lateral hamstring ● Distal Attachment:
● Proximal Attachment ○ Medial condyle of the tibia
○ Ischial tuberosity ● Primary Actions:
○ Lateral lip linea aspera ○ Hip extension, hip medial rotation
● Distal Attachment: ○ Knee flexion, knee medial rotation
ADDUCTOR MAGNUS (HAMSTRING PORTION) SACROILIAC JOINT MOTIONS

● The adductor magnus is a hip extensor in
most hip positions, the other smaller 1. BILATERAL MOVEMENTS
adductors may also provide extension - Similar motion on both sides
force when their lines of pull are posterior ● COUNTERNUTATION
to the axis of motion. ○ Extension of the Sacrum
● For example, the posterior fibers of the ○ Sacral promontory moves posteriorly and
adductor magnus can act as a hip inferiorly
extensor, the pectineus flexes the hip, and ○ Coccyx moves anterior and superior
most of the adductors contribute to ○ Innominate bone is anteriorly rotated
medial rotation. Against resistance or in ■ Iliac crest is far apart, thus the pelvic
pure frontal-plane adduction, all five inlet is wider
adductors adduct the hip. During ■ Ischial tuberosity is near to one another,
functional activities, the five primary thus pelvic outlet is narrower
adductor muscles all contribute to hip ○ Arthrokinematics
adduction and contribute as secondary ■ Pelvic motion: Anterior tilt
muscles to the other hip motions of ■ Glide of sacrum: Anterosuperior glide
flexion, extension, and rotation. ● NUTATION
○ Flexion of the Sacrum
Were you able to encounter the term “pes anserine” ○ Sacral promontory moves anteriorly and
muscle? What is the relationship of the pes anserine inferiorly
muscles to the stability of the pelvis?
○ Coccyx moves posteriorly and superior
PES ANSERINE ○ Innominate bone is posteriorly rotated
● Flat conjoined tendons of the sartorius, ■ Iliac crest approximates one another,
thus the pelvic inlet is narrower
gracilis, and semitendinosus muscles
■ Ischial tuberosity is far apart, thus
at the proximal medial side of tibia
pelvic outlet is wider
● The pes anserine muscles prevents valgus ○ Arthrokinematics
forces and provides stability to the knee ■ Pelvic motion: Posterior tilt
■ Glide of sacrum: Inferoposterior glide
2. UNILATERAL MOVEMENTS ■ (L) Sacral sulcus/base is deeper

- Sometimes only one side moves d/t pathology ■ (R) ILA is more posterior
- Primarily the innominate being influenced by ■ Problem: (L) Piriformis
external forces ● BACKWARD ROTATION ON OBLIQUE AXIS
● UNILATERAL SACRAL FLEXION - Posterior Sacral Torsion
○ Inferior sacral shear ○ LEFT ON RIGHT
○ Cause: When you land on one leg with spine ■ Sacrum facing the left side on the right
extended axis
■ Landing on leg will create a ground ■ (R) Sacral sulcus/base is deeper
reaction force from leg to thigh to ■ (L) ILA is more posterior
innominate bone, pushing the bone into ■ Problem: (L) L5, S1 Facet
a posteriorly directed rotation ○ RIGHT ON LEFT
● UNILATERAL SACRAL EXTENSION ■ Sacrum facing the right side on the left
○ Superior sacral shear axis
○ Rare ■ (L) Sacral sulcus/base is deeper
■ MOJ is not yet well-understood ■ (R) ILA is more posterior
○ Commonly happens on the right side ■ Problem: (R) L5, S1 Facet
3. SACRAL TORSION Note: If the axis is on the Right side, the

- Oblique axis is referenced to the base
problematic side most of the time is the Left side
(pain can be felt). If the axis on the other hand is
- (Where anterior aspect of sacrum faces) on (axis) on the Left side, the problematic side is on the
● FORWARD ROTATION ON OBLIQUE AXIS Right side (pain can be felt)
- Anterior Sacral Torsion
○ LEFT ON LEFT MOVEMENT OF THE “SACROILIAC JOINT”
■ Sacrum facing the left side on the left ● Difference with sacroiliac joint in terminology
axis is because of movement. It is the innominate
■ (R) Sacral sulcus/base is deeper bone moving on a fixed sacrum
■ (L) Inferior lateral angle (ILA) is more 1. Anterior Rotation- ASIS will be lower;
posterior PSIS will be higher
■ Problem: (R) Piriformis ○ In supine position, side of leg with anterior
○ RIGHT ON RIGHT rotation will be longer
■ Sacrum facing the right side on the ○ In sitting position, it will be shorter
right axis
○ Can be caused by hypertonic anterior 3. Outflare- innominate is rotated externally,

muscles (e.g. adductors), or weak posterior ASIS is farther from the midline, PSIS will
muscles (e.g. gluteus muscles, external be nearer, and sacral sulcus will be
rotators)
deeper
■ Hamstrings are controversial because
○ Gluteal muscles and external
they compensate and are hypertonic
when gluteal muscles are weak. Other rotators have a hypertone
references believe they are weak. ○ Anteriorly attached muscles are
2. Posterior Rotation- ASIS will be higher; weak
PSIS will be lower ○ Out-toeing can be observed
○ In supine position, side of leg with posterior
during gait
rotation will be shorter
4. Inflare- innominate is rotated interiorly,
○ In sitting position, it will be longer
ASIS is nearer to the midline, PSIS will be
○ Can be caused by hypertonic posterior
muscles (e.g. hamstrings), or weak anterior farther, and sacral sulcus will be
muscles (e.g. adductors, iliacus, reason shallower
being that gluteal muscles are not being ○ Anteriorly attached muscles have
countered) a hypertone (e.g. rectus femoris,
iliacus)
○ Gluteal and external rotators are
weak
○ Intoeing can be observed
5. Upslip- whole innominate bone goes in the same vertical alignment or ASIS is
upward slightly posterior. ASIS and PSIS are at
○ Mechanism of injury: falling on a the same level.
straight leg
○ Posterior sacroiliac joint is tender 1. Anterior Pelvic Tilt
because it is the primary restraint ○ Whole pelvis is rotated forward
6. Down slip- whole innominate bone goes ○ Anterior portion of the pelvis will
downward be nearer to the anterior portion
○ Mechanism of injury: excessive of the femur, creating hip flexion
pulling force of lower limb ○ Creates trunk flexion in an
○ Extremely rare open-kinematic chain
2. Posterior Pelvic Tilt
○ Whole pelvis rotated backward
○ Anterior portion of the pelvis will
be farther from the anterior
portion of the femur, creating a
hip extension
○ In an open-kinematic chain, the
trunk will follow the motion of the
pelvis, creating trunk extension
PELVIC MOTIONS ON A FIXED FEMUR

● Pelvis will be moving as one unit; pelvic
girdle will move together with the sacrum
● Open-kinematic and closed-kinematic
chain
OPEN-KINEMATIC CHAIN:
● In the normally aligned pelvis, ASIS and
anterior portion of symphysis pubis being
3. Lateral Pelvic Tilt 4. Pelvic Shifting

○ One lower limb will be in stance ○ Bilateral weight-bearing
leg ○ The side where the pelvis shifted
○ Hip Hiking has hip adduction, while the
● One side of the pelvis opposite side has hip abduction;
goes up; inferior aspect pelvis will also drop in the
of the pelvis is farther opposite side
from the stance leg, thus 5. Forward Rotation
creating hip abduction ○ Needs a stance leg
● Can be caused by ○ Opposite side moves forward,
quadratus lamborum and which creates internal rotation in
latissimus dorsi pulling stance leg
one side of the pelvis up 6. Backward Rotation
○ Hip Hiking ○ Needs a stance leg
● One side of the pelvis ○ Opposite side moves backward,
goes down; inferior which creates external rotation in
aspect of the pelvis is stance leg
closer to the stance leg,
thus creating hip
adduction
● Can be seen obviously in
gait; opposite side of the
weak muscle (e.g. gluteus
medius) will drop. This is
called the trendelenburg
sign. CLOSED-KINEMATIC CHAIN
Pelvic Accompanying Compensatory

Motion Hip Joint Lumbar Spine
Motion Motion
Anterior Hip Flexion Lumbar

Pelvic Tilt Extension
● Lower Cross Syndrome

Posterior Hip Extension Lumbar Flexion
○ Biomechanical imbalance of
Pelvic Tilt
tightness and weakness
Pelvic Right Hip Right Lateral ○ Common presentation of the
Drop Adduction Flexion
patient is an anteriorly tilted
Pelvic Right Hip Left Lateral pelvis
Hike Abduction Flexion ■ Tight hip flexors
(iliopsoas)
Forward Right Hip Rotation to the
■ Tight lumbar extensors
Rotation Medial Rotation Left
(erector spinae)
Backward Right Hip Rotation to the ■ Weak abdominals
Rotation Lateral Rotation Right
■ Weak gluteus maximus
○ In a posteriorly tilted pelvis, it is
○ Ipsidirectional Lumbopelvic
the same cross but with opposite
Rhythm- When pelvis and lumbar
weaknesses and tightness
spine move in same direction;
useful for activities such as
extending the reaching capacity
of the upper extremities (bending
over to pick something up)
(Source: internet hehe)
○ Contradirectonal Lumbopelvic
Rhythm- When the pelvis and the
lumbar spine move in opposite
directions; seen in walking,
dancing, or any other activity in
which the position of the
supralumbar trunk must be held
fixed (lumbar spine forward,
pelvis back) (Source: internet din
hasdjkhfjahsd)
PELVIC MOTIONS WITH LUMBAR SPINE PELVIC MOTIONS WITH HIP MOVEMENT
MOVEMENT
HIP INNOMINATE
Lumbar Innominate Sacrum
Spine Flexion Posterior Rotation
Flexion Anterior Rotation Nutation Extension Anterior Rotation

followed by
Medial Rotation Inflare (Medial Rotation)
counternutation
Lateral Rotation Outflare (Lateral
Extension Posterior Rotation Nutation
Rotation)
(slight)
Abduction Superior Glide
Rotation Same side: Nutation on the
posterior rotation same side Adduction Inferior Glide
Opposite side:
Anterior rotation
● Lower limb moves first against stable
Side Same side: Side bend trunk and pelvis
Flexion Anterior rotation
Opposite side:
Posterior rotation
● Trunk will move first

● At 60° trunk flexion, the posterior
structures, including the ligaments,
become tight and the motion from
nutation becomes counternutation

Hip&amp;Pelvis Kines Trans

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KINESIOLOGY MSC 2101-4

○ Providing a bony support for the

○ Iliac crest DIMPLE in the skin (Dimple of

NOTE: CLINICAL APPLICATION

● Pubis - anteroinferior portion of the pelvis ● From Combination of Innominate Bones

because it is a lateral projection

● Smooth curved line connecting medial

Snell: Short Head Biceps

PECTINEAL LINE Pectineus muscle

JOINTS THAT MAKE UP THE PELVIS: (7)

● An angle formed by a horizontal line and a

Female 28° 22° 20°

Decrease in neck-shaft Increase in neck-shaft

Related conditions: Related conditions:

CENTRAL-EDGE ANGLE ACETABULAR ANTEVERSION ANGLE

Hip flexion occurs when Hip extension occurs when

*Increase of Lumbar *Person sits in a slouch

Anterior and Posterior pelvic tilts are motions of the

Associated with LUMBAR Associated with LUMBAR

ANGLE OF FEMORAL TORSION ○ Increase in hip medial rotation

Anteverted Hip Retroverted Hip

● Medial femoral ● Lateral femoral

ilium/innominate bone against the sacrum.

Whenever the hip joint is weight-bearing, the femur is

ANTERIOR AND POSTERIOR PELVIC TILT

Anterior Pelvic Tilt Posterior Pelvic Tilt

● HIP FLEXION ● HIP EXTENSION

So, kapag tumayo ka sa kaliwang paa mo at tinaas mo

PELVIC SHIFTING FORWARD AND BACKWARD PELVIC ROTATION

B) Backward rotation around right hip

● Pelvic rotation can occur in bilateral stance as ● Type of Joint

Ang reference ng MEDIAL and LATERAL ● Structures for Stability

■ In this position, most of the capsule

ABDUCTION INTERNAL ROTATION

Range 0 – 40o Range 0 – 45o

End feel Firm End feel Firm

Tension in the inferior (medial) Tension in the posterior

Roll & glide Posterior roll, Anterior glide

Limits: Hip extension, Flexion Lax Lax Lax

● Plays a primary role in weight-bearing as

PIRIFORMIS OBTURATOR INTERNUS

ANTERIOR MUSCLES OF THE THIGH: ILIOPSOAS

ADDUCTOR MAGNUS SEMITENDINOSUS

ADDUCTOR MAGNUS (HAMSTRING PORTION) SACROILIAC JOINT MOTIONS

2. UNILATERAL MOVEMENTS ■ (L) Sacral sulcus/base is deeper

3. SACRAL TORSION Note: If the axis is on the Right side, the

○ Can be caused by hypertonic anterior 3. Outflare- innominate is rotated externally,

PELVIC MOTIONS ON A FIXED FEMUR

3. Lateral Pelvic Tilt 4. Pelvic Shifting

Pelvic Accompanying Compensatory

Anterior Hip Flexion Lumbar

● Lower Cross Syndrome

Flexion Anterior Rotation Nutation Extension Anterior Rotation

● Trunk will move first

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Hip&Pelvis Kines Trans

Increase of Lumbar Person sits in a slouch