BY JOAN WATT, MA MCSP MSMA

ASSESSMENT OF THE HIP JOINT

This is the 4th article in Joan Watt’s joint

assessment series. Previous articles in the series have included Patient Assessment: A Ready Reckoner (1), Ankle Assessment (2) and Knee Assessment (3). See the end of the article for references and details on accessing these articles.

HIP JOINT ASSESSMENT As discussed in previous assessment articles (1-3), always there are always two parts to be considered in any assessment: Subjective - refer to original assessment article and ensure you have obtained all the relevant history and completed all required formalities. Objective assessment - the observation, measurement, specific testing and functional activities. Then progress to palpation and specific examination, not forgetting to check any equipment or footwear needed for activities. In the case of a hip problem, be prepared to search other regions for the cause of the presenting symptomology. It may be necessary to assess ankle, knee, feet or spine to discover the cause of pain presenting in the hip joint.

FUNCTIONAL TESTS A good starting point for hip joint testing is to observe functional tasks. Restricted or painful movements can be presented as odd, awkward patterns of movement. Ask the patient to demonstrate some of the following actions: n walk n stand n get up from the seated position n remove and put on socks and shoes n get in and out of a car n cycling n running n whatever activity pertains to the person being assessed particularly if the sport requires the person to stand with one leg predominantly bearing full load.

Look specifically for: n asymmetry n preference of weight bearing n any sign of injury n muscle wasting n muscle spasm n the angle of leg when at rest – is it abducted, adducted, flexed or rotated?

PASSIVE MOVEMENTS Test all ranges of movement passively. Pay particular attention to facial expression as this can demonstrate areas of pain. Also look out for restricted “end feel” or grittiness. Box 1 outlines the approximate ranges of movement expected at the hip.

18 sportEX dynamics 2008:17(Jul):18-21