Lab- Extremity Counterstrain Flashcards
what is the normal flexion ROM of the shoulder?
180 degrees
what is the normal extension ROM of the shoulder?
60 degrees
what is the normal horizontal adduction ROM of the shoulder?
130-140 degrees
what is the normal horizontal abduction ROM of the shoulder?
40-55 degrees
what is the normal abduction ROM of the shoulder?
180 degrees
where is the tenderpoint of the supraspinatus located?
midsupraspinatus muscle just superior to the spine of scapula
what is the treatment position for the supraspinatus tenderpoint?
patient’s arm is flexed 45 degrees, abducted 45 degrees, and externally rotated
where is the tenderpoint of the levator scapulae located?
in the levator at the superior angle of the scapula
what is the treatment position for the levator scapulae tenderpoint?
internal rotation of the patient’s shoulder with mild to moderate traction with minimal abduction
where is the tenderpoint of the subscapularis located?
anterolateral border of the scapula on the subscapularis muscle
what is the treatment position for the subscapularis tenderpoint?
extension of the patient’s shoulder with internal rotation and traction
where is the tenderpoint of the long head of the biceps brachii located?
over the long head of the biceps tendon in the bicipital groove
what is the treatment position of the tenderpoint of the long head of the biceps brachii?
pt’s elbow and shoulder are flexed, arm is minimally abducted and internally rotated
where is the tenderpoint of the biceps brachii (short head) coracobrachialis located?
inferolateral aspect of the coracoid process on the short head tendon of biceps or coracobrachialis
what is the treatment position for the tenderpoint of the short head of the biceps brachii?
pt’s elbow and shoulder are flexed, arm is minimally adducted and internally rotated
where is the tenderpoint of the radial head located?
supinator muscle; the anterolateral aspect of the radial head at the supinator attachment
what is the treatment position for the tenderpoint of the radial head?
pt’s elbow is fully extended, forearm is markedly supinated, fine tune with valgus force
where is the tenderpoint for the medial epicondyle?
pronator teres muscle; near the medial epicondyle of the humerus associated with the common flexor tendon and pronator teres
what is the treatment position for the medial epicondyle?
the patient’s elbow is flexed, marked pronation, forearm adducted
what is the normal ROM of wrist flexion?
80-90 degrees
what is the normal ROM of wrist extension?
70 degrees
what is the normal ROM of wrist adduction/ ulnar deviation?
30-40 degrees
what is the normal ROM of wrist abduction/ radial deviation?
20-30 degrees
what is flexion of the wrist coupled with?
posterior/dorsal glide of the proximal carpal bones
what is extension of the wrist coupled with?
anterior/ventral glide of the proximal carpal bones
where is the tenderpoint for the dorsal wrist-extensor carpi radialis?
the dorsal surface of the second metacarpal associated with extensor carpi radialis muscle
what is the treatment position for the tenderpoint of the extensor carpi radialis?
pt’s wrist is passively extended and abducted
where is the tenderpoint located for the dorsal wrist- extensor carpi ulnaris?
the dorsal surface of the 5th metacarpal associated with the extensor carpi ulnaris muscle
what is the treatment position for the extensor carpi ulnaris tenderpoint?
pt’s wrist is passively extended and adducted
where is the tenderpoint located for the flexor carpi radialis muscle?
the palmar base of the second or third metacarpal in the flexor carpi radialis muscle
what is the treatment position for the flexor carpi radialis tenderpoint?
pt’s wrist is passively flexed and abducted
where is tenderpoint for the flexor carpi ulnaris muscle?
palmer base of the 5th metacarpal in the flexor carpi ulnaris muscle
what is the treatment position for the flexor carpi ulnaris tenderpoint?
pt’s wrist is passively flexed and adducted
where is tenderpoint located for the abductor pollicis brevis muscle?
the palmer base (radial aspect) of the first metacarpal in the abductor pollicis brevis muscle
what is the treatment position for the abductor pollicis brevis tenderpoint?
pt’s wrist is passively flexed and the thumb is abducted
what is the normal ROM of the hip flexion with the knee flexed?
120-135 degrees
what is the normal ROM of hip flexion with knee straight?
90 degrees
what is the normal ROM of hip extension?
15-30 degrees
what is the normal ROM of hip internal rotation?
30-40 degrees
what is the normal ROM of hip external rotation?
40-60 degrees
what is the normal ROM of hip adduction?
20-30 degrees
what is the normal ROM of hip abduction?
45-50 degrees
where is the tenderpoint of the tensor fasciae latae?
just inferior to the iliac crest in the body of the TFL
what is the treatment position of the TFL tenderpoint?
patient’s knee is abducted and slightly flexed
where is the tenderpoint for the iliotibial band?
along the iliotibial band distal to the greater trochanter
what is the treatment position for the IT band tenderpoint?
patient’s hip/ thigh is abducted and slightly flexed
where is the lateral hamstring tenderpoint?
the distal aspect of the biceps femoris near the attachment to the posterolateral surface of the fibular head
what is the treatment position for the lateral hamstring tenderpoint?
knee is flexed and the tibia is externally rotated with slight abduction; compression on the calcaneus is added to plantar flex the ankle
where is the medial hamstring tenderpoint located?
the distal aspect of the medial hamstring tendons near their attachment to the posterior medial surface of the tibial condyle
what is the treatment position for the medial hamstring tenderpoint?
patient’s knee is flexed and the tibia is internally rotated with slight adduction; compression on the calcaneus is added to plantar flex the ankle
what is the normal ROM of knee flexion?
145-150 degrees
what is the normal ROM of knee extension?
0 degrees
where is the lateral meniscus/ lateral collateral ligament tenderpoint located?
lateral aspect of the meniscus along the joint line
what is the treatment position for the lateral meniscus/ lateral collateral ligament tenderpoint?
pt’s thigh is abducted so leg is off tble, flex knee to 35-40 degrees, tibia is abducted and externally or internally rotated until tenderness is reduced
where is the anterior cruciate tenderpoint located?
superior aspect of the popliteal fossa adjacent to the hamstring tendons
what is the treatment position for the anterior cruciate tenderpoint?
towel roll or pillow under the distal femur for fulcrum, apply a force to the proximal tibia to translate the tibia posteriorly on distal femur
where is the posterior cruciate tenderpoint located?
slightly below the center of the popliteal fossa
what is the treatment position of the posterior cruciate tenderpoint?
towel roll or pillow under the proximal tibia for fulcrum, apply force on distal femur to translate femur posteriorly on the proximal tibia
where is the popliteus tenderpoint located?
in the muscle belly just inferior to the popliteal space
what is the treatment position for the popliteus tenderpoint?
the patient’s knee is flexed and the tibia is internally rotated
where is the gastrocnemius tenderpoint located?
within the proximal grastrocnemius muscles distal to the popliteal margin
what is the treatment position for the gastrocnemius tenderpoint?
pt’s knee is flexed and dorsum of foot is placed on doc’s thigh; add compressive force through the calcaneus
what is the normal ROM of the dorsiflexion of the ankle?
15-20 degrees
what is the normal ROM of the plantarflexion of the ankle?
55-65 degrees
what is the normal ROM of inversion of the ankle?
20 degrees
what is the normal ROM of eversion of the ankle?
10-20 degrees
where is the medial ankle: tibialis anterior tenderpoint located?
anterior and inferior to the medial malleolus along the deltoid ligament
what is the treatment position for the medial ankle tenderpoint?
apply inversion force to foot and ankle with slight internal rotation
where is the lateral ankle (fibularis longus, brevis, and tertius) tenderpoint located?
anterior and inferior to the lateral malleolus in the sinus tarsi
what is the treatment position for the lateral ankle tenderpoint?
apply eversion force to foot and ankle with slight external rotation
where is the quadratus plantae tenderpoint located?
anterior aspect of the plantar surface of the calcaneus at attachment of plantar fascia
what is the treatment position for the quadratus plantae tenderpoint?
pt’s knee is flexed, dorsum of foot on doc’s thigh, marked flexion while translating calcaneus toward the forefoot
where is the navicular tenderpoint located?
medial side of the foot just below the navicular bone
what is the treatment position of the navicular tenderpoint?
pt’s knee is flexed, dorsum of foot on doc’s thight, plantar flexion of the subtalar joint, supination of the forefoot
