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Rehab Principles > Upper/lower crossed syndrome & Key movement patterns > Flashcards

Upper/lower crossed syndrome & Key movement patterns Flashcards

1
Q

Skeletal muscles that have higher predominance of Type I fibers (myoglobin) and are resistance to fatigue are what kind of muscles

A

Postural muscles

Note: they shorten and tighten when chronically stressed and/or injured

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2
Q

Skeletal muscles that have higher predominance of Type II fibers (myoglobin and glycogen) and used for quick movements and short bursts of activity

A

Phasic muscles or arms and legs

Note: They have a tendency to lengthen and weaken when chronically stressed and/or injured

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3
Q

What are the 4 postural trunk muscles

A
  1. Cervical and lumbar erectors
  2. Quadratics lumborum
  3. Scalenes muscles
  4. Sternocleidomastoid m
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4
Q

What are the 4 postural shoulder girdle muscles

A
  1. Pec major and minor
  2. Levator scapula
  3. Upper trapezius
  4. Bicep brachii
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5
Q

What are the 2 phasic trunk muscles

A
  1. Mid thoracic erectors

2. Longus capitus and colli

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6
Q

What are the 4 phasic shoulder girdle muscles

A
  1. Rhomboids
  2. Middle trapezius
  3. Lower trapezius
  4. Triceps brachii
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7
Q

Reciprocal inhibition

A

When a muscle contracts, its direct antagonist relaxes to an equal extent allowing smooth movement.

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8
Q

Why do key movement patterns (KMP)?

A

Observe AROM and you can see/palpate altered firing patterns within synergistic groups of muscles

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9
Q

Upper crossed syndrome is associated with short ______ and long ________

A
  • Short tight postural muscles

- Long weak/inhibited phasic muscles

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10
Q

Upper crossed syndrome: postural/tight muscles (6)

A 
Cervical erectors
Upper traps
Levator
Pectorals
SCM
Scalenes
Upper extremity flexors
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10
Q

Upper crossed syndrome phasic/weak/inhibited muscles (5)

A 
Mid-thoracic erectors
Mid- and lower-traps
Rhomboids
Serratus anterior
Deep neck flexors — longus capitus and colli
Upper extremity extensors
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11
Q

What will you see in a lateral postural evaluation for someone with upper crossed syndrome?

A
  • Anterior head carriage
  • Forward and rounded shoulders
  • Internally rotated humerus
  • Thoracic hyperkyphosis
  • Protruding abdomen
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12
Q

What muscles are overactive/inhibited in anterior head carriage?

A

Overactive SCM

Inhibited deep neck flexors

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13
Q

What muscles are overactive/inhibited in forward and rounded shoulders?

A

Tight pectoralis major/minor

Inhibited rhomboid, serratus anterior

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14
Q

What muscles are overactive/inhibited in internally rotated humerus?

A

Tight pectoralis major/minor

Inhibited serratus anterior

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15
Q

What muscles are overactive/inhibited in thoracic hyperkyphosis

A

Facilitated T/L erectors

Inhibited gluts

16
Q

What muscles are overactive/inhibited in protruding abdomen

A

Facilitated poses

Inhibited gluts

17
Q

What are functional movement pattern evaluations for upper crossed syndrome?

A

Neck flexion
Trunk flexion
Shoulder abduction
Lowering from push-up with a plus

18
Q

What muscles are inhibited or tight in lower crossed syndrome?

A

Inhibited: Glut. Max, abdominals, (glut. Med)

Tight: spots, rectus femoris, lumbar erectors, TFL, QL

19
Q

What will you see in a lateral postural evaluation for someone with lower crossed syndrome?

A

PELVIS: A/P tilt, torsion, hiking, lateral shift

GLUT MAX: flattened upper-outer quadrant, sagging fold

ADDUCTORS: distal “notch” ipsilateral hip dysfunction

HAMSTRINGS: overactivity in distal 1/3 = inhibited glut

CALF: soleus hypertrophy

LUMBAR ERECTORS: should be > TL erectors

20
Q

What are some key functional movement patterns to evaluate lower crossed syndrome?

A

Hip extension
Hip abduction
Trunk flexion

21
Q

Do you perform key movement patterns (KMPs) on acute patients?

A

No

22
Q

What do you evaluate before doing KMPs?

A

Posture and gait

23
Q

How do you perform KMPs in general (4)?

A
  1. Expose area
  2. Give minimal verbal cues
  3. Pt performs 3+ trials
  4. Observe both sides for comparison
24
Q

List 4 positive findings for hip extension

A
  • deviations in lumbar spine
  • recruitment of upper back musculature
  • inability to maint knee extension
  • decreased hip extension
25
Q

List 5 positive findings for hip abduction

A 
Cephalad shift of the pelvis – overactive QL
Hip flexion – overactive TFL or psoas
Hip ER/extension – overactive piriformis
Limited abduction – tight adductors
Pelvic rotation – overactive TFL
26
Q

In hip abduction, what does a cephalad shift of pelvis suggest?

A

Overactive QL

27
Q

In hip abduction, what does hip flexion suggest?

A

Overactive TFL or psoas

28
Q

In hip abduction, what does hip ER/extension suggest?

A

Overactive piriformis

29
Q

In hip abduction, what does limited abduction capability suggest?

A

Tight adductors

30
Q

In hip abduction, what does pelvic rotation suggest?

A

Overactive TFL

31
Q

In hip abduction, what does faulty patterns suggest?

A

Inhibited gluteus medius contraction

32
Q

What are positive findings for the first part of the trunk curl-up?

A

Trunk flexion versus hip flexion.

WEAK ABS and OVERACTIVE ILIOPSOAS, the flexion movement of trunk is minimal and the movement will be mostly hip flexion. Tsk Tsk

Also, the back may stay straight and pelvis tilt anteriorly

+/- Heel pressure means iliopsoas is dominating

33
Q

In shoulder abduction, what are abnormal patterns?

A 
Early scapular movement (prior to 60˚)
Late scapular movement (after 90˚)
Winging
Contralateral side bending of the trunk
Bilateral assymetry
34
Q

In shoulder abduction, what might early scapula motion mean? (Movement prior to 60˚ abduction)

A

Short/tight

  • lateral scapula mm: teres, infraspinatus
  • Overactive upper trap

Long/weak

  • medial scapula mm: rhomboids
  • lower trap
35
Q

In shoulder abduction, what does late scapula motion mean? (Movement after 90˚ abduction)

A

Reverse.

Short/tight

  • medial scapula mm: rhomboids
  • lower trap

Long/weak

  • lateral scapula mm: teres, infraspinatus
  • upper trap
36
Q

What muscles coordinate to allow upward scapular rotation? What what oppose the motion?

A

Upper trap
Lower trap
Serratus anterior

Opposers:
Rhomboids
Levator scapula

37
Q

If upper trap and lower trap are not balanced or if serratus anterior m has portions that are shortened or weak, what will happen to scapular motion?

A

It’ll be atypical/aberrant because scapula isn’t adequately stabilized

38
Q

What are abnormal patterns for neck flexion?

A

Chin protrusion
Shaking
Chin deviation

Rehab Principles (6 decks)

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