63 Questions
What is the main reason why slump is more aggressive than SLR?
Compression with sitting affecting disc and neural structures
Which technique involves getting the nerve to move through a 'container' to address adverse soft tissue causing issues?
Flossing
What is the goal of therapy intervention when dealing with pain?
Centralization of pain
What is neural tension defined as in the context provided?
Inability of the nerve to move smoothly through tissue
Why should one be careful with nerve pain according to the text?
Latency in symptoms
What position is recommended to start radicular pain treatment?
Lying down position
What is the main purpose of performing manual traction?
To produce a gapping effect
What could be a consequence of having one segment out of alignment in hypermobility?
Biomechanical shifts in the rest of the spine
Which technique focuses on compression of innominate bones for form closure?
Muscle Energy Technique (MET)
Why is symmetry in the pelvis critical when considering loading bilaterally or on a single leg?
To ensure correct pelvic alignment
What is the purpose of performing active SLR as part of the treatment for hypermobility?
To assess symmetry and correct rotation
How can patients correct for good pelvic symmetry according to the text?
By activating hamstrings/hip flexors through MET
What is the recommended sequence of steps when correcting an anterior rotated pelvis?
Palpate ASIS, pull leg up on the opposite side, hold sub-max contraction, recheck ASIS levels.
Why is it important to activate local muscles rather than letting global muscles take over?
Local muscles can maintain segmental stability more effectively.
What is the key emphasis when focusing on anterior neutral spine or 'Pelvis Neutral'?
'Up & in' not flat back or posterior pelvic tilt.
What is the purpose of lumbar stabilization training?
To combine motor control and passive restraints for stability.
Why should individuals be taught to sit properly and maintain a normal lordotic curve?
To promote proper alignment and function of the lumbar spine.
What role does activation of the transverse abdominis play in lumbar stabilization?
It assists in promoting segmental stability.
What should be considered when assessing a patient's movements that trigger pain in the lumbar spine and pelvis?
Hypomobility issue
When working with a patient in physical therapy, what should you focus on incorporating into the plan of care?
Functional/meaningful activities
What is a crucial aspect to address before a patient can accomplish their most important task or activity?
Consider suspected pain generators
When assessing a patient's movements, what should be determined to understand if they are resistant to move or if they move too much?
Whether the pain is local or radiating
In the context of manual therapy, what factor should be considered when deciding if a patient can rely on self-management?
The suspected pain generators
What is the purpose of using instrumentation like the Chattanooga Stabilizer in stability training?
To monitor stabilization objectively
What does the SI Belt assist with when it is worn low around the hips?
Stabilizing the sacroiliac joints
In what manner can the lumbar corset or support be beneficial for individuals?
It replaces lacking abdominal musculature support
What type of exercises can be performed using the Chattanooga Stabilizer while maintaining a certain pressure?
Dynamic movements increasing cardio
What is a feature of the SI Belt when worn around S2 to provide stability to SI joints?
Stabilizing sacroiliac joints
How does utilizing multiple postures challenge stability during exercise?
By dynamically challenging stabilization
Why is exercise referred to as the most potent and underutilized free antidepressant?
Due to its effectiveness in improving mental health but often not prescribed
What is the importance of biomechanical correctness in exercise?
It helps in achieving the optimal benefits of exercise without injury
Why is activating local muscles emphasized over global muscles during exercise?
Local muscles provide better joint protection and stability
What determines the amount, plane, and speed of motion during exercise therapy activities?
The stage of healing the patient is in
Why should exercises be conducted with good form and posture?
To ensure effective muscle activation and prevent injury
In what way does exercise therapy focus on empowerment for patients?
By providing a sense of control and progress in their recovery
What is the most common mechanism of injury for osteitis pubis?
Repetitive overuse and stress
Which group of athletes is most prone to developing osteitis pubis?
Soccer players
What is a common symptom of meralgia paresthetica?
Numbness on the lateral thigh
Which factor is NOT considered a predisposing factor for meralgia paresthetica?
High-impact sports
What treatment approach is recommended for meralgia paresthetica?
Selective rest and avoiding irritating activities
What should be initiated when acute symptoms of osteitis pubis subside?
Start core stabilization training
What is a possible anatomical variant that may predispose to injury in E FAI?
Femoral neck anomalies
Which of the following is a resultant symptomatic pathology associated with E FAI?
Acetabular labral tears
What sign involves putting the thumb in front of the groin area to assess hip pain?
C sign
What does FADIR sign indicate in E FAI?
Limited and painful hip flexion & internal rotation
Which condition covers all hip pathologies that are not arthritic, according to the text?
Hip dysplasia
What is recommended as the highest level of therapeutic exercise prescription in E FAI?
'B' - Highest level including movement pattern retraining
In exercise dosing, what is the recommended course of action if a person experienced a flare-up and the symptoms lasted for 24 hours?
Decrease the load
Which scale is used to measure perceived exertion levels from 1 to 10, with 10 being extremely tough, in gauging exercise intensity?
Borg Rating of Perceived Exertion (RPE) scale
What type of exercises are typically prescribed for endurance training?
3 sets of 15-25 with 1-minute rest at 40-50% 1RM
For power training, what is the recommended number of sets and intensity level?
3 sets of 4 at 90%, 3 sets of 6 at 80%, 3 sets of 8 at 70%
What aspect is emphasized in the exercise progression to correct deviations and reduce pain?
Strength and Proprioception
What does the acronym RPE stand for in exercise prescription?
'Rating of Perceived Exertion'
Which condition is characterized by pain often aggravated by sitting, squatting, or walking, and is more common in females?
Piriformis syndrome
What is the best piriformis stretch according to the text?
Internal rotation above 90 degrees and external rotation below 70 degrees
Which injury results from a direct blow to the iliac crest and may exhibit exquisite tenderness in soft tissues around that area?
Quadriceps contusion
What differentiates a Morel-lavallee lesion from a quad contusion?
Tense feeling in the thigh
'Greater Trochanteric Pain Snapping Hips' is also known as:
Coxa saltans
What is a key characteristic of core muscle injury or athletic pubalgia without a true herniation?
Pain with resisted adduction
What should be considered when managing proximal hamstring injuries?
'Tearing at ischial tuberosity'
'Morel-lavallee lesion' is commonly managed with which intervention?
'Soft tissue myofascial techniques'
What is a common symptom of a core muscle injury or sports hernia that helps differentiate it from other conditions?
Pain with twisting/turning in single limb stance
What activity can exacerbate symptoms of proximal attachment injuries?
Lunging exercises
Study Notes
Treatment Principles for the Lumbar Spine and Pelvis
- Key goals to accomplish during PT: incorporate functional meaningful activities, consider category/classification of hypomobility, hypermobility, instability, and inflammatory issues
- Suspected pain generators: hands-on or hands-off treatment, reliance on manual therapy, and self-management
- Big picture considerations: resistance to movement, excessive movement, local pain, and radiating pain
Radicular Pain
- Radicular pain can also be referred to as peripheralization
- Goal of therapy intervention: centralization of pain
- Neural tension: inability of the nerve to slide and glide through tissue
- Flossing: technique to reduce adverse neural tension
- Be cautious with nerve pain due to latency
Hypermobility
- If one segment is out of alignment, it can cause biomechanics shift for the rest of the spine
- Excessive movement: constantly changing/shifting
- Causes of hypermobility: trauma, pregnancy, and SI instability
- Pain can be located in buttocks, hip, and groin
- Transitional movements and walking are uncomfortable
Treatment for Hypermobility
- Form and force closure: perform active SLR, compression of innominate bones, and sacrum wedged between two hemi-pelvis
- Muscle energy technique (MET): assess symmetry, need to assess if ASIS are level in supine
- Correction: patient can correct to have good pelvic symmetry
- Self-correction: whatever thumb is closer to the ground when checking ASIS
Lumbar Stabilization
- Stabilization training: combination of motor control, neural input, and passive restraints
- Sub-maximal training that should become subconscious
- Training should adapt to static and dynamic movements
- Teach in multiple positions, with normal breathing
Pelvic Thigh Pathology
- Osteitis pubis: classification based on tx mechanism of injury, overuse, stress injury
- Signs and symptoms: palpation tenderness over pubic symphysis, symptoms often exacerbated by passive ABD, resisted ADD, or abdominal contractions
- Management: rest, NSAIDs, normalize SIJ, and osteitis pubis cont management
Meralgia Paresthetica
- Definition: dysfxn of sensory lat femoral cutaneous n of the thigh
- Predisposing factors: obesity, pregnancy, and tight pants
- Signs and symptoms: pain and parethesias over upper anterolateral thigh
- Management: avoidance of irritating activities, selective rest, NSAIDs, SIJ screen/tx, wt loss, and ADL modifications
Piriformis Syndrome
- Definition: deep aching in the sciatic notch of the buttock
- Signs and symptoms: referred posterior thigh pain, often aggravated by sitting, squatting, or walking
- Management: ultrasound, HP manual therapy, and soft tissue mobilization, gentle piriformis stretching, and address faulty pelvis, hip, or foot mechanics
Test your knowledge on soft tissue mobilization techniques including selective treatment, purposeful traction, manual traction, self-management strategies, stretches, and hypermobility treatment for the lumbar spine and pelvis.
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