The movements are flexion, extension, abduction, adduction, medial and lateral rotation and circumduction.
Flexion of the hip joint will have been performed with flexion of the knee as already explained. Full extension of the hip joint can only be carried out in prone lying or side lying. In prone lying with the client's foot over the edge of the bed, place one hand on the buttock. The other hand is placed under and above the knee with the client's lower leg supported along the forearm.
Lift the straight leg into extension. Ensure that movement does not occur in the lumbar spine, by applying pressure downwards on the buttock and preventing the anterior aspect of the joint raising off the bed.
Both these movements can be carried out in side lying but the weight of the leg must be supported by the therapist, making the manoeuvre cumbersome and difficult.
Place the leg not being worked on into abduction: support the moving leg by cupping under the ankle with one hand while the other hand supports under the knee preventing hyperextension. Keep the leg in line with the body and take it out sideways into abduction and back across mid-line into adduction.
PROCEDURE FOR MEDIAL (INTERNAL) AND LATERAL (EXTERNAL) ROTATION
With the legs slightly apart but supported on the bed throughout, place one hand on the thigh and the other on the lower leg. Grasp the leg gently and turn it inwards and outwards. For continuity it is suggested that hip joint flexion is carried out with knee joint flexion: this is then followed by abduction, adduction, medial and lateral rotation, with the client in the supine position. S/he is then asked to turn over into the prone position, and extension of the hip is carried out.
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