Case 9 - Physical activity for physical and mental health

Question 1

how does an ACL tear occur

Answer 1

over rotated in hip - internal rotation of the femur due to weak gluteus medius and vests medialis

greater shear force in femoral

sheer force is moving lateral to medial around knee

Question 2

what muscles are weak that can cause the ACL tear or any pain in knee

Answer 2

gluteus medius, inner thigh, quads and hamstrings

Question 3

what are the 3 main factors contributing to the factor patellofemoral pain is more common in females

Answer 3

quadriceps muscle imbalance and or weakness

lower extremity and patellofemoral malalignment

physical overload of the patellofemeral joint

Question 4

what is the Q angle

Answer 4

angle between force vector of quadriceps tendon and the force vector of the patella tendon

Question 5

do women or men have a greater Q angle

Answer 5

women

Question 6

what does a weak gluteus medium muscle result in

Answer 6

internal rotation of the femur, which further exacerbates the effects of a greater Q angle in women. which in turn is exacerbated again by over pronation of the ankle

Question 7

what does quadriceps weakness contribute to

Answer 7

overall knee valgus, especially if fatigued or over trained

Question 8

what exacerbates shin splints

Answer 8

increased shear forces to tibia due to overprontation, added torsion

Question 9

chief medical officers guide for physical activity

Answer 9

150 minds of moderate intensity activity a week, with muscle strengthening activity at least 2 days a week

Question 10

what is the management

Answer 10

avoid running downhill and only uphill in recovery phase
orthotics don’t ultimately cure problem

needs to not be a heel striker

retrain to become a mid foot to forefoot striker to alleviate pressure to the heel and force transmission into the left and right leg - help running gait

strengthening of quads and hips recommended to make sure ACL has healed