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Hip Exam

Assessing Posture



    • How to Assess

    • Inspect the patient's posture while they are standing, sitting and squatting. Inspect from laterally, anteriorly and posteriorly.
    • Look For

      The relationship between the positions of the head, trunk, upper and lower limbs.
    • Head & neck - tilt and rotation
    • Shoulders - level of shoulders, scapular prominence
    • Chest - deformities
    • Spine - kyphosis, lordosis and scoliosis
    • Pelvis - pelvic tilt
    • Legs - angle between thigh and leg (genu valgum / varum)
    • Feet - position, pronation
    • Causes of Poor Posture

    • Structural - deformities of the spine, foot and ankle
    • Leg Length discrepancy
    • Poor foot posture
    • Muscular imbalance - habitual poor body position

Centre of Gravity

    • Look For

    • The line that falls from the earlobe down through the chest, abdomen, pelvis and lower limb (line of gravity).
    • Significance

    • Optimal posture involves the balanced distribution of body mass around the centre of gravity, with minimal muscular energy use. Any deviation from this results in instability, weakness and pain.

Extra Credit

    • Shoulder Cross Syndrome

    • Elevation of shoulders - tight upper shoulder girdle fixators / weak lower shoulder girdle fixators
    • Protraction of shoulders -  tight shoulder girdle protractors / weak shoulder girdle retractors
    • Head forward + cervical lordosis - tight neck extensors / weak deep neck flexors
    • Pelvic Cross Syndrome

    • Increased lumbar lordosis - tight hip flexors / weak hip extensors
    • Protuberant abdomen - tight lumbar extensors / weak lumbar flexors
    • AP pelvic tilt - tight tensor fascia lata / weak hip abductors
    • Lateral pelvic tilt - tight quadratus lumborum
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 Amerson JR. Inguinal Canal and Hernia Examination. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 96. Available from: http://www.ncbi.nlm.nih.gov/books/NBK423 Bailey R. The Role of the Trendelenburg Test in the Examination of Gait. Physical Therapy Reviews. 2009 Jun; 14(3): 190-197. Byrd JW. Evaluation of the hip: history and physical examination. N Am J Sports Phys Ther. Nov 2007; 2(4): 231–240.
Dixon JK, Keating JL. Variability in Straight Leg Raise Measurements. Physiotherapy. 2000;86:361-370.
 Dutro JA. Obturator hernia. Am Surg. 2012;78:E217. Hallaceli H, Uruc V, Uysal HH, Ozden R, Hallaceli C, Soyuer F, Ince Parpucu T, Yengil E, Cavlak U. Normal Hip, Knee and Ankle Range of Motion in the Turkish Population. Acta Orthop Traumatol Turc. 2014; 48(1): 37-42. Hardcastle P, Nade S. The Significance of the Trendelenburg Test. J Bone Joint Surg Br. 1985 Nov; 67(5): 741-746. Harvey D. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998; 32: 68-70. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. The Lancet. 2003 Nov; 362(9395): 1561-1571. Martin RL, Enseki KR, Draovitch P, Trapuzzano T, Philippon MJ. Acetabular Labral Tears of the Hip: Examination and Diagnostic challenges. Journal of Orthopaedic and Sports Physical Therapy. 2006: 36(7): 503-515. Martin RL, Sekiya JK. The Interrater Reliability of 4 Clinical Tests Used to Assess Individuals with Musculoskeletal Hip Pain. Journal of Orthopaedic and Sports Physical Therapy. 2008 Feb; 38(2): 71-77. Rahman LA, Adie S, Naylor JM, Mittal R, So S, Harris IA. A Systematic Review of the Diagnostic Performance of Orthopedic Physical Examination Tests of the Hip. BM Musculoskeletal Disorders. 2013; 14: 257. Roach KE, Miles TP. Normal Hip and Knee Active Range of Motion: The Relationship to Age. Physical Therapy. 1991; 656-665. Sabharwal S, Kumar A. Methods for Assessing Leg Length Discrepancy. Clin Orthop Relat Res. 2008; 466: 2910-2922. Shailam R, Jaramillo D, Kan JH. Growth Arrest and Leg-Length Discrepancy. Pediatric Radiology. 2013. 43(S1): S155-S165.
Smith NP, Kenny SE. Inguinal hernia and hydrocele. Surgery (Oxford). 2008;26:307-309.
 Whalen HR, Kidd GA, O'Dwyer PJ. Femoral hernias. BMJ: British Medical Journal. 2011;343:1271-1273.