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ESS 3092: KINESIOLOGY
Week 11- Wednesday
+
Review
3
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What is the most
common cause of sciatica?
4
+
Sciatica
Pain, tingling, or numbness produced by an
irritation of the nerve roots that lead to the sciatic
nerve
Causes
 The most common cause of sciatica is a bulging or
ruptured disc, pressing against the nerve roots
 It can also be a symptom of other conditions such as
stenosis, bone spurs, arthritis or nerve root compression
5
+
What are the two most powerful
external rotator of the hip?
6
+
External Rotators of the Hip
External rotators
 Piriformis
 Gemellus Superior
 Obturator Internus
 Gemellus Inferior
 Obturator Externus
 Quadratus Femoris
7
+
Piriformis
 Sciatic nerve passes inferiorly
 Tightness
 Origin
 Anterior surface of lateral
sacrum
Insertion
 Greater trochanter of femur,
along the upper medial surface
Actions
 Lateral rotation
+
Gemellus Superior
Origin
Ischial spine
Insertion
Medial aspect of greater
trochanter
Actions
External rotation
+
Obturator Internus
Origin
Ischiopubic ramus, obturator
membrane
Insertion
Medial aspect of greater
trochanter
Actions
Lateral rotation
+
Obturator Externus
Origin
Obturator membrane and the
adjacent surfaces of the pubic
body and pubic and ischial
rami
Insertion
Medial aspect of greater
trochanter
Actions
Lateral rotation
+
Quadratus Femoris
Origin
Lateral border of ischial
tuberocity
Insertion
Intertrochanteric crest
Actions
Lateral rotation
+
How would you strengthen the
external rotators of the hip?
13
+
Strength of ER 60% > IR
Challenge to condition
 Difficult to apply force to rotation
 Seated position, surgical tubing
 Stand on one leg- turn body away
Stretch
 Seated position, manual resistance
Strength & Conditioning
External rotators
+
+
Manual Stretch
17
+ Bony Landmarks- Femur
 Proximal end
 Head
 Femoral neck
 Greater trochanter
 Lesser trochanter
 Pectineal Line
 Shaft
 Linea aspera
 Distal end
 Medial & lateral condyles
 Patellar surface
+
Hip Joint Flexion/Extension- Muscles
 FLEXION
 Rectus femoris
 Iliacus
 Psoas major
 Sartorius
 Tensor fascia latae
 EXTENSION
 Semimembranous
 Semitendinous
 Biceps femoris
 Gluteus maximus
Gluteus Maximus
 Origin
 Posterior surface of the sacrum
and coccyx, posterior aspect of
the ilium
 Insertion
 Proximal end of the IT band
 Location
 Posterior/lateral
 Superficial
 Action
 Hip extension (powerful)
 External rotation
 Abduction (superior fibers)
21
Gluteus Medius
 Origin
 Lateral surface of the iliac
spine
 Insertion
 Lateral aspect of the greater
trochanter
 Location
 Lateral
 Action
 Hip abduction
 Internal rotation (weak)
23
Gluteus Minimus
 Origin
 Lateral surface of the ilium
 Insertion
 Superior and anterior aspect
of the greater trochanter
 Location
 Lateral
 Action
 Hip abduction
 Internal rotation (weak)
24
Tensor Fasciae Latae
 Origin
 Anterior aspect of the lateral
surface of the iliac crest and
ASIS
 Insertion
 IT band to the lateral tubercle of
the tibia
 Location
 Lateral
 Action
 Hip flexion
 Hip abduction
 Internal rotation (weak)
25
+
 Combo of gluteus max and TFL
 Crosses the knee (lateral femoral
condyle)
 Moves during flex & ext (knee)
 Palpate- above femoral lat condyle
Iliotibial Band
+
IT Band Syndrome
 Most common cause of lateral knee pain
 Recurrent friction
 Common in runners
 High mileage, track (turning one way constantly or on crowned
surfaces)
 Common symptoms
 Pain over the outside of the knee joint
 Swelling at the location of discomfort
 A snapping or popping sensation as the knee is bent
 92% patients w/ IT Band Syndrome improved by strengthening the
gluteus medius
+
Knee Joint Movements- Muscles
EXTENSION
 Rectus femoris
 Vastus medialis
 Vastus intermedius
 Vastus lateralis
FLEXION
 Biceps femoris
 Semitendinous
 Semimembranous
 Sartorius (*)
 Popliteus
 Gastrocnemius
 Gracilis
ROTATION
 Internal
 Semitendinous
 Semimembranous
 Popliteus
 Gracilis
 External
 Biceps femoris
 Sartorius
+ 29
+ Knee Extensors
 Generate power
 Strongest muscle groups
 3x stronger than antagonist
 Stabilize patella
 Reduce strain on MCL
 Assist PCL
 Posterior displacement
 Too much extension works against
the ACL
+
Quadriceps
Rectus Femoris
 Origin
 Anterior, inferior iliac
spine, ilium above the
acetabulum
 Insertion
 Patella, via patellar ligament
to tibial tuberosity
 Location
 Anterior
 Action
 Knee extension
 Hip flexion
31
Rectus
Femoris
Rectus Femoris
 The only biarticulate muscle of the extensors
(Crosses 2 joints)
 Contributes to knee extension best when hip
is extended or hyperextended
 Kicking
 Strengthened
 Knee extension (resistance)
 Flexibility
 Side-lying, full flexion while hip is extended
+
Quadriceps
Vastus Medialis
 Origin
 Medial lip of linea aspera;
lower part of intertrochanteric
line
 Insertion
 Patella, via quadriceps
aponeurosis and patellar
ligament to tibial tuberosity
 Location
 Anterior/medial
 Action
 Knee extension
33
Vastus
Medialis
+
Quadriceps
Vastus Lateralis
 Origin
 Greater throchanter and
lateral lip of linea aspera
 Insertion
 Patella, via patellar
ligament to tibial tuberosity
 Location
 Anterior/lateral
 Action
 Knee extension
34
Vastus
Lateralis
+
Quadriceps
Vastus Intermedius
 Origin
 Upper 2/3rds of the anterior and
lateral surface of the femoral
shaft
 Insertion
 Patella, via patellar ligament to
tibial tuberosity
 Location
 Anterior/ deep
 Action
 Knee extension
35
Vastus
intermedius
+
How do you stretch the knee
extensors?
36
+
Knee Joint Movements- Muscles
EXTENSION
 Rectus femoris
 Vastus medialis
 Vastus intermedius
 Vastus lateralis
FLEXION
 Biceps femoris
 Semitendinous
 Semimembranous
 Sartorius
 Popliteus
 Gastrocnemius
 Gracilis
ROTATION
 Internal
 Semitendinous
 Semimembranous
 Popliteus
 Gracilis
 Sartorius
 External
 Biceps femoris
+Knee Flexors
2 joint muscles
 Biceps femoris, semimem, semiten
Originate – ischial tuberosity
Rotate knee
 2 to the inside (semitend, semimemb)
 1 to the outside (biceps femoris)
+
Hamstrings
HDPE 26739
Musc
les
for
coac
hes
Semitendinosus
Biceps femoris
Semimembranosus
+
Biceps Femoris
 Origin
 Long head- medial surface of the
ischial tuberosity
 Short head- lateral lip of the linea
aspera
 Insertion
 Fibular head, lateral colateral
ligament, lateral condyle of the tibia
 Location
 Posterior/ Lateral
 Action
 Hip extension (long head only)
 Knee flexion
 External rotation (w/ hip flexion)
40
+
Biceps Femoris
Two heads
Provides lateral support
Produces external rot (of lower leg)
Assists ACL to stabilize (prevents ant
displacement)
Strengthen
 Hamstring curls w/ ext rot of knee
+
Semitendinosus
 Origin
 Ischial tuberosity
 Insertion
 Medial surface of the
proximal tibia
 Location
 Posterior/ medial
 Action
 Knee flexion
 Hip flexion
 Internal rotation (w/ hip
flexion)
42
Semitendinosus
+
Semimembranosus
 Origin
 Ischial tuberosity
 Insertion
 Medial condyle of the tibia
 Location
 Posterior/ medial
 Action
 Hip extension
 Knee flexion
 Internal rotation
43
Semimembranosus
+ Semimembranosus
Provides medial stability
Assists ACL to prevent anterior displacement
Internal rotation
Strengthen
 Leg curls, internal rotation of knee
+ Sartorius
 Origin
 Anterior, superior iliac spine
 Insertion
 Promixal aspect of the medial surface
of the shaft of the tibia
 Location
 Anterior/ superficial
 Insertion on the lateral/posterior side
 Action
 Knee extension
 Hip flexion
 Hip external rotation
 Hip abduction
+ Sartorius
 “Tailor’s Muscle”
 Longest muscle
 2 joints:
 Knee (Flexion- comes around behind the
knee)
 Hip (Flexion, abduction, external rotation)
 Weak during knee & hip flexion
 Sitting and crossing knees
 Knees extended
 Effective hip flexor
+
How do you stretch the knee
flexors?
47
Movement Analysis:
Anterior Pelvic Tilt/Posterior Pelvic Tilt
Plane
Axis
Action
Agonist
Antagonist
48
PHASE
1
2

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2

  • 3. + What is the most common cause of sciatica? 4
  • 4. + Sciatica Pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve Causes  The most common cause of sciatica is a bulging or ruptured disc, pressing against the nerve roots  It can also be a symptom of other conditions such as stenosis, bone spurs, arthritis or nerve root compression 5
  • 5. + What are the two most powerful external rotator of the hip? 6
  • 6. + External Rotators of the Hip External rotators  Piriformis  Gemellus Superior  Obturator Internus  Gemellus Inferior  Obturator Externus  Quadratus Femoris 7
  • 7. + Piriformis  Sciatic nerve passes inferiorly  Tightness  Origin  Anterior surface of lateral sacrum Insertion  Greater trochanter of femur, along the upper medial surface Actions  Lateral rotation
  • 8. + Gemellus Superior Origin Ischial spine Insertion Medial aspect of greater trochanter Actions External rotation
  • 9. + Obturator Internus Origin Ischiopubic ramus, obturator membrane Insertion Medial aspect of greater trochanter Actions Lateral rotation
  • 10. + Obturator Externus Origin Obturator membrane and the adjacent surfaces of the pubic body and pubic and ischial rami Insertion Medial aspect of greater trochanter Actions Lateral rotation
  • 11. + Quadratus Femoris Origin Lateral border of ischial tuberocity Insertion Intertrochanteric crest Actions Lateral rotation
  • 12. + How would you strengthen the external rotators of the hip? 13
  • 13. + Strength of ER 60% > IR Challenge to condition  Difficult to apply force to rotation  Seated position, surgical tubing  Stand on one leg- turn body away Stretch  Seated position, manual resistance Strength & Conditioning External rotators
  • 14. +
  • 16. 17
  • 17.
  • 18. + Bony Landmarks- Femur  Proximal end  Head  Femoral neck  Greater trochanter  Lesser trochanter  Pectineal Line  Shaft  Linea aspera  Distal end  Medial & lateral condyles  Patellar surface
  • 19. + Hip Joint Flexion/Extension- Muscles  FLEXION  Rectus femoris  Iliacus  Psoas major  Sartorius  Tensor fascia latae  EXTENSION  Semimembranous  Semitendinous  Biceps femoris  Gluteus maximus
  • 20. Gluteus Maximus  Origin  Posterior surface of the sacrum and coccyx, posterior aspect of the ilium  Insertion  Proximal end of the IT band  Location  Posterior/lateral  Superficial  Action  Hip extension (powerful)  External rotation  Abduction (superior fibers) 21
  • 21.
  • 22. Gluteus Medius  Origin  Lateral surface of the iliac spine  Insertion  Lateral aspect of the greater trochanter  Location  Lateral  Action  Hip abduction  Internal rotation (weak) 23
  • 23. Gluteus Minimus  Origin  Lateral surface of the ilium  Insertion  Superior and anterior aspect of the greater trochanter  Location  Lateral  Action  Hip abduction  Internal rotation (weak) 24
  • 24. Tensor Fasciae Latae  Origin  Anterior aspect of the lateral surface of the iliac crest and ASIS  Insertion  IT band to the lateral tubercle of the tibia  Location  Lateral  Action  Hip flexion  Hip abduction  Internal rotation (weak) 25
  • 25. +  Combo of gluteus max and TFL  Crosses the knee (lateral femoral condyle)  Moves during flex & ext (knee)  Palpate- above femoral lat condyle Iliotibial Band
  • 26. + IT Band Syndrome  Most common cause of lateral knee pain  Recurrent friction  Common in runners  High mileage, track (turning one way constantly or on crowned surfaces)  Common symptoms  Pain over the outside of the knee joint  Swelling at the location of discomfort  A snapping or popping sensation as the knee is bent  92% patients w/ IT Band Syndrome improved by strengthening the gluteus medius
  • 27. + Knee Joint Movements- Muscles EXTENSION  Rectus femoris  Vastus medialis  Vastus intermedius  Vastus lateralis FLEXION  Biceps femoris  Semitendinous  Semimembranous  Sartorius (*)  Popliteus  Gastrocnemius  Gracilis ROTATION  Internal  Semitendinous  Semimembranous  Popliteus  Gracilis  External  Biceps femoris  Sartorius
  • 28. + 29
  • 29. + Knee Extensors  Generate power  Strongest muscle groups  3x stronger than antagonist  Stabilize patella  Reduce strain on MCL  Assist PCL  Posterior displacement  Too much extension works against the ACL
  • 30. + Quadriceps Rectus Femoris  Origin  Anterior, inferior iliac spine, ilium above the acetabulum  Insertion  Patella, via patellar ligament to tibial tuberosity  Location  Anterior  Action  Knee extension  Hip flexion 31 Rectus Femoris
  • 31. Rectus Femoris  The only biarticulate muscle of the extensors (Crosses 2 joints)  Contributes to knee extension best when hip is extended or hyperextended  Kicking  Strengthened  Knee extension (resistance)  Flexibility  Side-lying, full flexion while hip is extended
  • 32. + Quadriceps Vastus Medialis  Origin  Medial lip of linea aspera; lower part of intertrochanteric line  Insertion  Patella, via quadriceps aponeurosis and patellar ligament to tibial tuberosity  Location  Anterior/medial  Action  Knee extension 33 Vastus Medialis
  • 33. + Quadriceps Vastus Lateralis  Origin  Greater throchanter and lateral lip of linea aspera  Insertion  Patella, via patellar ligament to tibial tuberosity  Location  Anterior/lateral  Action  Knee extension 34 Vastus Lateralis
  • 34. + Quadriceps Vastus Intermedius  Origin  Upper 2/3rds of the anterior and lateral surface of the femoral shaft  Insertion  Patella, via patellar ligament to tibial tuberosity  Location  Anterior/ deep  Action  Knee extension 35 Vastus intermedius
  • 35. + How do you stretch the knee extensors? 36
  • 36. + Knee Joint Movements- Muscles EXTENSION  Rectus femoris  Vastus medialis  Vastus intermedius  Vastus lateralis FLEXION  Biceps femoris  Semitendinous  Semimembranous  Sartorius  Popliteus  Gastrocnemius  Gracilis ROTATION  Internal  Semitendinous  Semimembranous  Popliteus  Gracilis  Sartorius  External  Biceps femoris
  • 37. +Knee Flexors 2 joint muscles  Biceps femoris, semimem, semiten Originate – ischial tuberosity Rotate knee  2 to the inside (semitend, semimemb)  1 to the outside (biceps femoris)
  • 39. + Biceps Femoris  Origin  Long head- medial surface of the ischial tuberosity  Short head- lateral lip of the linea aspera  Insertion  Fibular head, lateral colateral ligament, lateral condyle of the tibia  Location  Posterior/ Lateral  Action  Hip extension (long head only)  Knee flexion  External rotation (w/ hip flexion) 40
  • 40. + Biceps Femoris Two heads Provides lateral support Produces external rot (of lower leg) Assists ACL to stabilize (prevents ant displacement) Strengthen  Hamstring curls w/ ext rot of knee
  • 41. + Semitendinosus  Origin  Ischial tuberosity  Insertion  Medial surface of the proximal tibia  Location  Posterior/ medial  Action  Knee flexion  Hip flexion  Internal rotation (w/ hip flexion) 42 Semitendinosus
  • 42. + Semimembranosus  Origin  Ischial tuberosity  Insertion  Medial condyle of the tibia  Location  Posterior/ medial  Action  Hip extension  Knee flexion  Internal rotation 43 Semimembranosus
  • 43. + Semimembranosus Provides medial stability Assists ACL to prevent anterior displacement Internal rotation Strengthen  Leg curls, internal rotation of knee
  • 44. + Sartorius  Origin  Anterior, superior iliac spine  Insertion  Promixal aspect of the medial surface of the shaft of the tibia  Location  Anterior/ superficial  Insertion on the lateral/posterior side  Action  Knee extension  Hip flexion  Hip external rotation  Hip abduction
  • 45. + Sartorius  “Tailor’s Muscle”  Longest muscle  2 joints:  Knee (Flexion- comes around behind the knee)  Hip (Flexion, abduction, external rotation)  Weak during knee & hip flexion  Sitting and crossing knees  Knees extended  Effective hip flexor
  • 46. + How do you stretch the knee flexors? 47
  • 47. Movement Analysis: Anterior Pelvic Tilt/Posterior Pelvic Tilt Plane Axis Action Agonist Antagonist 48 PHASE 1 2

Notas del editor

  1. Flexed hip- medial rotation and almost zero contribution to abductionExtended hip- posterior fibers laterally rotate
  2. STRONGER than MVO