Podcast
Questions and Answers
What does the 'R' in the PRICEMEM acronym stand for in muscle strain treatment?
What does the 'R' in the PRICEMEM acronym stand for in muscle strain treatment?
- Rehabilitation
- Reinforcement
- Rest (correct)
- Recovery
Which condition can result from tightness in the iliotibial band or weakness in the gluteus medius?
Which condition can result from tightness in the iliotibial band or weakness in the gluteus medius?
- ITB friction syndrome (correct)
- Hip joint dislocation
- Quadriceps strain
- Hip flexor syndrome
Which test is used specifically to assess hip flexion contracture?
Which test is used specifically to assess hip flexion contracture?
- Trendelenburg Sign/Test
- Ely's Test
- FABER/Figure Four Test
- Thomas Test (correct)
What is commonly assessed by the Trendelenburg Sign/Test?
What is commonly assessed by the Trendelenburg Sign/Test?
Which component of the PRICEMEM treatment involves the use of ice?
Which component of the PRICEMEM treatment involves the use of ice?
What is indicated by a positive result in the 90-90 Straight Leg Raise Test?
What is indicated by a positive result in the 90-90 Straight Leg Raise Test?
During the Ely Test, what does spontaneous hip flexion during knee flexion indicate?
During the Ely Test, what does spontaneous hip flexion during knee flexion indicate?
What does the Ober Test evaluate?
What does the Ober Test evaluate?
In the Piriformis Test, what finding suggests tightness of the piriformis muscle?
In the Piriformis Test, what finding suggests tightness of the piriformis muscle?
What position should the patient be in during the 90-90 Straight Leg Raise Test?
What position should the patient be in during the 90-90 Straight Leg Raise Test?
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Study Notes
Muscle Strain Treatment
- Protect
- Rest
- Ice
- Compression
- Elevation
- Manual Therapy
- Early Motion
- Medication
Muscle Imbalances at the Hip
- Decreased flexibility and muscle strength imbalances can contribute to stress in the lower extremity joints
- Valgus collapse during weight-bearing due to hip abduction, extension, and external rotation weakness can contribute to:
- Patellofemoral impairment
- Anterior cruciate ligament (ACL) strain
- Piriformis syndrome
- Increased tension on the iliotibial (IT) band due to tightness (IT band or gluteus maximus) or compensation for weak gluteus medius can lead to:
- Trochanteric bursitis
- IT band friction syndrome
Common Hip Tests
- Thomas Test: Tests for hip flexion contracture
- 90-90 Straight Leg Test: Tests for hamstring tightness
- Ely's Test: Tests for rectus femoris contracture
- Ober's Test: Tests for IT band or tensor fascia latae contracture
- Piriformis Test: Tests for piriformis tightness or sciatic nerve compression caused by the piriformis
- FABER/Figure Four Test (Patrick's Test): Assesses for hip joint dysfunction
- Trendelenburg Sign/Test: Assesses for gluteus medius weakness
Tests to Assess Hip Muscle Length/Contracture/Tightness
- Thomas Test:
- Patient supine with legs fully extended.
- Patient brings one knee to chest.
- Observe the position of the contralateral hip.
- Positive test: The straight leg rises from the table.
- 90-90 Straight Leg Raise Test:
- Patient supine with hips flexed to 90 degrees and knees relaxed.
- Patient alternately extends each knee as much as possible while maintaining hips at 90 degrees.
- Positive test: Knee remains in 20 degrees or more of flexion.
- Ely Test:
- Patient prone.
- Therapist passively flexes the patient's knee.
- Positive test: Spontaneous hip flexion during knee flexion.
- Ober Test:
- Patient sidelying with lower leg flexed at hip and knee.
- Test leg moved into hip extension and abduction, then slowly lowered.
- Positive test: Inability of the test leg to adduct and touch the table.
- Piriformis Test:
- Patient sidelying with test leg positioned toward the ceiling and hip flexed to 60 degrees.
- Therapist stabilizes pelvis with one hand and the other hand on the knee. Applies a downward (adduction) force on the knee.
- Positive test: Pain or tightness.
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