Answers
The Straight-laced-with-no-unnecessary-jokes-or-dodgy-humour April Quiz
1. What is lower cross syndrome?
Lower X syndrome
SHORT & TIGHT LONG & WEAK
Quads & Hamstrings
Psoas & Abdominals
LESp
LOWER X
More in women
Normally dominant leg
Anterior pelvic tilt
Increased LSp lordosis
Gtr trochanters int rot
Knock-kneed
Pronation Pattern
Increased LCL (knee) stress
Increase load on medial meniscus
Can be unilateral and/ or unequal
Signs & symptoms include
Low back pain
Groin pain
Psoas
Intervertebral disc problems
Knee MCL problems
ACL
More vulnerable as pronation pattern predisposes to lateral hamstring (BF) pull. This is more common than medial hamstring pull 10:1. Biceps femoris is also agonist to ACL, so dysfunction in the muscle can lead to strain of ACL.
Femoral rotation
Femur can rotate medially with relative lateral tracking problem of patella due to pronation pattern.
Strengthen posterior gluteus medius (main lower limb abductor) fibres to externally rotate femur.
2. What is the largest sesamoid bone in the body?
The patella
3. Why are inversion strains more common than eversion strains in the ankle?
Two main reasons. The fibular malleolus extends more distally than the tibial, this gives a bony block. Also, the medial collateral ligament of the ankle (the deltoid ligament) is very strong. If this is traumatised you tend to get avulsion fractures rather than sprains.
Another reason is that the triceps surae (Gastroc & soleus) is very tight in most people, this tends to pull the foot into plantarflexion, one of the coupled motions of plantarflexion is inversion.
4. Which ligament in the ankle is the one which usually strains in an inversion strain?
The anterior talofibular ligament (I should know, I've just done it...). It runs from the anterior, distal aspect of the fibular malleolus to the anterior talus. If you trace around laterally to anteriorly along the 'crease' where your foot joins your lower limb, it's there. You may not feel it if it's healthy but sprain it and you do (trust me...)
5. How would you treat an ankle strain?
There's a theme here, talk about a self-fulfilling prophecy. We don't have space to go into great detail here but the basics include RICE then rehab. Also:
Acute
Hands on you can make sure that the rest of the lower limb, low back and other lower limb don't overwork too much when compensating. Think about which muscles will be working more to protect that ankle by 'splinting' it and by avoiding weight bearing on it. Plus plenty of distal drainage work.
Sub-acute/Chronic
Frictions, vibrations and work to the injury site. Go gently at first and treat conservatively until you know how the client is reacting to your treatment.
6. We normally have 12 pairs of ribs. Occasionally there may be more. Where and why? (And I'm not talking about surgery...)
Cervical rib (C7) or Lumbar rib (L1). Usually congenital anomalies. No spare ribs jokes please, I'm fighting the temptation to lapse into 'dad' jokes, is that the male equivalent of being 'broody'? Talk about stream of consciousness, I blame the sleep deprivation...
7. What is O'Donaghue's triad?
A knee injury where you get damage to the MCL/medial meniscus/ACL. Not too good.
8. Pes planus in another term for what?
Flat foot (and think what that does to the foot and therefore the lower limb etc.)
9. What does the popliteus muscle do?
Internally rotates the leg in an open kinematic chain (i.e. foot free) or laterally rotates the thigh in a closed kinematic chain (foot fixed). By doing this it 'unlocks' the knee from its locked, fully extended position. It also flexes the knee joint and provides some support.
10. Who was 'Satchmo'? And why is he famous?
Louis Armstrong, the jazz trumpeter/ singer who revolutionised...think I'll stop there, can feel another 'dad' moment coming on.
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