scholarly journals Patellofemoral Pain and Asymmetrical Hip Rotation

2005 ◽  
Vol 85 (11) ◽  
pp. 1201-1207 ◽  
Author(s):  
Michael T Cibulka ◽  
Julie Threlkeld-Watkins
Keyword(s):  
Knee Pain ◽  
Patellofemoral Joint ◽  
External Rotation ◽  
Womac Score ◽  
Patellofemoral Pain ◽  
Manual Muscle Testing ◽  
Muscle Testing ◽  
Medial Rotation ◽  
The Right ◽  
Hip Rotation

Abstract Background and Purpose. Patellofemoral joint problems are the most common overuse injury of the lower extremity, and altered femoral or hip rotation may play a role in patellofemoral pain. The purpose of this case report is to describe the evaluation of and intervention for a patient with asymmetrical hip rotation and patellofemoral pain. Case Description. The patient was a 15-year-old girl with an 8-month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 24%. Right hip medial (internal) rotation was less than left hip medial rotation, and manual muscle testing showed weakness of the right hip internal rotator and abductor muscles. The intervention was aimed at increasing right hip medial rotation, improving right hip muscle strength (eg, the muscle force exerted by a muscle or a group of muscles to overcome a resistance), and eliminating anterior right knee pain. Outcomes. After 6 visits (14 days), passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her WOMAC score was 0%. Discussion. The patient had right patellofemoral pain and an uncommon pattern of asymmetrical hip rotation, with diminished hip medial rotation and excessive hip lateral (external) rotation on the right side. The patient's outcomes suggest that femoral or hip joint asymmetry may be related to patellofemoral joint pain.

Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Measurement Techniques ◽  
Fourth Edition ◽  
Hip Motion ◽  
The Difference ◽  
The Right ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

Limb Position Biofeedback for Patellofemoral Pain

Biofeedback ◽  
2009 ◽  
Vol 37 (3) ◽  
pp. 112-113
Author(s):  
Wong Yiu Ming
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Patellofemoral Pain ◽  
Patellar Tracking ◽  
Knee Valgus ◽  
Functional Movement ◽  
Limb Position ◽  
Biofeedback System ◽  
Hip Rotation ◽  
Anterior Knee

Abstract Individuals with excessive internal hip rotation and knee valgus during functional movement often develop abnormal lateral patellar tracking, sometimes resulting in anterior knee pain. A configuration of currently available biofeedback instruments, including an electronic goniometer, can provide feedback on limb position, which is useful in correcting the knee valgus. The article reports on the use of this biofeedback system with three individuals with measurable knee valgus, producing a remediation of the limb angle in each case.

Patellofemoral Pain Syndrome and Its Association with Hip, Ankle, and Foot Function in 16- to 18-Year-Old High School Students

2011 ◽  
Vol 101 (3) ◽  
pp. 215-222 ◽  
Author(s):  
Carsten Mølgaard ◽  
Michael Skovdal Rathleff ◽  
Ole Simonsen
Keyword(s):  
High School ◽  
High School Students ◽  
Knee Pain ◽  
Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
School Students ◽  
Navicular Drop ◽  
Foot Posture ◽  
Hip Rotation

Background: An increased pronated foot posture is believed to contribute to patellofemoral pain syndrome (PFPS), but the relationship between these phenomena is still controversial. The objectives of this study were to investigate the prevalence of PFPS in high school students and to compare passive internal and external hip rotation, passive dorsiflexion, and navicular drop and drift between healthy high school students and students with PFPS. Methods: All 16- to 18-year-old students in a Danish high school were invited to join this single-blind case-control study (N = 299). All of the students received a questionnaire regarding knee pain. The main outcome measurements were prevalence of PFPS, navicular drop and drift, passive ankle dorsiflexion, passive hip rotation in the prone position, and activity level. The case group consisted of all students with PFPS. From the same population, a randomly chosen control group was formed. Results: The prevalence of knee pain was 25%. Of the 24 students with knee pain, 13 were diagnosed as having PFPS. This corresponds to a PFPS prevalence of 6%. Mean navicular drop and drift were higher in the PFPS group versus the control group (navicular drop: 4.2 mm [95% confidence interval (CI), 3.2–5.3 mm] versus 2.9 mm [95% CI, 2.5–3.3 mm]; and navicular drift: 2.6 mm [95% CI, 1.6–3.7 mm] versus 1.4 mm [95% CI, 0.9–2.0 mm]). Higher passive ankle dorsiflexion was also identified in the PFPS group (22.2° [95% CI, 18°–26°] versus 17.7° [95% CI, 15°–20°]). Conclusions: This study demonstrated greater navicular drop, navicular drift, and dorsiflexion in high school students with PFPS compared with healthy students and highlights that foot posture is important to consider as a factor where patients with PFPS diverge from healthy individuals. (J Am Podiatr Med Assoc 101(3): 215–222, 2011)

scholarly journals Visual Observation of Apparent Infraspinatus Muscle Atrophy in Male Professional Tennis Players

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095883
Author(s):  
Todd S. Ellenbecker ◽  
David M. Dines ◽  
Per A. Renstrom ◽  
Gary S. Windler
Keyword(s):  
Range Of Motion ◽  
Muscle Atrophy ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Manual Muscle Testing ◽  
Tennis Players ◽  
Muscle Testing ◽  
Professional Tennis ◽  
Rotation Strength ◽  
Infraspinatus Atrophy

Background: Previous studies have reported visually observed apparent muscle atrophy in the infraspinous fossa of the dominant arm of overhead athletes. Several mechanisms have been proposed as etiological factors, including eccentric overload, compressive spinoglenoid notch paralabral cysts, and cumulative tensile suprascapular neurapraxia. Purpose: To report the prevalence of apparent infraspinatus atrophy in male professional tennis players and to determine whether the suspected atrophy correlates with objectively measured weakness of external rotation. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 153 male professional tennis players underwent a musculoskeletal screening examination that included visual inspection of the infraspinous fossa. Infraspinatus atrophy was defined as hollowing or loss of soft tissue bulk inferior to the scapular spine in the infraspinous fossa of one extremity that was visibly different from the contralateral extremity. This finding was observed and independently agreed upon by both an orthopaedic surgeon and a physical therapist during the examination. Also assessed were rotator cuff instrument-assisted manual muscle testing, visual observation of scapular kinesis (or motion), and glenohumeral joint range of motion for internal and external rotation and horizontal adduction. Results: In the 153 players, dominant-arm infraspinatus atrophy was observed in 92 players (60.1%), and only 1 player (0.7%) was identified with nondominant infraspinatus atrophy. A Pearson correlation showed a significant relationship between the presence of dominant-arm infraspinatus atrophy and dominant-arm external rotation strength measured in neutral abduction/adduction (at the side) ( P = .001) as well as between the presence of dominant-arm infraspinatus atrophy and bilateral external rotation strength measured at 90° of glenohumeral joint abduction ( P = .009 for dominant arm and .002 for nondominant arm). No significant correlation was found with scapular dyskinesis, glenohumeral range of motion, or instrument-assisted manual muscle testing of the supraspinatus (empty-can test). Conclusion: Visually observed infraspinatus muscle atrophy is a common finding in the dominant shoulder of asymptomatic male professional tennis players and is significantly correlated with external rotation weakness. This condition is present in uninjured players without known shoulder pathology and is not related to glenohumeral joint internal rotation, total rotation range of motion, or scapular dysfunction. Players with visually observed infraspinatus atrophy should be evaluated for external rotation strength and may require preventive strengthening.

scholarly journals Impact of Movement with Mobilization and Triceps Eccentric Strengthening in Tennis Elbow: Case Report

2021 ◽  
pp. 10-14
Author(s):  
Nabeela Fatema ◽  
Bodhisattva Dass ◽  
Rinkle Hotwani
Keyword(s):  
Elbow Joint ◽  
Tennis Elbow ◽  
Limited Range ◽  
Treatment Session ◽  
Manual Muscle Testing ◽  
Outer Side ◽  
Lateral Epicondyle ◽  
Muscle Testing ◽  
Limited Range Of Motion ◽  
The Right

Background: Tennis elbow can be caused by repetitive wrist and arm motions. Pain is the primary symptom. It usually occurs on the outside of the elbow and sometimes in the forearm and wrist. Treatment includes rest, pain relievers and physiotherapy. Case Presentation: A 28years old male patient presented with a complaint of pain in outer side of the right side elbow. In subjective examination, He gave history of pain while playing tennis mainly in smashing the ball or passing shot, riding bike for more than 2kilometers, difficulty in holding objects sometimes as well. When this pain was unbearable to him he came to Physiotherapy department. Treatment: A Treatment session initially started with Cryotherapy (Ice Pack) application for 5min. On lateral epicondyle of right elbow. Then Ultrasound 0.8 watt/Cm² for 7minutes given, these helped in pain reduction. After 2days patient is asked to follow the commands to perform Triceps strengthening along with wrist strengthening with the help of Half Kg Dumb bell.  There was an effect on the reduction of the symptoms of the patient which were pain, reduce strength and limited range of motion of wrist in right hand. After 1week of treatment, we added Mobilization with movement (Mulligan) technique at elbow joint. The same procedure was continued for 2weeks after which patient's symptoms were minimized as to the day of assessment. Outcome measures used for the evaluation of the symptoms were NPRS Scale for Pain, Manual Muscle Testing (MMT) for Strength. Conclusion: Triceps strengthening along with Mulligan technique for elbow joint was found to be effective in patients with severe pain and reduced strength.

Effect of strengthening exercises in Hirayama disease: a case study

2020 ◽  
Vol 27 (11) ◽  
pp. 1-7
Author(s):  
Tinu Sethi ◽  
Sushma Rawat ◽  
SL Munde
Keyword(s):  
Hand Function ◽  
Manual Dexterity ◽  
Manual Muscle Testing ◽  
Hirayama Disease ◽  
Hand Functions ◽  
Muscle Testing ◽  
Hand Grip ◽  
Strengthening Exercises ◽  
The Right

Background/Aims The effects of strengthening exercises in patients with Hirayama disease are not well documented. This case study examined the effect of strengthening exercises on hand functions in a patient with Hirayama disease. Methods An 18-year-old man with weakness in the right hand was given a hand-function strengthening programme consisting of 40 minutes of exercises, which were performed 5 days a week over an 8-week period. The patient used theraputty, a gel ball, finger dexterity board, gym kit and hand grip exerciser. The effects of the programme were evaluated using manual muscle testing, a hand-held dynamometer, pinchometer and the Minnesota Manual Dexterity Test. Results The patient's manual muscle testing grades improved following the strengthening programme. Results from the Dynamometer, pinchometer and Minnesota Manual Dexterity Test objectively exhibited increased muscle strength and improved hand functions. Conclusions Strengthening exercises are effective in alleviating muscle weakness and improving hand functions associated with Hirayama disease.

scholarly journals A Rare Case of Acute-Onset Spastic Quadriparesis Caused by a Chondroma of the Cervical Spine

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Kaori Momota ◽  
Toshihiko Nishisho ◽  
Ryo Miyagi ◽  
Shunichi Toki ◽  
Kazuta Yamashita ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Rare Case ◽  
Ligamentum Flavum ◽  
Acute Onset ◽  
Manual Muscle Testing ◽  
Benign Tumors ◽  
Decompression Surgery ◽  
Muscle Testing ◽  
The Right ◽  
Spastic Quadriparesis

Chondromas are benign cartilaginous tumors that occur very rarely in the spine. Moreover, chondromas of the extraskeletal origin are also very rare. In this case report, we describe an extremely rare case of chondroma arising from the ligamentum flavum in the cervical spine. A 67-year-old man presented to our clinic with acute-onset spastic quadriparesis. We performed emergent magnetic resonance imaging and found an epidural mass in the right ligamentum flavum at C4-C5. The acute-onset presentation was suspicious for intraligamentous hematoma in the ligamentum flavum at this level. We performed emergency decompression surgery and en bloc removal of the epidural mass with the right C4 and C5 lamina. The lesion had the appearance of cartilaginous tissue rather than hematoma. Based on the histological investigation, the final diagnosis was intraligamentous chondroma of the cervical spine. The quadriparesis improved postoperatively, as did the results of manual muscle testing in the affected area, and he was able to resume walking independently with a cane. At the one-year follow-up, the manual muscle testing results were almost normal. Surgeons should keep in mind the possibility of benign tumors including chondroma of the cervical spine when a patient presents with acute-onset quadriparesis.

scholarly journals Concentric and Eccentric Torque of the Hip Musculature in Individuals With and Without Patellofemoral Pain

2009 ◽  
Vol 44 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Michelle C. Boling ◽  
Darin A. Padua ◽  
R. Alexander Creighton
Keyword(s):  
Knee Pain ◽  
External Rotation ◽  
Patellofemoral Pain ◽  
Stair Climbing ◽  
Lower Extremity Injury ◽  
Control Group ◽  
Prior History ◽  
Pain Group ◽  
Limited Participation ◽  
Hip Abduction

Abstract Context: Individuals suffering from patellofemoral pain have previously been reported to have decreased isometric strength of the hip musculature; however, no researchers have investigated concentric and eccentric torque of the hip musculature in individuals with patellofemoral pain. Objective: To compare concentric and eccentric torque of the hip musculature in individuals with and without patellofemoral pain. Design: Case control. Setting: Research laboratory. Patients or Other Participants: Twenty participants with patellofemoral pain (age  =  26.8 ± 4.5 years, height  =  171.8 ± 8.4 cm, mass  =  72.4 ± 16.8 kg) and 20 control participants (age  =  25.6 ± 2.8 years, height  =  169.5 ± 8.9 cm, mass  =  70.0 ± 16.9 kg) were tested. Volunteers with patellofemoral pain met the following criteria: knee pain greater than or equal to 3 cm on a 10-cm visual analog scale, insidious onset of symptoms not related to trauma, pain with palpation of the patellar facets, and knee pain during 2 of the following activities: stair climbing, jumping or running, squatting, kneeling, or prolonged sitting. Control participants were excluded if they had a prior history of patellofemoral pain, knee surgery in the past 2 years, or current lower extremity injury that limited participation in physical activity. Intervention(s): Concentric and eccentric torque of the hip musculature was measured on an isokinetic dynamometer. All volunteers performed 5 repetitions of each strength test. Separate multivariate analyses of variance were performed to compare concentric and eccentric torque of the hip extensors, abductors, and external rotators between groups. Main Outcome Measure(s): Average and peak concentric and eccentric torque of the hip extensors, abductors, and external rotators. Torque measures were normalized to the participant's body weight multiplied by height. Results: The patellofemoral pain group was weaker than the control group for peak eccentric hip abduction torque (F1,38  =  6.630, P  =  .014), and average concentric (F1,38  =  4.156, P  =  .048) and eccentric (F1,38  =  4.963, P  =  .032) hip external rotation torque. Conclusions: The patellofemoral pain group displayed weakness in eccentric hip abduction and hip external rotation, which may allow for increased hip adduction and internal rotation during functional movements.

scholarly journals CORRELATION BETWEEN HIP ROTATION DYSFUNCTION AND KNEE PAIN

2017 ◽  
Vol 6 (2) ◽  
pp. 32-37
Author(s):  
Batool Hassan ◽  
Anum Haidar ◽  
Nida Kanwal ◽  
Mehak Yaseen
Keyword(s):  
Knee Pain ◽  
Negative Correlation ◽  
External Rotation ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Knee Oa ◽  
Flexion Extension ◽  
Hip Internal Rotation ◽  
Hip Rotation

BACKGROUND AND AIM Hip and knee OA has been ranked as eleventh maximum contributor to global incapacity. The prevalence is expected to increase up to 25.9% by 2040. Hip arthritis reduces the mobility at the hip joint limiting flexion extension, abduction, and adduction, internal and external rotation. Similarly knee pain causes considerable disability among middle adult population affecting both proximal and distal joint (hip and ankle) respectively. Hence the present study aims to find out a correlation between Hip Rotation Dysfunction and Knee Pain METHODOLOGY A cross sectional study was conducted on patient with hip and knee pain of age in between 45 to 60 years. Ranges at the level of hip joints were assessed using goniometer. Knee pain was assessed using Visual Analog Scale. RESULT The result obtained from the study shows a moderate negative correlation between knee pain and hip internal rotation, r= -0.67 showing no significant correlation p=0.45. There is also a weak negative correlation between knee pain and hip external rotation, r= -0.37 with a p> 0.05. CONCLUSION The result obtained from the study concluded that no significant co-relationship exist between hip rotation dysfunction and knee pain, however more researches with larger number of sample size is required to further evaluate the causal relationship between the two variables.

scholarly journals The patellofemoral joint – often forgotten, ­erroneously unconsidered or simply misunderstood?

2020 ◽  
Keyword(s):  
High Risk ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Patellofemoral Joint ◽  
Pain Syndrome ◽  
Patellofemoral Pain ◽  
Chondromalacia Patellae ◽  
High Prevalence ◽  
And Performance ◽  
Anterior Knee

Up to 40% of all athletes suffer from patellofemoral disorders every season, with a high prevalence of 15-25% especially in pivoting sports [1]. It has a high risk of recurrence, might persist for a prolonged time and therefore considerably influence the athlete’s trainability and performance over his career. Exercise-related, peripatellar pain is the most frequent observed condition and usually described as anterior knee pain (AKP), or synonymously called patellofemoral pain syndrome (PFPS). The formerly used term “chondromalacia patellae” has been shown to be misleading, and is no longer used in literature...

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