Hip and Knee Dx/Tx MET/ART Flashcards
What is flexion of the hip? Extension of the hip?
90 with knee extended, 120-135 when knee is flexed
15-30
What is internal rotation of the hip? Which way are you moving the hip?
What is external rotation of the hip? Which way are you moving the hip?
30-40 internal rotation = moving the leg outwards.
40-60 external rotation = moving the leg inwards
What about abduction of the hip? adduction?
abduction = 45-50
adduction = 20-30
What is the Thomas Test?
Tests Hip Flexion SD
This is a special testing where the patient is supine
the physician flexes the contralateral hip with the knee flexed
as hip is flexed, physician observes the ipsilateral hip to see if it flexes off the table, indicating dysfunctional hip flexors (iliopsoas)
What is hip flexion SD MET?
the patient is prone
physician faces the pt and places cephalad hand on the iliac crest to stabilize and monitor
physicians other hand goes proximal to the pt’s knee cap and extends the pt’s leg at the hip until there is a restrictive barrier.
the pt then tries to flex the leg, i.e. push the leg downwards towards the table against the force of the physician.
after 3-5 seconds ,they relax, and the physician repositions pt into a new restrictive barrier.
do this 3-5 times until no new barriers are attained.
reassess
What does Hamstring Hypertonicity test? explain how it’s done
this tests hip extension SD
patient is supine
physician stabilizes the contralateral ASIS with one hand. other hand grasps pt’s leg above the ankle and flexes at hip until the barrier is reached.
pt is instructed to push leg downward toward the floor against the physician’s counterforce (shoulder) for 3-5 seconds
pt relaxes, physician repositions pt.
repeat 3-5 times or no new barrier.
reassess for tart
What is gluteus Hypertonicity MET?
Also a hip extension SD (for some reason)
pt is lateral recumbent
stabilizes at ipsilateral PSIS with one hand. other hand grasps pt’s leg above the ankle (like at the knee) and flexes at the hip until the barrier is reached and foot is placed on physician’s thigh.
pt instructed to push downward against the thigh for 3-5 seconds
pt relaxes, physician repositions pt into new restrictive barrier
3-5 times until no new barrier
What is Hip External Rotation SD MET?
pt supine
physician internally rotates the patients hip to restrictive barrier
pt externally rotates the hip against the counterforce for 3-5 seconds
relaxes, physician repositions pt into new barrier
repeat 3-5 times until no new barrier
reassess for tart
What is Hip Internal Rotation SD MET
pt supine
physician externally rotates the pt hip to restrictive barrier.
they’re instructed to internally rotate against the counterforce for 3-5 seconds
relaxes, physician repositions pt into new barrier
repeat 3-5 times until no new barrier
reassess for tart
What is Hip Abduction SD/ IT band restriction ST technique?
This is where they’re prone, you grab their ankle and flex the knee to 90 degrees.
Cephalad hand contacts pt’s lateral thigh
you push the pt’s foot and lower leg out laterally while engaging the IT band by compressing the cephalad hand and pulling posteromedially.
What is Hip Abduction SD / IT Band restriction MET?
The pt in this case is supine
remember for this one, you need to block their contralateral LE? LE is hip?
If they like going into abduction, you put them in their ADDuction barrier and have them push laterally against your force.
put them in their new barrier and try again
What is Hip Adduction SD MET (Hypertonic long adductor of lower extremity)?
the pt is supine with both legs straight at the hip and knee
you use one hand to abduct the leg that is being tested and stabilizes just proximal to the pt’s knee using own hip. physician places the other hand on the contralateral knee to stabilize the leg.
Physician abducts the patient’s leg until restrictive barrier is met. then they push against your thigh that’s going opposite of their barrier and you let them relax, then reposition the pt into the new barrier.
you do this over and over 3-5 times until no new barrier
remember to hold above the knee of the opposite leg so it doesn’t move
What is Hip Adduction SD MET (hypertonic short adductor of lower extremity)?
supine with the non-tested leg straight at the hip and knee
the tested leg is externally rotated and flexed at the thigh and knee with the foot RESTING AGAINST THE OTHER THIGH (chicken leg look)
the physician abducts the patient’s leg until restrictive barrier met.
pt instructed to push the knee of the affect leg into the physicians’ hand for 3-5 seconds
pt instructed to relax, repositions pt into new barrier
repeat 3-5 times or until no new barrier
reassess
How do you evaluate the internal/external rotation of the tibia on the femur?
the pt is supine
the physician faces the pt on the side that is being tested. Flex the knee and hip to 90 degrees.
thumbs go on each side of the tibial tuberosity with the hands wrapped around the calf. put the lower extremity in the doctor’s upper extremity.
you then induce internal and external rotation by turning medially or laterally
if they are really good at internal rotation but not so good at external = internal rotation dysfunction
if they are really good at external rotation but not so good at internal = external rotation dysfunction
How do you evaluate the flexion/extension of the tibia on the femur?
The pt is prone
observe if knee at rest extends to 0 degrees.
tell them to bring knee to butt
