Chapter 7 Flashcards
Thomas test goal
Passive straight leg goal
Assess length of hip flexors and rectus femoris
Assess length of hamstrings
Bend and lift screen
Sagittal view
Tight
Unable to keep heels in contact with the floor
Hip and knee initiate movement (dominance)
insufficient activation of
Plantar flexors
Hip flexor and quad dominance
Glutes
Shoulder flexion test lie _ on mat
Shoulder extension test lie _ on mat
Supine
Prone
Hurdle step screen
Pelvis and low back
Anterior tilt with forward torso lean
Tight.
Lengthened
Stance leg hip flexors
Rectus abdominis and hip extensors
Shoulder push screen
Compensations
Scapulothoracic - winging during push up movement
Trunk-hyperextension or collapsing of lower back (3)
Inability of parascapular muscles to stabilize the scapulae against the rib cage
Lack of core, ab, and low back strength
Initial assessment that should be conducted
Static postural assessment
acceptable score for RSB:LSB test
.95 to 1.05
Lumbar dominance
Quad dominance
Glute dominance 3
Chronically tight hip flexors
Reliance on quads during squat- pressure transferred to knees
Eccentrically loading glutes during squat- hip hinge *preferred movement, activates hamstrings
Rectus abdominis
Upper back extensors
Neck extensors
Ankle plantar flexors
Shortened/ hypertonic/facilitated muscles associated with flat back posture
Hurdle step screen
Knees move inward
Tight. 2
Lengthened 2
Hip adductors,tensor fascia latae
Gluteus medius and Maximus
Bend and lift screen
Sagittal
Unable to achieve parallel between tibia and torso
Hamstrings contact back of calves
Lack of dorsiflexion due to tight plantar flexors
Muscle weakness- inability to stabilize and control lowering phase
Posterior pelvic tilt
Tight muscles (2)
Superior posterior pelvis tilts backward and downward
Rectus abdominis and hamstrings
Focus on gross deviations that differ by
Quarter inch ( 0.6 cm) or more btwn compartments of the body
trunk extensor endurance test assesses endurance of what 4 muscles
erector spinae
multifidi
longissimus
iliocostalis
Iliacus /psoas major
Internal oblique
Lumbar extensors
Neck flexors
Lengthened/ inhibited muscles associated with flat back posture
Thomas test
Back of lowered thigh DOESNT touch the table and knee DOESNT flex to 80 degrees
Back of lowered thigh DOESNT touch the table and knee DOES flex to 80 degrees
Back of lowered thigh DOES touch the table and knee DOESNT flex to 80 degrees
Tight hip flexors
Tight iliopsoas - preventing posterior rotation and and inhibits thigh from touching table
Rectus femoris- dies not allow knee to bend
Apleys scratch test assesses 3 movements
Shoulder extension/flexion
Internal/external rotation of humerus
Scapular abduction and adduction
Non-correctible factors
4
Examples
Congenital conditions -scoliosis
Some pathologies - rheumatoid arthritis
Structural deviations - femoral
anteversion
Certain types of trauma-surgery, amputation
Bend and lift screen
sagittal
Lengthened
Back excessively arches 4
Back rounds forward 1
Core, rectus abdominis, glutes, hamstring
Upper back extensors
3 key components to include when conducting postural assessments
Client history - musculoskeletal issues, congenital issues, injury, pain, discomfort
Lifestyle information- occupation, side dominance and habitual patterns
Visual and manual observations-postural deviations, muscle imbalance, correctible vs non correctible compensations
Hurdle step screen objective
To examine the mobility of one limb and stability of the contralateral limb while maintaining hip and torso stabilization
Pronation can lead to tightened _ muscle because
Tight calf muscles
Calcaneus moves into eversion lifting heel off ground = ankle in plantar flexion
Tight muscles. 3
Protracted shoulders - forward rounded
Plane of view
Serratus anterior, anterior scapulothoracic muscles, upper traps
Saggital
Bend and lift
3 observations in frontal plane
Pronation/ supination
Alignment of knee over second toe
Lateral shift
Passive straight leg test
Raised leg achieves at least 80 degrees of movement before pelvis rotates
Raised leg DOESNT achieve 80 degrees of movement before pelvis rotates
Normal hamstring length
Tight hamstrings
side bridge (either side) and extension ratio should be
less than .75
ex: RSB 88 seconds
extension score 150
88/150 = .59
Apleys scratch test
Flexion
External rotation
Abduction
Arm over head, bent elbow
Palm facing inward
Reach for medial border of contralateral scapula or reach down spine as far as possible
All transverse views of limbs and torso are performed in
Sagittal and frontal plane positions
Hurdle step screen
Allow _degrees of hip flexion without compensation
70 degrees
trunk flexor endurance test asses endurance of what 3 muscles
transverse abdominis
quatratus lumborum
erector spinae
Sagittal plane view
Looking at client from side - divides anterior and posterior
Tight muscles 4
Kyphosis and depressed chest
Plane of view
Shoulder adductors
Pectoralis minor
Rectus abdominis
Internal oblique
Sagittal
trunk lateral endurance test (side bridge test) assesses endurance of what 4 muscles
transverse abdominis
quadratis lumborum
erector spinae
obliques
Bend and lift screen - Anterior view
LENGTHENED
Lack of foot stability - ankles collapse inward 3
Knees move inward 2
Lateral shift to a side
Medial gastrocnemius, sartorius, tibialis group
Gluteus medius and Maximus
Lack of stability in lower extremities
Hurdle step screen: forward lean can indicate
Tight hamstrings
Bend and lift screen
sagittal
Tight
Back excessively arches 3
Back rounds forward 4
Hipflexors, back extensors, latissimus Dorsi
Lats, teres major, pec major, pec minor
Hip adduction
(2)
View from
Lateral tilt of pelvis that elevates one hip
Elevated hip is identified as moving into adduction - LOG is tilted to the opposite and the elevated hip moves closer to the LOG
Back
Good shoulder flexion = _ to _ degrees
Inability to flex to _ degrees
Tightness in (6)
170 to 180 degrees
170
Pectoralis major Pectoralis minor Latissimus Dorsi Teres major Rhomboids Subscapularis
Bend and lift: 5 observations in sagittal plane
Heel remains in contact with floor
Glute or quad dominance
Parallel of torso and tibia
Degree of lordosis
Excessive thoracic extension
Supination
Foot movement
Tibial knee movement
Femoral movement
Plane of view
Inversion
External
External
View from front
Iliacus / psoas major Rectus femoris External oblique Upper back extensors Neck flexors
Lengthened/inhibited muscles associated with sway back posture
5 primary movements of ADL
Bending/lifting Single leg movements Pushing Pulling Rotation
Right angle model implies a state in the
Frontal plane
Stork stand stops when (5)
hands come off hips stance foot inverts, everts or moves elevated foot loses contact with stance leg heel of stance leg touches floor client loses balance
Hurdle step screen
Raised leg
Lack of dorsiflexion
Tight.
Lengthened
Ankle plantar flexors
Ankle Dorsi flexors
Anterior pelvic tilt
Tight muscles (2)
Lifestyle
Strengthen (2)
Superior anterior pelvis tilts forward and downward
Hip flexors - shortened hip flexors pull pelvis into anterior tilt and erector spinae
Sedentary, seated a lot
Abs and glutes
Hurdle step screen
Ankles collapse inward/feet turn outward
Tight. 3
Lengthened 6
Soleus, lateral gastrocnemius, peroneals
Medial gastrocnemius, gracilis, sartorius, tibialis group, gluteus medius and Maximus
Hurdle step screen
Raised leg
Hiking the raised hip
Tight.
Stance leg hip flexors -limiting posterior hip rotation during raise
Muscle imbalance at a joint =
2
Dysfunctional movement
Working relationships of muscles around the joint
Bend and lift screen Anterior view
TIGHT
Lack of foot stability - ankles collapse inward 3
Knees move inward 2
Lateral shift to a side
Soleus , Lateral gastrocnemius, peroneals
Hip adductors, tensor fascia latae
Lack of stability in lower extremities
Scapular winging definition
Lengthened muscle
Protrusion of inferior angle and medial border of the scapula
Serratus anterior
Internal/ medial rotation
ABILITY to internally rotate forearms 70 degrees toward mat
INABILITY to internally rotate forearms 70 degrees toward mat
Good mobility in the EXTERNAL (lateral rotators) allowing full ROM
Tightness in EXTERNAL rotators (infraspinatus and teres minor)
Altered neural action of the muscles moving around the joint =
Tight or shortened muscles are overactive and dominant at the joint
Thomas test: thigh off table, knee flexed 50 degrees
Tight iliopsoas and rectus femoris
to calculate mcgill torso test - flexion:extension
divide flexion score by extension score
ex: flexion score: 120 seconds
extension score: 150 seconds
120/150 = .80 ratio score
Bend and lift screen
Frontal view
3 Observations
Pronation, supination, eversion. Inversion
Alignment of knees over 2nd toe
Symmetry - lateral shift
Hurdle step screen
Pelvis and low back
Posterior tilt with hunched over torso
Tight. 2
Lengthened
Rectus abdominis and hip extensors
Stance leg hip flexors
Normal degree of trunk rotation in each direction
45 degrees
Hurdle step screen
Raised leg
Limb deviates from sagittal plane
Tight.
Lengthened
Raised leg hip extensors
Raised leg hip flexors
Hurdle step screen
Stance leg hip rotation
Tight.
Lengthened
Stance leg or raised leg internal rotators
Stance leg or raised leg internal rotators
Pronation increases (2)
Anterior pelvic tilt- to accommodate the head of the femur which is internally rotated
Lumbar lordosis
Tight muscles - 3
Medially rotated humerus
Plane of view
Pectoralis major, latissimus dorsi, subscapularis
Frontal
Inability to reach normal trunk rotation can lead to an increase in
Lordosis
right side bridge: left side bridge score should be no greater than
.05 from balanced score of 1.0
(.95 to 1.05)
ex:
RSB = 88 seconds
LSB = 92 seconds
88/92 = .96
3 torso tests
trunk flexor endurance test
trunk lateral endurance test
trunk extensor endurance test
Lack of thoracic dominance will negatively impact
Glenohumeral mobility
Hurdle step screen
Lateral tilt, forward lean
Tight.
Lengthened
Lack of core stability
Stork Stand Balance test assesses
static balance by standing on one foot on toes in a modified stork position
Tight hip flexors and erector spinae also known as
Lower cross syndrome
Stork Stand Balance Test results excellent/poor
Men
Women
men: greater than 50 seconds
less than 20 seconds
women: greater than 30 seconds
less than 10 seconds
Apleys scratch test
Extension
Internal rotation
Adduction
Reach arm behind back, bending elbow
Palm facing outward
Reach inferior angle of contralateral scapula or up spine as far as possible
Scapulothoracic movements
6
Elevation Depression Adduction (retraction) Abduction (protraction) Upward rotation Downward rotation
Scapular winging or protraction results from
Inabilities of rhomboids and serratus anterior to hold scapulae in place
Sharpened Romberg test assesss
3
Static balance
With reduced base of support
Visual sensory removed
Bend and lift screen
Sagittal
(5)
*list from feet to head
Heels remain in contact with the floor
Achieve parallel btwn tibia and torso
Glute or quad dominance
Degree of lordosis
Head position changes
Scapular protraction
Tight muscle
signs of protraction when viewing client anteriorly
Natural amount of
Protrusion of medial border outward
Serratus anterior
Palms face backward instead of to the sides
Shrugging
Bend and lift screen
sagittal
Head down
Head upward
Increased hip and trunk flexion
Tightness in cervical extensor region
Faulty neural control due to
2
Muscle tightness
Imbalance between muscles acting at the joint
With good posture earlobe should align
Cheek bone should align with
Plane of view
Over the acromion process
Collar bone
Sagittal
Primary objective is all training programs
Improve functionality
Forward head position
Tight muscles- 3
Plane of view
Cervical spine extensors, upper trapezius and levator scapular
Sagittal
External/lateral rotation
ABILITY to externally rotate forearms 90 degrees to touch mat
INABILITY to externally rotate forearms 90 degrees to touch mat
Good mobility in the INTERNAL (medial rotators) allowing full ROM
Tightness in INTERNAL rotators (subscapularis)
Tight muscles
Shoulders not level. - 3
Asymmetry to midline - 1
Plane of view
Upper trapezius, levator scapula, rhomboids
Lateral trunk flexors (flexed sides)
Frontal
Correctible factors of posture
6
Repetitive movements Awkward positions and movements Lack of joint Mobility Lack of joint stability Side dominance Imbalanced strength training programs
Pronation
Foot movement
Tibial knee movement
Femoral movement
Plane of view
Eversion
Internal rotation
Internal rotation
View from front
Bilateral discrepancy in trunk rotation could mean
Side dominance
Movement efficiency
2
Ability to generate appropriate levels of movement and force at desired joints
Stabilizing kinetic chain against gravity based forces
5 key postural deviations
Ankle pronation/supination - tibial and femoral rotation
Hip adduction
Pelvic tilting - anterior and posterior
Shoulder position
Head position
Lumbar spine exhibits rotation of approximately _
15 degrees
Apley’s Scratch test assesses simultaneous movement of:
the scapulothoracic and glenohumeral joint
Good shoulder extension = _ to _ degrees
Inability to flex to _ degrees
Tightness in (6)
50 to 60 degrees
50
Pectoralis major Abs Subscapularis Anterior deltoid Coracibrachialis Biceps brachii
Hip extensors
External obliques
Upper back extensors
Scapular stabilizers
Neck flexors
Lengthened/ inhibited muscles - kyphosis - lordosis posture
Raising arms over head
Glenohumeral - more mobile
Scapulothoracic- more stable
120 degrees
60 degrees
Proper posture
Muscle action from deep muscles with high concentrations of Type I muscle fibers
Frontal plane view
Looking at clients head on or from behind
Divides right and left side
Hurdle step screen
Hip adduction
Tight. 2
Lengthened 2
Hip adductors, tensor fascia latae
Gluteus medius, Maximus
Static posture
2
The alignment of the body’s segments
How the person holds himself statically or isometrically in space
Hamstrings
Upper fibers of posterior obliques
Lumbar extensors
Neck extensors
Shortened/ hypertonic/facilitated muscles associated with sway back posture
Internal- external rotation of humerus at the shoulder
External
Internal
Lateral- rotate forearms backward toward the mat -aiming the forearms and backs of hands on the mat
Medial- rotate forearm forward toward mat, Turing palms downward
Thoracic spine mobility screen evaluates
Trunk rotation in the transverse plane
when evaluating the torso flexion:extension test ratio should be
less than 1.0
Hip flexors Lumbar extensors Anterior chest / shoulders Latissimus Dorsi Neck extensors
Shortened/ hypertonic/facilitated muscles associated with kyphosis- lordosis
