Ligaments[edit]

Intracapsular ligament. Left hip joint from within pelvis with acetabular floor removed (left); right hip joint with capsule
removed, anterior aspect (right).

The hip joint is reinforced by four ligaments, of which three are extracapsular and one intracapsular.
The extracapsular ligaments are the iliofemoral, ischiofemoral, and pubofemoral ligaments attached to the
bones of the pelvis (the ilium,ischium, and pubis respectively). All three strengthen the capsule and prevent an
excessive range of movement in the joint. Of these, the Y-shaped and twisted iliofemoral ligament is the
strongest ligament in the human body. [17] In the upright position, it prevents the trunk from falling backward
without the need for muscular activity. In the sitting position, it becomes relaxed, thus permitting the pelvis to tilt
backward into its sitting position. The iliofemoral ligament prevents excessive adduction and internal rotation of
the hip. The ischiofemoral ligament prevents medial (internal) rotation while the pubofemoral ligament restricts
abduction and internal rotation of the hip joint. [18] The zona orbicularis, which lies like a collar around the most
narrow part of the femoral neck, is covered by the other ligaments which partly radiate into it. The zona
orbicularis acts like a buttonhole on the femoral head and assists in maintaining the contact in the joint. [17] All
three ligaments become taut when the joint is extended - this stabilises the joint, and reduces the energy
demand of muscles when standing [19]
The intracapsular ligament, the ligamentum teres, is attached to a depression in the acetabulum (the
acetabular notch) and a depression on the femoral head (the fovea of the head). It is only stretched when the hip
is dislocated, and may then prevent further displacement. [17] It is not that important as a ligament but can often
be vitally important as a conduit of a small artery to the head of the femur, that is, the foveal artery.[20] This artery
is not present in everyone but can become the only blood supply to the bone in the head of the femur when the
neck of the femur is fractured or disrupted by injury in childhood. [21]

Hip ligaments strengthen the articular capsule of the hip stabilizing the joint. Ligament strains or
ruptures occur if the joint is twisted or overstretched. Usually a snapping or cracking occurs when a
ligament ruptures, which is followed by bruising, swelling and pain. Movement of the involved joint will
usually be limited due to pain.

Hip Sprain
The hip is a ball-and-socket joint and the primary weight-bearing joint in the body. It includes the pelvis and femur and
several ligaments that help stabilize the joint. The Iliofemoral ligament connects the pelvis to the femur, and covers the
hip joint anteriorly, providing support during hip extension and supporting the weight of the body. This ligament can be
partially or fully torn from a direct blow to the hip or overuse injury. Rehabilitation should include gentle stretching and
strengthening exercises that promote range of motion and pelvic stability.
The iliofemoral ligament is required to prevent hyperextension of the hip.

What is Hip Sprain?

A hip sprain is a condition that occurs due to stretching or tearing of ligaments that support the hip
joint, which not only results in pain but also limits the regular activities. However, there are various
kinds of exercises and physical therapy that help in preventing or treating hip sprain.
Hip sprain occurs when sudden contraction of stretched out muscle takes place. Overstretching and
hard blow caused to the muscle may result in tearing the tissue of the muscle. This kind of tissue tear
is called as hip sprain. Old injury, old age and inappropriate warm up before exercise are few of the
common reasons that increase the chances of hip sprain. The injured hip may also lead to bruising and
swelling. Hip sprain may also occur due to other problems like arthritis. Pain is often associated with
hip fractures, or broken bones inside the hip which can be treated by realigning them back together by
operation.
Medications are prescribed depending upon the type of injury for reducing swelling and pain. Elevating
the leg and application of ice compresses helps in reducing pain related to hip sprain. Lifting heavy
objects must be avoided in order to prevent further damage and wearing down of the ligaments.
Exercise and conditioning often helps in preventing hip injuries. Individuals with strong leg muscles are
less prone to hip problems. Appropriate stretching not only helps in increasing hip flexibility but also
prevents heavy sprains.

Types of Hip Sprain

The hip sprains can broadly be classified into three types depending upon the condition of the injury.

First degree hip sprain as mild.

Second degree hip sprain as moderate.

Third degree hip sprain as severe.

Each type has its particular signs and symptoms which assist in evaluating the status of the injury. The
severity of a hip sprain varies with each patient.

First Degree Hip Sprain:

First degree hip sprain is referred as a minor hip sprain and there is light stretch in ligament. First
degree hip sprain heals up in few weeks with appropriate rest.

Second Degree Hip Sprain:

Second degree sprain can be referred to as moderate type of hip sprain. Second degree hip sprain is a
step ahead to the first degree hip sprain, which means comparatively it is quite severe than first degree
hip sprain. Second degree hip sprain often results in partial tearing of ligaments. Second degree hip
sprain heals up in about two months.

Third Degree Hip Sprain:

Third degree hip sprain can be referred to as severe sprain. Third degree hip sprain is very severe in
nature as it could lead to complete tearing of ligaments. Surgery may be required to reconnect the
tissue.

Causes and Risk Factors of Hip Sprain

In most of the cases, hip sprain is caused from traumatic impact to the hip or an accident such as a fall
or direct and forceful contact i.e. contusion, or overstretching or overuse of the ligaments or muscles in
the hip. This often results in small tears in the tendons, ligaments and muscle fibers which may go on
from mild to become moderate and then ultimately severe. Hip sprain more frequently occur in patients
who have previous injury in the area, repetitive overuse and inappropriate warm up before performing
exercise.

Signs and Symptoms of Hip Sprain

Pain is experienced in the hip while performing sudden movements.

Pain is experienced at the front side of the hip.

Pain is experienced while moving the leg in the backward direction.

Typical quality where there is no pain on lifting the thigh forwards.

Tenderness.

Swelling and bruising in severe cases.

Hip SprainTreatment

Rest.

Avoiding activities that aggravate the symptoms.

Application of ice helps in treating bleeding, swelling and pain.

Crutches help in making the walks pain free.

Non-steroidal anti-inflammatory medications not only help in relieving pain but also reduce
swelling and inflammation.

Physical therapy such as sports massage, heat therapy and ultrasound following range of
motion, stretching and strengthening exercises may also helps with improving condition.

Gradual return to activity as the symptoms reduce.

Surgery is required only in case of complete tearing of the tendon, muscle and ligament.

Rehabilitation program is performed following surgery in order to regain flexibility and strength.
Rehabilitation program not only improves muscle strength, but also helps in maintaining hip stability.

Hip Sprain Exercises

Outer Hip Stretch Exercise for Hip Sprain:

This exercise is performed by lying down straight on the floor by placing the arms perpendicular
towards the shoulders with palms flat on the floor. Now by bending the left knee keeping the ball of the
left foot against the back side of the right knee, roll the hips to the right side in order to place the left leg
on the floor and push it down with the help of the right hand. Repeat same on the other side.

Kneeling Hip Flexor Stretch Exercise for Hip Sprain:

This exercise is performed for hip flexors, which are attached with many muscles. Keeping the right leg
straight kneel the left knee down in order to push the hips in the forward direction and bend the right
knee until a pain free stretch is felt in the left hip. Repeat the same on the other side.

Lying Hip Flexor Stretch Exercise for Hip Sprain:

This exercise is performed by lying face up on a bench, the knees bent and the feet on the edge of the
bench. Now with the knees bent, pull the right knee into the chest and lower the left foot towards the
floor. Hold the position for few seconds and release. Repeat the same on the other side. This exercise
works out the same muscles as that of kneeling hip flexor stretch hence any one of the exercise can
be performed.

Standing Iliotibial Band Stretch Exercise for Hip Sprain:

This exercise is performed by standing straight and crossing the left leg behind the right foot. Now
reach overhead with the right arm and lean to the left until a pain-free stretch is felt in the right hip.
Hold the position for few seconds and release. Repeat the same on the other side.

Tests to Diagnose Hip Sprain

A complete subjective and physical examination is performed to diagnose hip sprain. Physical
examination involves placing pressure on the affected areas of the injury to identify pain, bruising,
swelling and tenderness. Patient may be asked to perform certain movements for determining muscle
strength, stability of the joint, range of motion limitations, and finding out the reason for decrease and
increase of pain.
Other tests that help in assessing the severity and ruling out potential causes and other injuries may
include:

X-ray.

MRI.

Recovery Period of Hip Sprain and When To Start Exercising

Hip sprain pain may last 6 to 10 weeks. Hip sprain caused by tendon or ligament tear can take 8 to 10
weeks to completely heal. Sprain caused by muscle injury may recover in 4 to 6 weeks. You should
consult Orthopedic Surgeon to evaluate cause of hip sprain. Depending on cause you could begin
exercise between 6 to 10 week following initial pain. If you experience increased pain immediatedly
following exercise lasting more than 2 to 4 hours, you should consult your physician or visit ER. The
diagnosis of the pain in such cases should be re-evaluated.