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39 Cards in this Set

  • Front
  • Back
What are the three joints located in the hips?
- Sacroiliac
- Symphysis pubis
- acetabulo - femoral
What type of joint is the acetabular joint? What are the ligaments that hold it together?
- Ball and socket joint
- Held by pubofemoral, ischiofemorla and iliofemoral ligaments
What is the hips axis of motion?
Polyaxial in all directions including circumduction
What is the normal hip ROM?
Add 20, Abd 40, Flexion 120, Extension 20, Med/lat rotation 45
(varies between individuals)
What do hamstrings do in hip flexion?
- Hamstrings should allow 70 degrees for hip flexion
What is the position of the hip?
- The hips rotates roughly 4 degrees med and lat
- The hip list in FP roughly 5 degrees either way
- Hips maybe int or ext rotated due to muscular or osseous factors.
How do we diffrentiate muscular and osseous muscle tightness?
- Test ext and flex position.
- If flex limited, posterior muscles are tight and vice versa
- If ext rotation is limited, int rotators are tight and vice versa
- If both positions show restricted motion, osseous involvement indicated.
What 2 joints does the knee compromise of?
tibio femorla and patello femoral
What are the strong ligamentous support at the knee?
ACL, PCL, Medial collateral ligament, Lateral collateral ligament
Where does the ACL run, and what role does it have?
Location - runs post and sup from ant aspect of tibial plateau to posterolateral aspect of intercondylar notch
Role - prevents tibia moving forward on femur and controls rotational motion
Where does the ACL run, and what role does it have?
Location: runs ant and sup from posterior aspect of the tibial plateau to med aspect of the intercondylar notch
Role - prevents the femur from sliding forward on the tibia
What role does the medial collateral ligament have? and where does it run?
Role - Provides medial stability
Location - Originates from med condyle of femur to anteromedial aspect of tibia and med meniscu
What stress causes injury to the medial collateral ligament?
Valgus stress
What role does the lateral collateral ligament play? and where does it run?
Role - provides lateral stability
Location - originates from lateral border of femur to head of fibula (cord like)
What stress causes injury to the lateral collateral ligament?
Varus stress
What role does the med and lat menisci play? and where are they located?
Role - absorb forces, protect cartilage and aid in stabilisation, lubrication and nutrition of the knee
Located - Intra articular attatchments to tibial plateau
What is the patellofemoral joint? What role does it play?
It is the sesamoid within the quad tendon inserting into the tibial tubercle, and is stabilised by the med and lat patella retinacula
What are the motions at the knee?
- Flexion and extension in SP
- Some motion in TP due to condyles and meniscal anatomy
- FP motion is pathological
What is the range of motion of the knee?
0 degrees extension
140 degrees flexion
What is TP motion in the knee neccessary for?
In order to 'screw home' the knee in ext, caused by medial rotation of the femur into the larger medial condyle, stabilising the knee and tightening the collaterals
What does popliteus do?
Externally rotates the knee on flexion to unlock it
Describe the knee in gait...
- Flexes from ext position at heel strike to absorb shock
- Extends from Ffoot loading to lift body and allow swing of opposite leg
- Flexes after heel lift to inc propulsion power
- Remains flexed in swing for ground clearance, before extension at heel strike
What did Blake et al (1979) find in regards to knee pathologies?
46% of a group of 1500 runners had exp knee pain, many due to acute traumatic events
What are chronic conditions generally termed?
Idiopathic, but however may be foot related.
What is patello-femoral syndrome?
It is related to subluxation of the patella from its tract, generally at 10-20 degrees of flexion. Leads to cartilage erosion and arthritic changes
What factors that lead to PFS?
- Large Q angle (ASIS to patella bisection and patella bisection to tibial tubercle)
- Varus allignment
- VMO weakness
- Foot pronation
What was Tiberio (1987) pusblished theory?
That excess foot pronation increases medial tibial rotation when the leg should be ext rotated, which leads to femoral int rotation and lat tracking of patella
What is the ilio-tibial band? and how many people suffer from ilio-tibial band syndrome?
Ilio-tibial band runs from upper thigh to insert into the lat tibial tubercle. It passes over the lateral femoral condyle with ext and flex, 16% of runners.
What did Messier (1995) find?
Found that feet with less pronation more common in ITB syndrome symptom group compared to control group
What did 3 studies on ACL find?
3 studies compared ACL to control group found that a measure of pronation was greater for ACL group compared to control group
What is the theory of pronated feet and ACL straining?
That foot pronation may allow increase knee flexion, allowing the tibia to slide forward on femur, straining ACL
What does the 'anterior drawer test' test?
It assesses the ACL and more specifically the PCL.
What does the 'lachmen test' test?
Assesses the ACL for injuries
What does the 'pivot shift test' test?
Can help detect ACL injuries
What force generally injures the menisci?
Rotational (torsion) forces - asssociated with a 'pop' sound when injured
What is the McMurray's test? and when should it NOT be used?
It is used to test to test injury of the Menisci, and is not to be done on an acute painful knee
How should lower back pain be approached?
- Through a multidisciplinary approach
- Podiatry can help with identifying and compensating for LLD, orthoses can absorb shock.
How does a cavus foot lead to lower back pain?
- Cavus foot with rigid attitute may transfer GRF to lower back rather than absorbing more distally - which exacerbates injury or increase predopisition
What else can orthoses correct in terms of lower back?
Sagittal plane blockade (increase forward lean, increase erector spinae contracture, increase pain)