Knowledge Base Musculoskeletal What mobilizations facilitate what motions, specifically for the hip and shoulder joints. There has been discrepancies among different sources. What does the FSBPT acknowledge as correct? Which movement of shoulder joint get restricted first in adhesive capsulitis? Can you please tell me which muscles are weak in Upper cross syndrome? Extension, ipsilateral side bending and contralateral side rotation – closes the facet joint. Extension and ipsilateral side bending narrows the ipsilateral intervertebral foramen. Am I correct? Is there a maximum number of socks/ply a patient can use before they should get a different prosthetic or be referred back to the prosthetist? I know about plagiocephaly, which means flat head syndrome, but I don’t understand what happens with torticollis with frontal and occipital plane? Eg. If left torticolis happens it will lead to left frontal and right occipital regions flattening! How exactly does it happen? Can you explain the motions of the medial and lateral meniscus and their relation to the screw home mechanism? I understand that: Pronation – IR tibia – genu valgum – IR femur – anterversion – coxa vara. But TherapyEd, Magee and Wikipedia says genu valgum results in lateral tibial torsion (TherapyEd: genu valgum/varum description in lower extremity conditions). Is torsion and rotation of the tibia different? Also, could you please explain wrt intoeing and outtoeing of the foot also. Thnx. Please tell me if this concept is right or wrong. What symptomatic presentations would you expect from a PT with an AA subluxation? Would a pt be able to present with isolated neurological presentations in either the LE or UE? Explain Dermatome or Myotome pattern possibilities if any? Most of the things I’ve seen have involved are UE symptoms, perhaps due to nerve root origin. Why is it that when a patient has a problem with push off the forefoot, why would the patient have a decrease in big toe extension and not big toe flexion? I know in Trendelenberg gait the patient’s R hip will drop and this causes the stance leg (the L glut medius) to be weak. I also know that in backward lurch the gluts are weak and in forward lurch the hip flexors are weak. I do not understand why if a patient lurches to the R side as soon as the L foot touches the ground, why would the L glut medius be weak? How to interpret T-score & Z-score on BMD report for Osteoporosis? In Phelps test, how does the concept work for gracilis being tight? It says that if abduction further with knee in flexion in prone. Then it means it is gracilis tightness. Gracilis is a hip flexor int rot and add. Please, can you explain. What’s the direction of mobilization of the lumbar vertebral and iliosacral joint? Which muscle does work first during going up and down a ramp and stairs? Is the active insufficiency happen in all two joint muscle when they are doing their specific action, for example, in hamstrings occur active insufficiency when the hip is ext and the knee is flex? Is the passive insufficiency more like eccentric contraction or is more stretching of the tissue? What is the difference between tendonitis and tendonosis regarding healing time? In my Pathology book by Goodman, it states that flexion activity is contraindicated for people with osteoporosis and we should focus on extension activities. I don’t understand why flexion would be contraindicated. If there is pelvic drop on left hip while on midstance, why is standing hip abduction of left better than hip abduction of the right? I always have confusion in correct hand placement for decreased right rotation caused by left thoracic facet joint capsular tightness at T5-T6. What mobilization technique is used and what hand placement for extension, flexion and rotation of spinal levels? What does a closing and opening restriction of spine means? For example, what manual therapy technique is used to improve closing restriction of T4-T5? Therapist is performing Thomas test for hip flexion contracture and found while doing the test PT was doing hip abduction and lateral tracking of patella, so which muscles you should stretch? I am having trouble understanding the differences between spondylosis, spondylitis, and spondylolisthesis. I have always had trouble with trying to understand the differences between these three terms. Please help! How to different sports bursitis in hip like hurdle race and running, cause which kind of bursitis? In the hypothetical case of unilateral thoracic facet join, when may I choose to perform the ant-sup glide to the upper or to the lower vertebra at the transverse process? In order to stretch the capsule and open the join. In case of pes planus, which compensation sets in first? I have difficulty understanding Calcaneal valgus compensation coupled with tibial rotation in case of flat foot. I understand that forefoot valgus will cause rearfoot varus. Now, my Q is, is this a bodily compensation? Also, when we do we need to add a wedge and how do we know if we need to add in forefoot or rear foot? What happens when there is rearfoor valgus? Thnx Can you please explain forefoot valgus? In the textbook it is mentioned that a lateral wedge is used to correct the forefoot valgus. As I try to visualize, I feel that a lateral wedge will further enhance valgus position of the forefoot and worsen the condition. Same is the question for forefoot varus, where the textbook recommends a medial wedge, whereas, I feel that a medial wedge will push the forefoot further into varus. In Magee, it says correlated postures for lateral tibial torsion is toeing out and excessive subtalar supination and the compensatory postures are excessive subtalar pronation and functional forefoot varus. Shouldn’t be functional forefoot valgus? Because when I do it I feel its valgus. Pronation is eversion and supination is inversion, right? Is the loose packed position of a joint always the position that is most vulnerable for that joint to dislocate? What is the difference between Ortolani and Barlow test and which one is mostly done for congenital hip dislocation? Weakness of what muscle groups makes the person to walk uphill difficult, hip flexors and knee extensors or hip extensors? In our bonus session Manvi was mentioning that, one should need gluts strength to go uphill/steps and quads strength to downhill. I found this in Sullivan “Going up step-over-step requires good quadriceps strength and a medium to long residual limb. Going down a steep hill again requires good quadriceps strength and prosthetic control but is accomplished by most individuals.” Please clarify. Thanks. Is it safe to associate an everted calcaneus with an everted subtalar joint all the time in a closed kinematic chain? For example in pes planus? Also, is it safe to always associate an inverted calcaneus with an inverted subtalar joint in a closed chain? When would you use isokinetic exercises; specifically with what population, or when you are trying to achieve what outcome? If a patient’s left innominate is locked in posterior rotation that means anterior rotation is restricted so the intervention would be MET of Left hip flexors? For the PNF techniques, is Rhythmic Stabilization and Alternating Isometrics similar, or somewhat different in terms of indications? Is there any easy way to remember referred pain from shoulder and forearm muscles? Individuals with scoliosis have S or C shaped curve and are named based on the convexity. Would this mean that the muscles on the concave side would be shortened and the muscles on the convex side stretched? If so how would we go about with interventions? Would I strengthen trunk extensors, glutes, and abs. Or focus more on stretching (based on the limitations of ROM) the iliopsoas, lateral trunk flexors, and low back extensors? When is a plastic AFO indicated and when is a steel enforced AFO indicated? I don’t understand how a thrust manipulation of the thoracic spine can assist with improving hypomobility of the cervical neck. How does the line of gravity act at hip, knee and ankle, when there is a flexion contracture at knee during gait training? How do we square our pelvis and how do we know where the problem is in our leg wrt discrepancy? As in if the distance is normal between the malleolus or knee? What if there are abnormalities in pelvic obliquity? Ant pelvic tilt – nutation. Correct? I have a query about ligament palpation, especially lateral and medial collateral ligament, is there any particular way we can palpate it? I’ve read somewhere, in order to palpate lateral collateral ligament, the involved foot should be put on uninvolved knee in sitting position, in this position the knee is 90′ of flex and HIP ER. Is that correct? If yes, what should be for MCL? Is there a particular procedure to palpate a tendon of a muscle? For example, supraspinatus can be palpated by placing the involved UE behind the back in full IR. Will Cervical disc herniations in later stages lead to instability? Please correct me, I believe that in forefoot valgus, it’s eversion of forefoot with compare to rearfoot, but it’s long term compensatory motion will lead to a supinated foot, due to what it will lead to pressure on lateral aspect of foot, and clinically resembles as planus foot? With reference to Magee, 6th edition, pages 906, 907, it suggests that with forefoot valgus and varus, it leads to decreasing of the medial longitudinal arch and clinically resembles pes planus. How’s that possible with the different conditions? What is the difference between disc displacement with reduction and disc displacement without reduction in temporomandibular joint? The Anterior Drawer Test is used to assess ACL integrity, but this test is not that necessary to enquire if ACL is ruptured, as compared to tests like Lachman’s, Slocum’s and Lateral Pivot Shift, isn’t it? Please explain the concept of tensile and compressive stresses on both menisci in McMurray’s test. E.g. Which menisci suffers which force during internal rotation at the knee? When it says – INTERNAL ROTATION AT THE KNEE, does it mean tibial IR or femoral IR at the knee? What are the joints of Luschka? The effects of weakness, tightness, muscle crossing multiple joints. How will this affect activities such as rolling over, sitting up, stair climbing, using ramps, transferring? What is a synergist or the effects of synergists in producing a particular motion or function such as ascending stairs, throwing a ball, foot pronation during weight bearing, etc.? A patient comes in OPD for treatment of partial meniscectomy after 2 weeks and complains about pain in calf muscle. The signs include pain, inflammation and swelling in calf. My question: Can DVT happen after 2 weeks or is there any other reason for that? I’m trying to understand the lever system in the body. While studying the MS chapter in the O’Sullivan review book, it says, ‘…most muscles in the human body are third class levers (elbow flexion)…’. Why is elbow flexion a third class lever? When you look up side to side and down side to side, which eye muscles act? In piriformis syndrom, in Magee it says it is an overuse syndrome due to too much ER of the hip and excessive pronation of the foot which leads to abnormal femoral IR. I don’t understand how excessive motion of ER of hip and pronation of the foot leads to abnormal femoral IR. Please explain. Thanks. Although I have found that TrA is activated first with abdominal hollowing and the obliques more with pelvic tilts, is there a particular order in which the abdominals (IO, EO, RA, TrA) are recruited with any kind of activity? I am confused about knee mobilization. I thought that the patella moves inferiorly with knee flexion and superiorly with knee extension. Therefore, how would a superior glide of patella promote terminal knee extension? I thought you always go in the opposite direction. For example, to improve ankle dorsiflexion we do talocrural posterior glide. Is the patella just an exception? Thanks. What are CTSIB 3-6 indicative of sensory selection issues? ACL and PCL are located within articular surfaces, but outside the synovial lining. I’ve read this somewhere, but I can’t understand how, as I believe that articular cartilage is just attached to the bone while synovial lining is outside of a joint. Also what is the procedure to palpate the ACL and the PCL? Trapezius muscle works as the opposite side rotation and same side flexion of the neck, so, accessory nerve injury, nitration injury should be with the same side rotation and shoulder depression. Is that right? But Magee suggests, it is with the opposite side neck rotation and shoulder depression. Please, correct me. Is spinal mobilization contraindicated in any trimester of pregnancy? With hyperextension injury, which structure is affected, ACL or PCL? In Magee, it says PCL and with hyper flex. ACL is affected, but I think it should be reverse. I can’t understand what’s the reason for it. Is pelvis shifting anteriorly causing hip and lumbar extension the same as posterior pelvic tilt? Adaptive shortening of the anterior shoulder muscles and adaptive lengthening of the upper posterior back muscles causes medial rotation of the scapula. How? Will rounded shoulders cause medial rotation of the scapula? In my notes from the PT school (which come from Kinesiology by Oatis), I have that normal for adult toe out angle with free speed walking is 12-14 degrees. Is this correct? I found that 14 degrees was considered abnormal in Levangie, pg 528. Thank you. Can you please explain autogenic and reciprocal inhibition and how it relates to contract/hold relax? Considering that there are no abnormalities such as hypomobility or decreased bone mineral density, what is the average youngest and oldest age that you would perform a joint mobilization on? And how soon after a joint surgery would you complete a mobilization (considering it is just a grade 1 or 2 for pain relief)? What is the norm for horizontal abduction? I found that the norm for horizontal adduction is 130 or 45 degrees depending on the starting point. I am assuming that the 130 degrees is if the starting point is at 90 degrees of shoulder abduction and the 45 degrees is if starting point is 90 degrees of shoulder flexion. Can you confirm this? Oh and the open pack position for the glenohumeral joint is 55 degrees abduction and 30 degrees of horizontal adduction. Does the horizontal adduction portion mean the starting point was from 90 degrees of shoulder abduction to get the 30 degrees? Thank you so much! Why is it that there is more pain with ascending vs descending stairs in hamstring strains? I would have thought it would have been the opposite. I read in my notes from PT school that with an AC joint lesion, it is important to palpate the suprasternal angle (even more so than the SC joint). I cannot figure out why. Do you know why? Whenever median nerve is damaged then we say abduction is affected but abductor pollicis longus is supplied by radial, so why does it not compensate for the function of abductor pollicis brevis? When treating patients with flexor tendon resection surgery of the hand (FDS, FDP) the treatment best is passive flexion at surgical site and active extension as it would avoid damage to surgical site, but Kisner mentions use of early controlled active motion based on experiment. Which theory should be applied and why post op. Will the approach be the same for mallet finger too? What is the open and closed chain motions of supination and pronation? If you have a Left sided innominate, you can do MET to strengthen the L Hip flexors or stretch the L Posterior muscles. I can’t picture what the patient’s position and action would be as well as the therapist. For interventions, what is the correct progression: should you have a patient perform closed chain exercises or open chain exercises first? My initial thought was that you should do open chain first then progress to closed chain. Exceptions would be ACL surgery where open chain is contraindicated. For example, what would be the best intervention for a patient who has fair strength after long thoracic nerve injury. Would I be correct to chose the open chain activity of supine arm overhead with weights instead of closed chain activities such as standing wall push-ups? What should be the treatment for retrolisthesis? Traction is contraindicated, how to relieve radicular pain? When is it appropriate to use an ISOKINETIC machine for ACL repairs? I have a patient in clinic who is s/p 8 months ACL repair and every few months she has been going for isokinetic testing as she wants to return to playing college lacrosse. From my understanding, isokinetic machines can be set at a constant speed in which the limb has to move throughout the ROM. Is the purpose of the machine just for strengthening and to assess something like quads/hamstrings ration? I was studying the pelvic rotation and treatment for it, so for the right side anteriorly rotated innominate, on examination on long sit test, supine involved leg (right side) will be longer and sitting (shorter leg) compared to uninvolved side. Treatment will be stretching of the rectus femoris and strengthening of the hamms and gluts. Right? What is the best way to learn ideal plum alignment and positioning adapted to specific scenarios i.e. amputee, people on crutches, etc.? Windswept deformity is also seen and observed in CP population either because of DDH or Scoliosis, if one of the hip is in FLEXION, ADDUCTION and INTERNAL ROTATION then what would be the position of the other hip? Which positioning is most important in order to prevent further deterioration of this child? I’m having a hard time understanding the shoulder joint capsule and concurrent instability as a result of injury. Is the anterior joint capsule a compilation of ligaments or is it one specific ligament? When there is an injury to an anterior capsule (from overhead throwing, or hyperextension) why does the scapula and rotator cuff muscle become weak and injured if the detriment is to the anterior muscles (pecs, subscapularis) since the humerus shifts forward? How does bilateral knee flexion contractures (of about 30 degrees) and a forward trunk lean during gait affect a patient’s line of gravity? (question modified). Which muscle groups, between the plantarflexors and knee extensors, are most active during loading response? It appears that both muscle groups are active during this phase of gait. (question modified). For a patient who is leaning forward with increased hip flexion during ascending stairs the muscles being used to the best advantage with this forward posture will be gluteus maximus, iliopsoas or quadriceps, I’m stuck in glut max and quads as body leans forward for gaining advantage by shifting LOG forward in weak quads. Also, in weak glut max body will learn forward for stretch sling shot contraction of hip from flexion to passive hip extension. So, which one is the correct answer here? I have some doubts in gait abnormalities: during pre-swing phase of a gait cycle. 1. If PT has weak PF he won’t be able to push of and clear the ground, so the PT will have increased step length in contralateral extremity or on ipsilateral extremity? 2. If a patient is having turf toes, what compensation and deviation will be seen in pre-swing phase: will that be an antalgic gait? Or will step length of contralateral extremity will increase? Please explain. What are the main differential diagnosis of SCFE vs Legg-Calve-Perthes? I’m getting varied info from different sources specifically with ROM limitations. what are the treatment positions or postures that are to be avoided for pregnant women of second or third trimester? this is in regards with stretching plantar fascitis, a given HOME program to the patient…..why is the position for the knee should be in KNEE FLEXION? I was thinking it can be done in Knee extension to further stretch the plantar fascia. Please advice. What is the relation between Q angle and Patellofemoral dysfunction? What are the results of increase and decreased Q angle, and dysfunction related? Can you please explain about the hamstrings:quadriceps ratio? what is is for? what are the normal values? Can you explain what muscles are shortened and what muscles are then lengthened when a patient is in a posterior pelvic tilt and an anterior pelvic tilt? Can you help me understand more on Kinetics of Gait? How does the Ground force applies on hip, knee and ankle? Thank you. I know there is a previous question regarding Spondylolisthesis, Spondylolysis, and Spondylosis, but I was wondering if you can explain the differences in appearance such as which is the vertebral body slipping forward, which is the scotty-dog, which is the fracture, etc. Also, do you name it by slippage of the superior vertebrae? I was wondering if you can help site some examples for spinal conditions (e.g. spondylolisthesis etc.) with regards to flexion and extension biases. What might be the possible cause(s) for a circumduction gait in a patient with transfemoral amputation who ambulates by circumducting the prosthetic limb of swing side. (question modified). Q. How can I differentiate between synovitis and capsulitis in TMJ dysfunction? A. What is the correct direction for glenohumoral mobilization for a patient with adhesive capsulitis? Anterior-inferior gliding or posterior inferior gliding? I am confused because I found two differing answers from both the Scorebuilders and TherapyEd texts. (Edited). Q. What are the five positions of grip strength test by using handheld dynamometer? Q. Could you please explain (1) TMJ disfunction in such cases of : capsular restriction,hyper mobility and capsulitis (2)mobilization direction in case of capsular restriction. Q. Does the scapular move in an upward or downward rotation with push up?, pull ups? and/or chin ups? I am having difficulty understanding. I cannot find a good source to explain it.
What mobilizations facilitate what motions, specifically for the hip and shoulder joints. There has been discrepancies among different sources. What does the FSBPT acknowledge as correct?
Extension, ipsilateral side bending and contralateral side rotation – closes the facet joint. Extension and ipsilateral side bending narrows the ipsilateral intervertebral foramen. Am I correct?
Is there a maximum number of socks/ply a patient can use before they should get a different prosthetic or be referred back to the prosthetist?
I know about plagiocephaly, which means flat head syndrome, but I don’t understand what happens with torticollis with frontal and occipital plane? Eg. If left torticolis happens it will lead to left frontal and right occipital regions flattening! How exactly does it happen?
Can you explain the motions of the medial and lateral meniscus and their relation to the screw home mechanism?
I understand that: Pronation – IR tibia – genu valgum – IR femur – anterversion – coxa vara. But TherapyEd, Magee and Wikipedia says genu valgum results in lateral tibial torsion (TherapyEd: genu valgum/varum description in lower extremity conditions). Is torsion and rotation of the tibia different? Also, could you please explain wrt intoeing and outtoeing of the foot also. Thnx. Please tell me if this concept is right or wrong.
What symptomatic presentations would you expect from a PT with an AA subluxation? Would a pt be able to present with isolated neurological presentations in either the LE or UE? Explain Dermatome or Myotome pattern possibilities if any? Most of the things I’ve seen have involved are UE symptoms, perhaps due to nerve root origin.
Why is it that when a patient has a problem with push off the forefoot, why would the patient have a decrease in big toe extension and not big toe flexion?
I know in Trendelenberg gait the patient’s R hip will drop and this causes the stance leg (the L glut medius) to be weak. I also know that in backward lurch the gluts are weak and in forward lurch the hip flexors are weak. I do not understand why if a patient lurches to the R side as soon as the L foot touches the ground, why would the L glut medius be weak?
In Phelps test, how does the concept work for gracilis being tight? It says that if abduction further with knee in flexion in prone. Then it means it is gracilis tightness. Gracilis is a hip flexor int rot and add. Please, can you explain.
Is the active insufficiency happen in all two joint muscle when they are doing their specific action, for example, in hamstrings occur active insufficiency when the hip is ext and the knee is flex? Is the passive insufficiency more like eccentric contraction or is more stretching of the tissue?
In my Pathology book by Goodman, it states that flexion activity is contraindicated for people with osteoporosis and we should focus on extension activities. I don’t understand why flexion would be contraindicated.
If there is pelvic drop on left hip while on midstance, why is standing hip abduction of left better than hip abduction of the right?
I always have confusion in correct hand placement for decreased right rotation caused by left thoracic facet joint capsular tightness at T5-T6. What mobilization technique is used and what hand placement for extension, flexion and rotation of spinal levels?
What does a closing and opening restriction of spine means? For example, what manual therapy technique is used to improve closing restriction of T4-T5?
Therapist is performing Thomas test for hip flexion contracture and found while doing the test PT was doing hip abduction and lateral tracking of patella, so which muscles you should stretch?
I am having trouble understanding the differences between spondylosis, spondylitis, and spondylolisthesis. I have always had trouble with trying to understand the differences between these three terms. Please help!
In the hypothetical case of unilateral thoracic facet join, when may I choose to perform the ant-sup glide to the upper or to the lower vertebra at the transverse process? In order to stretch the capsule and open the join.
In case of pes planus, which compensation sets in first? I have difficulty understanding Calcaneal valgus compensation coupled with tibial rotation in case of flat foot.
I understand that forefoot valgus will cause rearfoot varus. Now, my Q is, is this a bodily compensation? Also, when we do we need to add a wedge and how do we know if we need to add in forefoot or rear foot? What happens when there is rearfoor valgus? Thnx
Can you please explain forefoot valgus? In the textbook it is mentioned that a lateral wedge is used to correct the forefoot valgus. As I try to visualize, I feel that a lateral wedge will further enhance valgus position of the forefoot and worsen the condition. Same is the question for forefoot varus, where the textbook recommends a medial wedge, whereas, I feel that a medial wedge will push the forefoot further into varus.
In Magee, it says correlated postures for lateral tibial torsion is toeing out and excessive subtalar supination and the compensatory postures are excessive subtalar pronation and functional forefoot varus. Shouldn’t be functional forefoot valgus? Because when I do it I feel its valgus. Pronation is eversion and supination is inversion, right?
Is the loose packed position of a joint always the position that is most vulnerable for that joint to dislocate?
What is the difference between Ortolani and Barlow test and which one is mostly done for congenital hip dislocation?
Weakness of what muscle groups makes the person to walk uphill difficult, hip flexors and knee extensors or hip extensors? In our bonus session Manvi was mentioning that, one should need gluts strength to go uphill/steps and quads strength to downhill. I found this in Sullivan “Going up step-over-step requires good quadriceps strength and a medium to long residual limb. Going down a steep hill again requires good quadriceps strength and prosthetic control but is accomplished by most individuals.” Please clarify. Thanks.
Is it safe to associate an everted calcaneus with an everted subtalar joint all the time in a closed kinematic chain? For example in pes planus? Also, is it safe to always associate an inverted calcaneus with an inverted subtalar joint in a closed chain?
When would you use isokinetic exercises; specifically with what population, or when you are trying to achieve what outcome?
If a patient’s left innominate is locked in posterior rotation that means anterior rotation is restricted so the intervention would be MET of Left hip flexors?
For the PNF techniques, is Rhythmic Stabilization and Alternating Isometrics similar, or somewhat different in terms of indications?
Individuals with scoliosis have S or C shaped curve and are named based on the convexity. Would this mean that the muscles on the concave side would be shortened and the muscles on the convex side stretched? If so how would we go about with interventions? Would I strengthen trunk extensors, glutes, and abs. Or focus more on stretching (based on the limitations of ROM) the iliopsoas, lateral trunk flexors, and low back extensors?
I don’t understand how a thrust manipulation of the thoracic spine can assist with improving hypomobility of the cervical neck.
How does the line of gravity act at hip, knee and ankle, when there is a flexion contracture at knee during gait training?
How do we square our pelvis and how do we know where the problem is in our leg wrt discrepancy? As in if the distance is normal between the malleolus or knee? What if there are abnormalities in pelvic obliquity?
I have a query about ligament palpation, especially lateral and medial collateral ligament, is there any particular way we can palpate it? I’ve read somewhere, in order to palpate lateral collateral ligament, the involved foot should be put on uninvolved knee in sitting position, in this position the knee is 90′ of flex and HIP ER. Is that correct? If yes, what should be for MCL?
Is there a particular procedure to palpate a tendon of a muscle? For example, supraspinatus can be palpated by placing the involved UE behind the back in full IR.
Please correct me, I believe that in forefoot valgus, it’s eversion of forefoot with compare to rearfoot, but it’s long term compensatory motion will lead to a supinated foot, due to what it will lead to pressure on lateral aspect of foot, and clinically resembles as planus foot?
With reference to Magee, 6th edition, pages 906, 907, it suggests that with forefoot valgus and varus, it leads to decreasing of the medial longitudinal arch and clinically resembles pes planus. How’s that possible with the different conditions?
What is the difference between disc displacement with reduction and disc displacement without reduction in temporomandibular joint?
The Anterior Drawer Test is used to assess ACL integrity, but this test is not that necessary to enquire if ACL is ruptured, as compared to tests like Lachman’s, Slocum’s and Lateral Pivot Shift, isn’t it?
Please explain the concept of tensile and compressive stresses on both menisci in McMurray’s test. E.g. Which menisci suffers which force during internal rotation at the knee? When it says – INTERNAL ROTATION AT THE KNEE, does it mean tibial IR or femoral IR at the knee?
The effects of weakness, tightness, muscle crossing multiple joints. How will this affect activities such as rolling over, sitting up, stair climbing, using ramps, transferring?
What is a synergist or the effects of synergists in producing a particular motion or function such as ascending stairs, throwing a ball, foot pronation during weight bearing, etc.?
A patient comes in OPD for treatment of partial meniscectomy after 2 weeks and complains about pain in calf muscle. The signs include pain, inflammation and swelling in calf. My question: Can DVT happen after 2 weeks or is there any other reason for that?
I’m trying to understand the lever system in the body. While studying the MS chapter in the O’Sullivan review book, it says, ‘…most muscles in the human body are third class levers (elbow flexion)…’. Why is elbow flexion a third class lever?
In piriformis syndrom, in Magee it says it is an overuse syndrome due to too much ER of the hip and excessive pronation of the foot which leads to abnormal femoral IR. I don’t understand how excessive motion of ER of hip and pronation of the foot leads to abnormal femoral IR. Please explain. Thanks.
Although I have found that TrA is activated first with abdominal hollowing and the obliques more with pelvic tilts, is there a particular order in which the abdominals (IO, EO, RA, TrA) are recruited with any kind of activity?
I am confused about knee mobilization. I thought that the patella moves inferiorly with knee flexion and superiorly with knee extension. Therefore, how would a superior glide of patella promote terminal knee extension? I thought you always go in the opposite direction. For example, to improve ankle dorsiflexion we do talocrural posterior glide. Is the patella just an exception? Thanks.
ACL and PCL are located within articular surfaces, but outside the synovial lining. I’ve read this somewhere, but I can’t understand how, as I believe that articular cartilage is just attached to the bone while synovial lining is outside of a joint. Also what is the procedure to palpate the ACL and the PCL?
Trapezius muscle works as the opposite side rotation and same side flexion of the neck, so, accessory nerve injury, nitration injury should be with the same side rotation and shoulder depression. Is that right? But Magee suggests, it is with the opposite side neck rotation and shoulder depression. Please, correct me.
With hyperextension injury, which structure is affected, ACL or PCL? In Magee, it says PCL and with hyper flex. ACL is affected, but I think it should be reverse. I can’t understand what’s the reason for it.
Adaptive shortening of the anterior shoulder muscles and adaptive lengthening of the upper posterior back muscles causes medial rotation of the scapula. How? Will rounded shoulders cause medial rotation of the scapula?
In my notes from the PT school (which come from Kinesiology by Oatis), I have that normal for adult toe out angle with free speed walking is 12-14 degrees. Is this correct? I found that 14 degrees was considered abnormal in Levangie, pg 528. Thank you.
Can you please explain autogenic and reciprocal inhibition and how it relates to contract/hold relax?
Considering that there are no abnormalities such as hypomobility or decreased bone mineral density, what is the average youngest and oldest age that you would perform a joint mobilization on? And how soon after a joint surgery would you complete a mobilization (considering it is just a grade 1 or 2 for pain relief)?
What is the norm for horizontal abduction? I found that the norm for horizontal adduction is 130 or 45 degrees depending on the starting point. I am assuming that the 130 degrees is if the starting point is at 90 degrees of shoulder abduction and the 45 degrees is if starting point is 90 degrees of shoulder flexion. Can you confirm this? Oh and the open pack position for the glenohumeral joint is 55 degrees abduction and 30 degrees of horizontal adduction. Does the horizontal adduction portion mean the starting point was from 90 degrees of shoulder abduction to get the 30 degrees? Thank you so much!
Why is it that there is more pain with ascending vs descending stairs in hamstring strains? I would have thought it would have been the opposite.
I read in my notes from PT school that with an AC joint lesion, it is important to palpate the suprasternal angle (even more so than the SC joint). I cannot figure out why. Do you know why?
Whenever median nerve is damaged then we say abduction is affected but abductor pollicis longus is supplied by radial, so why does it not compensate for the function of abductor pollicis brevis?
When treating patients with flexor tendon resection surgery of the hand (FDS, FDP) the treatment best is passive flexion at surgical site and active extension as it would avoid damage to surgical site, but Kisner mentions use of early controlled active motion based on experiment. Which theory should be applied and why post op. Will the approach be the same for mallet finger too?
If you have a Left sided innominate, you can do MET to strengthen the L Hip flexors or stretch the L Posterior muscles. I can’t picture what the patient’s position and action would be as well as the therapist.
For interventions, what is the correct progression: should you have a patient perform closed chain exercises or open chain exercises first? My initial thought was that you should do open chain first then progress to closed chain. Exceptions would be ACL surgery where open chain is contraindicated. For example, what would be the best intervention for a patient who has fair strength after long thoracic nerve injury. Would I be correct to chose the open chain activity of supine arm overhead with weights instead of closed chain activities such as standing wall push-ups?
What should be the treatment for retrolisthesis? Traction is contraindicated, how to relieve radicular pain?
When is it appropriate to use an ISOKINETIC machine for ACL repairs? I have a patient in clinic who is s/p 8 months ACL repair and every few months she has been going for isokinetic testing as she wants to return to playing college lacrosse. From my understanding, isokinetic machines can be set at a constant speed in which the limb has to move throughout the ROM. Is the purpose of the machine just for strengthening and to assess something like quads/hamstrings ration?
I was studying the pelvic rotation and treatment for it, so for the right side anteriorly rotated innominate, on examination on long sit test, supine involved leg (right side) will be longer and sitting (shorter leg) compared to uninvolved side. Treatment will be stretching of the rectus femoris and strengthening of the hamms and gluts. Right?
What is the best way to learn ideal plum alignment and positioning adapted to specific scenarios i.e. amputee, people on crutches, etc.?
Windswept deformity is also seen and observed in CP population either because of DDH or Scoliosis, if one of the hip is in FLEXION, ADDUCTION and INTERNAL ROTATION then what would be the position of the other hip? Which positioning is most important in order to prevent further deterioration of this child?
I’m having a hard time understanding the shoulder joint capsule and concurrent instability as a result of injury. Is the anterior joint capsule a compilation of ligaments or is it one specific ligament? When there is an injury to an anterior capsule (from overhead throwing, or hyperextension) why does the scapula and rotator cuff muscle become weak and injured if the detriment is to the anterior muscles (pecs, subscapularis) since the humerus shifts forward?
How does bilateral knee flexion contractures (of about 30 degrees) and a forward trunk lean during gait affect a patient’s line of gravity? (question modified).
Which muscle groups, between the plantarflexors and knee extensors, are most active during loading response? It appears that both muscle groups are active during this phase of gait. (question modified).
For a patient who is leaning forward with increased hip flexion during ascending stairs the muscles being used to the best advantage with this forward posture will be gluteus maximus, iliopsoas or quadriceps, I’m stuck in glut max and quads as body leans forward for gaining advantage by shifting LOG forward in weak quads. Also, in weak glut max body will learn forward for stretch sling shot contraction of hip from flexion to passive hip extension. So, which one is the correct answer here?
I have some doubts in gait abnormalities: during pre-swing phase of a gait cycle. 1. If PT has weak PF he won’t be able to push of and clear the ground, so the PT will have increased step length in contralateral extremity or on ipsilateral extremity? 2. If a patient is having turf toes, what compensation and deviation will be seen in pre-swing phase: will that be an antalgic gait? Or will step length of contralateral extremity will increase? Please explain.
What are the main differential diagnosis of SCFE vs Legg-Calve-Perthes? I’m getting varied info from different sources specifically with ROM limitations.
what are the treatment positions or postures that are to be avoided for pregnant women of second or third trimester?
this is in regards with stretching plantar fascitis, a given HOME program to the patient…..why is the position for the knee should be in KNEE FLEXION? I was thinking it can be done in Knee extension to further stretch the plantar fascia. Please advice.
What is the relation between Q angle and Patellofemoral dysfunction? What are the results of increase and decreased Q angle, and dysfunction related?
Can you please explain about the hamstrings:quadriceps ratio? what is is for? what are the normal values?
Can you explain what muscles are shortened and what muscles are then lengthened when a patient is in a posterior pelvic tilt and an anterior pelvic tilt?
Can you help me understand more on Kinetics of Gait? How does the Ground force applies on hip, knee and ankle? Thank you.
I know there is a previous question regarding Spondylolisthesis, Spondylolysis, and Spondylosis, but I was wondering if you can explain the differences in appearance such as which is the vertebral body slipping forward, which is the scotty-dog, which is the fracture, etc. Also, do you name it by slippage of the superior vertebrae?
I was wondering if you can help site some examples for spinal conditions (e.g. spondylolisthesis etc.) with regards to flexion and extension biases.
What might be the possible cause(s) for a circumduction gait in a patient with transfemoral amputation who ambulates by circumducting the prosthetic limb of swing side. (question modified).
A. What is the correct direction for glenohumoral mobilization for a patient with adhesive capsulitis? Anterior-inferior gliding or posterior inferior gliding? I am confused because I found two differing answers from both the Scorebuilders and TherapyEd texts. (Edited).
Q. Could you please explain (1) TMJ disfunction in such cases of : capsular restriction,hyper mobility and capsulitis (2)mobilization direction in case of capsular restriction.
Q. Does the scapular move in an upward or downward rotation with push up?, pull ups? and/or chin ups? I am having difficulty understanding. I cannot find a good source to explain it.