00:00:02
the hip is a true ball and socket joint
00:00:05
this arrangement gives the hip the large
00:00:07
amount of motion needed for daily
00:00:09
activities like walking squatting and
00:00:12
stair climbing
00:00:23
understanding how the different layers
00:00:25
of the hip are arranged and connected
00:00:26
can help you understand how the hip
00:00:29
works how it can be injured and how
00:00:32
challenging recovery can be when this
00:00:34
joint is injured or damaged by arthritis
00:00:36
the deepest layer of the hip includes
00:00:39
the bones and the joints the next layer
00:00:42
is made up of the ligaments of the joint
00:00:43
capsule and finally these ligaments are
00:00:46
covered by the important tendons and the
00:00:49
muscles that help move the leg the
00:00:52
important structures of the hip can be
00:00:54
divided into several categories
00:00:55
these include bones and joints ligaments
00:00:59
and tendons muscles nerves blood vessels
00:01:04
and Bursa
00:01:13
that form the hip or the femur or the
00:01:15
thigh bone and the pelvis
00:01:19
the top end of the femur is shaped like
00:01:22
a ball this ball is called the femoral
00:01:24
head the femoral head fits into a round
00:01:27
socket on the side of the pelvis this
00:01:30
socket is called the acetabulum the
00:01:33
femoral head is attached to the rest of
00:01:35
the femur by a short section of bone
00:01:37
called the femoral neck a large bump
00:01:40
juts outward from the top of the femur
00:01:42
next to the femoral neck this bump
00:01:45
called the greater trochanter can be
00:01:47
felt along the side of your hip large
00:01:50
and important muscles connect to the
00:01:52
greater trochanter articular cartilage
00:01:55
is the material that covers the ends of
00:01:57
the bones of any joint articular
00:02:00
cartilage is about 1/4 of an inch thick
00:02:02
in the large weight-bearing joints like
00:02:05
the hip articular cartilage is white and
00:02:08
shiny and has a rubbery consistency it
00:02:11
is slippery which allows the joint
00:02:13
services to slide against one another
00:02:15
without causing any damage the function
00:02:18
of articular cartilage is to absorb
00:02:20
shock and provide an extremely smooth
00:02:23
surface to make motion easier we have
00:02:26
articular cartilage essentially
00:02:28
everywhere that two bony surfaces move
00:02:30
against one another or articulate in the
00:02:34
hip articular cartilage covers the end
00:02:37
of the femur and the socket portion of
00:02:39
the acetabulum in the pelvis the
00:02:42
cartilage is especially thick in the
00:02:44
upper and back part of the socket as
00:02:46
this is where most of the force occurs
00:02:48
during walking and running ligaments are
00:02:53
soft tissue structures that connect
00:02:55
bones to bones there are several
00:02:58
important ligaments in and around the
00:03:00
hip surrounding the hip joint the joint
00:03:03
capsule is formed by a group of strong
00:03:05
ligaments that connect the top of the
00:03:07
femur to the acetabulum a joint capsule
00:03:11
is a watertight sac that surrounds a
00:03:13
joint these ligaments of the joint
00:03:16
capsule are the main source of stability
00:03:18
for the hip they help hold the femoral
00:03:21
head in place in the acetabulum or
00:03:23
socket a small ligament connects the
00:03:27
very tip of the femoral head to the
00:03:28
acetabulum this ligament called the
00:03:31
ligamentum Teri's doesn't play a role
00:03:33
in controlling hip movement like the
00:03:35
main hip ligaments it does however have
00:03:38
a small artery within the ligament that
00:03:40
brings a very small blood supply to part
00:03:43
of the femoral head
00:03:51
tendons are soft tissue structures that
00:03:53
connect muscles to bones a long tendon
00:03:56
band called the iliotibial band runs
00:04:00
alongside the femur from the hip to the
00:04:02
knee the iliotibial band provides a
00:04:05
connection point for several of the
00:04:07
large hip muscles a tight iliotibial
00:04:10
band can cause hip and knee problems a
00:04:14
special type of ligament forms a unique
00:04:16
structure inside the hip called the
00:04:19
labrum the labrum is attached almost
00:04:21
completely around the edge of the
00:04:23
acetabulum the shape and the way the
00:04:26
labrum is attached create a deeper cut
00:04:28
for the acetabular socket this small rim
00:04:32
of cartilage can be injured and cause
00:04:34
pain and clicking in the hip joint the
00:04:37
hip is surrounded by large thick muscles
00:04:41
three gluteal muscles the gluteus
00:04:44
minimus gluteus medius and gluteus
00:04:46
maximus make up the muscles of the
00:04:50
buttock on the back of the hip these
00:04:52
muscles extend or pull the thigh
00:04:55
backwards and abduct or pull the thigh
00:04:58
away from the other leg these muscles
00:05:01
are also important for keeping the
00:05:02
pelvis level as we shift the weight from
00:05:05
one leg to the other during walking the
00:05:09
inner thighs formed by the abductor
00:05:11
muscles the main action of the abductors
00:05:13
is to pull the leg inward toward the
00:05:16
other leg the muscles that flex the hip
00:05:19
or pull the thigh forward are in front
00:05:22
of the hip joint these include the
00:05:24
iliopsoas and the rectus femoris
00:05:27
the iliopsoas muscle is a very deep
00:05:30
muscle that begins attached to the lower
00:05:32
spine it travels out of the pelvis to
00:05:35
connect on the inside edge of the upper
00:05:38
femur the rectus femoris is one of the
00:05:41
quadriceps muscles the large group of
00:05:43
muscles on the front of the thigh
00:05:45
there's also a small thin strap like
00:05:48
muscle called a Sartorius muscle that
00:05:51
runs from the pelvis across the knee and
00:05:53
connects to the upper tibia just below
00:05:56
the knee joint several small muscles
00:05:59
travel from inside the pelvis across the
00:06:01
back of the hip joint and attach to the
00:06:04
back of the
00:06:04
upper femur these muscles help to
00:06:07
stabilize the hip joint and rotate the
00:06:09
leg outwards together as a group
00:06:12
these muscles are called the external
00:06:13
rotators of the hip
00:06:16
finally the hamstring muscles run down
00:06:18
the back of the thigh these muscles
00:06:21
originate at the bottom of the pelvis
00:06:23
because the hamstring muscles cross the
00:06:26
back of the hip joint on their way to
00:06:27
the knee they help to extend the hip
00:06:30
pulling it backwards all of the nerves
00:06:33
that travel down the thigh pass by the
00:06:35
hip the main nerves are the femoral
00:06:38
nerve in front and the side ik nerve in
00:06:41
the back of the hip a smaller nerve
00:06:43
called the obturator nerve also goes to
00:06:46
the inside of the hip these nerves carry
00:06:49
the signals from the brain to the
00:06:51
muscles that move the hip the nerves
00:06:54
also carry signals back to the brain
00:06:56
about sensations such as touch pain and
00:07:00
temperature traveling along with the
00:07:04
nerves are the large vessels that supply
00:07:06
the lower limb with blood the large
00:07:09
femoral artery begins deep within the
00:07:11
pelvis it passes by the front of the hip
00:07:13
area and goes down toward the inner edge
00:07:16
of the knee if you place your hand on
00:07:19
the front of your upper thigh you may be
00:07:21
able to feel the pulsing of this large
00:07:23
artery the femoral artery has a deep
00:07:26
branch called the pre-fund ephemeris
00:07:28
profunda means deep the pre-fund
00:07:31
ephemeris ends to vessels that go
00:07:33
through the hip joint capsule these
00:07:36
vessels are the main blood supply for
00:07:38
the femoral head as mentioned earlier
00:07:40
the ligamentum teres contains a small
00:07:43
blood vessel that gives a very small
00:07:45
supply of blood to the top of the
00:07:48
femoral head other small vessels form
00:07:51
within the pelvis and supply the back
00:07:53
portion of the buttocks and hip
00:07:59
where friction occurs between muscles
00:08:02
tendons and bones
00:08:04
there is usually a structure called a
00:08:06
bursa a bursa is a thin sac of tissue
00:08:09
that contains fluid to lubricate the
00:08:12
area and reduce friction the bursa is a
00:08:15
normal structure that is produced by the
00:08:17
body in response to friction between two
00:08:20
structures a bursa that sometimes causes
00:08:23
problems in the hip is sandwiched
00:08:25
between the bump on the outer hip the
00:08:28
greater trochanter and the muscles and
00:08:30
tendons that cross over the bump this
00:08:33
bursa called the greater trochanteric
00:08:38
versatile
00:08:40
trochanteric bursitis another bursa sits
00:08:44
between the iliopsoas muscle and the hip
00:08:46
joint where the iliopsoas tendon when
00:08:51
this Bursa becomes inflamed the
00:08:53
condition is called iliopsoas bursitis a
00:08:56
third bursa covers the ischial
00:08:59
tuberosity the bump of bone in your
00:09:01
buttocks that you sit on and again
00:09:04
inflammation of this bursa is called
00:09:07
ischial bursitis as you can see the hip
00:09:11
is complex with a design that provides a
00:09:13
great amount of stability it also allows
00:09:16
good mobility and range of motion for
00:09:19
doing a wide range of daily activities
00:09:21
many powerful muscles connect to and
00:09:24
cross by the hip joint making it
00:09:26
possible for us to accelerate quickly
00:09:28
during actions like running and jumping
00:09:39
you