GAIT-- Hip

Question 1

In Stance phase:

IC

where is hip?

Answer 1

Neutral

*neither ABD nor ADD

Question 2

In stance phase:

LR–> MSt

where is hip?

Answer 2

• Stance limb will norm ADD to 5deg

Question 3

LR–> MSt and the Hip:

Explain glute med. weakness

If glute med. isnt strong enough to eccentrically control ADD =====

Answer 3

• EXCESSIVE hip ADD. will occur t/o MSt if glute med is weak
  
  • contralat pelvis on contralateral side will DROP more than it should
    
    • ​Trendelenberg Gait

Question 4

In Stance Phase:

MSt–> Toe off

where is hip?

Answer 4

• Hip will gradually ABD to 10deg

Question 5

During Swing:

what is going on w/ Hip?

Answer 5

Hip ADD’s BACK to Neutral in prep for next IC

Question 6

Sag. Plane HIP

IC

Answer 6

Hip == 30deg FLEX

Question 7

Sag. plane Hip

LR–TSt

Answer 7

• Hip normally extends to 10-20deg
  
  • Lack of Hip Ext during Stance
    
    • ​limit HOW FAR Opp. (Swing) limb can advance
  • Tight Hip Flexors
    
    • ​actively limit Hip EXT
      
      • esp. as tibia progresses forward over fixed foot

Question 8

Sag Plane HIP

REC FEM

*hip flexor/knee extensor 2 joint mm

Answer 8

• Stretched when hip is EXT and knee is still slightly FLEXED
  
  • ​If Tight:
    
    • ​prevents hip from EXT as you approach MST
  • TESTS:
    
    • ​Thomas== hip flexors
    • Mod’d Thomas==Rec Fem

Question 9

Hip MM activation t/o Gait

IC–> LR

Answer 9

• Hip EXT
• Glute Med
  
  • act. INCs t/o LR
    
    • ​eccentrically controls Stance limb ADD
    • WEAK GLUTES==
      
      • ​Weak Ecc. ADD==
        
        • ​contralat. pelvis drop
• TFL active during LR

Question 10

Hip MM activation t/o Gait

MSt

Answer 10

• Glute Med
  
  • Conc ABD’s hip to assist w/ swing of opp. leg

Question 11

Hip MM activation t/o Gait

TSt–> MSw

Answer 11

Adductors

Question 12

Hip MM activation t/o Gait

PSw–> early MSw

Answer 12

Hip flexors concentrically

Question 13

Hip MM activation t/o Gait

@ LR and moving to MSt

Answer 13

• BW vector just ANT to hip===FLEXION moment
  
  • ​here we use the glute max (int. moment hip ext)
    
    • prevents hips collapsing into FLEX
• Compensation for weak Glute Max
  
  • Lurch== lean back so BW vector falls POST to hip joint
    
    • ​causes Hip EXT moment instead of normal FLEX moment
  • Glute max lurch==weak glute max

Question 14

Glute med activation causes what?

Answer 14

Compression forces (JRF’s) @ hip

• To LESSEN need for Glute Med during STANCE
  
  • or lessen JRF
    
    • ​pt will lean TOWARD Stance limb
  • or to DEC pain
    
    • ​this lessens the ADD moment so ABDs dont have to work as hard

Question 15

Lessening need for Glute Med eventually leads to….

Answer 15

pattern contributes to disuse weakness of Glute Med

Question 16

@ LR—- glute med activity

Answer 16

• Glute med activity INCs to ecc. control Stance limb ADD
• ECC. contraction is MOST POWERFUL glute med contraction that causes MOST compressive forces @ hip
  
  • ​if pt already leaning over Stance limb===> little need for any conc. act in MSt