Capsular patterns, ROM, MMT Flashcards
Osteokinematics: Within the hip joint, what are the motions permitted, the plane the motion occurs and the axis of rotation?
Flexion/extension = saggital plane, ML axis AB/ADduction = frontal plane, AP axis IR/ER = transverse plane, vert. or longitudinal axis
Arthrokinematics: What happens the motion of the hip in open chain?
Femoral head rolls in the same direction of the movement and slides in the opposite direction
What is the capsular pattern of the hip joint?
IR > Flexion = abduction > no limitation of ER or adduction
What is the range of motion for hip flexion?
0-120 degrees
What is the primary muscles being tested in hip flexion MMT?
Posts major and Iliacus
What is the end feel of hip flexion?
Soft; may be firm due to tension in post. joint capsule and the glut max muscle
What substitutions do you need to look for with hip flexion?
Use of the sartorius and TFL
What is the range of motion for hip extension?
0-20 degrees
What are the primary muscles being tested in hip extension?
Glut max and hamstrings
How do you isolate glut max?
Bend the knee in hip extension
What is the end feel for hip extension?
Firm; ligamentous, unless there is tight musculature
What is the range of motion for hip abduction?
0-45 degrees
What primary muscles are being testing in hip abduction?
Glut med and glut min
What is the end feel of hip abduction?
Firm; ligamentous unless there is tight musculature
What substitutions do you have to look for with hip abduction?
- “hip hike” by using trunk muscles to move leg
- ER and flexion substitution
- TFL substitution
How do you isolate the TFL in hip abduction?
place the leg at 45 degrees of hip flesion
What is the range of motion for hip adduction?
0-15/20 degrees
What muscles are being tested in hip adduction?
Adductor magnus, brevis, and longus; pectine and gracilis
What is the normal end feel for hip adduction?
Firm; ligamentous unless there is tight musculature
What substitutions do you need to look for in hip adduction?
IR at the hip
What is the range of motion for hip external rotation?
0-45 degrees
What muscles are you testing in hip ER?
Deep ERs; Obturator externus and internus, quadrates femurs, gemellus superior and inferior, and glut max
What is the normal end feel of hip ER?
Firm; tendinous, unless there are tight muscles
What substitutions do you need to look for?
- Lifting contralateral buttock
- increased flexion
- abducting test hip
What muscles are you testing in hip IR?
Glut min and med, TFL
What is the normal ROM for hip IR?
0-45 degrees
What is the normal end feel of hip IR?
Firm; tendinous, unless there are tight muscles
Osteokinematics: Within the knee joint, what are the motions permitted, the plane the motion occurs and the axis of rotation?
Flexion/extension = sagittal plane, ML axis Rotation = transverse plane, vertical axis
Arthrokinematics: What happens the motion of the hip in open chain?
Concave tibia rolls on the convex femur, and tibia sides in the same direction
What is the capsular pattern of the knee joint?
Flexion limitation > Extension limitation > no rotation restriction
What is the normal ROM of knee flexion?
0-135 degrees
What muscles are you testing in knee flexion?
all hamstrings
What are your medial hamstrings?
Semimembranosus and tendionosus
What are your lateral hamstrings?
Long and short head of biceps femoris
What is the end feel for knee flexion?
Soft; unless firm due to muscle tension
What substitutions do you need to watch for with knee flexion?
- hip flexion substitution
- sartorius substitution (hip flexion, ER of hip)
- gracilis substitution (hip add)
- garou substitution (strong dorsiflexion)
What is the ROM for knee extension?
135 - 0 degrees (may allow to 10 degrees of hyper extension)
What muscles are you testing in knee extension?
Quadriceps femoris
What substitutions do you need to look for in knee extension?
- lifting pelvis
- side lying, hip IR
What is the end feel for knee extension?
Firm; tendinous
What is the capsular patterns for the talocrural joint?
Greater limitation in plantar flexion than dorsiflexion
What is the capsular pattern for the subtalar joint?
Greater limitation of inversion
What is the capsular pattern for the transverse tarsal joint?
Limitation of inversion (adduction and supination); other motions are full
What is the capsular pattern for the MTP joints?
Gross limitation of extension and slight limitation of flexion at first MTP, other MTP joints limitation is more restriction of flexion than extension
What is the ROM in ankle plantar flexion?
0-45 degrees
What muscles are tested in ankle plantar flexion?
Gastroc and soleus
