Term
HIP
Osteology-Parts of the Innominate Bone |
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Definition
Ilium (2/5 of the Innominate)
Ischium (2/5 of the Innominate)
Pubis (1/5 of the Innominate) |
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Term
| HIP Osteology-Joint surfaces of the Innominate |
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Definition
- Right and left bones connect at the pubic symphasis and sacrum
- Each contributes to the shape of the acetabulum
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Term
HIP
Angle of Torsion-Definition |
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Definition
| The angle formed by one axis through the head and neck of the femur, and another through the distal femoral condyles |
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Term
HIP
Angle of Torsion-Diagram |
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Definition
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Term
Hip
Angle of Torsion-Normal Values |
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Definition
In the adult, the norm is 10 to 20 degrees.
There is substantial variability |
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Term
Hip
Angle of Torsion-Anteversion -Definition |
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Definition
| A Pathologic increase in the angle of torsion. |
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Term
Hip
Angle of Torsion-Best View |
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Definition
| The angle of torsion is best seen looking down the length of the femur from top to bottom. |
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Term
Hip
Angle of Torsion-Retroversion -Definition |
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Definition
| A pathologic decrease in the angle or reversal of torsion |
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Term
Hip
Angle of Inclination of the Femur-Diagram |
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Definition
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Term
HIP
Angle of Inclination-Definition |
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Definition
| The angle formed by the line of the head and neck of the femur AND the Longitudinal Axis of the Femur |
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Term
Hip
Angle of Inclination-Normal Values |
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Definition
The angle of inclination ranges from 115 to 140 in the unimpaired adult.
It tends to be smaller in women than in men due to the greater width of the femal pelvis |
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Term
Hip
Angle of Inclination-Coxa Valga definition |
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Definition
| A pathological increase in the medial angulation between the neck and shaft |
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Term
Hip
Angle of Inclination-Coxa Vara definition |
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Definition
| A pathologic decrease in the angle of inclination |
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Term
| HIP Osteology-Effects of Abnormal Angles of Inclination and torsion |
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Definition
| Can cause compensatory hip changes and can substantially alter hip stability and WB biomechanics. Also affect tibial alignment w/Femur |
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Term
HIP
Capsule of the Hip Joint |
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Definition
-Very Strong-contributes substantially to stability
-Attaches proximally to the entire periphery of the acetabulum and forms a sleeve around the neck of the femur |
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Term
HIP
Capsule-relationship of neck and trochanters |
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Definition
-Femoral neck is intracapsular
-Greater and lesser trochanters are extracapsular |
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Term
| HIP Ligaments of the Hip Joint |
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Definition
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Term
Hip
Location and Function of the Iliofemoral Ligament |
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Definition
-Anterior
-Fan shaped, resembles inverted Y
-Resists hip extension |
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Term
Hip
Location and Function of the Pubofemoral Ligament |
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Definition
Anterior and medial to Iliofemoral
prvnts hyperextension and hyperabduction |
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Term
Hip
Location and Function of the Ischiofemoral Ligament |
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Definition
-posterior side of the hip
-limits medial rotation and posterior dislocation |
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Term
| If a person comes in on crutches recovering from an ACL surgery on their right leg and they are NWB where is the center of mass on the patient? |
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Definition
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Term
| If a pt comes in and you notice that their pelvis is dropped forward what muscles would you want to test for strength? |
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Definition
| abductors, they create an equal and opposite force to keep the pelvis stable. |
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Term
| If a pt comes in complaining of hip problems you might want to begin by measuring the acetabular anteversion angle and the center edge angle. What are the typical values fro both men and women? |
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Definition
acetabular- men 18.5°
Women 21.5°
Center- men and women – 35-40° |
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Term
| If you found a problem with the acetabular anteversion angle how would you explain to the patient what is wrong? |
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Definition
| The measurement found describes where your hip joint sits on your body. This particular measurement describes how far in front of your body this joint is found. A typical measurement for a female is 21.5° for a male 18.5°. |
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Term
| A pt comes in after a spinal injury. You notice them throwing their weight backwards. Since they probably to not have the musculature to be supporting their weight you realize that they must be supporting their weight using which ligament? |
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Definition
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Term
| A patient comes in with lower extremity problems. You take all the measurements and you record you data as follows: Hip flex knee ext 75° Hip flex knee flexed 110° Hip Ext 25° Hip Abd 30° Hip Add 30° Hip in/ex rot 50° Which motions are impaired? |
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Definition
| hip flex with knee flex, hip flex with knee ext, hip abd |
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Term
| You ask a pt to perform a left pelvic rotation. So the pt has their left leg behind them and is in a WB position. What motions do you expect to see at the femur of each leg? |
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Definition
| Left leg internal rotation, right leg external rotation |
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Term
| A pt comes in complaining of pain on her right hip. You notice that when she walks she hikes her left hip in the air. What type of force can be causing her right hip pain? |
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Definition
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Term
| A pt comes in with a Trendelenburg gait pattern. He has a pelvic drop on the left side. You educate him about assistive devices and you want to set him up with a cane. Which side would you advise him to hold the cane and why? |
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Definition
On the right side so it will not only take off 15% of the weight, but also increase his base of support and release come of the compression force.
(p. 383 of textbook) |
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Term
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Definition
HAT-Head And Trunk
GRF-Ground Reaction Force |
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Term
HIP
Weight Bearing-Pelvis to Acetabulum |
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Definition
| Most WB stress in the pelvis pass from the SI joint to the acetabulum |
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Term
HIP
Weight Bearing-During standing/upright |
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Definition
In standing, at least half the HAT passes through the pelvis to the femoral head.
The GRF travels up the shaft. |
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Term
HIP
WB - Force of HAT and GRF create force on neck |
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Definition
| These forces create a bending force across the femoral neck. That creates a tensile force on the superior femoral neck and compression on the inferior neck. |
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Term
HIP
WB- Forces on neck countered by muscles |
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Definition
| The forces on the neck of the femur are countered by the pull of the abductor. |
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Term
HIP
Osteokinematics-Close Pack Position |
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Definition
Extension, Internal Rotation and Abduction
*NOT the most congruent position*
All ligaments are taut in this position. |
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Term
HIP
Osteokinematics-Open Pack Position |
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Definition
| Slight flexion, abduction, slight external rotation |
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Term
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Definition
120 deg Flexion
10-30 deg extension
45-50 deg Abduction
20-30 deg Adduction
50 deg Medial and lateral rotation (w/hip flexed) |
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Term
HIP
Weight Bearing - Diagram |
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Definition
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Term
HIP
Weight Bearing - Trabecular adaptation |
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Definition
The trabeculae of the proximal femur adapt to the WB forces. One area becomes stronger against compression, another against the GRF and another against tesile forces.
In between these strong lines is a small triangular weak spot called the "Zone of Weaknes" |
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Term
| HIP Osteokinematics-Movements of Femur on Pelvis |
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Definition
Flexion/Extension
Abduction/Adduction
Medial/Lateral Rotation
3 degrees of freedom |
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Term
HIP
Osteokinematics-Movements of Pelvis on Femur |
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Definition
Anterior/Posterior Pelvic Tilt
Lateral Pelvic Tilt
Pelvic Rotation |
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Term
| HIP Osteokinematics-Movements of Pelvis on Femur-Anterior Pelvic Tilt |
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Definition
A pelvic motion in which the ASIS rotates down and forward.
-Sagittal Plane Coronal Axis
Produces relative hip flexion and Extension in the lumbar spine. |
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Term
| HIP Osteokinematics-Movements of Pelvis on Femur-Posterior Pelvic Tilt |
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Definition
A movement of the pelvis in which the ASIS rotates up and back.
-Sagittal Plane Coronal Axis
This produces relative hip extension and spinal flexion. |
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Term
HIP
Osteokinematics-Movements of Pelvis on Femur-Pelvic Tilt-Neutral |
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Definition
| The ASISs of the pelvis on a horizontal line with the PSIS and on a vertical line with the pubic symphysis |
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Term
HIP
Osteokinematics-Movements of Pelvis on Femur-Lateral Pelvic Tilt |
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Definition
A frontal plane motion of the pelvis around the anteroposterior axis.
About 20-30 deg of mvment
One ASIS rotates up while the other rotates down. |
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Term
HIP
Osteokinematics-Movements of Pelvis on Femur-Lateral Pelvic Tilt-Types |
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Definition
One hip joint acts as the pivot point for the motion on the opposite side.
If the opposite side elevates-->pelvic hiking
If the opposite side drops-->pelvic drop |
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Term
HIP
Osteokinematics-Movements of Pelvis on Femur-Lateral Pelvic Tilt-Assoc. mvmts |
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Definition
| Abduction on low side, adduction on high side; Lateral flexion of the spine toward the high side |
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Term
| HIP Osteokinematics-Pelvic Rotation-Def |
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Definition
A motion of the entire pelvis in the horizontal plane along the longitudinal axis.
In other words, when seen from above, one side of the pelvis shifts forward or back.
Most commonly occurs in unilateral stance with the axis passing through the hip joint |
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Term
| HIP Osteokinematics-Pelvic Rotation-Associated movements |
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Definition
Back hip internally rotates
Forward hip externally rotates
Spinal rotation in opposite direction |
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Term
HIP
Osteokinematics-Lumbopelvic Rhythm-def |
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Definition
Related movement of the lumbar spine and pelvis
Involved in motions such as touching your toes or sitting up straight in a chair. |
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Term
HIP
Osteokinematics-Lumbopelvic Rhythm-Example |
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Definition
-Spine moves in the same direction as pelvis-> Spine rounds as in bending down to touch toes
-Spine and pelvis move in opposite directions-> Spine Arches |
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Term
| HIP Osteokinematics-Lumbopelvic Rhythm-Diagram |
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Definition
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Term
| What makes up the adductor musculature of the hip? |
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Definition
pectineus, adductor longus, gracilis, adductor brevis, and adductor magnus
Mnemonic for adductors:
Please Leave Great Big Marks
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Term
| In what plane does the adductors create torque? |
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Definition
| In all planes-frontal plane (both pelvic on femur and femur on pelvic) and sagittal plane (causes flexors or extensors to fire depending on hip position) |
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Term
| What makes up the flexor musculature of the hip? |
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Definition
| iliopsoas, sartorius, tensor, rectis femoris, pectineus, and adductor longus |
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Term
| What is the special test used to look at hip flexor length? |
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Definition
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Term
| What special test is used to look at ITB length? |
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Definition
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Term
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Definition
| They are a hip joint pathology due to bony failure of the femoral neck |
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Term
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Definition
| Is a hip joint pathology which is due to the deterioration of the joints articular cartilage and leads to decreased ability to dissipate load |
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Term
| What if the abductors cannot generate enough torque in single leg stance? |
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Definition
| Lateral trunk lean, Trendelenburg, or cane-same side, or cane-opposite side |
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Term
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Definition
| Will lean towards the side of weakness so the abductors do not have to work as much. This also brings the LOG closer to the hip joint. |
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Term
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Definition
| The pelvis drops to the unsupported side even when the lateral lean is present |
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Term
| Cane-same side (as weak side) |
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Definition
| This decreases body weight by the amount of the downward thrust- up to 15% of weight relief is possible |
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Term
| cane-opposite side (as weak side) |
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Definition
| The reduction of the weight is similar to that of cane-same side but in this case the cane is further from the painful hip so it can assist the abductors in providing countertorque |
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Term
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Definition
| ASIS moves anteriorly and inferiorly while spine extends. |
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Term
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Definition
| PSIS moves anteriorly and superiorly while the the spine flexes |
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Term
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Definition
Spine laterally flexes toward side of elevated hip
Compression force on WB side
Concentric contraction of abductors |
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Term
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Definition
Tensile force on WB side
Lengthening of abductors |
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Term
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Definition
Reference point for motion is side opposite supporting hip
Forward and backward rotation |
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Term
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Definition
| When femur moves on pelvis in non-weight bearing |
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Term
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Definition
Lies just posterior to axis for flexion/ extension
Creates extension moment |
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Term
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Definition
Hips in neutral and all body weight distributed evenly
If all is aligned, little to no muscular force nedded |
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Term
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Definition
One hip carries full body weight
Causes compression as well as torque |
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