Lower Limb Treatments

Question 1

How can you assess muscle and tendon tissue?

Answer 1

AROM/PROM differential diagnosis 
Length 
Strength
Isometric 
Palpate for tenderness 
Endurance
Power
Motor control

Question 2

What are some treatment options in the lower limb?

Answer 2

Exercise
Education (pathophysiology/ anatomy, scans/x-rays, prognosis, address yellow flags)
Manual therapy (joint mobs)
SSTM’s (soft tissues)
ICE/ heat
TENS, electrotherapy
Gait re-education, walking aids

Question 3

What does POLICE stand for?

Answer 3

Protection 
Optimal Loading
Ice
Compression
Elevation

Question 4

What are the 5 steps in mechanotherapy?

Answer 4

1. Loading of tissue
2. Stimulates cellular response
3. Tissue adapts
4. Tissue improves structure
5. Tissue able to maintain homeostasis =less pain

Question 5

What does active movements test for?

Answer 5

Contractile and inert tissues

Question 6

What does passive movements test for?

Answer 6

Inert tissues only

Question 7

What are the indications for treating a patient with joint mobilisations?

Answer 7

Restoration of movement to a joint
Pain
Spasm
Joint soft tissue tightness
Specific to the joint

Question 8

What are the effects of joint mobilisations

Answer 8

Improves ranges of active, passive and accessory joint movements
Increased length of joint soft tissue structures
Increasing length of joint surrounding soft tissue structures
Relief of pain
Decreased muscle spasm
Placebo effect

Question 9

What are graded joint/ soft tissue mobilisations determined by?

Answer 9

Sin factor
Position in the range
Relationship to resistance (and pain)
Amplitude

Question 10

What are the different grades and respective amplitudes?

Answer 10

Grade 1- small and fast
Grade 2-large and slow
Grade 3- large and slow into resistance
Grade 4- small and fast into resistance

Question 11

What are some soft tissue treatment techniques?

Answer 11

Specific soft tissue mobilisations 
Deep transverse frictions
Muscle lengthening 
Trigger point 
Exercise

Question 12

What is a physiological SSTM?

Answer 12

Self stretch
Therapist stretch
Engage barrier
Oscillate using mainland grading or static holds

Question 13

What is an Accessory SSTM?

Answer 13

Direct pressure
Bowing
Transverse mobilisations

Question 14

What is a deep transverse friction massage?

Answer 14

Applies force perpendicular to fibre orientation

Brings about numbing 5-8 minutes and then deeper friction for 10 reps

Question 15

How does DTFM work?

Answer 15

Breaks down adhesions
Increases blood supply
Activates cells in the area
Helps reorientate fibres

Question 16

Brainstorm an ideal exercise for lower limb?

Answer 16

Stretching exercise- aims to increase tissue length/ROM. As a static stretch, hold for 30-40 seconds, repeat 3x Daily

Question 17

What other exercises would be possible to do?

Answer 17

Rom exercises- stretches (static or dynamic), active, active assisted, passive
Strength, endurance, power, plyometric exercises
Graded loading
Sports specific
Functional
Balance, proprioceptive exercises