Exam 3 Flashcards
what makes up a motor unit
nerve (motor neuron aka efferent)
muscle fibers
what are the filaments within the sarcomere
actin and myosin
small contractile units
sarcomeres
sliding filament theory
-action potential causes myosin heads to flex and create cross bridges with actin
-myosin pulls actin toward sarcomere center
-H-band becomes smaller
-Z discs move toward center
-changes in sarcomere length
I-bands
contains actin
A-band
contains myosin
action potential sequence
- action potential is released to trigger nerve response at motor end plate
- release of Ach at motor end plate initiates muscles response
- Ca+2 ions released from SR
- Ca+2 ions bind to troponin to slide tropomyosin away from actin binding sites
- extended myosin heads attach to actin’s binding sites, creating cross-bridges
- myosin contact with actin causes hydrolysis of ATP to ADP and phosphate, producing energy
- ADP releases from myosin heads creating “power stroke” as myosin heads move back to uncocked position while attached to actin
- new ATP attaches to myosin, detaching myosin from actin
- Ca+2 releases from troponin and re-enters SR
- tropomyosin covers actin binding sites
- sarcomeres returns to proactivity conditions
4 whole muscle functions
produce movement
maintain posture
stabilize joints
generate body heat
characteristics of type 1 muscle fiber
slow
small
red
greatest resistance to fatigue
lots of mitochondria
high oxidative capacity
oxidative system
endurance/aerobic activity
characteristics of type 2A muscle fibers
fast
larger
white
moderate to fatigue
high oxidative capacity
ATP-PC system
high-intensity activity less than 2min
characteristics of type 2B muscle fibers
fastest
largest
white
fatigue easily
minimal mitochondria
glycolytic system
max-intensity bursts, less than 30 sec
muscle strength
max force a muscle or muscle group can exert
determining factors: genetics, gender, exercise, neural recruitment, lifestyle, muscle fiber type
power
strength applied over a distance for a specific time (P = Fxd/T)
components of power
strength
speed
coordination
movement efficiency
timing
muscle endurance
ability to perform repeated contractions against less than max load
determining factors of muscle endurance
energy system used (type 1 recruited first then type 2 if enough stimulation)
quantity of force resisted
T/F endurance is inversely proportional to force intensity
true
strength is developed through
low reps with high resistance
endurance is developed through
high reps with low resistance
rest for strength
longer rests between sets and reps
rest for endurance
shorter rest periods
sources of muscle fatigue
neural system (out of Ach to use)
energy system (out of ATP)
sarcoplasmic reticulum (runs out of Ca+2)
T/F according to the sliding filament theory, action potential causes actin heads to flex and create cross-bridges with myosin filaments
false
what fiber type uses oxidative energy system
type 1 muscle fibers
T/F efferent input provides afferents response
false
force production determinants
joint angle
muscle length
muscle size
fiber arrangement
speed of contraction
numbers and type of fibers
muscle fiber recruitment
-recruits small (type 1 or 2a) for low intensity and before large (type 2b)
monoarticular muscles
recruited before biarticular muscles during low-level activities
-cross only 1 joint ex: vastus medialis
-provides the force
biarticular muscles
control direction of movement during joint motion
-cross over 2 joints ex: rectus femoris
-provides control over movement
static/isometric definition
tension is produced in the muscle without change in muscles length
advantages of isometrics/statics
-early in rehab
-low joint stress
-can be used with weak muscles
disadvantages of isometrics/statics
-strength gains isolated to minimal joint angles (not going thru full ROM)
-valsalva maneuver can occur more easily with other exercises
for optimal strength gains to occur the muscles effort must be at
66% to 100% of its max output
dynamic definition
implies that a change in muscles position occurs
isotonic
change in the muscles length occurs during activity
-concentric: muscle shortens
-eccentrics: muscle lengthens
isokinetic
velocity is controlled and maintained at a specific speed of movement, but amount of resistance provided to muscles varies (requires equipment)
open kinetic chain activities
-distal segments move freely and independently of proximal segments
-produce high velocity movements
-creates shear stress in joints
-have less joint stability
-occur in normal and sports activities
closed kinetic chain activities
-distal segment is weight bearing and moves with other segments
-produce forceful movements
-create less shear stress in joints
-have more joint stability
-occur in normal and sports activities
how to evaluate muscle strength
MMT
cable tensiometers
isokinetic machines
free weight or weight machines (1RM)
grip or pinch dynamometers
from least active to most active ROM
PROM
AAROM (assisted)
AROM
RROM
following major surgery which of the following gradients of muscle activity would you use
PROM
when should strength exercises start
soon after inflammatory phase of healing and when tissue is in the proliferation phase after flexibility and mobility have been restored
T/F straight plane exercises are used to isolate and strengthen weak muscles
true
ex: 4-way ankle
diagonal plane exercises
used after weak muscles is strong to perform activity correctly
progression of strengthening program
isometrics
single plane isotonics
multiple plane isotonics
functional
performance specific
SNAP principle
specific exercises
no pain
attainable goals
progressive overload
SAID principle
Specific Adaptations to Imposed Demands
-a muscles will adapt and perform according to the demands placed upon it
term used to identify a tendon that presents with pain, swelling, and impaired function
tendinopathy
mechanical stress of tendons
repeated stress applied to tendons cause fatigue resulting in tendon failure
vascular supply of tendons
tendons lack good blood supply making them more compromised perfusion, which results in tendon failure
neural basis of tendons
chronic tendon overuse leads to disproportionate substance P neurotransmitter facilitation, promoting mast cell production
intrinsic factors to tendinopathy
age
gender
pathomechanics
genetic or acquired systemic diseases
extrinsic factors to tendinopathy
overtraining
poor equipment or training surface
excessive duration or distance
excessive increases in speed
tendinopathy management
identify cause
correct the cause
identify level of tendinopathy
use eccentric exercises early
T/F according to sliding filament theory, the H-band becomes larger during muscle fiber contraction
false
which type of muscle fiber is white, has moderate fiber size, and high oxidative capacity
type 2a
example of lower extremity OKC activity
straight leg raise
definition of pylometrics
uses quick movement of eccentric activity followed by burst of concentric activity to optimize power output (explosive movements)
mechanical components of pylometrics
contractile (sarcomeres)
noncontractile (collage, elastic)
neurological components of pylometrics
muscle spindles and GTOs
contractile components
myofibrils
-increase speed of cross bridge detachment
-number of cross bridge formations increase
-control the noncontractile components
noncontractile
muscles tendons
connective tissues
series elastic components
tendons, sheaths, sarcolemma
parallel elastic components
muscles CT
concentric contraction
muscle force comes from contractile components and stretch is applied to series elastic components (stretch the muscle = stretch the tendon)
eccentric contraction
series and parallel components resist the muscle movement as muscle elongates
-contractile components controls speed and quality of movement
eccentric movements produce a stretch or
myotatic reflex (aka monosynaptic reflex)
what inhibits muscle activity
GTOs
-as muscle shortens the GTOs send signals to spinal cord to limit force production
3 phases of pylometrics exercises
- eccentric or lengthening phase where the muscle is prestretched
- amortization of transition phase amount of time it takes to change from eccentric to concentric
- concentric or shortening phase to produce the powerful output
pre-pylometric consideration
certain levels of strength, flexibility, and proprioception
intensity of pylometrics
-magnitude of effort applied during activity (stress)
-can change increased weight, height, distance, speed
volume of pylometrics
quantity of work (setsxreps)
depends on intensity and goals
recovery of pylometrics
-amount of rest determines if exercise will be more effective at improving power or endurance
-short = endurance
-longer = power
how often perform pylometrics
rest of 48hrs in between sessions
plyometric considerations
-age: 16+
-body weight: increase stress on joint in heavy PTs
-comp level: more appropriate level of fitness for plyos over recreational PTs
-surface: shock absorbing
-footwear: supportive and shock absorbing
-proper technique
-goals
precautions of plyomtrics
time: avoid long session
DOMS due to nature of plyos
contraindications of plyometrics
-acute inflammation
-postoperative conditions
-instability
if you are focusing on endurance, which of the following activity to rest ratios should you use
1:2
which of the following best describes the proper landing technique for plyometric activities
land on midfoot
functional exercises
-before performance-specific
-involve multiplanar activities, increased stressed and demands
-common across different sports
performance-specific exercises
-mimic tasks found within the sport
-move PT toward safe return to sport
-include exercises and skill drills
assessment of the PTs ability to perform an exercise or skill drills safely and accurately before being allowed to advance to next level
performance evaluation
early to middle program goals
-attain full functional levels of flexibility, strength, endurance, and coordination
-achieve full functional ability so normal speed, power, control, and agility are restored
late program goals
-restore PTs self confidence in their performance and confidence in injured part
-RTP safely and efficiently
considerations for basic to final phase therapeutic exercise
-normal motion
-multifaceted muscle activity
-multiplanar motion and multiple muscle group performance
-stabilization and acceleration changes
-proprioceptive stimulation
-agility and power development
-performance-specific skill development
-confidence development
what is the transition parameter for function or performance specific
proprioception
precautions to functional and performance specific
-explain the exercise to the PT
-avoid pain and swelling
-understand tissue integrity and healing process
-know their confidence level
-be aware of progression tolerance
step by step evaluation determines when the PT should advance to next stage in functional exercise program
final evaluation
-determine if PT is ready to RTP
final functional eval
-occurs before PT is allowed to RTP
-highly individualized
-based on specific demands to be placed on PT upon RTP
-should be as objective as possible
RTP participation steps
- acute S&S of injury are resolved, no pain or edema present
- PT has full ROM, normal strength, endurance, cardio endurance, proprioception, agility, coordination in relation to performance skills
- PT performs all activities as they could prior to injury
- PT has confidence in ability and ability of injured area without hesitation or doubt
performance specific progression would most likely occur in which phase of healing
maturation/remodeling
T/F performance specific exercises are multiplanar activities which are foundation for more specific skill activities
false
what determine progression of functional activities
proprioception
correct order of lower extremity functional progression
NWB -> stork standing -> dynamic -> running
massage characteristics
-collection of techniques
-muscle spasm relief may enhance lymph drainage
-mechanical energy may stretch CT
-little impact on blood flow
-may stimulate muscle repair
light massage
gate control theory explains analgesic benefits (rubbing area overrides nociceptor stimulation)
deep massage
activation of descending analgesic pathway explains relied (endogenous opiates)
deep friction massage
proposed to increase blood flow and disrupt adhesion
myofascial release
activity/injury changes length-tension relationship of fascia and muscles
-gamma efferent neurons activity leads to gamma gain, trigger points, myofascial pain syndrome
-gamma activity from input of pain
indirect myofascial release
place muscle/fascia in relaxed position
direct myofascial release
stretch fascia to decrease stress on afferent input
direct strain-counterstrain
apply force against restrictive barrier to improve motion
indirect strain-counterstrain
move body away from motion-restricting barried to a comfortable position
-slowly move body segment
-hold for 90-120s
long standing pain patterns and related to the spine
myofascial
short-duration pain pattern and during tissue repair and early maturation phase
strain-counterstrain
joint mobilization
restore joint motion, ease pain, improve willingness to move a joint
-uses convex-concave rule
-ex: restore posterior glide of talus post injury
when a convex surface moves on a concave surface, roll and glide are in
opposite direction
when concave surface moves on convex surface, roll and glide are in
same direction
muscle energy
PT actively contracts against counterforce in a specific position
-addresses cause of pain, leads to pain relief and reduced muscle tension/guarding
effectiveness of joint mobilizations
early posterior mobilization of talus may speed recovery and prevent loss of motion after lateral ankle sprain
effectiveness of myofascial release
leads to improvement of 4 PTs with carpal tunnel syndrome
effectiveness of massage
treat LBP, carpal tunnel, and knee osteoarthritis
-low cost, low risk
manual cervical traction
-PT is supine
-clinician relaxes hands and gradually increases force to increase space between intervertebral bodies
-neck position: neutral for upper spine, flexion for lower spine, side-bending to relieve spinal nerves
-break pain-spasm cycle
mechanical cervical traction
continuous or intermittent setting
15-25lbs
20-30min
-may relieve pain from intervertebral disc herniation or stenoiss
precautions for cervical traction
-use manual traction for those with history of cervical spinal injury
-head positioning may compromise vertebral arteries (risk of stroke)
contraindications for cervical traction
-acute injury
-suspected dens fracture
-osteoporosis and RA
lumbar traction characteristics
-relieve pressure on spinal nerves
-used for disc injury (lie prone with extension)
-harness hugs above iliac crests and lower ribs
-PT positioned to decrease pain
precautions for lumbar traction
-belt adjustment on very thin or obese PTs
-inability to tolerate treatment
-claustrophobia from tight belts
contraindications for lumbar tractions
-pregnancy
-hiatal hernia
-advanced osteoporosis
-conditions that affect integrity of CT
intermittent compression characteristics
-reduce edema and swelling
-best treatment of persistent swelling and wounds from venous insufficiency
-game ready and normatec
considerations of intermittent compression
-setup time is time consuming
-PT not actively engages
-pain free active exercises may better assists lymph drainage
contraindications of intermittent compression
-healing fractures
-gross joint instability
-infection
-thrombophlebitis
-pulmonary edema
-congestive heart failure
effectiveness of traction
high vs low dose
-reduce cervical spine pain and radicular symptoms
effectiveness of intermittent compression
comparison of modalities, decrease lower limb and hand edema, effusion post ankle sprain
pain relief from light massage may be explained by what
gate control theory
what is the on time for intermittent compression
30-40 seconds
sacroilium and pelvis create a
closed sacroiliac ring
3 lever points that attach to the pelvis
spine
2 legs
what makes up the lumbopelvic-hip complex
pelvis
sacrum
lumbar vertebrae
hip joints
dsyfunction
lack of stabilization; cause of back and pelvic pain
stabilization
important in relieving pain and in transmitting forces
form closure (SI)
-pelvic ring stability provided by joint shape and structure
-reduced with ligament or bone injury/changes
force closure (SI)
-stability provided by dynamic forces on pelvic
-reduced with muscle (core) injury
neuromotor control (SI)
-proper activation and sequential recruitment of muscles
-dysfunctional recruitment following injury
what makes up the box of the core
diaphragm = top
pelvic floor = bottom
paraspinals and gluteals = sides and back
ability to maintain and control proper SI positioning to provide trunk stability with correct movement of the pelvic and lower extremities
lumbopelvic stabilization
what makes up the inner core (deep muscles)
transverse abdominis
diaphragm
pelvic floor muscles
internal oblique
what makes up the outer core (superficial muscles)
erector spinae
rectus abdominis
external oblique
gluteal muscles
thoracolumbar fascia (QL and lats)
trunk movers are
global muscles (large muscles)
trunk stabilizers are
local muscles (smaller muscles)
pelvis is stable when it is
pelvic neutral
abdominal hollowing
-abdomen drawn in to facilitate transverse abdominis and multifidus
-does not activate outer core muscles (stabilizing)
abdominal bracing
-abdominal and back muscles activate to co-contract (isometric contraction)
-activates outer core muscles
-provides greater pelvic and spinal stability
multifidus is activated when
the transverse abdominis is activated
-causes LBP
-palpated when PT is able to relax erector spinae
combining local and global muscles
maintain pelvic neutral and recruitment of core stabilizers while performing functional and performance specific activities
early rehab core exercises
dead bug
bird dog
goal: recruit core muscles during simple extremity motions while holding proper neutral position
purpose of muscle energy treatment techniques in pelvis and SI
relieve barriers and restore balance
when identifying SI pathology what should you do first
investigate posture, alignment, and lumbar ROM
movement test
-identifies differences in movement between R and L SI sides
-identify presence of SI dysfunction or side of a lesion
standing forward bend test
-aka Piedallus test
-identifies side of lesion
-positive test is when one thumb either does not move or moves up (both thumbs should move down)
kinetic test
-aka Gillet or one-leg stork
-identifies side of SI or IS dysfunction
-positive test: thumb does not move down
alignment tests for SI
passive and used to identify malalignment and reproduce pain
-leg-length, IC height, ASIS height, ASIS to umbilicus
PSIS and Sulci tests
positive when one side is deeper than other
-examines levels of PSIS and sulci
inferior lateral angle test
positive when one side is more posterior and test produces pain
sacrotuberous ligament test
positive when one side is looser than other
SI joints provide a load transfer between
spine and lower extremities
core activation and stabilization steps
-find and maintain pelvic neutral
-abdominal hollowing exercises to recruit transverse abdomnis
-abdominal bracing to activate local and global muscles
-engage abdominal bracing while performing simple ADLs
-engage abdominal bracing while performing sport/work specific tasks
nutation
proximal sacrum (base) moves into anterior tilt relative to ilium
counternutation
posterior tilt of sacral base relative to the ilium
during lumbar flexion what occurs
-sacrum rotates posterior to ilia (counternutates)
-ischial tuberosities move closer together
-iliac crests move apart
what occurs during nutation
-sacral base moves forward and downward
-IC move closer together
-ischial tuberosities move further apart
what occurs during counternutation
-sacral base moves backward and upward
-IC moves further apart
-ischial tuberosities move closer together
bilateral hip flexion
anterior pelvic tilt
-sacrum moves into counternutation
bilateral hip extension
posterior pelvic tilt
-sacrum moves into nutation
what axis does the pelvis rotate on
diagonal axis
sacral flexion injury
MOI: bending and twisting activities, push-pull activities
-common on left side (L sulcus is deeper and L ILA more posterior)
-may feel a pop
-treatment: PT is prone, clinician lifts quad off table and presses on sacrum
-at home: both knees to chest
forward torsion injuries
-sulci are symmetrical after moving into sphinx position
-most common SI injury (L side)
-MOI: bending with twisting, getting out of car quickly
-pain in back, butt, legs
-one side of sacrum is twisted on other
-at home: chest is prone on table and twist hips so knees are off table (same as treatment)
backward torsion injury
-sulci becomes deeper after moving into sphinx position
-MOI: sudden bending and twisting
-pain with extension, pain in low back and butt
-treatment: bend over on table and PT slowly walks up as clinician pressures on sacrum
-at home: press ups or standing trunk extension
anterior iliac subluxation: upslip
-always occurs on R
MOI: fall on butt or step off a curb
-pain on L side, low back, coccyx
-R leg shorter, R IC higher, R sacrotuberous ligament is slack
-treatment: pull R leg while prone
posterior iliac subluxation: upslip
-occurs only on L
-MOI: fall on butt or step off curb
-L leg shorter, L IC higher, L sacrotuberous ligament is slack
-treatment: pull let while supine
anterior iliac rotation
-aka anterior innominate lesion
MOI: occurs with other lesions
-IC is low on involved side, ASIS low, PSIS high
-cervical or lumbar symptoms
-treatment: PT prone and involved leg off table and they resists hip flexion (knee is flexed)
-at home: pelvic tilt and knee to chests
posterior iliac rotation
-aka posterior innominate lesion
-MOI: after a fall or sudden hamstring contraction
-antalgic gait with reduced hip extension on involved side, pain in butt or knee
-ilium posteriorly rotated, ASIS, PSIS, and IC high on involved side; short leg on involved side
-treatment: prone hip extension
-at home: press ups and hip flexor stretches
pubic subluxation
-superior: isometric hip flexion
-inferior: isometric hip extension
-isometric abduction and adduction
(fixes leg length differences)
inflares and outflares
-inflare: distance from ASIS to umbilicus is short on affected
-outflare: distance from ASIS to umbilicus is greater on affected
-common in soccer
MOI: falling on IC or direct blow
-groin, leg, hip pain
-treatment: isometric hip adduction (inflares), hip flexion, adduction, medial rotation at same time (outflares)
-at home: inflares same as treatment; outflares same
program considerations for SI and pelvis
-LBP and hip should be address to eliminate sites of referred pain
-use with hip strengthening and flexibility exercises
-include core exercises, strength, function training for mainenance of pelvic neutral, agility
vertebral artery insufficiency S&S
dizziniess
lightheadedness
nausea
blurry vision
tinnitus
headaches
facial sensory deficiencies
cervical joint mobs
-distraction: aka traction
-central posterior-anterior: apply pressure to spinous process
-unilateral PA: apply pressure to transverse process and move side to side
thoracic joint mobs
-central PA: spinous
-unilateral PA: transverse
-unilateral costovertebral PA: apply pressure where the ribs connect to the vertebrae
lumbar joint mobs
-central PA: spinous
-unilateral PA: transverse
-rotation: rotate the transverse processes of the lumbar or they can rotate themselves
how long should a stretch be held for
30 seconds and only once
what is required for good posture
core support
what is necessary for full spinal recovery
good posture and mechanics
must have endurance for back health
local muscles
must have strength for back health
global muscles
types of strengthening exercises for the spine
aquatic
swiss-ball
foam roller
weights: dumbbells, pulleys, machines, med balls
basic principles of agility and coordination exercises for the spine
-start once strengthening exercises are mastered
-include trunk rotation and plyometrics that involve higher forces, quicker movements, and functional multiplane motions
-pelvic stability should be maintained
ex: resisted leg lifts and med ball exercises (Russian twists)
problems associated with LBP
-reduced proprioception
-reduced muscle endurance
-lack of muscle coactivation
-delayed core muscles recruitment
-hip muscle imbalances
-reduced trunk stability
-muscle coactivation reduces pain
LBP treatment program
-addresses all the problems
-pelvic neutral
-soft-tissue mobilization
-joint mobs
-proprioceptive, strength, endurance exercises
-functional and performance-specific exercises in pelvic neutral
William’s flexion exercises
- sit up in a flexed knee position to strengthen abs
- pelvic tilt to strengthen gluteal muscles
- single knee to chest and double knee to chest to stretch erector spinae
- seated reach to the toes with knees extended to stretch erector spinae and hamstrings
- in quadruped position with 1 knee forward under chest and other hip and knee in extension to stretch TFL and iliofemoral ligament
- starting in standing and moving to full squat to strengthen quads
McKenzie back program
- lie prone for 5 min
- lying prone with elbows under shoulders for 5 min
- prone press-up position; prone with elbows extended out in front of you
- standing trunk extension
- seated cat cows/ slouch to upright
- double knee to chest
integrated rehab program for the spine
-PTs are active
-early use of modalities
-use manual techniques, exercises, and education
-pelvic neutral
-proper posture and body mechanics
-correction of deficiencies
causes of upper and lower crossed syndromes
-poor postural habits
-muscle imbalances: tight and lengthened muscles
tight muscles of upper crossed syndrome
upper trap
levator scapulae
pec
lengthened muscles of upper crossed syndrome
deep cervical muscles
serratus anterior
rhomboids
middle and lower trap
tight muscles of lower crossed syndrome
hip flexors and back extensors
lengthened muscles of lower crossed syndrome
abdominals and gluteals
posture characteristics of upper crossed syndrome
forward head
rounded shoulders
upper cervical spine lordosis
thoracic kyphosis
posture characteristics of lower crossed syndrome
lumbar lordosis
protruding abdomen
anterior pelvic tilt
hip flexion
knee hyperextension
how to treat crossed syndromes
-multifactorial approach
-PT education
-soft tissue and joint treatments
-postural changes
-stretching and strengthening exercises
-changing habits
common spine injuries that require rehab
-sprains and strains
-spondylosis
-spondylolysis
-spondylolisthesis
-disc lesions
-microdiscetomy
-spinal fusion
-facet injuries
-TOS
rehab progression for the spine
-perform a thorough exam
-establish a problem list
-establish goal list
-create treatment program (manual and corrective exercises)
-know injury precautions
-reassess and change program periodically
-move through short to long term goals
cervical and upper thoracic spine rehab inclusions
-core exercises
-posture correction
-all neck and scapular muscles
-lumbar spine
lumbar and lower thoracic spine rehab inclusions
-core exercises
-posture correction
-hip strengthening
-lats strengthening
Fryett’s first law
-regards normal vertebral coupled motions
-when lumbar or thoracic spine is in neutral, side-bendings occurs to opposite side of that vertebral levels rotation
Fryett’s 2nd law
-regards pathological coupled motions
-when spine is in either flexion or extension (out of neutral), side-bending and rotation of the vertebrae will be towards the same side
Fryett’s 3rd law
-regards total available spinal coupled motions
-if motion of the spine occurs in one plane (side-bending or rotation), motion in other plane is diminished
facet dysfunctions
-identify positional dysfunction (position in which it is stuck in) and motion restriction (unable to move into it)
-open vs closed
-left vs right
TOS treatment program
-symptom control via modalities and position instruction
-soft-tissue mobilization of the cervical spine and scapular movements
-improve joint mobility of first rib
-cervical and thoracic spine mobilization
-flexibility and strengthening, once inflammation has subsided
-correction of posture and body mechanics
-breathing instructions
what is a common site for a lumbar area trigger point
QL
what is the final progression of the dead bug exercise
stabilization with arm and unsupported leg movement
the McKenzie back program can be used for what
postural syndromes
where is glycogen stored
mitochondria
during conditioning a volleyball player uses 10lb weight for a elbow curl, his biceps work harder when
muscle contracts concentrically
you are helping a sprinter to work in improving his power, you know that one way to facilitate the muscle spindles in his quads is to have him
stretch quads immediately before sprints
which factor provides a muscles additional force during eccentric contractions
series elastic components and parallel elastic components contribute to overall tension development
true statements regarding plyometric exercises
-plyometrics use quick movements of eccentrics followed by burst of concentric to optimize power output
-with eccentric contraction, the speed of cross-bridge detachment increases
-short neurological pathway of the muscle spindles action is relied upon for force production
microscopic tears of tendon caused by repeated trauma
tendinosis
most importnat treatment element in dealing with tendinopathy is
identifying and relieving the cause
a max isometric contraction can be sustained for how many seconds before fatigue becomes evident
5-10s
ultimate goal of plyometrics
increase power production
T/F a normal functional activity is usually performed in a therapeutic exercise program before plyometric
false
T/F final evaluations prior to returning to activity can be generally subjective
false
an example of an advanced functional activity for a baseball pitcher
throwing a med ball
T/F functional testing may include running, jumping, or agility, tests for time or distance
true
to distract the lower region of the cervical spine, the neck should be placed in
flexion
what are advanced skills needed for performance-specific exercises
speed and control
performance specific progression would most likely occur in which phase of healing
maturation/remodeling
T/F during functional activities, muscles act as stabilizers, accelerators, or decelerators
true
T/F all PNF extremity movements incorporate rotation and diagonal patterns
true
indirect release techniques are most likely to
decrease gamma gain
T/F it is better to overestimate an athletes ability to withstand functional stresses than to underestimate it
false
contraindications for joint mobs
advance osteoporosis
bone to bone end feel
infection
long term goals should include
RTP
pelvic neutral is
-one of first positions taught to PT with a weak core
-position in which spine should always be placed
T/F SI joint has no motion
false
an example of a coupled motion occurs when the pelvis moves into a posterior tilt and
the hips flex
which of the following is a mechanism for backward torsion of SI joint
bending and twisting activities
T/F muscle energy on the SI joint uses a mild resistance to realign joint segments
true
the kinetic test could be used to identify
SI dysfunction
T/F pelvic floor muscles provide pelvic stabilization because of their transverse arrangement in the pelvis
true
a prone plank exercise strengthens
abdominal muscles
muscle of the outer core
external oblique
an SI standing forward bend test indicated
side of lesion
