- Hip Arthrokinematics
- Abd- inf glide
Add- sup glide
IR- post glide
ER- ant glide
F/E- distraction - Hip Closed Packed, Resting position, capsular pattern
- CP: Ext/IR/ABDRP: 30 F / 30 abd / lat rotCapsular pattern: early: Ext / med rot /Flex add late: Flex / adb / med rot
- Hip Osteokinematics
- F/E -spinAdb/Add- cardinal swing
- Key muscles L1-2
- hip flexhip Add
- Key musclesL3
- knee exthip add
- Key musclesL4
- ankle DF and INV
- Key musclesL5
- great toe exthip abd
- Key MusclesS1
- ankle PF, ankle ev, knee flex
- Key musclesS2
- hip extLat hamstrings
- Knee Osteokinematics
- F/E impure swing IR/ER impure spin abd/add not physiological
- KneeClosed packed, resting position, capsular pattern,
- CP ext + ext rotRP 25-30 flexCap pat F>E
- Kneejoint type
- synovial, compound, complex modified ovoid
- KneeRange of motion
- Flex 130-140 degrees active 160 degrees squatext 5-10Rotation 0-0 degrees, max rot at 90 degreesIR 0-40 degrees ER 0-30 degreesAbd and Add 10-13 degrees at 30 degrees
- locking-extension-flexion-contralateral SF-ipsilateral SF
- ext-vertically towards ceilingflex-horizontally forward, parallel to floorcontra-pull caudallyipsilateral-pull cranially
- locking-rotation
- constant, side to be treated on top
- Pelvic GirdleSI jt classification Pubic symphysis jt classification
- synovial jt, complex and variablesymphysis
- structures that limit spinal flexant translation
- articular facets
- structures that limit spinal flexsagittal rotation
- post long ligsupraspinousinterspinouslig flavumthoracolumbar facia, erector spinae
- subtalararthrokinematics
- Pronation-ant- lat glidePost-medial glideSupination-ant-medialPost- lat glide
- Ankle Dorsiflexors (4)
- Tibialis ant.
Ext Dig long
Peroneus tertius
Ext hallucis longus
- Ankle Plantarflexors (8)
- Peroneus longus
Peroneus brevis
Tib post
Plantaris
Flex dig long
Flex hallucus long
Soleus
Gastroc - Arthokinematics innominate
- ant rot- inf (short arm) and post (long arm)post rot-sup (short arm) and ant (long arm)
- Arthrokinematics sacrum
- Counternutation- sup and ant
Nutation- inf and post - arthrokinemetics Lumbar spine
- Flex: cranial glideExt: caudal glide
SF: ipsi-inf, postcontra-sup and ant - Cluster of 5
- DistractionCompressionFaberPelvic TorsionThigh Thrust
- Combination of movements in SF
- Upper levels SF/rot oppositeL4-L5 variableL5-S1 SF/rot same direction
- Foot Eversion (4)
- Peroneus longus,brevis,tertius
Ext dig long.
- Foot inversion (4)
- Tib ant. post.
Ext hallucis longus
Flex dig longus
Flex hallucis longs - Hip Abduction (11)
- Psoas maj
iliacus
Sartorius
TFL
Glute med, min, max
Gem inf, sup
Piriformis
obt int. - Hip Adductors (6)
- pectineus
Add long, brevis, mag
gracilis
obt ext - Hip Extension (7)
- Adductor mag
Glute med, max
semimembranosis
Semitendonosis
piriformis
biceps fem. - Hip Flexors (10)
- psoas maj
iliacus
sartorius
pectinius
add long, brevis, mag
rectus fem
TFL
Glute min med - Hip joint type
- simple, synovial, unmodified ovoid, 3DF
- Hip Lateral Rotators (12)
- Psoas maj.
Iliacus
Sartorius
obt ext. int.
Glute med, max
Gem inf. sup.
Quadratus fem
Piriformis - Hip Medial Rotators (7)
- Add long, brevis
TFL
Glute med min
Semimembranosis
Semitendonosis - Hip Range of motion
- flex-90-100 knee ext, 110-120 with knee flexedAbd-30-57Add 30-45IR-30-40ER-40-60
- how much extension?
- 20-35 degrees total
- how much flexion per segment
- 8-13 degrees1-3 mm
- how much lumbar rot?
- 3 degrees per segmentL5-5 degrees
- How much SF?
- total 15-30 degrees10 degrees upper three levels6 degrees at L4/L53 degrees L5/S1
- inferior tibiofibular jt. classification
- syndesmosis-fibrouspain with splayingCP-wt bearing in DF
- Knee Flexors (5)
- Sartorius
gracilis
popliteus
plantaris
semimembranosis
semitendonosis
biceps fem
gastroc - Knee Lat rotators
- biceps fem
- knee med rotators
- sartorius
gracilis
popliteus
semimembranosis
semitendonosis - Ligaments limiting pronation
- medial talocalcanealmedial interosseous
- Ligaments limiting supination
- lat talocalcanealcervical ligamentlat interosseous
- Ligaments that limit counternutation
- Long dorsal ligament
- Ligaments that limit nutation
- sacrotuberous and interosseous
- Lumbar capsular pattern
- SF=rot > E
- Lumbar jt. stability tests
- compressiontractiontorsion (rotational)translations -ant -post -lateral
- Lumbar specific questions
- effect of sittingstanding vs. sitting vs. walkingcough, sneeze, valsavabed (hard or soft)sleeping position
- Mandatory questions
- Bladder, Bowel, genital dysfunctionsaddle paresthesiarectal, scotal, testicular, penile, vaginal paingroin and medial thigh painmedication usage, steroids, NSAIDs, anti-coagulantsWeight lossSpecial tests
- muscles of the ant. oblique
- oblique abscontralateral adductors
- muscles of the lateral system
- Glute medcontralateral adductors
- muscles of the longitudinal systems
- erector spinae, sacrotuberous ligament and biceps femoris
- muscles of the post oblique
- Glute maxLat dorsi -resist adduction of extended med roted arm
- Muscular Forces in SF
- QLPsoasobliquesipsilateral intertransversariiiliocostalis lumborum and gravity
- name the four systems
- Post obliqueanterior obliquelateral Deep longitudinal
- Pelvic Girdle Osteokinematics
- Sacrum moves congruently with the side of the POST. rotating innominateL5 appears to rotate and SF congruently with the sacrum
- PG osteo Hip Flex
- innominate-R post rotates relative to sacrumRight PSIS down Sacrum-rotates rightNutated relative to right innominate, Left sacral base nutates L5-rotates to right
- PG osteo Right Rot
- Intra pelvic torsioninnominate- R inno post rot / L inno ant rotSacrum- rot RL5-R rot,
- PG osteo Right SF trunk
- Intra pelvic torsion innominate-Left translation
R inno ant rot / L inno post rot Sacrum-rot L
L5-R sf, rotates L - PG osteo trunk ext
- innominate-post rotates relative to sacrum Sacrum-NutatesL5-ext and post translates on the sacrum
- PG osteo trunk flex
- innominate-post rotates relative to sacrum Sacrum-NutatesL5-flexes and ant translates on the sacrum
- repeated loading of the spine in flex can produce
- end plate fracturesinternal disruptures of the annulusradial ## of pars interarticularis
- specific SI questions
- locationradiation into the limbsaggravating activitieseffect of walking, stair climbing, rolling over in bed, getting in/out of a chair, stepping up onto a curb, cough, sneeze, valsalva, effect of rest
- Stabilization training progression
- segmental control, functional, CKC, OKC,
- sub talar CP, cap pat, RP
- end range pro/sup, sup>pro, mid position
- Sub talar joint types
- anterior-compound, synovial together work as modified sellar
- Subtalar Osteokinematics
- Pronation-DF, Abd, eversionSupination- PF, Add, inversion
- talocrural arthrokinematics
- DF-post glidePF-ant glide
- talocrural DF, CP, RP, Cap Patern
- 1 DF - PF, DFcap pat- PF>DFCP- DFRP 10degrees PF
- Talocrural jt. classification
- compound, synovial, modified sellar
- talocrural Osteokinematics
- impure swingext rot with DFint rot with PF
