4. Gait: able to heel and toe walk, gait intact
ROM: limited AROM of the L spine in all planes
Motor: 4/5 b/l hip extension and abduction 5/5 strength in the
bilateral lower extremities including
HF,KE, KF,AD, EHL, PF, inversion, eversion
Sensation: intact to light touch in all dermatomes tested from L2-
S1 bilaterally
Reflexes: 2+ b/l patella and Achilles, plantar response down
going, proprioception intact
Palpation: Diffusely tender over lumbar paraspinals -TTP over
the b/l greater trochanters and bilateral SI joint
Tone: normal in the b/l LEs
Lymph: no lymphadenopathy at groin or popliteal fossa
Provacative tests: - SLR, seated root (slump test), Kemp, FABER
testing, FADIR testing, Ely's test to 0 degrees, Ober's negative
bilaterally
5. Gait Eval
Look at feet, ankle, and knees
Heel strike, lat foot, then cross over medially to
big toe off
Look at shoe wear
What is trendelenberg ?
6. Trendelenberg
Marilyn Monroe
Weak Glut med
Hip Abductor
Sup gluteal N
L4/L5 S1
7. Controversial if should do this, can worsen
pain
Flexion 90 degrees
Extension 30 degrees
Lat Bending 30 degrees
8. Muscle Grading
5 full strength and full range
4 less than full strength, full range
3 against gravity full range
2 gravity eliminated, full range
1 twitch
0 nothing
9. HE; one of the core muscles
Range 0-30
Glut max
Hamstrings
How isolate hamstring? Does it matter?
Glut max prime mover (inf gluteal nerve L5,
S1, S2)
What is the most common herniation?
10. HF
Range 0-125
Iliopsoas (iliopsoas nerve L2,L3) prime hip
flexor
Rectus femoris, sartorius (fem nerve L2,L3,L4)
11. KE
Range degrees
Quads (Rectus femoris, vastus lateralis, vastus
intermedius, vastus medialis oblique) femoral
nerve L2/L3/L4
12. KF
Range 0-135
Need greater than 90 degrees to stand up out of
chair
Hamstrings:
Semimembranosus (sciatic, tibial portion
L4/L5/S1/S2
Semitendinosus (sciatic, tibail portion L4/L5/S1/S2
Biceps Femoris(Long head (sciatic, tibial portion
L5/S1/S2, SHORT head common fibular portion
L4/L5/S1/S2
13. AD
Range 0-20
Tibialis anterior, deep peroneal nerve
L4/L5/S1
14. EHL does toe extension
Deep fibular nerve L4/L5/S1
28. FABER: Flexion/Abduction, External Rotation
Opp SI joint, or hip pain
29. Ober’s
Check’s TFL tightness
Press on TFL to find tender points which also
signifies tightness
Found a lot in runners
Changes running mechanics