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Knee Lab W2013.docx

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Krista M Baker

1 Knee Lab You may find it helpful to review the actions and general locations of the following muscles:  Rectus Femoris and the 3 Vasti of the Quadriceps muscle group  Biceps Femoris, Semitendinosus, Semimembranosus  Adductor Magnus, Longus and Brevis, Pectineus and Gracilis  Gluteus Maximus, Gluteus Medius, Gluteus Minimus  Tensor Fascia Lata and Iliotibial Band (ITB)  Piriformis  Gastrocnemius, Soleus Plus locations of the following bony landmarks: Iliac crest, greater trochanter, head of fibula Stretching Quadriceps Stretching • Knee flexion is the key component • Errors: anterior tilting of the pelvis and increasing the lumbar lordosis • Can be performed in a variety of positions:  Prone lying when knee flexion is significantly limited o Can loop a belt or strap around the lower leg to control the stretch Department of Kinesiology, McMaster University KIN 4KK3, Winter 2013 2  Side lying variation for emphasis on lateral thigh (incl. ITB) o Can add hip extension and allow the hip to laterally rotate Lunge stretch for Rectus Femoris • Kneeling, target leg behind • Front leg: hip and knee flexed approximately 90 degrees • Posterior pelvic tilt • Back leg: hip is neutral, or in extension, depending on patient flexibility • Back leg: progressively introduce knee flexion (as available) • Lift up through the spine, hands on iliac crest or reaching up • Place a hand on a table or other stable surface to improve balance • Wider knee placement can improve balance Hamstring Stretch: Straight Leg Raise position • Model lies supine on the ground, tester stands at their feet, facing the model’s head • Tester: grasp the target leg just above the malleoli, use your other hand to press against the front of the model’s thigh to bring the knee into extension • Knee fully extended (or as full as tolerable) Department of Kinesiology, McMaster University KIN 4KK3, Winter 2013 3 • Ankle loose, hanging in plantarflexion • Bring the hip up into flexion, slowly feeling the resistance build in the posterior thigh • Normal range? • Errors: posterior tilting of the pelvis, lifting of the opposite thigh/hip off the ground, hiking/rising of the pelvis on the target side (pelvis shifting upwards towards the ribs) • Modify to emphasize medial hamstrings: ABD with LR of thigh and leg • Modify to emphasize lateral hamstrings: ADD with MR of thigh and leg Resistance Exercises Terminal Knee Extension using Theraband Wall Squats Reverse Lunge OR Bulgarian split squat Single Leg Short Squat: opposite hand on wall Each of the above listed exercises can be used to target (though not isolate) the knee extensors. The following cues/observations can be applied to most weight-bearing knee extensor exercises: Department of Kinesiology, McMaster University KIN 4KK3, Winter 2013 4 Looking from the front • Shoulder level symmetry • Pelvis symmetry • Feet aligned under the hip joints* nd rd • Knee centered over the 2 or 3 toe, toes pointing forward* Looking from the side
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