Prox Lower Limb (chris)

Question 1

what position is our hip in normally (SP)

Answer 1

approx. 10 ant tilt (natural inclination)

Question 2

why do runners need good hip extension range?

Answer 2

because if they have a limitation here, the hamstrings will be in an eccentrically lengthened position, increasing risk of injury

Question 3

describe the constraint’s of hip motion

Answer 3

extra capsular: synovial membrame, iliofemL, ischofem L

intracapsular: Lof head of femur, labrum, bony geometry etc.

Question 4

what determines the amount of hip flexion we achieve in gait? (2)

Answer 4

• stride length

- ant pelvic tilt

Question 5

name hip flexors (sagittal plane)

Answer 5

iliopsoas, sartorius, rectus femoris

Question 6

name hip extensors (sagittal plane)

Answer 6

gluteus maximus, biceps femoris (long head), semitendinosus, semimembranosus, adductor magnus (post. head)

Question 7

name hip abductors (coronal plane)

Answer 7

gluteus medius (all fibres), gluteus minimus (all fibres), TFL

Question 8

name hip adductors (coronal plane)

Answer 8

pectineus, adductor longus, adductor brevis, aductor magnus (both heads), gracilis

Question 9

name hip external rotators (transverse plane)

Answer 9

gluteus maximus, piriformis, obturator externus, gemellus superior, gemellus inferior, quadratus femoris

Question 10

name hip internal rotators (transverse plane)

Answer 10

gluteus medius (ant fibres), gluteus minimus (ant fibres), TFL, adductor longus, adductor brevis, pectineus

Question 11

name the 2 distinct joints of the knee

Answer 11

1. tibiofemoral

2. patellofemoral

Question 12

if you rupture your ACL what motion can’t you do?

Answer 12

side to side motion e.g. cutting in skiing, surfing, golf, netball

Question 13

what has chris told us about menisci

Answer 13

they are hella important.
- if you do your ACL then they will probably need to take off the flaky bits of menisci which leads to increase medial knee OA

Question 14

what is the “normal” position of the tibiofemoral joint?

Answer 14

normally in some degree of valgus

Question 15

should we see any hyperextension of the knee in gait?

Answer 15

no way! if you see that then something is not right…

Question 16

if you see external rotation of the tibia during gait where /why do you think that’s happening?

Answer 16

its from the hip probs (i.e. not the foot)

Question 17

if you see internal rotation of the tibia during gait where /why do you think that’s happening?

Answer 17

its probably from STJ pronation (i.e. the foot not the hip)

Question 18

what is the “screw home mechanism of the knee”?

Answer 18

during the last 20 degrees of extension tibia rotates approx. 10 degrees (during late swing)

Question 19

if you see a really loose unstable knee in extension during swing then they probably have an issue with their…

Answer 19

screw home mechanism

Question 20

if you see a really locked up rigid knee in extension (swing phase) then they probably have an issue with:

Answer 20

popliteus

Question 21

what has chris told us about patellofemoral pain?

Answer 21

• mutlifactorial condition
• requires tailored multimodal intervention
• loss of trunk+pelvic control
• pelvic maltracking and increas PFJ stress (lateral tilt, glide and rotation)
• hip mm function deficits + increase hip adduction and internal rotation on WB side
• quads weakness + delayed VMO activation (WB side)
• increased foot mobility (WB side)

–> all when we go into knee flexion