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QUADRICEPS
MUSCLE STRAINS
This injury is commonly the result of quick sprints or quick stops
while running. With a muscle strain, there is localized tenderness
or a "bulge" in the tender area of the thigh. The pain
is aggravated by lifting the thigh (a straight leg raise), ascending/descending
stairs, or getting up from a seated position.
QUADRICEPS
TENDON RUPTURE
This injury is often the result of forceful kicking or a traumatic
impact to the tendon, which may occur with a fall. Signs and symptoms
include pain and bruising just above the kneecap, an inability to
walk, and severe weakness of the quadriceps (making it impossible
to ascend/descend stairs). Surgical repair is necessary.
GROIN
STRAIN (Adductor Strain)
This injury usually occurs in sports where cutting, side-stepping,
or pivoting are required. Often, there is forceful separation of
the legs or twisting of the toe outward. Signs and symptoms include
pain and tenderness in the inner thigh region.
HIP
POINTER
Hip pointers are the result of a direct blow to the iliac crest
in sports such as football, rugby, and soccer. Signs and symptoms
include pain, bruising, and tenderness at the bony prominence at
the side of the hip. Treatment usually involves rest, ice, and compression.
TRONCHANTERIC
BURSITIS
A bursa is a fluid-filled sack that decreases shear forces between
tissues of the body. Trochanteric bursitis (inflammation of a bursa)
is caused by excessive stress on the bursa between the IT Band and
the greater trochanter. Signs and symptoms include pain over the
outer aspect of the hipbone, which often is exacerbated when lying
on the affected side, standing on the affected leg, or excessive
walking. Treatment often includes rest, ice, and compression, physical
therapy including stretching and progressive strengthening, and
steroid injection may be helpful.
HAMSTRING
STRAINS
A strain is a minor tear of a muscle. Quick acceleration while running
or cutting is most often the cause of hamstrings strains. A minor
pulling or a pop may be noted in the back of the thigh. Pain, swelling,
and an inability to run result. Treatment includes rest, ice, compression,
elevation, and physical therapy.
FEMORAL
NECK FRACTURE
A bad fall or blow to the hip can break (fracture) the thigh bone
typically around the femoral neck region. If the broken bone does
not heal properly, the joint may slowly wear down. Blood flow through
the femoral head may be restricted or cut off leading to the necrosis
of the joint.
AVASCULAR
NECROSIS of the HIP
Avascular necrosis means bone death due to a lack of blood supply.
A disrupted blood supply occurs when there is a fracture, dislocation,
or repetitive trauma to the neck of the femur. Signs and symptoms
include pain, limitation of movement and pain with walking. X-rays,
MRI, or a bone scan may be helpful in diagnosing this disorder.
Surgical decompression or total hip replacement may be necessary.
HIP
OSTEOARTHRITIS
Osteoarthritis of the hip occurs when the cartilage coverings on
ball (the head of the femur) and the socket (the acetabulum) wear
out. It is worse when you bear weight on the affected limb. Range
of motion is often limited especially internal rotation and hip
flexion. Recent studies have demonstrated that joint mobilization
and stretching can result in significant pain relief.
HIP
REPLACEMENT
For some osteoarthritic hip joints and femur fractures, the only
option is a total hip replacement. As the image shows, both the
ball (the head and neck of the femur) and the socket (the acetabulum)
are replaced. You will receive physical therapy in the hospital.
Recent research suggests that patients can gain significant strength
and improve balance skills with additional
outpatient physical therapy.
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