Musculo day I

• Convex surface moving on a concave surface

  • roll and slide occur in the OPPOSITE direction
  • mobilizing force should be applied in the OPPOSITE direction of the bone movement
• Concave surface moving on a convex surface

  • roll and slide occur in the SAME direction
  • mobilizing force should be applied in the SAME direction of the bone movement
• End-feel


  type of resistance that is felt when passively moving a joint through the end range of motion
• Firm (stretch) end-feel

  • ankle dorsiflexion
  • finger extension
  • hip medial rotation
  • forearm supination
• Hard (bone to bone) end-feel

  elbow extension
• Soft (soft tissue approx) end-feel

  • elbow flexion
  • knee flexion
• Abnormal end-feel

  • consists of any end-feel that is felt at an abnormal or inconsistent point in the range of motion or in a joint that normally presents with a different end-feel
• Empty end-feel

  • joint inflammation
  • fracture
  • bursitis
• Firm end-feel

  • increased tone
  • tightening of the capsule
  • ligament shortening
• Hard end-feel

  • fracture
  • osteoarthritis
  • osteophyte formation
• Soft end-feel

  • edema
  • synovitis
  • ligament instability/tear
• Strength of Evidence Grading

  • B - evidence refers to evidence of moderate strength
  • D - evidence refers to a conclusion based on conflicting studies
  • E - evidence refers to theoretical findings
  • F - evidence refers to expert opinion
• Swan-Neck Deformity


  PIP extension, DIP flexion, and MCP flexion
• Unhappy Triad


  MCL, ACL, medial meniscus
• Postop Precautions

  • Cervical spinal fusion procedure: no lifting >5-10 lbs for four weeks
  • Lumbar spinal fusion procedure: avoid end-range rotation and extension, intensive abdominal exercise, impact loading for three months
• Medial Epicondylitis

  • "golfer's elbow"
  • affects the pronator teres and tendinous attachment of the flexor carpi radialis
• Compartment Syndrome

  • caused by elevated pressure that restricts blood flow
  • anterior is the most common presentation
  • acute is a medical emergency that is usually caused by direct trauma
  • strength training is appropriate intervention for these patients
• Transient Synovitis

  • affects children aged 3-10
  • causing sharp, sudden hip pain
• Equinovarus

  • gait dev of ankle and foot
  • result of spasticity of the posterior tibialis and/or gastrocnemius-soleus
• MMT Grading pt1

  • Zero (0/5): no palpable muscle contraction
  • Trace (1/5): muscle contraction can be palpated, but no joint movement
  • Poor Minus (2-/5): does not complete ROM in gravity-eliminated position
  • Poor (2/5): completes ROM in gravity-eliminated position
  • Poor Plus (2+/5): able to initiate movement against gravity
  • Fair Minus (3-/5): does not complete ROM against gravity, but completes more than half of the range
• MMT Testing pt2

  • Fair (3/5): completes ROM against gravity without manual resistance
  • Fair Plus (3+/5): completes ROM against gravity with minimal resistance
  • Good Minus (4-/5): completes ROM against gravity with min-mod resistance
  • Good (4/5): completes ROM against gravity with mod resistance
  • Good Plus (4+/5): completes ROM against gravity with mod-max resistance
  • Normal (5/5): completes ROM against gravity with max resistance
• Gait - Standard Stance Phase

  • heel strike
  • foot flat
  • midstance
  • heel off
  • toe off
• Gait - Standard Swing Phase

  • acceleration
  • midswing
  • deceleration
• Gait Cycle

  • stance: 60%
  • swing: 40%
• Heel Strike

  instance that the heel touches the ground to begin stance phase
• Foot Flat


  point in which the entire foot makes contact with the ground and should occur directly after heel strike
• Midstance


  point during the stance phase when the entire body weight is directly over the stance limb
• Heel off


  point in which the heel of the stance limb leaves the ground
• Toe off


  point in which only the toe of the stance limb remains on the ground
• Acceleration


  begins when toe off is complete and the reference limb swings until positioned directly under the body
• Midswing


  point when the swing limb is directly under the body
• Deceleration


  begins directly after midswing, as the swing limb begins to extend, and ends just prior to heel strike
• RLA - Stance Phase

  • initial contact
  • loading response
  • midstance
  • terminal stance
  • pre-swing
• RLA - Swing Phase

  • initial swing
  • midswing
  • terminal swing
• Initial Contact


  beginning of the stance phase that occurs when the foot touches the ground
• Loading Response


  amount of time between initial contact and the beginning of the swing phase for the other leg
• Midstance


  point in stance phase when the other foot is off the floor until the body is directly over the stance limb
• Terminal Stance


  begins when the heel of the stance limb rises and ends when the other foot touches the ground
• Pre-swing


  when the other foot touches the ground and ends when the stance foot reaches toe off
• Initial Swing


  when the stance foot lifts from the floor and ends with maximal knee flexion during swing