Ax and Rx Hip MSK

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What do we observe in gait in the objective ax?
Want to be looking at their step balance, weight bearing, walking pattern, positioning of their feet, positioning of the rest of the body.
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What movements do we test when using the Goniometer to measure the capsular patterns of the hip?
Measure flexion, extension, abduction, adduction and medial and lateral rotation.
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Explain goniometer use for measuring flexion and extension of the hip?
Put the circle on the greater trochanter, one of the blades in line with the femur and the other one moves as the leg moves.
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Explain goniometer use for measuring abduction and adduction of the hip.
Circle goes on the anterior marking of the hip, one of the blades is in line with the circle and the other moves with the leg as it adducts and abducts.
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Explain goniometer use for measuring medial and lateral rotation of the hip.
Prone position - knee bent - put the circle on the middle of the patella - one blade in line with this circle and the other moves as the lower leg moves.
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What do we want to test when doing strength testing for the hip?
Flexion, extension, abduction, adduction, medial and lateral rotation.
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Explain the timed up and go test?
This is done to determine fall risk, balance, sit to stand and walking and determine the progress with them. Patient is in sitting - gets up - walks 3 metres - returns to chair - sits down. Process is timed. If they use an assistive device -document.
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What does the FABER test stand for and test?
Flexion, abduction and external rotation of the hip. It is a pain provocation test which tries to identify pathologies at the hip, lumbar and sacroiliac region. It tests the hip joint, sacroiliac joint dysfunction and iliopsoas muscle spasm.
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How do you carry out the Faber Test
Pt supine - cross one leg over the other - put one hand on opposite ASIS and on the bent knee - press down and then when at end of rom do some oscilations.
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What is a positive Faber test?
Where pain is produced when we do the test, if there is spasm, limited range of motion.
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What is the Thomas test and what does it test for?
This is a muscle length test, it tests hip flexion contracture and flexibility of their iliopsoas muscle group.
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How to do the Thomas Test?
Get them to sit on the plinth, get them to hug one leg and keep the other leg straight and then get them to lie back whilst still hugging that leg. If their relaxed leg is raised from the bed then it will show some tightness of the muscles there.
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What is the modified Thomas test, how to do it?
Get them to sit on the edge of the bed - get them to hug their leg again and relax the other and lie back. We would expect their lower leg to drop down because of gravity. If it does not, then it shows muscle tightness.
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Explain doing the PNF on the hip?
pt side lying - bend knee - hold their leg under your arm - get stance position - hold their lower leg with one arm and the other hand holds knee - get them to push into your hand for 10 seconds - stretch with rotate and bringing hip into you.
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What is the Obers Test?
A muscle length test for TFL and ITB to see if they are inflamed or tight. It is used for anterior knee pain and hip problems
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How do we do the Obers Test?
pt sidelying - bottom knee and hip flexed (good leg) - bring their afffected leg knee towards their other knee, forwards into flexion, into abduction, round and then straighten it out and adduct hip and let it hang. Scooping motion.
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What are the negative and positive tests for the obers test?
Negative indicates the ITB is normal and so the leg will adduct and the person will not experience any pain. A positive indication is when the ITB is tight and so the leg remains in the abducted position, wont adduct and they will have lat knee pain.
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What is Groin Strain?
muscular tear or rupture to any one of the groin muscles, normally from high speed activities like kicking or change of direction. They are graded from 1-3
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Where can groin strain go from to?
adductors or pectineus to the iliopsoas.
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what are the symptoms of groin strain?
Groin pain and tenderness, muscle spasm, tightness in the groin muscles, pain on stretching the groin muscles and groin pain during groin muscle contraction
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Explain the grades for groin strain?
Grade 1 is mild groin strain, Grade 2 is moderately groin strain which can affect our sporting ability and walking and grade 3 is severe groin strain which impacts our ability to run, jump and hop and may need surgical intervention.
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What is Osteitis Pubis?
inflammation of the pubic symphysis and the surrounding muscle insertions which is caused by repeated trauma.
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What is the main cause of Osteitis Pubis?
Instability of the pelvic bones (especially the pubic symphysis). The instability is worsened when uneven load is put through the pelvis e.g. when running, the person has poor lumbopelvic control and so cannot control the load - causes injury.
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when is Osteitis Pubis normally diagnosed?
When the pubis bones have begun to erode at the pubic symphysis.
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Where will they get pain when they have Osteitis Pubis?
Over their pubic symphysis and referred pain in their inguinal region and the groin.
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How is pain elicited with people with Osteitis Pubis?
Resisted muscle contraction of the hip adductors and the flexors elicits pain. Stretching into abduction and extension elicits pain in the acute stage. Coughing, sneezing, sit ups reproduce pain.
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What are some of the stages for rehab for Osteitis Pubis?
Rest (unload injured region), retrain stabilisation control of pelvic girdle, normalise the adjacent soft tissue and muscle flexibility to avoid excess forces being placed through region, improve lumbo pelvic, hip and LL biomechanics.
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What is Ischaemic Pain?
Pain associated with decreased blood flow to tissues. Includes ache, burning, tingling in back, buttocks, shoulders, legs. Also stiffness and knots in muscles.
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What would need to be done if there was pain in the Bursa?
Steroid injection or Bursa would need to be removed.
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Other cards in this set

Card 2

Front

What movements do we test when using the Goniometer to measure the capsular patterns of the hip?

Back

Measure flexion, extension, abduction, adduction and medial and lateral rotation.

Card 3

Front

Explain goniometer use for measuring flexion and extension of the hip?

Back

Preview of the front of card 3

Card 4

Front

Explain goniometer use for measuring abduction and adduction of the hip.

Back

Preview of the front of card 4

Card 5

Front

Explain goniometer use for measuring medial and lateral rotation of the hip.

Back

Preview of the front of card 5
View more cards

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