Taping and Bracing for Pelvic and Hip Injuries

Fig. 12.1

Molded thermoplastic protection of the hip. (a) Select an appropriate thermoplastic material. (b) Half-inch high density foam. (c) Place the heated thermoplastic material over the foam. (d) Cut the thermoplastic material to appropriate size. (e) Remove the foam from the thermoplastic material. (f) Place the thermoplastic material over the involved side. (g–i) Using a hip spica technique, wrap the mold to the patient. (j) Secure the elastic bandage with white athletic tape

12.7 Taping Techniques

Numerous taping techniques have been purported to be efficacious in the treatment and prevention of injury about the hips and pelvis (Fig. 12.2). Some examples of injuries/conditions in which taping/bracing have been utilized include greater trochanteric bursitis, iliac crest contusion (hip pointer), and osteoarthritis of the hip.

Fig. 12.2

Hip spica technique . (a) Place a 1–2 in. object under the heel to slightly flex the hip. (b) Lateral view of 12.1a. (c) Using a 6-in., double-length elastic bandage, wrap lateral to medial on the involved side at a slight downward angle. (d) Wrap the bandage around the involved side and cross the anterior hip. (e) Wrap the bandage around the back of the patient and around the anterior aspect of the involved side. (f) Continue across the anterior aspect of the hip

12.7.1 Compression Shorts

One common brace utilized in sports for injury prevention and rehabilitation about the hip and pelvis is compression shorts. It has become increasingly popular during the last decade despite little research to support its efficacy. Light compression materials (i.e., Spandex) have not been found to hinder performance [1, 15]. While no increase in single maximal jump power was noted, compression shorts did help maintain higher jumping power during repeated vertical jumping exercise [15].

Performance and proprioception at the hip with the use of elasticized compression shorts that offer considerably more compression and resistance to movement than conventional compression shorts have been studied. Their use did not limit performance on any measures except active range of motion during hip flexion [16, 17]. There is scientific evidence that movement of skin overlying activated muscle triggers cutaneous receptors to send proprioceptive information to the brain; [2, 9] however, there was no increased proprioception at the hip noted with the use of the compression shorts [17]. Subjective data revealed over 93 % of subjects felt the shorts were supportive, although its proper fit was an issue [17]. Doan et al. [16] found countermovement vertical jump height and 60-m. sprint times to be enhanced with the use of neoprene and rubber compression shorts which provided compression similar to those used in the previous study. Further research is needed to delineate if compression shorts offer any enhancement to athletic performance or efficacy in prevention of injury.

12.8 Case Study 1

A 20-year-old female collegiate goalie presents herself to the athletic training clinic for the evaluation of right lateral hip pain. The pain started a day earlier when she dove and landed on the lateral aspect of her right hip in order to block a shot. She complains of pain in that area exacerbated by hip abduction.

On examination, there is edema overlying the greater trochanter but no ecchymosis is present. She has full passive range of motion of the hip and resisted abduction increases pain in the area of the greater trochanter. Log roll is negative. Ober test is negative but produces pain in the area of the greater trochanter. There is no pelvic obliquity noted. She is neurovascularly intact.

12.9 Case 1 Conclusion

The patient was diagnosed with traumatic greater trochanteric bursitis. Ice and analgesics were used for pain control. The athlete was advised to wear compression shorts and hip spica taping was performed during practice and competition. This treatment provided her with more confidence in hip movement but did not decrease her pain. Her symptoms completely resolved after 2 weeks.

12.10 Case Study 2

The athlete involved in this case study is a 6 feet 2 in., 260 lb. male Collegiate American Football player. The athlete is a defensive lineman. The injury sustained occurred during an NCAA sanctioned football game after the play was blown dead and determined by the officials to be over. The athlete was slowly jogging in pursuit to the point of tackle, where the opposing running back had been stopped. The whistle had blown and the athlete did not anticipate the contact since the play was over. The athlete was clipped in the back of the right shoulder by an offensive lineman. His left foot was planted and right foot was elevated in mid-stride. The force received from his right shoulder caused his right leg to whip across the front side of his lower body, resulting in his right forefoot making hard contact with the ground. The whipping motion created a stretching force to the gluteal region. It also created an over contraction force to the hip flexors and adductor muscles. The athlete was able to walk over to the sideline on his power, but was badly limping. The initial evaluation by the team physician was performed on the sideline. Due to the athlete’s level of discomfort, it was thought that he might have a hip fracture. X-rays performed at the stadium were negative, but the athlete was unable to return to the game and was placed on crutches to aid ambulation. The next day an MRI was ordered. The results showed no bony involvement. It did show injury to the gluteus medius, adductor brevis, and rectus femorus tendon origin.

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