The Hip Joint – Part Three

The effect on the function of the hip joint of a difference in the length of the legs has been mentioned previously in an article in this series. The longer of the two legs will attempt to keep the head level by flexing slightly at the hip and knee, leading to a lack of movement into extension of the hip as we walk. Rotation of the hip and pelvis is required to achieve a more normal gait pattern if extension is not fully achievable. This may be a small change in joint movement, but on repetition thousands of times per day this can set up difficulties in joint movement and over time a painful joint condition.

The Human Hip

The trunk and the legs are connected mechanically at the large ball and socket joints of the hips. The acetabulum, the large rounded and deep hip socket with a cartilage rim, neatly covers the similarly shaped femoral head, the ball at the top of the thigh bone. This is a stable joint with deep structure and strong stabilisers. The surfaces of the hip joint are covered by an almost friction-free material called articular cartilage which allows movement to occur easily under stress, a vital ability in this joint. The greatest weight is taken in the roof of the socket and the uppermost part of the femoral head and this is where cartilage is thickest.

The Ankle ” Part Two

The arch of the foot is also partly maintained by a strong ligament under the foot called the spring ligament, connecting the navicular with the calcaneus. It holds the arch together by resisting the tendency for the bones to separate under vertical stresses, becoming tighter the more weight is placed upon it. Due to its great strength the spring ligament is particularly useful when we are doing very vigorous movements such as running or jumping which might otherwise be too much for the muscle to resist the splaying of the arch. The muscles work more continuously at a lower level but between them and the spring ligament the talus is maintained at the top of the arch of the foot.

The Elbow Joint

The elbow is the central joint of the arm and divides it up into two convenient halves, looking initially merely like a backwards and forwards hinge. On closer examination the elbow shows itself to be a remarkably clever and multi-talented joint. The humerus or upper arm bone connects with the two lower arm bones, the radius and the ulna. The elbow joint itself is formed from the lower end of the humerus and the upper end of the ulna which makes up the bony point of the elbow which can be easily felt. The upper end of the ulna has a ladle like shape which carries in its bowl the end of the humerus.

The Management Of Joint Pain

There are many different potential causes for joint pain and these include infection, accidents, crystals in the joint, inflammation and articular cartilage damage. The clinical history and joint examination are the strongest guides to establishing a differential diagnosis and once a provisional decision about the likely cause has been made then laboratory investigations can be useful to confirm or refute this. Without an initial guiding thought as to the possible diagnosis investigations can be more confusing than enlightening. The primary effort is in pinning down the likely pain source and then working out the disease process.