9.0 Pathological Gait Knee Flashcards
When is Articular pressure greatest in the Quads?
When Quads are Weakest, or after Anesthesia
What is a knee flexion contracture?
The knee is stuck at a certain angle and can only flex beyond that angle, but not extend.
When is Intra articular pressure greatest in Knee Flexion?
at 0°
at 90-120°
What is the relationship between Quadriceps demand and Knee Flexion Angle?
As Knee Flexion increases, Quadricep demand increases
This is failure to achieve normal amount of flexion
Inadequate Flexion
This is extension beyond neutral (Hyperextension)
Excessive Extension
Being able to flex the knee more than normal range is known as…
Excessive Knee Flexion
This is persistent knee flexion when the knee should be extending
Inadequate Extension
What are potential causes of inadequate knee flexion during Loading Response?
- Quadricep Weakness
- Hip Extensor Weakness
- Muscle or Joint Pain (Avoidance)
- Excessive Quadricep Activity
- Decreased Heel Rocker
Limited Knee Flexion ALWAYS limits ________
Limits Hip Flexion
What are the penalties associated with inadequate knee flexion during Loading Response?
Decreased Shock Absorption
-(Increased Bone and Cartilage Loading)
During Pre-Swing and Initial Swing, Inadequate knee flexion could be caused by…
- Muscle or Joint Pain (Avoidance)
- Excessive Quadriceps Activity
- Hip flexor Weakness
- Knee Flexion Weakness
During Pre-swing and Initial Swing, the penalty for Inadequate Knee Flexion is…
Decreased foot clearance
During Loading Response, Mid stance, and terminal stance, ONLY IF RANGE IS AVAILABLE, the potential causes for Excessive Extension are…
- Quadricep Weakness
- Muscles or Joint Pain (Avoidance)
- Excessive Quadriceps Activity
- Excessive Ankle Plantar Flexion
What is the penalty associated with Excessive Extension from Loading-Response to Terminal Stance?
Penalty
-Posterior Knee Joint Stress
During Pre-swing and Initial-Swing, excessive knee flexion can be caused by
- Compensatory action to assist in foot clearance due to excessive plantar flexion
- Abnormal Motor Control (Flexor Pattern)
What is the penalty associated with Excessive Knee Flexion during Pre-swing and Initial-swing?
Increased energy expenditure related to muscle overuse
- Hip Flexors
- Biceps Femoris Short head
What stages are you likely to experience inadequate knee extension
Mid-stance and Terminal-Stance
What are the potential causes of Inadequate knee extension in Mid stance and Terminal Stance?
- Knee flexion Contracture
- Hip flexion Contracture
- Excessive Dorsiflexion (Calf Weakness)
- Excessive Hamstring Activation
What are the penalties associated with Inadequate Knee Extension in Mid and Terminal Stance?
- Increased Energy Expenditure related to muscle overuse (Quadriceps)
- Diminished forward progression
- Decreased Stride Length
What swing phases is one likely to see Inadequate knee extension?
Mid swing and Terminal Swing
What are the potential causes of Inadequate knee extension in Mid and Terminal SWING?
- Quadricep Weakness
- Knee Flexion Contracture
- Excessive Hamstring Activation
- Purposeful Strategy to reduce heel rocker
- Weakness
- Poor balance/Instability
- Heel pain
What are the penalties associated with Inadequate knee extension during Mid and Terminal SWING?
- Decreased preparation for Stance
- Decreased limb Advancement
- Decreased stride Length
What is the leading potential cause for Dynamic Knee Valgus in the stance phases?
- Excessive Hip Adduction
- Excessive Hip Internal Rotation
- Both related to weak hip abductors and/or external rotators
What are the penalties associated with Dynamic Knee Valgus in the stance phases due to
A. Excessive Hip Adduction
B. Excessive Hip Internal Rotation
- Knee Joint Stress/Strain
- MCL Stress
- Pes Anserine Strain
- IT Band Strain - Patellofemoral Joint Stress
What is the potential cause of dynamic knee varus during the stance phases?
Pelvic Drop owing to hip Abductor weakness
What are the penalties associated with Dynamic knee Varus during the stances phases, due to pelvic drop owing to hip abductor weakness?
Knee joint stress and strain
- LCL Strain
- IT Band Strain
- Medial Compartment Compression
What are the causes for excessive knee rotation during the stance phases?
- Excessive Pronation
2. Weakness of Hip External Rotatorss
What are the penalties associated with Excessive Knee rotation during the stance phases due to excessive pronation and/or weakness of hip external rotators?
- Knee Joint Stress/Strain
- MCL Stress
- Pes Anserine Strain
- IT Bane Strain - Patellofemoral Joint Stress
What is the influence of muscle weakness in the sagittal plane for knee weakness?
Quadriceps
