CHANGING MOVEMENT IMPAIRMENTS IN THE LOWER QUADRANT
30th April 2014
Many kinds of pain and dysfunctions in the hip and lower leg may exist if there is an incorrect weight-bearing line of the femur and tibia. There is a risk of hip impingement, patellofemoral pain, shin splints, tibialis posterior insufficiency, and ankle inversion sprain injuries to name a few. But fortunately we can change these movement impairments by teaching the people to use correct movement strategies - this is supported by the paper below.
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** assess, identify and retrain hip and lower leg movement control in order to get rid of pain, recover movement impairment and improve activity limitations **
Trunk and lower extremity segment kinematics and their relationship to pain following movement instruction during a single-leg squat in females with dynamic knee valgus and patellofemoral pain Valentina Graci, Gretchen B. Salsich
To understand how instructing females with patellofemoral pain to correct dynamic knee valgus affects pelvis, femur, tibia and trunk segment kinematics. To determine if pain reduction in the corrected condition was associated with improved segment kinematics.
A 3D-motion capture system was used to collect multi-joint kinematics on 20 females with dynamic knee valgus and patellofemoral pain during a single-leg squat in two conditions: usual movement pattern, and corrected dynamic knee valgus. During each condition pain was assessed using a visual analog scale (VAS). Pelvis, femur, tibia and trunk kinematics in the frontal and transverse planes were compared between conditions using a paired T-test. Pearson correlation coefficients were generated between VAS score and the kinematic variables in the corrected condition.
In the corrected condition subjects had increased lateral flexion of the pelvis toward the weight-bearing limb (p < 0.001), decreased femoral adduction (p = 0.001) and internal rotation (p = 0.01). A trend toward decreased tibial internal rotation (p = 0.057) and increased trunk lateral flexion toward the weight-bearing limb (p = 0.055) was also found. Lower pain levels were associated with less femoral internal rotation (p = 0.04) and greater trunk lateral flexion toward the weight-bearing limb (p = 0.055).
Decreased hip adduction after instruction was comprised of motion at both the pelvis and femur. Decreased pain levels were associated with lower extremity segment kinematics moving in the direction opposite to dynamic knee valgus. These results increase our understanding of correction strategies used by females with patellofemoral pain and provide insight for rehabilitation.
Journal of Science and Medicine in Sport Available online 26 April 2014