hip and ankle tidbits

Question 1

5 predictive hip OA variables

Answer 1

1) squatting aggrivates it
2) hip flexion causes lateral hip pain
3) scour+ adduction causes lateral hip/groin pain
4) hip extension= pain
5) passive IR <25 degrees

Question 2

what is internal snapping hip?

Answer 2

illiopsoas snaps over structures like femoral head, lesser trochanter, AIIS, iliopectineal eminence during flexion! –OR it is tenosynovitis of the iliopsoas insertion

Question 3

what is external snapping hip?

Answer 3

IT band or glut. max snaps over greater trochanter

Question 4

best indicator of acetabular labral tears in hip?

Answer 4

pt reporting clicking

Question 5

femoral acetabular impingement?

Answer 5

cam or pincer, probs with either femoral head or acetabulum

Question 6

gait abnormality with LCPD?

Answer 6

outtoe, drag leg, trendelenberg

Question 7

what is a person with LCPD limited in?

Answer 7

IR and abduction

Question 8

best exercises to get the gluteals and TFL activated

Answer 8

> clamshell with band
side step in squat with band (monster walks)
unilateral bridge
quadruped hip extension with knee flexed, sole of foot to cieling
quadruped hip extension with knee extended, donkey kicks

Question 9

what is a small benign tumor that is very painful and occurs in teenage boys most often. symptoms are a dull chronic ache, hip/knee/thigh pain with tenderness and hip ROM limitations? it is worse at night and occurs in the prox. femur and pelvis?

Answer 9

osteoid osteoma

Question 10

What might the dx be if there is pain in the R medial thigh and femoral triangle causing mm spasms and R hip flexion contracture. there is IR of the R hip and the pt is experiencing fever and night sweats, also possible GI symps and hx of chron’s disease, apendicitis, diverticulitis or AIDS.

Answer 10

psoas abcess

Question 11

what is the dx if a person has feeling of fullness in hip joint, limited flex, abduction and ER and has a fever

Answer 11

hip hemarthrosis

Question 12

pain with groin that radiates down into lower abdomen, accompanied by nausea, vomitting, tender abdominal palpation.

Answer 12

ureteral pain

Question 13

4 As that sometimes contribute to hip pain?

Answer 13

Ascites and

Abdominal Aortic Aneurysm

Question 14

when are peroneals most active during gait?

Answer 14

terminal stance

Question 15

dx with pain post. to lateral malleolus that is inc. by activity after prolonged inactivity. pain with heel raises, weak peroneals in MMT.

Answer 15

peroneal tendonitis

Question 16

what glide is good for peroneal tendonitis?

Answer 16

lateral calcaneal glide

Question 17

chronic inflammation of prox. plantar fascia can lead to entrapment of what nerve?

Answer 17

lateral plantar nerve

Question 18

how do u tell if its nerve pain?

Answer 18

pain with non weight bearing and at night, increased pain with use of orthotic

Question 19

DF stretching protocol with achilles tendon repair

Answer 19

0-2 weeks= DF to neutral
3-4 weeks= DF to 5
4+ weeks = inc. DF as tolerated

Question 20

what is most important to focus on with regaining ankle ROM?

Answer 20

DF/PF, a lil eversion, inversion will come with walking!

Question 21

best way to strengthen quads after ACL repair?

Answer 21

closed chain 30 degrees-0, open chain is stressful on ACL

Question 22

how soon should a pt have full ROM after an ACL repair?

Answer 22

full extension ASAP!
flexion:
90 deg. week 1
120 deg. week 2
full ROM weeks 3-4

Question 23

when can ACL repairs return to sport?

Answer 23

autograft- 4-5 mo.

allograft- 6-9 mo.

Question 24

meniscal repair precautions

Answer 24

ttwb x4 weeks
no loaded flexion x4weeks,
no twisting or rotation but compression/decompression and full Ext. and ER are good for nutrition and healing

Question 25

carticel transplant precautions

Answer 25

no WB x4wks

no twisting/pivoting x12 wks

Question 26

regaining ROM for patellar tendon repair and for medial patella femoal ligament repair? (same protocol)

Answer 26

increase by 30 degrees flexion every 2 weeks then Full ROM by 6-8 wks

Question 27

MPFL repair restriction

Answer 27

no open chair knee extension, return to fxnl acts 20-24 weeks out

Question 28

how to predict possible injury in a person’s movement patterns?

Answer 28

Functional movement screen, need score of at least 14 for min. risk of injury, score of 13 or <= high risk of reinjury

Question 29

7 parts to a functional movement screen?

Answer 29

deep squat
hurdle step
IN line lunge
shoulder mobility
active SLR
trunk stability push up
rotary stability