4⃣ Pain

Major causes of musculoskeletal pain are :

1-Excessive tissue tension.

2-joint distension related to trauma or arthritis.

في المسدجات دي تجميعات أهم النِّقاط المهمة فى الـ Gait🚶🏻.

حفظها وفهمها هيساعدك تراجع أسرع وتثبت المعلومة أكتر، ومتنسوش تحتفظوا بيهم للمراجعة وقت الحاجة! 👀📝
#Biomechanics #gait

https://forms.gle/YRXAw1EgzQ9N5aWS8
كويز على Muscle energy technique.
#Therapeutic_2

JOINT ROM in sagittal plane.pdf
#Biomechanics #gait

الفرق بين انواع الـDiadynamic currents
🤩🤩
#Electro_2

شرح ال motor control , motor learning
ل دكتور سرحان exercise physiology
#ex_physiology

Lecture 12 (final)

اخر محاضره gait 🥳🔥
شرح دكتور سرحان
#gait

🔹Hip flexion (anterior thigh muscles) :

🔸Psoas major
Nerve supply : lumbar plexus,
Problem in this nerve causes compression or external trauma leading to weakness or paralysis.

🔸Iliacus
Nerve supply : femoral nerve.

🔹Acessory hip flexors :
- Rectus femoris
- Sartorius
- Tensor fasciae latae
- Pectineus

🔸ROM : from Zero to 115 or 125

🔹Limitations :
1- contact of thigh on abdomen with knee flexed.
2- tension of hamstring with knee extended.

🔸Notice that
1- Knee flexed or extended to prevent the substitution.
2- Hamstring is a two jointed muscle which has a passive insufficiency.
3- To get the exercise more difficult increase the lever arm.

🔹Palpation of
1- Psoas major : distal to inguinal ligament.
2 - Iliacus : slide in iliac crest.

🔸Notice that inguinal ligament presents in the medial side of sartorius.

🔹Substitution by 2 muscles :
1- Sartorius in hip flexion causes lateral rotation and abduction of thigh.
2- Tensor fasciae latae in hip flexion causes medial rotation and abduction of thigh.

🔸To avoid the substitution, we should keep the thigh toward the med line (other leg)

🔹Weakness of hip flexors :
1- Disability in climbing stair, walking, bringing the trunk forward in sitting position.
2- Marked weakness in walking because the patient should do propulsion of hip (bringing the leg forward by pelvic motion) which comes from anterior and lateral abdominal muscles action rather than hip flexion.

🔸Notice that :
1- In propulsion of hip there is :
🔹Anterior pelvic tilt
🔹Hyper lordosis (extension in lumber)

2- Also weakness in hamstring causes inability to stand up strightly
و دا يحصل اما اجيب حاجه من ع الأرض، وعندي ضعف في ال hamstring، فـ هطلع بال trunk extensors و مش هكمل الحركه هفضل معوج كدا لان اللي مفروض تكمل الحركه فيها weakness و هي ال hamstring.

🔹Contracture of hip flexors:
1- Unilateral causes flexion, abduction, external rotation.
2- Bilateral causes lower cross syndrome which is :
🔹Anterior pelvic tilt (hip flexion deformity)
🔹Lumber hyper lordosis

🔹Hip extension (posterior thigh muscles)

🔸Gluteus maximus
Nerve supply : inferior gluteal nerve.

🔸Notice that if iliotibial band is :
- tight causes lateralization of patella.
- weak causes knee rocking

🔹Biceps femoris
Nerve supply :
🔸Long head : tibial branch of Sciatic nerve
🔸Short head : pernoeal branch of Sciatic nerve.

🔹Semitendinosus and Semimembranosus
Nerve supply : Sciatic nerve

🔹ROM :
- from 115 or 125 to Zero
- Or It's 10 to 15 degrees beyond the mid line.

🔸The ROM of hip extension can be limited by tension in :
🔸The ilifemoral ligament
🔸The hip flexor muscles

🔸Fixation :
🔹Contraction of iliocustalis
🔹Quadratus lumborum
🔹Weight of trunk

🔸Palpation of gluteus maximus through iliac crest from posterior

🔹Substitution by lumber spine to rise the thigh, the patient do hyperlordosis which is not a compound action (It's just carrying the weight)

🔸Notice that in flat lumber curve there is :
🔹Flexion in abdomen
🔹Posterior pelvic tilting

🔸To isolate the gluteus maximus muscle, all the test tasks must be performed with knee in flexion.

🔹Weakness of hip extensors :
🔸Bilateral marked weakness of the gluteus maximus muscle makes walking extremely difficult, and necessitates the aid of crutches.
🔸Postero-lateral displacement of the trunk over the femur (hyperextension of hip joint )
🔸Patients must push themselves to an upright position by using their arms.