Lower Limb & Trunk General Facts Flashcards
What is the Pes Anerinus? (where is it located)
What forms it?
A region on the medial near where tendinous structures attach.
Provides dynamic medial support to the knee joint, thereby actively resisting abduction of the tibia on the femur (knee valgus) and tibial external rotation
Think Sargent (SGT)
S artorius
G racilis
T Semi Tendinosus
What is Active Insuffficiency?
Refers to a muscle being too short to produce maximal force.
Where a biarticular muscle is shortened at one joint, it cant produce a maximal contraction at the other joint of which it crosses.
What is Passive Insufficiency?
Refers to a bi-articular muscle not being long enough to produce a full ROM at both joints of which it crosses.
–> The length of a 2 joint muscle affects its ability to achieve full range
What muscles provide arch support in the foot?
HINT - There is two mechanisms
Sling mechanisms - the muscles pull the middle of the foot upwards –> attach at the apex of the arch
Sling muscles include Tib Ant, Tib Post & Peroneus Longus
Bowstring Mechanism - muscles that pass across the sole of the foot pulling outwards to maintain the two ends of the arch to maintain the height of the arch
Muscles include Intrinsic foot muscles & Flexor Hallucis or Flexor Digitorum Longus
The Amount of Pelvic movement (COG) is limited because….
- Minimises energy expenditure
- Limits the wear and tear on the musculoskeletal system –> due to a compensation movement of the spine moving when the pelvis moves
- Provides a stable “core” from which the lower limb is able to provide a precise and powerful movement
In CM, Approximately how much movement of the pelvis is there in the vertical direction?
3-5cm –> throughout a normal GAIT cycle
During GAIT what sort of pelvic movement accompanies the preswing phase?
Bonus Point - Explain why/mechanism?
Ipsilateral downward tilt
BONUS POINT
This tilt helps to assist with knee flexion required for the early swing phase
How do trunk muscles achieve more pelvic movement or range?
- via pelvic tilt produced by non-isometric trunk muscles —> non functionally specific for trunk stability
Explain why spine stability is important
- facilitate the weightbearing role of the vertebral bodies
- protection of the intersegmental discs & Spinal Cord
- Provides a stable base for which the lower limb can move from –> indirectly –> due to the spines direct connection to the pelvis via the sacroiliac joints
Why do we want to stiffen the spine?
- prevent unwanted movement
- prevent lateral translation
What is lumbopelvic rhythm and what is its function?
It refers to the coordination of the hip, pelvis and spine movement
It’s function is to:
- increase ROM of the trunk on the lower limb in closed chain and vice versa in open chain
- maintain Line of Gravity (LOG) within base of support using CKC movements to: maintain an upright posture, minimise energy expenditure and limit wear and tear
What are the principles to determine functionally specific exercises for lower limb?
- Muscles targeted (including consideration for active insufficency
- Functional role - mover OR stabiliser
- Contraction mode - Dynamic or static
- ROM
- Load Level
- OKC or CKC
- Unilateral/bilateral
What components make a trunk exercise functionally specific?
- Not working as an agonist (could be synergist)
- Working in mid range
- Isometric contraction
- Upright and weight baring
- Limb is moving on a fixed trunk
What is the main functional role for Peroneus Longus?
Is Predominately a Stabiliser Muscle
- Acts to accomodate for uneven ground during GAIT
- Stabilises the ankle rather than causing a movement at the joint
Exercises of progressive intensity to target Peroneus Longus
- Calf raises - Targets its mover role
- Single leg Wobble board balancing –> targets stabiliser function (its predominate role
- Tip Toe walking - Hardest exercise due to the increased instability within the ankle joint
