Lower Extremity Flashcards by Yessenia Gutierrez

CAM

femoral head shape is round and thickened

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Pincer

front rim of acetabulum is elongated

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What are two types of femoro-acetabular impingement?

- Pincer

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Tight psoas leads to what?

anterior pelvic tilt

- weak glutes

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What causes tight hamstrings?

weak glutes

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What are some functional hip tests?

pelvic tilts
step downs
pelvic rotation
bridge with leg extension

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What are things to look for in step downs?

trunk lean
neutral pelvis
knee over 2nd toe

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What is the hip extension motor pattern?

ipsi hamstring
ipsi glut
contra paraspinal
ipsi paraspinal

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What is tight in lower cross syndrome?

hip flexors
paraspinals
IT band

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What is inhibited in lower cross syndrome?

glutes

- abdominals

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What is a stride?

heel strike of right foot to heel strike of right foot

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What is a step?

heel strike of right foot to heel strike of left foot

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How much does the patella increase extension force?

30%

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What areas are prone to mobility loss?

ankle
hip
thoracic spine
gleno-humeral
upper cervical spine

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What areas are prone to stability loss?

knee
lumbar spine
scapula
lower cervical spine

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What is the patellofemoral joint reaction force at walking level?

0.5 x body weight

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What is the patellofemoral joint reaction force with the knee flexed to 90 degrees?

2.5 to 3 x BW

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What is the patellofemoral joint reaction force in climbing and descending steps?

3 to 4 x BW

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What is the patellofemoral joint reaction force when squatting?

7 to 8 x BW

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What is the patellofemoral joint reaction force when jumping?

20 x BW

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At what angle in the patellofemoral joint reaction force decreased?

between 0 to 30 degrees

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What is the Screw Home Mechanism?

external tibial rotation and anterior glide of the medial tibia during final 20 degrees of knee extension

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What does the Screw Home Mechanism do?

tightens both cruciate LIG
locks the knee
tibia in max stability
allows quads to relax while standing

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What is the function of the popliteus?

unlock knee to begin knee flexion

- externally rotates femur

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What is a normal Q angle?

10-15 degrees

What can an increased Q angle lead to?

lateral patellar tracking

What is maltracking of the patella?

medial or lateral deviation of 1/4 - 1/2 the width

What are active patella stabilizers?

- vastus medialis | - vastus lateralis

What are passive stabilizers of the patella?

- femoral groove - lateral patellofemoral LIG (w/ IT band) - medial retinaculum

What is the MC type of patellar maltracking?

lateral patellar tracking

What is the MC cause of lateral patellar tracking?

- VMO inhibition due to inflammation | - facilitation of ITB

What is the treatment for lateral tracking?

-train VMO -terminal arc extension ==>TKE -stretch ITB -taping/bracing

What are other causes of lateral tracking?

- pronated ankle - internal tibial ROT - inc valgus stress

What is the MC cause of knee pain in teenagers and young adults?

patella-femoral dysfunction

What causes PF dysfunction?

delayed onset of vastus medialis relative to lateral quad

Tightness of what muscles are risk factors for PF dysfunction?

- gastroc - hamstring - quad - ITB

What biomechanics are risk factors for PF dysfunction?

- excessive pronation - femoral anteversion - patella alta

What is patellofemoral pain associated with?

reduced hip abduction and rotation strength

What is the treatment for PF dysfunction?

- eval glute medius - eval stability at foot arch - eval activation of VM

What does the ACL limit?

- anterior tibial translation | - internal rotation

How do ACL tears occur?

landing from a jump | increased valgus stress

ACL incomplete tear - | ROM

prevent knee extension beyond 40 degrees flexion

ACL incomplete tear - Strengthen

hamstrings ==>isometric ==>half-squat

ACL incomplete tear - stretch

soleus | ==>stabilizes knee during gait

What is medial tibial stress syndrome?

tendonitis/periostitis of anterior tibialis, posterior tibialis or medial soleus

Who are most affected by medial tibial stress syndrome?

-female runners ==>especially with female athlete triad -military recruits -novice runners

Anatomic risk factors for medial tibial stress syndrome

- leg length difference - pes planus - hyperpronation - femoral neck anteversion

What are some complications/differentials of medial tibial stress syndrome?

- compartment syndrome | - tibial stress fx

Where is the MC location for a tibial stress fx?

distal 1/3 of shaft

What are some provocative tests for medial tibial stress syndrome?

- plantar flexion against resistance - passive dorsiflexion - standing on tiptoe - jumping in place

What are some preventative exercises for medial tibial stress syndrome?

- arch stability | - glute medius stability

What is achilles tendinopathy?

clinical syndrome of overuse tendon injury with pain, swelling and/or functional limitation

What is not considered to be a part of achilles tendinopathy?

inflammation

Who does achilles tendinopathy typically affect?

mid-aged men

Other than exercise, what are other causes of achilles tendinopathy?

- shoes with tight heel | - high heels to sandles or barefoot walking

What is the treatment for achilles tendinopathy?

eccentric calf muscle training

What makes up the Deltoid LIG?

- anterior tibiotalar LIG - posterior tibiotalar LIG - tibionavicular LIG - tibiocalcaneal LIG

What ligaments are found on the lateral aspect of the ankle joint?

- anterior inferior tibiofibular LIG - anterior talofibular LIG - calcaneofibular LIG

Acute phase ankle rehab

- PRICE | - pain free ROM

Subacute phase ankle rehab

- Active/Resisted ROM - adjusting - gastroc/soleus stretching - resistance exercise - proprioception

What are some possible risk factors for plantar fasciitis?

- inc in running distance - faulty running shoes - cavus foot (high arch) - shortened achilles tendon

Site of tenderness in plantar fasciitis

- posterior: heel pad - medial: medial calcaneal nerve - no tenderness: DJD in subtalar joint

What are some treatment options for plantar fasciitis?

- strengthen tibialis anterior and posterior - intrinsic foot muscles - myofascial release - adjusting

What is the name of the technique utilized to stabilize the foot arches?

Janda's short foot exercise

What is the best tool that effects swelling?

1. pain free ROM 2. compression 3. ice 4. adjustment

What is the MC mechanism of injury of the deltoid LIG?

inversion via compression forces