Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LE Ortho > Week 2 Lecture 2A > Flashcards

Week 2 Lecture 2A Flashcards

1
Q

Coo

A

Coo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Quads are stronger than hamstrings by a (1/3 / 2/3) ratio.

A

2/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
The Point: 
strengthening hamstrings (increased/decreased) injury risk
A

decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Isometric hamstrings at 20 deg flexion and 60 deg flexion.

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If you have a hamstring injury, (sagittal/frontal) plane movements will be the most affected so you start with (sagittal / frontal plane/transverse) plane activity and then progress to sagittal plane

A

sagittal; frontal/transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hamstring strengthening, core stabilization and agility work is probably the best thing to do for hamstring recovery.

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Got it

A

got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hamstring Rehab

Phase I goals
Protect healing tissue
Avoid excessive active or passive lengthening of hamstrings
Minimize atrophy

Phase II goals
Regain (90%/pain free) hamstring strength
Develop neuromuscular control of trunk and pelvis

Phase III goals
Symptom free during (most/all) activity
Normal conc and ecc hamstring strength through (90%/full) ROM and speeds
Improved neuromuscular control of trunk and pelvis with sport specific movements

Phase 1 - Create a healing environment for the hs – don’t stretch it, but engage the hamstrings in noncommittal ways

A

pain free; all; full;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phase 1

(Sagittal/Frontal) plane movements

A

Frontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Criteria to progress to phase II

Normal walking stride (with limited/without) pain

Performs dynamic frontal plane movement (with limited/without) pain

Pain-free isometric contraction against submaximal resistance during (supine knee extension/prone knee flexion) (90°) manual strength test

A

without; without; prone knee flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment Strategies

Hamstrings work…

 In open chain:
Decelerate knee (flexion/extension) at end of (stance/swing) phase

In closed chain:
In stance to facilitate hip (flexion/extension) at initial contact and knee (flexion/extension) during terminal stance (running)
The hamstrings and rectus abdominis are decelerators of pelvic anterior tilt throughout stance.

Consequence of short RF, weak RA?

A

extension; swing; extension; extension;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sagittal Plane

Work through swing phase with focus on (Limb/Pelvic) control

A

Pelvic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Sagittal Plane

Eccentric hamstring work with Pelvic control

Simulate (initial/terminal) swing phase

A

terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Criteria to Progress to Phase III

(Almost full strength (4/5)/Full strength (5/5)) (with limited/without) pain during prone knee flexion (90°) manual strength test

(Limited pain/Pain-free) forward and backward jog, moderate intensity
Unilateral sagittal plane activity (with limited/without) pain

A

Full strength (5/5); without pain; Pain-free; without;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Got it

A

Got it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Got it

A

Got it

28
Q

Got it

A

Got it

29
Q

Got it

A

Got it

30
Q

10 most efficient hamstring exercises from a biomechanical perspective

https://www.youtube.com/watch?v=Wl8KZNnTlPw&t=1s

A

Cool

31
Q

Exercises that target eccentric hamstring strength at (shorter/longer) muscle length (important for sprinting).

A

longer

32
Q

Stabilize pelvic tilt - prevent (anterior/posterior) pelvic tilt

Stable core allows development of (smaller/larger) forces at the hip and facilitates an efficient transfer of power during sprinting.

A

anterior; larger

33
Q

Got it

A

Got it

34
Q

Criteria to progress
Return to Sport

Full strength (with limited/without) pain:
(Limited pain/Painfree) maximum effort manual strength test in each prone knee flexion position (90° and 15°)
Normalized H/Q strength ratio
_% limb symmetry hamstrings

(95%/Full) range of motion (with limited/without) pain

Replication of sport specific movements (at/near) maximal speed without pain:
Able to sprint
Hop test: _% limb symmetry

A

without; Painfree; 85; Full; without; near; 85

35
Q

LSI

A

LSI

36
Q

Grade (2/3) to tendon/ligament is a complete tear. It will be up high around the isch tub and come off of the bone.

A

3

37
Q

MOI:

Extreme forceful hip (flexion/extension) with knee fully (flexed/extended)

Pulls them forward and their hips drop back. Knees are locked up and they go into hip flexion.
Slip and fall and slide - leg out in front and knee extended
Foot gets caught – head over heels

A

flexion; extended

38
Q

Better repaired (acutely/chronicly) – wait too long = harder to repair

When it domes off of the bone it starts to contract towards the distal part where it is attached and it shortens up.

Outcomes are good overall and people do well. Very low rerupture rate.

A

acutely;

39
Q

Putting it back on the ischial tuberosity

Sewing tissue back under the bone – don’t want to tear it. Think what would damage the repair that was just done. Avoid hip (flexion/extension) and knee (flexion/extension).

A

flexion; extension

40
Q

Pt in a knee brace so they don’t go into knee extension, some are in a hip brace so they don’t flex the hip.

A

Got it

41
Q

Got it

A

Got it

42
Q

Rehab Progression Overview:

Phase 1: protection (surgery to _wks)
Limited WB

ROM limits?:
Knee extension possibly (tension on repair?)
What motion(s)?
Hip (flexion/extension), knee (flexion/extension)
Combined motions (hip _____+ knee _____)

Brace

Try not to ruin the surgery

Limited WB – put them on crutches, unload them and shorten their stride with AD

ROM Limits – if it was repaired with tension ROM limits will be higher.

Avoid hip flexion and knee extension

A

6; flexion; extension; flexion; extension;

43
Q

Have them (flex/extend) their knee as they get up

A

flex

44
Q

Phase 2 (Wks _ - _)

Progress WB / gait

Progress ROM
Hip flexion (knee (flexed/extended))
Knee extension (hip (flexed/extended))
Neural glides

No resisted hamstrings yet!!
No hamstring stretch yet!!

Everything takes 6-8 weeks to heal except for the scaphoid and a couple of other bones.

Blood supply, age, bone quality, diabetes, smoking, activity level before the surgery influence healing times.

When starting to restore ROM – do it one piece at a time – hip flexion with the knee flexed. Knee extension with the hip extended (heel slide).

The sciatic nerve is next to the hamstring insertion – a lot of scarring is possible. They might get stuck so have to do neural mobilization. Nerve pain going down their leg – think sciatic nerve.

A

6-9; flexed; extended

45
Q

Phase 3: (-) Months

A

3-4;

46
Q

Phase 4 (-) months

return to sport activity

Functional strength progression
Plyometrics
Running
Return to sporting activities is typically allowed at - months postoperatively

A

5-9; 6-9

47
Q

Proximal Hamstring Tendinopathy

Middle aged athlete
History of hamstring strain

MRI:
partial tearing / degeneration
Scar - tendon thickening

Weak hip extension with flexed knee prone:
Poor (hamstring/gluteal) control / activation

Hamstring cramping (unilateral bridge)
Tender to palpation at IT

Proximal hamstring stretch (decreases/reproduces) pain

Weak hip extension with knee flexed in prone – testing glute max

Tender to palpation in the isch tub

Proximal hamstring stretch – good test to do to rule in or out

A

gluteal; reproduces;

48
Q

Eccentric hamstrings – good for organizing scar tissue at the insertion of the HS

Lower cross syndrome – Tight hip flexors, tight trunk extensors, weak glutes, and weak abs.

Injection is good to use in conjuction with the rehab.

PRP – get all the RBCs condensed and they reinject it (evidence isn’t great).

A

Got it

49
Q

Got it

A

Got it

50
Q

External – outside, caused by thickening in the lateral structures. Greater trochanter bursa could be inflamed. Tissue snaps as the tissue moves from flexion to extension.

Internal – movement from flexion to extension

Intra-articular – labral tear and they’ll describe clicking as the primary complaint

A

Got it

51
Q

The Snapping Hip
(Coxa Sultans)

Internal and external cases will (not likely/likely) report snapping and symptoms (in front of/behind) hip or (medial/lateral) thigh - Patient can often self-demonstrate these findings with activity

The intra-articular case will more likely report “clicking”, with a (primary/secondary) complaint of joint pain

A

likely; in front of; lateral; primary

52
Q

Got it

A

Got it

53
Q

Possibly (gluteus medius/gluteus maximus), inflamed GT bursa

A

medius

54
Q

Stretching – abductors, hip flexors

A

abductors; flexors

55
Q

Often don’t need surgery

Take out the bursa that is irritated or causes pain

A

Got it

56
Q

True piriformis syndrome involves the (pudendal/sciatic) nerve so there are nerve symptoms, there is pain in the butt

A

sciatic;

57
Q

Radiates down the back of the leg

A

Got it

58
Q

Cause

Spasm or shortening of piriformis muscle that causes compression of _____ nerve

Why spasm:

Direct trauma:
Hematoma, scarring
“wallet neuritis”

Overuse:
Lumbar / SIJ pathology
Crosses SIJ

Si joint instability or hypomobility can irritate the piriformis and the sciatic n.

A

sciatic;

59
Q

Got it

A

Got it

60
Q

Either stretching or activating/or both with these tests

FAIR – Positive with pain

Frieberg – reproduction of pain

A

Got it

61
Q

Leg held in position of ER (static position)
(Short / hypertonic piriformis)

Resisted (Adduction/Abduction) (activates piriformis)
Hip flexed + test = pain

A

Abduction;

62
Q

Surgical release is uncommon

US doesn’t work
Soft tissue mobilization – people are tender, don’t want you poking in that area because it is sensitive

A

Got it

63
Q

People love to stretch it, have to tell them to tone it down if they stretch aggressively – keeps the sxs irritable.

A

Got it

64
Q

Another Theory

Excessive Adduction and IROT:
Weakness of (hamstrings/ glute max/medius)
Lower crossed syndrome

Glutes are ineffective
Greater eccentric load may be shifted to piriformis muscle
Results in irritation of _____ nerve

Causes greater load on the piriformis if glutes aren’t doing its job

A

glute max/medius; sciatic

65
Q

Got it

A

Got it

66
Q

Got it

A

Got it

67
Q

Hip (adductor/abductor) weakness as an associated finding in piriformis syndrome

Treatment: Hip strength and movement re-education

A

abductor

LE Ortho (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions