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Definition of ideal posture
least amount of muscular activity and least amount of stress on connective tissues
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Open chain concept
- non-weight bearing
- distal segment freely moveable
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Closed chain concept
- weight bearing
- distal segment fixed on stable object
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What are the 3 types of muscle function?
- Concentric (accelerate)
- Eccentric (decelerate)
- Isometric (stabilize)
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Agonist muscle
primary mover
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Antagonist muscle
oppose primary mover
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Synergist muscle
assist primary mover
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Stabilizer muscle
support and stabilize primary mover
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Neutralizer muscle
counteracts unwanted actions of related musculature
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Muscle Length-Tension Relationship
- the amount of force a muscle can generate from a certain position
- dependant on the number of cross bridges of Actin and Myosin
- Affects Force-Couple
- Alters proprioceptive input to CNS
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Force-Couple Relationships
- Muscles performing according to their classification with a particular movement
- closely dependant upon length-tension relationships
- dysfunction may alter proprioceptive input to CNS
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Proprioception
Mechanoreceptors in tissue that convert mechanical stimulation into electrical information
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Reciprocal Inhibition
- A chronically tight muscle causes decreased neural drive in its antagonist
- This alters the Force Couple, creating substitution by the synergists and neutralizers
- In turn, producing a synergistic dominance
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Synergistic Dominance
- Synergist compensates for the Prime Mover to maintain force production
- this further alters functional posture
- this can also alter joint arthrokinematics via muscles firing out of sequence
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Arthrokinetic Inhibition
- Neuromuscular occurrence whereas joint dysfunction inhibits muscles surrounding that joint
- not necessarily pain inhibition but very similar
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Muscle Imbalances
- One overactivated, shortened and tightened
- The other, inhibited and weakened
- chronic imbalance may lead to adaptive changes in posture and function
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plumb line
a string and pendulum that hangs perpendicular to surface
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Causes of postural dysfunction
- neurologic
- hyper/hypo mobility of joints
- injury/pain/stiffness
- ADL's/work/athletics
- developmental or congenital
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Muscle Tightness testing
- subjective fell or athlete feedback
- objective goniometric evaluation/flexibility testing
- linear measurements such as girth
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Articular Deviations testing
- subjective visual inspection - use of plumb line
- objective ROM evaluation with goniometer or inclinometer
- palpable deformity
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Functional Abnormalities testing
- subjective gait or athletic activity assessment
- utilize coaching "experts"
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Compensatory Postures/Movements testing
- body's ability to adapt to obtain function due to pain, adhesion, or deformity
- may result as consequence of activity
- may be acquired from use of equipment/uniform
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ECTomorph
thin, increased joint mobility, decreased joint stability
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ENDomorph
stocky, decreased joint mobility, increased joint stability
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Mesomorph
average to muscular, WNL with mobility and stability
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Postural Assessment of Head
- perpendicular to floor (head and neck)
- Natural movement vs. compensatory movement
- cervical spine is concave to anterior side
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Postural Assessment of Shoulders
- level (dominant may be depressed)
- Scapular positioning (positioned over ribs T2-T7)
- Slight kyphosis (posterior curvature) to ribs
- Palms are toward thighs in relaxed state
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Postural Assessment of Lumbro-Thoracic
- Kyphosis - too much convexity, may be related to bone density
- Lordosis - anterior pelvic positioning, weak abdominal musculature
- Scoliosis - lateral spinal curvature
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Postural Assessment of Pelvis
Level with shoulders and/or ground
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Postural Assessment of Knee
- Extension capabilities -
- - valgum <180
- - varum >195
- - recurvatum (lateral plane)
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Postural Assessment of Knee
- patellar positioning -
- slight valgus curvature is normal
- excessive valgus "squinting" or varus "frog eyed"
- Q-Angle = center of femur to middle point of patella, center of patella to tibial tuberosity (Males = 13d, Females = 18 d)
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Postural Assessment of Ankle
- Weight bearing and non-weight bearing (NWB)
- Tibial alignment
- Note lateral malleolus position is slightly posterior
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Postural Assessment of Foot
- Hind foot: calcaneal position var/val, Achilles line of pull
- Midfoot: pes cavus or pes planus, domed appearance of dorsum of foot
- Forefoot: all toes are straight and flat, all are touching ground, great toe is longest
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Leg Length Discrepancy
- Structural (physical length of limb) - measure ASIS to distal medial malleolus
- Functional (torsion, obliquity, etc) - measure umbilicus to distal medial malleolus
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Genu Varum
- bow legged
- lateral angulation of femur and tibia
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Genu Valgum
- knock-kneed
- medial angulation of femur and tibia
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