LL Problem Solving

gluteal gait/hip drop

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-hip abduction stance leg

-glut med, glut min

-sup gluteal n

-L5-S1

-NO (glut n don’t have sensory, and overlap)

Foot Drop

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-DF (ext ankle)

-Tib ant (and anterior leg muscels: EDL, EHL)

-deep fibular n

-L4-5

-YES=between 1st and 2nd toes

*dorsum foot also effected bc deep fibular n

Hip Stepping Gait

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

same as “foot drop” just dif sign; another way to compensate for a limb that is “too long”

-DF (ext ankle)

-Tib ant (and EDL, EHL)

-deep fibular n

-L4-5

-YES=1st and 2nd toes

*dorsum foot also effected bc deep fibular n

-gluteal gait results from

-high stepping gait is a sign of

-weaker lesser gluteal muscles

-foot drop

^both ways to compensate for a limb that is “too long”

Hammer/Claw toes

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-flex MTP and extend IP

-lumbricals

-plantar n (1=med, 2-4=lat)

-S2-3

-YES=plantar foot (toes 2-5 in image; depends on location of lesion)

Case: calc tendon rupture

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-PF

-Gastroc, soleus

-tibial n

-S1-2

-YES= post and lateral elg [heel/tibial n; plantar ; and medial sural n (post/lat leg)]

case: Trochanteric bursitis

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-tenses IT band, so pain if engage TFL (no motor really impacted)

• pain during knee and/or hip flexion

-TFL

-sup glutal n

-L5-S1

-No (glut n no sensory)

case: pain anterior thigh, located midshaft femur and towards knee, worse after activty

aka Quad strain

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-knee extension

-quads

-fem n

-L2-4

-YES, ant/med thigh and med leg (bc saphenous)

case: medial thigh pain, brusing and swelling, sudden onset, reduced hip mobility

aka Groin pull

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-hip add

-adductors (adductor brevis most frequently injured)

-obt n

-L2-4

-Yes, med thigh

Heel Spur case: foot pain, radiates anteriorly from heel worse when standing

-action impeded

-muscles affected

-innervation

-roots of the nerve

-where paresthesia

-standing and walking are painful; if nerve compressed=ab/ad digits

-plantar fascia/connective tissue (if too tight compresses plantar foot, thick and not very elastic; “plantar fascititis”)

-plantar n may be compressed

-S2-3

-Yes, plantar foot (but more likely pain than paresthesia)