Midterm Material Flashcards
Weak Muscles UCS
“Really? My Love, Share Too Much Info(TMI)
PDLCC
Rhomboids, Medial and Lower Trapezius, Serratus Anterior, Teres Minor/Infraspinatus, Posterior Deltoid, Longus Coli and Capitus (Deep Neck Flexors)
UCS Syndrome TIGHT Muscles
PLUSS SLR
Pectoralis Major and Minor, Levator Scapulae, Upper Trapezius, Subscapularis, SCM, Latissimus Dorsi, Rectus Capitus, Scalenes
Arthokinematic UCS
C0-C1 Cervico-thoracic Thoracic - Rib AC Joint SC Joint GH Joint
Neuromuscular Dysfunction UCS
Excessive ______ P______
______ Winging
Early Excessive _______ Elevation
Excessive Cervical Protraction
Scapular Winging
Early Excessive Scapular Elevation
Pronator Distortion Syndrome WEAK Muscles
“Troys Analogy”
Posterior Tibialis Anterior Tibialis Vastus Medialis Oblique Fibers Biceps Femoris Gluteus Medius
Pronator Distortion Syndrome TIGHT Muscles
“Pam HAd TIme 2 Pee”
Peroneals Medial Hamstring Adductors TFL/ITB Psoas
Arthokinetic Dysfunctions Pronator Distortion Syndrome
1st MCP
SubTalar Joint
Tibiotalar Joint
SI/IS/PS Joint
NeuroMuscular Dysfunction Pronator Distortion Syndrome
↓ P____ and Control of the F____ and A_____
↓ ______ and ____ Plane control at the Knee
↑ Compensation of the
Decreased pronation and control of the foot and ankle
Decreased frontal and transverse plane control at the knee
Increased compensation of the LPHC
(Lumbar Pelvic Hip Complex)
Name 7 muscles prone to tightness and hypertonicity when the Glutes shut off (inhibited) due to PSOAS Tightening
GHAIT QLP
Gastrocnemius/Soleus Hamstrings Adductors ITB/TFL (Iliotibial band / tensor fascia lata) Thoracolumbar Fascia Quadratus Lumbordum Piriforms
LCS TIGHT Muscles
PARS
Psoas
Adductors
Rectus Femoris
Superficial Erector Spinae
LCS WEAK Muscles
“Lamde Sells Geek Books”
Lower Abdominals Multifidus Deep Erector Spinae Gluteus Maximus Biceps Femoris
Articular Dysfunction LCS
“SIIP on ST Juice”
Neuromuscular Dysfunction
“ADI”
Sacroiliac joint Iliosacral joint Iliofemoral Joint Proximal Tib/Fib Subtalar joint
Altered Hip Extension
Decrease in Frontal Plane Stabilization
Increase in Lumbar Extension
- Joint by Joint Theory by Janda ____, _____, _____ are ______ integrated. What two systems work together to as sensorimotor?
- The muscular system often reflects the status of which system?
- Stable or Mobile Articulations
SMS MSM SMS (Foot to C-spine w/ excpetion)
Elbow, Wrist, Hand
- Theory: joints, muscles, and nervous system are
functionally integrated. Sensory and motor - Sensorimotor
Foot-S Ankle- M Knee- S Hip- M LumboPelvic- S Thoracic - M Scapulothoracic Articulation- S GHJ- M Cervical Spine- S - exception of C0, C1, C2 (Mobile)
Elbow, Wrist, Hand
SMS
Steindler, 1955
“A kinetic chain is a combination of several successively arranged joints constituting a complex _______ ______”
motor unit
Clark, 2001
“The kinetic chain is made up of the soft tissue system (_______, _______, _______, and fascia), neural system and ______ system, which is composed of ST, nerves and joints”
muscle, ligament, tendon and fascia (s/t system)
Each component system within the kinetic chain works interdependently to allow structural and functional efficiency. If any of these systems do not work efficiently, what 2 things occur that lead to
- Tissue Overload
- Decreased ________
- Predictable ______ of ______
Compensation and Adaptation
Tissue overload
Decreased performance
Predictable pattern of injury
The spinal stability system has 3 musculoskeletal subsystems, what are they?
Passive
Active
Neural/Feedback
Passive musculoskeletal subsystem consists of ____ ___
which has a tranducer and structural function.Explain
spinal column
Transducer- mechanorecpetor signals
Structural - spine stiffness
Active musculoskeletal subsystems consists of ______ to move spinal column. This subsystem is primarily responsible for muscle activation and coordination.
spinal muscles
Neural and feedback subsystem
neuromuscular control unit - Communication
The three subsystems work together to accomplish basic __________ functions of the spinal system
biomechanical
Describe the normal function of the Spinal Stabilizing System
Intact mechanoreceptors (tranducer function) send signals to NM control unit causing a normal muscle response pattern.
Mechano–>NMCU–> Muscle Response
Ligaments play both a role in joint _____ and _____
Joint stability and proprioception
- Joint mechanical properties of ligaments allow for joint stability
- Sensory (Stimulates neurons, affect muscle spindle system leading to proprioception)
TQ: The sensory properties of ligaments can stimulate ______ that control muscle stiffness (structural function ) and coordination and lead to _________ stability.
neurons
joint stability
Slide 16 Week 1 “Failure of Ligaments” *
Tats and Cats Analogy
Injured Mechanoreceptor
↓
Corrupted Tranducer signal
↓
Corrupted Muscle response pattern
↓
Adverse Conditions (higher facet load, muscle fatigue, etc)
↓
Tissue Inflammation
↓
Chronic PainIn the Stokes and Iatrick (2004) article titled, “Mechanical Conditions that Accelerate Intervertebral Disc Degeneration,” is concluded that probably any abnormal loading conditions (including overload and immobilization) can produce tissue trauma and/or adaptive changes that may result in disc degeneration.
Adverse mechanical conditions can be due to external ________, or may result from impaired neuromuscular control of the ________ and ________muscles
external forces
impaired neuromuscular control of
1. paraspinal muscles
2. abdominal muscles
Proprioceptive Deficit and LBP
Lee AS, Cholewicki J, Reeves NP, Zazulak BT, Mysliwiec LW. Comparison of trunk proprioception between patients with low back pain and healthy controls. Arch Phys Med Rehabil. 2010 Sep;91(9):1327-31.
Conclusion suggest that impairments in proprioception may be detected in patients with ______ when assessed with a motion perception threshold measure.
LBP
Faulty mvmt of foot can travel all the way up the kinetic chain. Over pronated foot (pes planus)
ipsi genu valgus –> ipsi coxa varus –> ipsi dropped
iliac crest –> ipsi lumbar scoliosis –> contra thoracic scoliosis–> ipsi dropped shoulder
IT band syndrome “Tight Psoas”
Stretch Psoas
Strengthen Glutes
Three things to decrease ankle dorsiflexion
- Anterior talus Subluxation
- Tight Gastroc and/or soleus
- Scar tissue in the anterior aspect of the talus
Lateral Line can affect tightness in ITB syndrome
Tightness in intercostal muscles as an exmaple
three goals to assess spinal stability
identify loss of stability
identify loss of motor control
identify aberrant recruitment of motor patterns
Most important attribute for spinal stability?
Endurance
Spinal stability in neutral posture 5-10 maximal volunatry contraction (MVC) of ________ and _______ muscles
paraspinal and abdominal
Overloading and Immobillization which causes the most problem, example
immobilization
i.e. sitting for prolonged times
Postural Muscles - responsible for maintaining posture especially during gait
o Type I Slow _______
o Tend to be ______ and tight
o Stabilizers
o Triceps surae (gastroc + soleus), Hamstrings, Adductors, Rectus Femoris, TFL, Iliopsoas
o Erector spinae, QL
o Pecs, Upper traps, SCM, suboccipitals, masticatories
Slow twitch
short and tight
Stabilizers
Triceps Surae (Gastro/Soleus)
Short foot exercises
Sit, flex toe training abductor hallucis longus
Proprioceptive Deficit and Neck Pain
Falla D, Jull G, Hodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004 Jul;157(1):43-8.
Conclusion: the delay in neck muscle activity associated with movement of the arm in patients with neck pain indicates a significant _______ in the automatic _______ control of the cervical spine
deficit in the automatic feedforward control of the cervical spine.
Altered Muscle Response and Resolved LBP
MacDonald D, Moseley GL, Hodges PW. People with recurrent low back pain respond differently to trunk loading despite remission from symptoms. Spine (Phila Pa 1976). 2010 Apr 1;35(7):818-24.
Conclusion: Despite symptom remission, Deep Muscle EMG during predictable loading and Superficial Muscle EMG during unpredictable loading were______ in people with recurrent ____ than healthy participants
less
LBP
Basically, even though patients were symptomatic (previous Hx LBP), deep and superficial EMG were less in ppl that had previous recurrent LBP.
Altered Muscle Response and Resolved LBP
Cholewicki J, Greene HS, Polzhofer GK, Galloway MT, Shah RA, Radebold A. Neuromuscular function in athletes following recovery from a recent acute low back injury. J Orthop Sports Phys Ther. 2002 Nov;32(11):568-75.
Conclusion: Objective measures of neuromuscular function indicated an a______ m________ response pattern to sudden trunk loading in athletes following their clinical recovery from a recent acute ______.
Altered Muscle response
LBI (low back injury)
Residual Functional Deficit
Residual Functional Deficit in Pts with Hx of LBP: Nadler
- Athletes with resolved LBP were ______ in a 20m
shuttle run vs healthy athletes - Athletes w/ resolved lower extremity injuries were
slower in 20m shuttle run vs healthy athletes
Conclusion - Kinetic chain deficits may exist long after symptomatic ________ from injury resulting in functional deficits, which may be missed on a standard
physical assessment
slower
recvery
Janda believes that muscles are at “functional crossroad” between _____and _____and that the motor system
acts as a window into the CNS function.
CNS and PNS
Rehabilitation Program Design and Motor Control Re-programming
Boudreau SA, Farina D, Falla D. The role of motor learning and neuroplasticity in designing rehabilitation approaches for musculoskeletal pain disorders. Man Ther. 2010 Oct;15(5):410-4.
CONCLUSIONS: Rehabilitation efforts that attempt to maximize the extent of cortical neuroplastic changes stand to provide the greatest potential for _______ success.
rehabilitation success
Layered Syndrome
LCS + UCS = Layer Syndrome (Posterior view-S t A R)
Hypertrophic- THE-T & C
Hypotrophic - Stick Man 2 triangles, an F, an Rectangles
Posterior View - Rhomboids, lower/middle trap, serratus anterior
T-Traps (Upper)
H- Hamstrings
E- Erector Spinae of Thoraco lumbar
C-cervical Erector Spinae
Lower stabilizers of the Scap
Lumbosacral Erector Spinae and Glute Max
Static, tonic, postural muscles tend to become _______
Dynamic, phasic muscles tend toward _______/______
tight
weakness/inhibition
5 Muscles that are synergistic dominant with Iliopsoas TIGHT, Glutes inhibited/weak
HIT QLP
Hamstrings ITB/TFL Thoraco Lumbar Fascia GL Piriformis
