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  1. What is the definition of Piriformis Syndrome?
    Compression of sciatic nerve by piriformis muscle
  2. What are of the body does the sciatic nerve supply motor&sensory functions?
    Posterior thigh, leg, & foot
  3. What are the actions of piriformis?
    • Eccentric internal rotation during gait
    • External rotation with hip in extended or neutral position
    • Horizontal abduction in a seated position
  4. Trigger points for piriformis are located:
    • Near lat border of sacrum
    • 1/3 way from greater trochanter
  5. Causes of PS are:
    • Direct/indirect trauma to piriformis
    • Overuse
    • Postural/positional issues
  6. Compression of sciatic nerve from piriformis affects what region of body?
    Progressively from thigh down to foot
  7. TPs in piriformis refer to where?
    SI region, buttocks, hip & posterior thigh
  8. The following are common observations seen w PS:
    • Difficulty sitting for long periods of time
    • Swelling in lower limb may be observed
    • Guarding affected leg
  9. What is a positive result w resisted testing of piriformis?
    Pain and/or weakness
  10. What special test is positive for piriformis involvement?
    Piriformis length test
  11. What tests are (-) for PS but (+) for compression of sciatic nerve at lumbar spine?
    • Kemps
    • Valsalva
    • Straight Leg Raise
  12. The following are contraindications of PS:
    • No local massage up to 10days after cortisone injection
    • No fx strokes if client on anti-inflam
    • Avoid hip mobs during 3rd trimester
  13. Where do GlutMax TPs refer?
    Locally to buttock along SI jt & Sup to IschTub
  14. What Ms need to be warmed up & treated for TPs before piriformis?
  15. TX freq for PS:
    1x/wk for 4-6wks
  16. What is the definition of ITB Contracture?
    A contracture/thickening of ITB
  17. When ITB becomes contractured, what other structures can be affected?
    • Hip&knee
    • SI jt & ankle
    • Trochanteric bursae
  18. What MS of hip directly attach to ITB?
    GlutMax & TFL
  19. What is likely to lead to shortening of ITB?
    • Activities involving prolonged sitting
    • Ant pelvic tilt/hyperlordosis
    • Consistent weight bearing/shifting weight to one side
  20. What symptoms are common w ITBC?
    • Pain felt along lat side leg into lat knee
    • Trigger/TPs in Ms attached to ITB may contribute to tightness in ITB
    • Ct may present w valgus knee positioning
  21. All the following are true of ITBC:
    • Ct may show lat tilt to affected side from Ant view
    • Ct may present w Ant pelvic tilt w bilat ITBC
    • Ct may present w pes planus on affected side
  22. With Active Flex testing of hip, what actions show reduced ROM w ITBC?
    Extension & Abduction
  23. What special test used for shortening of TFL or ITB?
    Modified Ober's
  24. What hydro most appropriate following fx on ITBC?
  25. What is the length of initial tx plan freq for ITB?
    1x/wk for 6wks
  26. What is definition of strain?
    Overstretch injury to musculotendinous unit
  27. During what kind of contraction is Ms more predisposed to injury?
  28. What grade strain is described as minor stretch & tear to musculotendinous unit w minimal loss of strength & ability to continue w activity suffering mild discomfort?
    Grade 1
  29. What grade strain is known as a moderate strain?
    Grade 2
  30. What is appropriate course of action if health history presents significant Ms weakness, loss of fx or palpable gap in tissue?
    Refer ct out to physician
  31. What area of body most freq affected by strains?
    Lower extremity
  32. During acute phase all grade strains, what appropriate form testing indicated?
    AF ROM
  33. In early & late subacute stages, when performing resisted testing on Ms, grade 2 strains reveal:
    Moderate loss of strength & pain
  34. When performing PROM on early & late subacute stage of strain, the affected Ms is tested:
  35. Which tx contraindicated w Ms strains?
    • Distal circulatory tech to strain should be used in acute/early subacute stages
    • Remove all protective Ms splinting/spasming around acute strain to relieve discomfort
    • Use hot therapy w grade 3 strains that are casted immediately proximal to cast
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Clinical Massage Therapy 4
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