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Chapter 7: Thigh, Hip, and Pelvis

LEARNING OBJECTIVES

  1. Discuss common injuries that occur to the thigh, hip, and pelvis.

  2. Demonstrate the ability to apply tapes, wraps, braces, and pads to the thigh, hip, and pelvis when preventing, treating, and rehabilitating injuries.

  3. Explain and demonstrate evidence-based practice for the implementation of taping, wrapping, bracing, and padding techniques for the thigh, hip, and pelvis within a clinical case.

INJURIES AND CONDITIONS

Acute and chronic injuries can occur to the thigh, hip, and pelvis in athletic and work activities. Thigh and hip contusions are common in athletic activities but vary in severity. Many athletes are able to return to activity following a mild contusion with additional padding, while a severe contusion may require hospitalization. Strains of the thigh and hip musculature can occur in athletic and work activities and are typically caused by rapid movements. Repetitive stress to the thigh, hip, and pelvis can result in chronic inflammation and/or stress fractures. Common injuries to the thigh, hip, and pelvis include:

  • Contusions

  • Strains

  • Overuse injuries and conditions

Contusions

Contusions to the thigh, hip, and pelvis are caused by direct forces. These areas are susceptible to injury in many sports that do not require protective padding. Thigh contusions (charley horse) typically involve the anterior and/or lateral aspect (Fig. 7–1). A contusion can result, for instance, when a soccer sweeper is struck in the anterior/lateral right thigh by an opponent’s knee while attempting to stop a breakaway (Fig. 7–2). Heterotopic ossification (sometimes referred to as myositis ossificans) may result from a single, violent direct force or repeated direct forces to the anterior or lateral thigh1,2 (Fig. 7–3). A delay in treatment, forceful manipulation, or a quick return to activity following a quadriceps contusion can also lead to the development of heterotopic ossification.3,4 A direct force or fall on the hip can cause an iliac crest contusion (hip pointer) with associated injury to the abdominal soft tissue (Figs. 7–4 and 12–2). These contusions are common in collision and contact sport activities (Fig. 7–5).

Fig. 7–1

Superficial muscles of the anterior thigh.

An illustration depicts the superficial muscles and tendons of the anterior thigh.
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Fig. 7–2

Quadriceps contusion.

An illustration of a quadriceps contusion shows the flexed knee of one person making contact with the quadriceps of another. The quadriceps muscles are crushed against the femur bone and torn at the point of impact.
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Fig. 7–3

Femoral heterotopic ossification resulting from a quadriceps contusion. (Courtesy of Starkey, C. and Brown, SD. Examination of Orthopedic & Athletic Injuries. 4th ed. Philadelphia, PA: F.A. Davis Company: 2015.)

An M R I reveals a femoral heterotopic ossification. An abnormal growth of bone is visible within the quadriceps muscle at the site of the contusion.
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Fig. 7–4

Superficial muscles of the lateral thigh and hip.

An illustration for the superficial muscles of the lateral thigh, hip, and buttocks.
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Fig. 7–5

Contusion to the Iliac crest. This Injury, the so-called “hip pointer,” results In gross discoloration, swelling, pain, and loss of function. (Courtesy of ...

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