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94 Cards in this Set

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hip flex/ext rom

120, 20

hip abd/ass rom

45/30

hip IR/ER rom

45/30

resting pack hip

30 flex, 30 abd, 20 ER

closed pack hip

ext, abd, IR

capsular pattern hip

flex, IR, ext, abd




abd, IR, flex

transverse ligament hip

between space in acetabulum

illiac bura

squeezed out in weight bearing, moved in in traction




when pathology keeps pad out it decreases shock absorption and decreases lubrication

iliofemoral ligament

anterior band limits extension, lateral band limits adduction

pubofemoral ligament

limits external rotation and abduction

ischiofemoral ligament

limits internal rotation and adduction

signs of OA at hip (6)

pain, decreased AROM/PROM, decreased strength, decreased joint mobility, early morning stiffness and with inactivity, initially decrease in pain with movement

precaution posterolatral approach THA

avoid hip flex >90, adduction and IR

precaution anterolateral approach THA

avoid flex >90


hip extension, add & external rotation past neutral


combined hip flexion, abduction and external rotation

either THR avoid

high cross leg

transgluteal/trochanteric THR approach (6)

avoid adduction past neutral, no antigravity hip abduction for 6-8 wks, no WBing exercises for 12 weeks, sleep with abduction pillow, don't high cross, WB restricted 6-8 weeks

treatment of early stage OA

progress quickly to grade 3 if early stage, lateral traction, caudal distraction, stretch and strengthen (high rep low resistance), strengthen nonWBing if painful

ER/IR of knee in flexion

45 deg external, 30 deg internal

knee rotation in extension

5 deg ER

movement of fluid in knee with ROM

anterior with extension


posterior with flexion

arthrokinematics with small steps (0-25 deg flexion knee)

all roll, no glide




at end range all glide

collateral ligaments knee

tight in ER and extension

lateral knee stabilizers

LCL, TFL

ACL taught in

flex - anteromedial


posterolateral - taut in extension




taut in IR when knee flexed (same with PCL)

acl runs

from posterior medial lateral condyle to anterior lateral medial condyle, also attaches to meniscus



quad forces on patella

VM pulls at larger angle than VL


VL has posterior component

quad pull on tibia

anterior translation force closer to full extension, at >60 deg flexion little to no anterior translation




open chain no TKE post ACL


closed chain no deep squat

causes of excessive lateral tracking of the patella

tight lateral retinaculum, tight ITB, glute tightness, walking toed out

patella rotation follows

tibial rotation

during flexion force on patella

increases

patella contact throughout flexion

0 deg inferior pole


45 eg large area in middle of patella


90 deg superior aspect only, max force

exercises for patellar pain

minisquat (not much flexion, 0-50), open chain do 30-60/45-90 deg flexion

post ACL repair initially exercise

closed chain 0-30, open chain 45-90

post PCL initially

open chain 0-25 deg extension

severe muscle contusion rehab

start with AROM, high rep, avoid vigorous stretching or strengthening

excessive pronation leads to

tibial internal rotation, femoral internal rotation, valgus at the knee, femoral adduction, increased Q angle

3 thins to examine for patellofemoral pain

tibial rotation, femur rotation, knee position

effect of weak hip ER

hip will internally rotate, increasing valgus at knee, increases compression at tibial and femur

causes of medial collapse

poor glute med/min strength, inability to come out of pronation, anteversion of hip causing decreased effectiveness of abductors

treatment for medial collapse

mule kicks, mini squat

resting pack talocrural

10 deg PF

closed pack talocrural

full dorsiflexion

minimum DF needed

10 deg or else will over pronate

distal fibular movement in plantarflexion

distal and posterior, rotates internally

distal fibular movement in dorsilexion

proximal and anterior, rotates externall

glide of subtalar inversion

lateral glide, internal rotation (adduction)

glide of subtalar eversion

medial, external rotation

open chain supination

calcaneus: PF, add, inverts




anterior, lateral, medial rotation

closed chain supination

calcaneus inverts (lateral glide)


talus DF and abd

tib posterior

medial rotation of navicular, plantarflexion, inversion

movement of navicular on talus in PF and inversion

plantar

movement of navicular on talus in DF and evs

dorsal

all tarsal bones are

concave on convex except cuboid on calcaneus

resting position of MTPs

neutral or 10 deg extension

closed pack of MTPs

extension or full flexion

resting pack of DIP and PIP toes

slight flexion

closed pack of DIP and PIP

full extension

initial contact to foot flat

hit in 2-3 deg supinatoin, end in 3-4 deg pronation

foot flat to midstance

start to come out of pronation and get to neutral

midstance to heel off

neutral to 2 deg supination

heel off to toe off

continue supinating to 3 deg supination

do not post

rearfoot valgus

compensated rearfoot varus leads to

early excessive pronation and late pronation

compensated forefoot valgus leads to

excessive early supination

compensated forefoot varus leads to

calluses under the 2-4th toes, excessive pronation, from midstance though toe off

uncompensated subtalar varus leads to

excessive over supination throughtout entire cycle

uncompensated forefoot varus leads to

slight lack of pronation early

rearfoot and forefoot varus leads to

early and late excessive pronation

compensated rigid forefoot valgus

early excessive supination

compensated subtalar varus and flexible forefoot valgus

early excessive pronation

rigid plantarflex first ray

early and excessive supination

flexible plantarflexed first ray

near normal gait

compensated equinus

excessive late pronation

normal distribution of gait

60% stance, 40% swing

normal step width

5-10cm

COG sway in gait

less than 5 cm in any direction

significant limb length discrepancy

2cm

normal pelvic rotation

4 deg either side for total of 8

knee flexion in gait

should increase until end of midstance before heel off

if knee flexion contracture

work soleus, glute max to pull back tibia

hip flexion contracture treat

soleus, quads

flexed posture work

all extensors but quads

weak quads work

hyperextension, soleus, glute max

step length

72 cm

stide length

144cm

loss of ankle dorsiflexion can cause (5)

toe out gait, genu recurvatum, increased WB, medial knee stress, increased midtarsal mobility

normal natural stance

0-4 deg tibial


0-2 deg rearfoot

issues compensated forefoot valgus can lead to

heel spur, plantar fascitis, metatarsalgia, lateral ankle sprain, pes cavus-like foot, stress fracture

issues compensated forefoot varus can lead to

hallux valgus, internal tibial rotation, increased Q angle, stress at knee, increased hip internal rotation

metatarsal raise

helps to try and restore distal transverse arch

breaking in orthotic

wear for 2 hours walking time at first, add an hour a day until comfortable for 6 hours, wear for first part of sporting event then take out

compensated tibial varum leads to

early excessive pronation

stretch tibialis posterior

eversion and dorsiflexion

stretch peroneus longus

dorsiflexion and inversion