NPTE MSK Basics, Biomechanics, and Kinematic Chain

Osteokinematics

Gross movement of joint segments, expressed in terms of range of motion.

A physical therapist observes limited mobility at the thoracic spine during an examination. Which of the following is the MOST likely compensatory finding?

A. Decreased mobility at the lumbar spine

B. Hypermobility at adjacent spinal segments

C. Increased muscle strength throughout the trunk

D. Symmetrical motion throughout the spine

B. Hypermobility at adjacent spinal segments

Rationale: When one joint is hypomobile, adjacent joints often compensate with excessive motion (hypermobility), increasing stress on those segments.

Arthrokinematics

Small, involuntary movements occurring at joint surfaces, including rolling, sliding, and spinning.

Convex-Concave Rule: Convex on concave Surface

Sliding/gliding occurs in the opposite direction of the bone shaft movement.

Convex-Concave Rule: Concave on convex Surface

Sliding/gliding occurs in the same direction as the bone shaft movement.

Special movement descriptions of the ankle for OKC and CKC

OKC:

pronation= eversion + DF+ ABduction

supination = inversion+ PF+ ADduction

THINK EDAB AND IPAD

CKC:

PRONATION= eversion + PF + ADDuction

supination = inversion + DF+ ABduciton

think EPAD and IDAB

Which is the only exception where the convex/concave rule does not apply

Adhesive capsulitis because external location is limited my extension is limited so as a combination motion, it is very hard to just give one glide for capsulitis and for that when you see that on the exam, you're going to the posterior inferior like this is a combination flight it is one of the very few occasions. They will ask you on the exam but just have to remember that it has like a little follow straight pattern and say abduction is limited if you like, but you know, but you have to do a posterior glide to make the correct answer

Joint Mobilization Grades 1 and 2

Used primarily for pain relief and joint neuromodulation.

Joint Mobilization Grades 3 and 4

Used primarily to stretch connective tissue and improve joint range of motion.

know the joint mob grades (think of the FF hand to help:))

jandas cross syndrome

upper crossed: Tight Muscles: Upper trapezius, levator scapulae, sternocleidomastoid, and pectorals.

Weak Muscles: Deep neck flexors, lower trapezius, and serratus anterior.

lower crossed:

tight Muscles: Hip flexors (iliopsoas, rectus femoris) and lower back muscles.

Weak Muscles: Abdominals (like the transversus abdominis) and gluteal muscles.

mnemonic for remembering which is tight vs weak

Wii: weak is inhibited

Facetime:facilitation is tight

ALPS Mnemonic (Supine to Sit Test)

Anterior Longer, Posterior Shorter leg length discrepancy in the supine position.

Anterior Rotated Innominate (Supine to Sit)

The affected leg appears longer in supine and shorter in sitting.

Posterior Rotated Innominate (Supine to Sit)

The affected leg appears shorter in supine and longer in sitting.

Isometric Contraction

Muscle contraction where muscle torque equals load torque, resulting in no joint movement.

Concentric Contraction

Muscle contraction where muscle torque exceeds load torque, shortening the muscle.

Eccentric Contraction

Muscle contraction where muscle torque is less than load torque, lengthening the muscle.

Trendelenburg Gait (Right Side Midstance Drop)

Caused by weakness of right hip abductors or right superior gluteal nerve injury.

Trendelenburg Gait Exercise (Right Weakness)

Stand on the right leg and abduct the left leg.

Mobilization to Improve Hip External Rotation

Anterior glide of the femur on the acetabulum (convex on concave).

Mobilization to Improve Ankle Plantarflexion

Anterior glide of the talus on the tibia.

Glenohumeral Medial Rotation Slide

The humerus slides in a posterior direction (convex on concave).