Uncontrollable Factors

Question 1

Examples of Uncontrollable genetic or congenital factors?

Answer 1

• Age
• Gender
• Musculoskeletal deformities
• Leg length discrepancies

Question 2

What are the trainable, uncontrollable factors?

Answer 2

• Coordination
• Incorrect body weight
• Poor posture
• Lack of joint mobility
• Lack or imbalance of muscle strength

Question 3

Which physiological adaptations occur with Ageing?

Answer 3

• Average adult’s bone mass peaks between 20-40yr old
• From 20yr onwards, average reductions per decade are 5-9% for Ultimate tensile stress, 12% for energy absorption to failure
• After 30yrs old, tendon’s are less resistant to tension than bone, prior to this high risk of avulsion fractures
• Decrease in bone mass of 0.5-1% in men and 1-2% in women after 35-40yrs old
• Ultimate tensile strength of the ACL decreases up to 60% by the age of 65

Question 4

What happens following immobilisation or disuse?

Answer 4

• Ligaments, decrease in failure strength and energy absorption before failure. As a result - increase in joint stiffness and injury susceptibility
• Bone, atrophy. Mass and size decrease through loss of equal proportions of matrix and mineral content. Bones require loading to stay strong.

Question 5

Difference between the genders.

Answer 5

• Kinematics of Women running increases susceptibility of ACL injuries . The reasons for, a wider pelvis, smaller bone surfaces, greater rate of loss of bone with age, less muscle mass and higher fat content
• Increase prevalence of stress fractures in sports women
• recent studies showed that women are more efficient at pacing in marathons and are less likely to drop out that men.

Question 6

Reasons for Abnormal Gait

Answer 6

• Neurological disorders
• Skeletal disorders
• Muscular disorders
• Pain
• Age
• Personality
• Inability to hear and see

Question 7

Biomechanical Abnormalities?`

Answer 7

• Leg length discrepancies -> anatomical difference, functional difference (foot architecture)
• Genu Varum or Genu Valgum
• Anatomical origins and attachments

Question 8

Lower Extremity problems

Answer 8

-Trendelenburg gait, weak hip adductors (glut med). Pelvis not supported position during stance phase of walking, this results in hip-hitching to prevent foot contact

Question 9

Flat feet (Pes planus)

Answer 9

Flat feet (pes planus) - flat, quite flexible. Pronated position during gait and they tend to toe-off closer to the big toe side of the foot. Pes planus can potentially lead to internal tibial torsion and increased femoral rotation. Shin splints more common, ITB syndrome, Patellofemoral pain syndrome.

• SI joint dysfunction
• Tarsal stress fractures

Question 10

High Arched Feet (Pes cavus)

Answer 10

High arched feet (pes cavus) - Tighter arches, greater supination and and the centre of pressure is more lateral. High arches can lead to external tibial torsion and increased external femoral rotation.
Implicated In a number of overuse injuries
-lat colat knee lig injury
-metatarsal stress fractures
-peroneal muscle tendinitis
-Plantar fasciitis