Lower Extremity Rehab

Question 1

segmental stabilization of the glutes**

Answer 1

force closure of SI
control and centralize the femur in acetabulum
co-contraction with psoas major provides pelvic stability
segmental stagilizer through tensin TL fascia and triggering deep lumbar multiifdus

Question 2

eccentric lengthening or isometric holding to control ROM of glutes**

Answer 2

sagittal plane stabilization of trunk
controls trunk rotation during gait through connection with latissimus
frontal plane stabilizer during single leg (trendelenburg)

Question 3

produce high force or power (glutes) *****

Answer 3

hip extension
external rotation
superior fibers (abductors)
lower fibers (adductors)

Question 4

what are the different corrective exercises?

Answer 4

inhibit techniques (self-myofascial release)
lengthen techniques (static stretching, neuromuscular stretching)
activate techniques (positional isometrics, isolated strengthening)
integration techniques (integrated dynamic movmemnts)

Question 5

phases of healing

Answer 5

acute inflammatory
subacute proliferative
chronic remodeling

Question 6

what is the presentation for hip injury?

Answer 6

trauma
sharp stabbing pain, catching, locking, giving way- usually on anterior side of joint
exacerbations (twisting, prolonged fleion-sitting, rising from sitting, inclines, difficulty with socks and shoes)

Question 7

modified thomas test for hip flexors

Answer 7

mobility assessment of iliacus/psoas major/rectus femoris/TFL-IT band
tightness will limit hip hyperextension in gait leading to anterior pelvic tilt and weakness in glutes

Question 8

hamstring muscle length

Answer 8

mobility assessment of hamstrings
tightness usually result of glute weakness
hamstrings pick up most of the extension load of the leg
common occurence with hamstring strains

Question 9

pelvic tilts

Answer 9

evaluate the patient’s ability to mobilize and control movments at the pelvis
movment must be smooth, no shaking
arthridities can limit motion
tight hip flexors, paraspinals, weakness in abs and glutes

Question 10

step down

Answer 10

functional hip control
similar to single leg squat
hands on hips
avoid trunk lean
neutral pelvis
knee over 2nd toe

Question 11

pelvic rotation

Answer 11

move lower body without upperbody movement
requires mobility of the spine, hips and pelvis while stabilizing the roso
hip rotators and oblique abs ro rotate

Question 12

bridge with leg extension

Answer 12

tests primarily gluteal strength
highlights inhibition of gluteals and reliance on synergists muscles (hamstrings and paraspinals)
cramping of hamstring key sign

Question 13

hip extension motor pattern

Answer 13

patient prone
lock knee and lift leg at hip
monitor the sequence of muscle contraction
one hand near top of gluteal muscles
feel for timign of muscle activatoin

Question 14

how should the muscles react during hip extension+?**

Answer 14

ipsilateral hamstring
ipsilateral glutes
contralateral T/L paraspinal
ipsilateral T/L paraspinals

Question 15

how do you retrain hip extension motor pattern?

Answer 15

prone
toes on table
straighten knee (knee extension, no activation of spinal erectors should be used)
progress to gluteal activation
work on speed of contraction
no activation of extensors
after this is achieved add full extension of the hip

Question 16

hip abduction motor pattern***

Answer 16

glut med activation
patient side lying
abduct and internally rotate hip
patient attempts to maintain position
watch for movment of leg from original position

Question 17

rehabilitation exercises for abduction of hip

Answer 17

focus on effects of lower cross syndrome
tightness (hip flexors, paraspinals)
inhibition/weakness (gluteals, abdominals)