PF disorders part 2 Flashcards
1
Q
summarize PFP rehab
A
- avoid exacerbating activities
- improve lower limb mechanics and NM control
- improve hip strength and quad strength
- correct patellar positioning and tracking
- stretching and mob of quads, HF, calves, hip, lumbar, ankle, knee joints
2
Q
what should you not do for PFP?
A
- manual therapy in isolation
- dry needling
- biophysical agents like cryo, US, iontophoresis, ESTIM, laser
3
Q
explain patellar subluxation/dislocation
A
- lateral displacement most common
- commonly occurs with knee in 20-30 degrees of flexion but may also have valgus load at knee
- may have associated fracture of patella, osteochondral fracture of patellar or femur and/or chondral defect
noncontact injury: femur goes into IR and adduction with very strong quad contraction
if they have had dislocation: get imaging
4
Q
what are the structural patellar instability risk factors?
A
- patellar hypermob
- increased q angle
- shallow trochlear groove
- flat patella
5
Q
what are the NM patellar instability risk factors?
A
- dynamic valgus pattern
- hip msucle weakness
6
Q
what is the q angle?
A
- ASIS to middle patella to tibial tuberosity
males: 10-14
females: 15-17
7
Q
what happens wtih patellar subluxation/dislocation
A
- effusion
- common damage to distal attachment of medial quad tendon
- medial retinaculkum and medial patellofemoral ligament damage
- evaluated w apprehensino test and moving/dynamic patellar apprehension test
8
Q
what is post patellar subluxation/dislocation rehab?
A
- R/O fracture
- reduce effusion by RICE
- restore rOM and muscle function (full ROM at 8-10 weeks)
- brace if unstable
- correct altered movement patterns
to reduce dislocation: extend knee and push patella medially