China
Africa
Explore chapters and articles related to this topic
Musculoskeletal and Soft-Tissue Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Assess for any reduction in straight-leg raise (SLR), suggesting sciatic nerve-root irritation. Inability to leg raise more than 30° due to pain going down the leg is abnormal.Remember that being able to sit up in bed with the legs out straight is equivalent to a SLR of 90° on both sides.
Sports medicine and sports injuries
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Complete quadriceps rupture : this is less common, but may occur when kicking balls or in older patients. The patient can often perform a straight leg raise due to trick manoeuvres. However, they cannot restraighten the raised leg (quadriceps lag). Surgical repair is not usually needed in the elderly but is necessary in athletes.
The neurological examination
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Straight leg raise can be used to assess nerve root compression or irritation in the lumbar spine. The test is performed while the patient is supine. The examiner raises the affected leg in a straight position. The leg is raised slowly to 90 degrees, and one should assess at what degree the patient experiences pain in the posterior aspect of the leg. The presence of pain in the affected leg at less than 60–70 degrees indicates nerve root compression or irritation.
Physiotherapist management of a patient with spastic perineal syndrome and subsequent constipation: a case report
Published in Physiotherapy Theory and Practice, 2021
Shankar Ganesh, Mritunjay Kumar
The patient had exaggerated thoracic kyphosis and anterior pelvic tilt. The posterior superior iliac spine on the left side was found inferior compared to the right-hand side (Petty and Moore, 2001) (Figure 1). There was an apparent limb shortening of 3 cms on the left lower limb (Magee, 2008). The sacrum was found to have a right-on-right forward torsion with L5 rotated to the left. The lumbar spring test was negative (Magee, 2008). The straight leg raise was found to be limited on the left side (< 30 degrees). Freiberg sign was positive on the left side (Magee, 2008). There was a loss of end range of motion during lumbar forward flexion. The active movements of hips were normal except left hip internal rotation which was limited (30 degrees on the left side compared to 40 degrees on the right; measured using a goniometer in the prone position). Maitland posterior-anterior mobilization to the spine showed reduced intervertebral segmental motions in the lower thoracic (T 10–12) and lumbar region (L1-5). The left piriformis muscle and bilateral hip flexors were tight (Magee, 2008) and palpation of these muscles revealed local tenderness. No other soft tissue impairments were identified.
The immediate and 1-week effects of mid-thoracic thrust manipulation on lower extremity passive range of motion
Published in Physiotherapy Theory and Practice, 2020
Derrick Sueki, Shaun Almaria, Michael Bender, Brian McConnell
Beyond localized effects, research is beginning to demonstrate that interventions directed at the thoracic spine can have effects on more remote regions of the body. De Oliveira et al. (2013) found that in subjects with chronic pain, both upper thoracic and lumbar manipulation produced changes in lumbar and foot pressure pain thresholds. The results of this study corroborate findings from a systematic review by Coronado et al. (2012) that found changes in pain sensitivity in both local and sites remote following spinal manipulation. Beyond pain perception, research is also demonstrating that manipulation can change mobility in regions remote to the site of intervention. Szlezak, Georgilopoulos, Bullock-Saxton, and Steele (2011) found that in healthy subjects, lumbar spine mobilization immediately improved passive straight leg raise (PSLR) whereas passive stretching did not. Additionally, Ganer (2015) found that, in healthy subjects, spinal manipulation directed at the thoracic spine also significantly increased PSLR. In this study, PSLR was measured initially at the onset of stretch and at the maximal tolerable stretch. In both instances, PSLR was significantly larger after thoracic manipulation than pre-manipulation assessment. One limitation of this study was the lack of a comparative control group. Because no control group was used for comparison, it cannot be definitively determined whether the changes in PSLR were from the spinal manipulation or from some other undetermined factor.
Rectus femoris intrasubstance tear in a collegiate football kicker and its mechanism
Published in Baylor University Medical Center Proceedings, 2020
Shiv J. Patel, Daniel Dat Nguyen, Brett Heldt, Prathap Jayaram
At the 6-week follow-up visit, the patient returned with minimal to resolved pain at rest but persistent pain in the right mid-thigh region with kicking activities. He stated that 2 weeks after the last visit, he tried warming up with field goal kicks and felt pain immediately. This pain was exacerbated with leg raises. After these events, he continued to punt for his team but stopped kicking field goals. The patient inquired about additional treatment options, because conservative management had failed. Football season ended 1 week before this visit and he wanted to be ready for spring training. He elected to have a leukocyte-rich, platelet-rich plasma injection. The patient was sent home with instructions not to ice the area or use any nonsteroidal anti-inflammatory drugs to prevent antagonizing the healing, pro-inflammatory effects of the injection.4 He was also placed on a rehabilitation program that employed the use of an eccentric strengthening protocol.