+

ESS 3092: KINESIOLOGY Week 11- Wednesday

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+Review

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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

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+

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

+Piriformis

Sciatic nerve passes inferiorly Tightness

OriginAnterior surface of lateral

sacrum

InsertionGreater trochanter of femur,

along the upper medial surface

ActionsLateral rotation

+Gemellus Superior

OriginIschial spine

InsertionMedial aspect of

greater trochanter

ActionsExternal rotation

+Obturator Internus

OriginIschiopubic ramus,

obturator membrane

InsertionMedial aspect of

greater trochanter

ActionsLateral rotation

+Obturator Externus

OriginObturator membrane and

the adjacent surfaces of the pubic body and pubic and ischial rami

InsertionMedial aspect of greater

trochanter

ActionsLateral rotation

+Quadratus Femoris

OriginLateral border of ischial

tuberocity

InsertionIntertrochanteric crest

ActionsLateral rotation

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+ How would you strengthen the

external rotators of the hip?

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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 & ConditioningExternal rotators

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+Manual Stretch

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+ 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

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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)

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Gluteus Medius

Origin Lateral surface of the iliac

spine

Insertion Lateral aspect of the

greater trochanter

Location Lateral

Action Hip abduction Internal rotation (weak)

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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)

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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)

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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 Semimembran

ous Sartorius (*) Popliteus Gastrocnemius Gracilis

ROTATION

Internal Semitendinous Semimembranou

s Popliteus Gracilis

External Biceps femoris Sartorius

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+ 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

+QuadricepsRectus 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

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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

+QuadricepsVastus 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

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Vastus Medialis

+QuadricepsVastus Lateralis

Origin Greater throchanter and

lateral lip of linea aspera

Insertion Patella, via patellar

ligament to tibial tuberosity

Location Anterior/lateral

Action Knee extension

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Vastus Lateralis

+QuadricepsVastus 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

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Vastus intermedius

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+

How do you stretch the knee extensors?

+Knee Joint Movements- Muscles

EXTENSION Rectus

femoris Vastus

medialis Vastus

intermedius Vastus

lateralis

FLEXION Biceps femoris Semitendinou

s Semimembran

ous Sartorius Popliteus Gastrocnemius Gracilis

ROTATION Internal

Semitendinous Semimembrano

us 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 267

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Muscles for coaches

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)

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+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)

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Semitendinosus

+Semimembranosus

Origin Ischial tuberosity

Insertion Medial condyle of the

tibia

Location Posterior/ medial

Action Hip extension Knee flexion Internal rotation

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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

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+

How do you stretch the knee flexors?

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Movement Analysis: Anterior Pelvic Tilt/Posterior

Pelvic Tilt

Plane

Axis

Action

Agonist

Antagonist

PHASE 12