In what order do we present the 3 planes/axes?
Sagittal plane/frontal axis
Frontal plane/sagittal axis
Transverse plane/longitudinal axis
What is the keystone to the medial longitudinal arch?
Navicular
What 2 muscles produce knee flexion and cross the hip?
Gracilis, Sartorius
What muscles control hip pronation?
Gluteus maximus, gluteus medius
What is a step vs a stride?
Step - toe off to initial contact (limb advancement) (initial, mid, terminal swing)
Stride - toe off to initial contact of contralateral limb (initial, mid, terminal swing, loading response, midstance)
What muscles contribute to the movement of the ankle during the lowering phase of a squat?
Plantarflexors - gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, flexor hallucis longus, peroneus longus/brevis
Why is a high ankle sprain so detrimental?
Affects syndesmosis and extends up into interosseus membrane
What are the common and technical terms for knee valgus and varus?
Knee Valgus - knock-knee - genu valgum
Knee Varus - bow-legged - genu varum
Which of the 3 iliopsoas muscles is an outlier and why?
Iliacus, attaches at iliac crest
How is the gait cycle subdivided between stance and swing phases?
Swing - 40%
Stance - 60% = 40% single limb support + 20% double limb support (10% initial 10% terminal)
Describe the arthrokinematics of ankle dorsiflexion.
Tibfib - concave/same - anterior - anterior
Talus - convex/opp - anterior - posterior
What are the technical terms for flat foot, and high arch?
Flat foot: pes planus
High arch: pes cavus
Give the functions of the ACL, PCL, MCL, LCL.
ACL - resist internal/external rotation, tibial anterior translation, hyperextension
PCL - resist posterior translation, hyperflexion, external rotation
MCL - resist knee valgus
LCL - resist knee varus
Which limb is analyzed during pelvic drop and hip hike?
These movements are due to weakness of what muscle?
Non weight bearing limb
Gluteus medius
What are the 3 phases of gait? Relate to 7 phase system.
Weight acceptance - loading response
Single limb support - midstance, terminal stance
Limb advancement - initial, mid, terminal swing
What muscles help to limit a lateral ankle sprain?
Evertors - peroneus longus/brevis/tertius, extensor digitorum longus
What 3 structures support the tibiofibular syndesmosis?
What movements do each of them resist?
Anterior talofibular ligament: plantarflexion/inversion
Posterior talofibular ligament: dorsiflexion/inversion
Deltoid ligament: pure inversion
Explain the train and tracks analogy.
Train - patella. Tracks - femur.
Open chain knee extension - patella tracks laterally b/c pull from Q angle
Closed chain knee extension - patella appears to track laterally b/c femur internally rotates
Anterior pelvic tilt is due to _____ and the muscles stretched are ____.
Posterior pelvic tilt is due to _____ and tightened muscles are _____.
tight hip flexors, hamstrings
quad dominance, hams
Describe the 3 stances/phases of running.
Initial contact - foot strike
Loading response - absorb GRF/rockthrough
(Midstance - end of loading response where knee is most bent)
Terminal stance - push-off
Describe the arthrokinematics for knee flexion.
Femur - convex/opp - posterior - anterior
Tibia - concave/same - posterior - posterior
Pronation and supination
Give the movements, functions (3 for pronation, 2 for supination), and active muscles.
Pronation
Movements: calcaneal eversion, talar plantarflexion, talar adduction, tibiofibular internal rotation
Functions: stability, shock absorption, mobile adaptor
Muscles: Tibialis posterior, flexor digitorum longus, flexor hallucis longus, tibialis anterior (eccentric)
Supination
Movements: calcaneal inversion, talar dorsiflexion, talar abduction, tibiofibular external rotation
Functions: Rigid lever (locks midtarsal joints), requires concentric contraction of invertors ***
Muscles: same (concentric)
What is the screw-home mechanism?
How does it relate to pronation and supination in the first 2 gait phases?
Tibial external rotation occurs during the last 20 degrees of knee extension
Loading response - pronation - tibial internal rotation
Midstance - supination - tibial external rotation
Define coxa valga and coxa vara with proper angles.
How do they affect the knee?
Coxa valga - greater than 140 degrees, causes genu varum
Coxa vara - less than 125 degrees, causes genu valgum
In running, what are the causes of hip/knee injury, and foot/ankle injury (3 for each)?
Hip/knee causes of injury:
Inadequate use in sagittal plane (quad dominance)
Poor dynamic stability (excessive IR/abduction)
Poor pelvic/trunk stability (affects transmission of forces)
Foot/ankle causes:
Excessive pronation
Different contact patterns
High force impact