Term
| Give one prime mover of internal rotation of the hip. |
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Definition
> TFL
> Gluteus minimus
> Anterior fibres of gluteus medius |
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Term
| Name the muscles that are being stretched by passive relaxed internal rotation. |
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Definition
> Piriformis
> Gluteus maximus
> Gluteus medius |
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Term
| Which bones make up the pelvis? |
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Definition
| 2 innominate + sacrum = pelvis |
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Term
| What does Ober's Test assess and what is a positive sign? |
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Definition
> Ober's Test: Asses for tension on ITB
> positive sign = the leg does not drop very far with the foot still hanging above the table |
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Term
| Which muscle, on which side, is being assessed with the Trendelenburg test? |
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Definition
| Trendelenburg test: assesses Gluteus Medius on the stance leg |
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Term
| What is the closed-packed position of the hip? |
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Definition
| Closed-packed = maximum extension, medial rotation and adduction |
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Term
| What is the loose-packed position of the hip? |
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Definition
| Loose-packed: 30o flexion, aBDuction, slight lateral rotation |
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Term
| What is the normal for the hip in flexion? Abduction? Adduction? Internal rotation? External rotation? Extension? |
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Definition
Flexion: 110-120o
Abduction: 30-50o
Adduction: 20-30o
Internal rotation: ≈35o
External rotation: ≈45o
Extension: ≈30o |
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Term
| Which muscles are prime mover for internal rotation of the hip? |
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Definition
Hip internal rotation
Gluteus minimus, ant. fibres of gluteus medius, tensor fascia lata |
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Term
| What are the two most common causes of a back ache? |
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Definition
Back ache
> Short psoas (tight m pulls on TVPs anteriorly)
> Short hamstrings (can cause hyperlordosis) |
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Term
| Why would you place your hand under your client's lower back in the Thomas test (not modified)? |
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Definition
| Placing a hand under the low back enables to see if there is any contracture with their hip flexors (lordotic curve = back lifts off table as leg returns to extension) |
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Term
Modified Thomas test
With the hip extended, what does it tell you if the knee does not flex to 90o? |
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Definition
| Knee cannot flex to 90o = tight rectus femoris |
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Term
Modified Thomas test
While extending the leg and hip; if the leg is abducted, which structures may be short/tight? |
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Definition
Leg abducted = short/tight TFL, gluteus medius, ITB
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Term
Modified Thomas test
After the leg and hip are extended; if the hip appears laterally rotated, which structures may be tight/short? |
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Definition
Hip laterally rotated = tight lateraly rotators especially piriformis
*sometimes unilateral hamstrings tightness can cause tibial rotation* |
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Term
Modified Thomas test
After the hip and knee have been extended; you notice that the thigh still remains slightly flexed and does not come parallel with the table/plinth top. What may this indicate? |
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Definition
| Thigh still flexed and deviates off table = tight iliopsoas OR rectus femoris |
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Term
| With the modified Thomas test, how can you differentiate between a tight iliopsoas or tightness of rectus femoris? |
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Definition
Rectus femoris: thigh slightly flexed; extending the knee passively will make the thigh drop to the table (avoids passive insufficiency)
Iliopsoas: thigh slightly flexed; extending the knee passively but the thigh still remains flexed (iliopsoas only goes to one joint and by eliminating rectus femoris from passive insufficiency, it is then determined that only iliopsoas can be root of tightness) |
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Term
| What structures are being tested with the Ober's test? |
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Definition
Ober's test
> test for tightness in ITB and TFL
> isolate TFL: repeat Ober's test with knee flexed
*stabilized pelvis at iliac fossa*
*positive sign: leg remains above table* |
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Term
| What is a positive sign for Piriformis test? |
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Definition
Piriformis test
+ sign: pain felt in buttock, may radiate down the leg if sciatic nerve is impiged
*sideline, stabilize at illiac fossa, mobilize leg to hip flexion and knee extension (push knee towards floor)* |
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Term
| What position does the hip need to be in Faber/Patrick's test? |
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Definition
Patrick/Faber: Flexion, aBDuction, external rotation
*tests for flexibility of adductor mm*
Positive sign
* pain in inguinal region = hip joint pathology*
* pain felt in SI joint regions = SI joint affected* |
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Term
| If you want to rule out OA in the hip joint, which test would you perform? |
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Definition
Scouring : tests for presence of osteoarthritic changes
> tests articular surfaces of head fo the femur and surface of the acetabulum
*aka quadrant test*
*+ sign: grating, sound accompanied with movement, pain*
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Term
| If you suspect a client to have a tight rectus femoris, what test will you perform? What will be a positive sign? |
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Definition
Ely's test: assess for tight/injured/contracture on rectus femoris
> + sign: buttock rising before 90o
> buttock rising before 30o = rectus femoris is very tight
*prone, passively flex client's knee, note when buttock starts to rise* |
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Term
| Which test would you perform if you suspect lesion in the SI joint? |
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Definition
Pelvic compression/approximation/transverse posterior stress test: for SI lesion
*sideline, place hand over iliac crest and push towards table; tests SI joints BL*
*+ sign: pain* |
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Term
| If you want to specifically test anterior SI ligaments, which test would you perform? |
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Definition
Pelvic gapping/transverse anterior stress test: assess anterior SI ligaments
*+ sign: pain*
*supine, cross arms and place hands over ASIS, pressure aplied down and out so ASIS move apart*
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Term
| With pelvic rocking/squish test, what does it imply if translation of the pressure from one ASIS into the other is immediate? |
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Definition
Immediate pressure translation from one ASIS to the other = ASIS being pressured is locked
*+ sign: pain felt in region of SI joint* |
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Term
| What angle is the rocking directed, in the Pelvic rocking/squish test? |
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Definition
| Pelvis rocking/squish test: rocking action is initiated at a 45o angle on one of the ASIS |
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Term
| If the pain is felt on an SI joint, is that SI joint most likely hypermobile or hypomobile? |
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Definition
Pain on the SI joint = SI joint is hypermobile and inflamed
*result of hypomobility on contralateral side*
*mobilize hypomobile joint to ↓ pain and inflammation of hypermobile joint* |
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