1What does Indication mean
Things that SHOULD be done to help a certain pathology
2What does Contraindication mean
Things that should NOT be done, as they could WORSEN the condition
3**What are the two KEY COMPONENTS that make up the Hip Joint
Acetabulum: Region of the Pelvis
Femoral Head: Head of the Femur
4What acts as an extra ring of cartilage in the Acetabulum that helps protect the joint
The Labrum
5What are the 6 Deep Rotator muscles in the Hip
Piriformis
External Obturator
Internal Obturator
Superior Gemellus
Inferior Gemellus
Quadtratis Femoris
6What are some Exercises that can help STRENGTHEN the Deep Rotators
Clam Shells
Band Walks
Single Leg Stance and Progressions: Step-Downs and Single-Leg RDLs
7**What 2 conditions cause Pain ("Sciatica") down 1 leg
Disc Herniation
Piriformis Syndrome
8What are INDICATIONS of "Sciatica"
Spine Stability
Hip/Thoracic Stability
Stretch/SMR Piriformis
Strengthen Core and Neutral Spine
9What are CONTRAINDICATIONS for "Sciatica"
Spinal Flexion and Rotation
External Rotation at the Hip
10What is Osteoarthritis and what does it do
Referred to as "Wear-and-Tear Arthritis"
Affects the cartilage and can cause pain, stiffness, and reduced ROM in affected joints
11What are INDICATIONS for Osteoarthritis
Stabilize and Strengthen the HIP
Weight loss if necessary
12What are CONTRAINDICATIONS for Osteoarthritis
Impact
Painful ROM
13What is the Arthritis Process
Destruction of Cartilage
Bone Remodeling/Spurs and NARROWING of cavity
Cartilage erodes away further
Bone-on-Bone Contact and nerve endings exposed
Pain with hip movement and/or weight bearing
14How do they perform a Total Hip Replacement
The client is laying on their side in a position of extreme Hip Flexion, Internal Rotation, and Adduction across the midline to access the joint
15What are the steps for a Total Hip Replacement
1. The Femur head and Neck are SURGICALLY REMOVED
2, The Acetabulum and Proximal Femur are REMOVED
3. The Cup and Implant are INSERTED
4. Artificial Articulation and Incision are SEWN BACK UP
16What are INDICATIONS for Total Hip Replacement
Strengthen Hip Extensors
Strengthen Abductors
Strengthen External Rotators
Improve Spinal Stability/Mechanics
Improve Mobility/Function
17What are CONTRAINDICATIONS for Total Hip Replacement
Hip Flexion > 90 Degrees
Hip Adduction ACROSS the midline
Hip Internal Rotation > ~ 20 Degrees
Avoid Fall Risk
Avoid Impact
18How are Birmingham Resurfacing Procedures done and where are they performed and why
They are performed ANTERIORLY
There is a Smaller Incision and Less Muscle Damage
19What are the Joints of the Knees
Tibio-Femoral Joint: Articulation of the TIBIA and FEMUR
Patella-Femoral Joint: Articulation of the PATELLA and FEMUR
20What are the Menisci and what are their function
They Sit on top of the Tibial Plateau and under the MEDIAL and LATERAL FEMORAL CONDYLES
They act as SHOCK ABSORBERS
21Which Meniscus is bigger
The MEDIAL Meniscus is BIGGER and often torn
22Where is their most Compression in the Meniscus
Most Compression is at about 90 Degrees of KNEE FLEXION (POSTERIOR) and FULL KNEE EXTENSION (ANTERIOR)
23What is the Anterior Cruciate Ligament (ACL) and what does it do
A Ligament that runs from the POSTERIOR side of the LATERAL FEMORAL CONDYLE to the CENTER of the TIBIAL PLATEAU
It controls ANTERIOR movement and ROTATION in the Tibia BENEATH the Femur
24**How do ACL injuries happen
EXTENSION and ROTATION at the Knee
25What does the Posterior Cruciate Ligament (PCL) do
It helps CONTROL POSTERIOR MOVEMENT and ROTATION of the Tibia UNDER the Femur
26What does the Medial and Lateral Collateral Ligaments (MCL and LCL) do
They CONTROL VALGUS and VARUS forces at the Knee
27What is Valgus and Varus
Valgus = Knees go in
Varus = Knees go out
28What is the Q-Angle
The Alignment of the Quadriceps-Q-Angle which can increase Knee Valgus
29TRUE or FALSE: ACL tears are more common in women because they have a greater Q-Angle
TRUE
30How do you find the Q-Angle
By Bisecting Two Lines:
A relatively vertical line
A line from the Anterior Superior Iliac Spine (ASIS) to the midpoint of the patella
31What is Patella-Femoral Syndrome and what is another name for it
"Runners Knee"
When the Patella runs across the Lateral Femoral Condyle due to tightness in the TFL/IT Band and weakness in the Vastus Medialis
32What are INDICATIONS for Patella-Femoral Syndrome
Strengthen Vastus Medialis (Closed-Chain TKE)
Stretch or SMR TFL/IT Band, Vastus Medialis
Strengthen Glutes and Deep ROTATORS
Address Valgus
33What are CONTRAINDICATIONS for Patella-Femoral Syndrome
Open-Chain TKE
Impact Activity
Repetitive Knee Flexion/Extension
Anything that causes knee pain
34What are INDICATIONS for ACL Reconstruction
**Strengthen Hamstrings (To help STABILIZE against anterior movement)
Strengthen Glutes and Deep Rotators
Strengthen Quads
Hip and Ankle Mobility
35What are CONTRAINDICATIONS for ACL Reconstruction
Open-Chain TKE
Impact
Frontal Plane Movement
36What causes Meniscal Tears
Full Flexion & Rotation
37What INDICATIONS for Meniscal Tears
Lower Body Strength
Weight Loss if needed
38What are CONTRAINDICATIONS for Meniscal Tears
Impact
Full Extension, ESPECIALLY in Open-Chain
90 Degrees of Knee Flexion
39What can lead up to Total Knee Replacements
Patella-Femoral Syndrome -> Arthtiris -> TKR
ACL Tear -> Meniscal Tear -> Arthrtitis -> TKR
40What are INDICATIONS for Total Knee Replacements
Strengthen/Stretch Quad
Strengthen/Stretch Hamstring
Weight loss if needed
41What are CONTRAINDICATIONS for Total Knee Replacements
Impact
Frontal Plane Movement
Open Chain TKE
42What is Patellar Tendinitis and what is it also called
Repetitive stress on the patellar tendon that causes irritation
AKA "Jumper's Knee"
43What muscles are WEAK and what muscles are TIGHT that may cause Shin Splints
Weak: Anterior Tibialis
Tight: Calves
44How do most ankle sprains occur
They occur with INVERSION
45What is Achilles Tendinitis and what happens
Misalignment of the arches, causes supination or pronation and strain on the tendon
The Achilles becomes inflamed
46What are INDICATIONS for Achilles Tendinitis
Strengthen and Stretch Plantar Flexors
Strengthen Anterior Tibialis
Regain ROM and Gait Patterns
Effective landing mechanics to absorb force
47What are CONTRAINDICATIONS for Achilles Tendinitis
High Impact
Frontal Plane Movement