A friend of minewent on a bicycle with me, and after about an hour started to experience severe knee pain. After reviewing their lower extremity I found she had "knock knees". The clinical term for knock knee is genu Valgum. The opposite would be "bowlegged" or Genu Varum. Genu Varum Since it is generally not with pain or problems, we concentrate on my friend with Genu Valgum. However, both conditions are the result of the Q-angle.
The Q-angle in the frontal plane by a line from the anterior superior spine of Ilium until the mid-patella, and a second line from the center of the patella to the tibial tuberosity. A normal Q-angle for quadriceps femoris function is usually 10 -14 degrees in men and from 15 to 17 degrees for women.
Anyway, back to my friend ...
In the assessment of lower extremity, you must "get out of the box" kind of talk, says Ruben Salinas, PT, OCS. Ruben is the clinical director of the Fortansce and Associates Physical Therapy Clinic in Arcadia, California. "They concentrate not only where the pain is look at the whole picture. Remember that the lower extremity is a closed chain, especially in cycling."
usually Genu Valgum find pronation or flat feet, tight gastrocnemius and in some cases, trochanteric bursitis.
Let us at a time:
at the ankle, the body will try to compensate for the valgus knee stress (tensile forces on the medial side of the knee; compressive forces on the lateral side) of offset. In the hallway you have to dorsiflex an ankle in order to swing the other leg.
If your customers gastroc fixed, they will not be able dorsiflex, which cause the foot to cave in. This will also impact on the knees and hips. To extend the gastroc, have your customers track. Be careful not to their feet in the cave during pregnancy. If necessary, within the foot with a wooden block so that her foot does not pronate.
For the tibialis posterior (which is an inverter and crosses the ankle) are your customers with "wipers". By strengthening the inverter (see Figure) can cause the foot to the supinate is the opposite of pronation.
Here's how:
Lie a light weight on a towel. With their feet flat on the ground have the person push the weighted towel inwards towards its other foot. There are also other ways of supporting the foot, but that's an entirely different article.
My friend was not complaining about their feet but the pain was on the lateral or outside of her knee.
Let us, therefore the knee:
Due to the excessive Q-angle is more pressure forces on the lateral side, and train more or distraction forces on the medial side of the knee. How do you do?
"This is a great theme gray area in the physical therapy," says Ruben Salinas. He is an expert on the knee. VMO weakness or inability, fire has been suggested as the culprit for patella - femoral dysfunction. The experts still can not agree. It is definitely worth a try. To increase VMO activity, try quad is in all directions, or your customers a small ball or rolled up towel between her legs when the conduct of leg extensions. Do they squeeze or adduct closely at the top of the extension.
Another method is Ruben proposes bio-feedback. Have the clients, their hands on the vastus lateralis and vastus medialis, then they have their contract leg. With the fingers, they should be able to feel the side contracts first. Try it and to "fire" inside (vastus medialis) from. It would be nice if you had some of surface EMG, but hey, we are only a trainer!
on the waist, you are often weak external rotators. It's almost as if the head of the femur has rolled forward and inward. If this happens, the greater trochanter begins smash against a Bursa, which eventually could lead to bursitis.
The external rotators of the hips are the key here. Concentrate on the Gluteus maxims, and not the Gluteus medius. Remember that the medius is an internal rotator. Do not forget the deep external rotators either. By external rotation with a cable or hose attached to the ankle, then the piriformis, superior and inferior gemellus, obturator externus and internus and the quadratus femoris. This will help to stabilize the hip, so that the bone against bone smashing not occur.
Be aware some customers have an aversion. This is the angle of the femoral neck in the frontal plane. (see diagram). Anteversion the feet turn inward, increasing the mechanical advantage Gluteus maxims as an external rotator, the Q-angle and cause more pronation at the foot. Anteversion is structural, so you can not repair that without a scalpel and a chainsaw.
Finally, I hope you can see that in the case of the lower extremity, you must have a holistic approach. Make a lot of questions. How did it this way? Is the condition acute or chronic? Is it innate? Is it muscular or structural? Their gait.
If pain, these exercises when they refer them out and get a medical release.
I hope this will help you and your customers, and I sincerely hope that your attitude, before you invite anyone with a weight.
By the way, after a bit of rice, (rest, ice, compression, elevation) my friend was able to walk again. Now they only need one of you to train them.
Autor: John Platero John Platero
Level: Basic PLUS
John Platero is the founder and owner of Future Fit, Inc. a successful multi-faceted fitness company that manages Personal Trainers, provides fitness products, services and ... ...
John Platero is the founder and owner of Future Fit, Inc. a successful multi-faceted fitness company that manages personal trainers, provides fitness products, services and educational services for the consumer. He is also the Director of the N.C.C.P.T. (The National Council of Certified Personal Trainers) which has certified thousands of personal trainers at its intensive, two-day workshops held throughout the country. For more information please visit http://www.nccpt.com
Added: July 3, 2009
Source: http://ezinearticles.com/
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