Pelvis and lumbar spine

Question 1

Pelvic Joints

Answer 1

o Pubic symphysis
o Sacroiliac Joint
o Femoral joint

Question 2

Muscles Superior to Pelvis

Answer 2

Quadratus Lumborum (QL) 
o	Deepest abdominal muscle
o Supports posture, stabilizes spine during side bending or lower back extension

Question 3

Muscles Inferior to Pelvis

Answer 3

Groin Muscles 	
Adductor Brevis	
Adductor longus	
Adductor magnus	
Gracilis

Hip extensions
Gluteus maximums
Gluteus mindius
Rectus Femoris

Hip Flexors
Sartorius

Question 4

ITB Syndrome (ITBS)

Answer 4

• Over activity in ITB can result in pain and tightness

Results from overuse, technique flaws (cycling ‘toe in’ or excessive knee flexion), muscular weakness (e.g. abductors, lateral rotators of femur)

Question 5

Hip Internal and External Rotation

Answer 5

Open chain movements of the muscles involved rotate the femur

Closed chain movements contribute to pelvis & trunk balance over the lower extremity

Question 6

Sacroiliac Joint (SIJ) Dysfunction

Answer 6

Inflammation of the sacroiliac joint

Question 7

Iliopsoas Tightness

Answer 7

Chronic tightness in psoas (and iliacus) resulting in tension, pain and/or spasms in the lower back, hips, pelvis or buttocks (possibly sciatic issues)

May be triggered by overuse (sports) or prolonged sitting (especially leaning back)

Question 8

Groin Strain

Answer 8

Strain to any adductor muscle, leading to pain and loss of function
- Repeated strain of active muscles

Question 9

Rectus Femoris Strain

Answer 9

May result from RF (or general hip flexor) tightness or poor eccentric strength; usually acute rather than overuse

• stimulate hip extension and hip flexion (Kicking

Question 10

Hamstring Injury

Answer 10

Most common non-contact injury in many running-based sports (>1/3 of all injuries in soccer)

• Connective tissues and extracellular matrix
• Stretch type injury mostly in semimembranosus, and sprint type mostly in biceps femoris (long head)

Question 11

Lombard’s Paradox

Answer 11

Rectus femoris has a smaller moment arm than hamstrings at the hip but larger moment arm at the knee, so simultaneous rectus femoris and hamstrings activation causes hip and knee extension â this improves efficiency during gait but may increase injury risk when hip and knee either extend or flex at the same time (muscles work at longer lengths)

Benefits
- ( Rectus femoris) hamstrings co-activation tends to extend the hip (hamstrings win) and extend the knee (RF wins)

Costs

RF significantly stretched during hip extension with knee flexion (leg cocking in kicking, and end of swing phase in running)

Hamstrings significantly stretched during hip flexion with knee extension (end of kicking follow-through and end of recovery phase in sprinting)

Question 12

Core Stability

Answer 12

Refers to ability to maintain pelvic and spinal posture during movements

Question 13

Core stability Stages (3)

Answer 13

Stage 1
Ability to activate or control muscles

Stage 2
Active during complex task

Stage 3
Sports or ADL practice/drills

Question 14

Four main bones involving the pelvic girdle

Answer 14

Ilium, ischium, sacrum, coccyx

Question 15

Muscle anterior to pelvis

Answer 15

Psoas minor/major

Iliacus

Question 16

In a closed kinetic chain task, the main action of the gluteus maximus muscle will be to:

Answer 16

Extend the hip, causing the upper body to rotate backwards (erect the body upright)

Question 17

The ‘sprint-type’ hamstring injury:

Answer 17

Most commonly occurs in the long head of biceps femoris (usually in the transition from leg recovery to swing phases or just prior to foot-ground contact), is linked to suboptimal muscle strength (particularly eccentric strength) and running technique flaws, and may be more likely to occur when the muscles are fatigued

Question 18

Osteitis pubis, causing pain at the front of the pubic bone region, has the following characteristics:

Answer 18

Usually an overuse injury that may be associated with weak internal rotators, requiring correction of observable muscle imbalances and flexibility/mobility limitations around the pelvis/hip region then slow return to exercise/sports with focus on optimisation of running and kicking technique