notes for skills check
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| piriformis syndrome max protected phase | AROM in pain free range- mm setting of glutes
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| piriformis syndrome mod protected phase | isometrics of glutes- deep tissue massage
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| piriformis syndrome min protected phase | piriformis stretching- tubing exercises for strengthening in ER- strengthen hip ext/abd SLR- deep tissue massage
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| OA/Bursitis of hip max protected phase | pain-free AROM all planes- glute sets/quad sets/ ham sets
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| OA/Bursitis of hip mod protected phase | AROM- TKEs- knee rocks
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| OA/Bursitis of hip min protected phase | stretching of TFL, Rectus, Hamstrings- open & closed chain strengthening glute max, glute med & hamstrings using theraband & free wts
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| THA/Post Op Hip Fx ORIF max protected phase | IP 1st wk-AP, QS, GS, HS, heel slides, AROM, ABD slides, TKE & SLR-protected WB w/wheeled walker/ WBAT. if biological-may be TDWB. hip precautions for THA.
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| THA/Post Op Hip Fx ORIF mod protected phase | Immediate Post-Op period wk 2-3-Home or SNF-prone/standing hip ext-bridging-closed chain (minisquats)- standing ABD, knee flex. hip precautions for THA
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| THA/Post Op Hip Fx ORIF min protected phase | I @ home wk 3-6-Return to Normal ADL-walking -swimming-stepper/treadmill-sidelying ABD- step ups/down- Basic Balance Exercises- one legged bridging- std pelvis drop- hip precautions
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| Lat ankle sprain/Pes Planus/Pronation max protective phase | PROM/AROM?- Gentle mm setting-limited WB
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| Lat ankle sprain/Pes Planus/Pronation mod protective phase | AROM- isometrics (all but esp inversion, eversion)- proprioception (alphabet, NWB rocker board)
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| Lat ankle sprain/Pes Planus/Pronation min protective phase | stability/proprioception/plyo-isometrics (all but esp inv, ev)-theraband for inv/ev- glute med strengthening-intrinsincs proprioception (marbles, sand, towel ex w/toes)-towel stretch
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| Post Op ORIF Ankle Fx Max Protective Phase | gentle mm setting, limited WB in Bledoe
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| Post Op ORIF Ankle Fx Mod Protective Phase | AROM, isometrics (all but esp inv, ev), proprioception (alphabet, NWB rocker board) Bledsoe off
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| Post Op ORIF Ankle Fx Min Protective Phase | stability/proprioception/plyo, isometrics (all but esp inv/ev), theraband for inv/ev, towel stretch, stretching for inv/ev
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| ant shin splints max protective phase | gentle mm setting
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| ant shin splints mod protective phase | AROM, proprioception (alphabet, NWB rocker board)
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| ant shin splints min protective phase | stability/proprioception/ply, isolated strengthening/endurance sets for ant tib, strengthening of inv/ev, towel stretch
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| non-operative MCL/LCL/ACL sprain 1st/2nd degree max protected phase | mm setting/isometrics, AROM-painfree, AP if edema, may be PWB/cx
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| non-operative MCL/LCL/ACL sprain 1st/2nd degree mod protected phase | 2 wks post injury-AROM, 4 way SLR (avoid shearing force by placing wt abv knee)
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| non-operative MCL/LCL/ACL sprain 1st/2nd degree min protected phase | stability, agility plyo, glute med strengtheing, ITB stretching, HS/Quad stretching
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| Post Op-ACL reconstruction max protected phase- full open chain resisted ext may be contraindicated (TKEs) | 1st 8 wks-patellar mobilization, QS & more QS, HS/GS/cocontraction, ham curls/heel slides, SLR, multiangle isometrics, AROM flex to >90, full passive knee ext-propping heel/prone hand, 4way SLR-brace on-pt may be in brace locked @ 0& initially PWB
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| Post Op-ACL reconstruction mod protected phase | Immediate post hospital (2-3 wks)-patellar mobs, scar massage, 4-way SLR, AROM/stretching to regain full range
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| Post Op-ACL reconstruction min protected phase | 12-24 wks-patellar mobilization, stability, ply, balance & agility, mini tramp hopping & progress to plyo, progress to sport specific
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| Post Op-TKR max protected phase | IP phase (1st wk) QS, HS, GS, cocontraction, heel slides, ABD slides, AP, AA SLR, TKE-if biological fixation pt may be PWB for longer period. pt will be in immobilizer-PWB-WBAT-remove for ex
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| Post Op-TKR mod protected phase | immediate post hospital (2-3 wks) patellar mobs, scar massage, 4-way SLR, AROM/stretching to regain full range
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| Post Op-TKR min protected phase | pt I @ home-patellar mobs, scar massage, closed chain ex-squats, std ABD, step-ups, balance ex, bike or pool, cont stretching until full ROM 135
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| Menisectomy/Partial Menisectomy max protected phase | pain free full AROM, QS, HS, GS, patellar mobilization-may be PWB/WBAT for up to 2 wks
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| Menisectomy/Partial Menisectomy mod protected phase | start at 2 wks, stretching hams/quads, minisquats, patellar mobilization, 4 way-SLR, closed chain ex
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| Menisectomy/Partial Menisectomy min protected phase | start @ 6 wks, low level plyo & agility w/slow progression to impact exercises, cycling, closed chain strengthening, stretching hams, quads & ITB
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| meniscus repair max protected phase | pain free AROM to 90, QS, HS, GS, patellar mobilization, 4-way SLR if pt NWB- pt is in brace locked @ 90 of flexion & may be NWB/PWB for up to 4 wks
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| meniscus repair mod protected phase | starts @ 4 wks, stretching hams/quads, minisquats, patellar mobilization, 4 way SLR, closed chain ex
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| meniscus repair min protected phase | starts @ 4 months, low level plyo & agility w/slow progression to impact ex, cycling, stretching hams, quads & ITB
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| PFPS max protected phase | mm setting, AROM-pain free
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| PFPS mod protected phase | stengthen glute med, VMO strengthening (TKEs), SLR, ITB stretching, patellar mobs w/lat retinaculum stretch/ medial glide- avoid closed chain knee flex in range of 45-90. Avoid TKEs initially
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| PFPS min protected phase | step-ups/step down w/knee control, slowly increasing step ht, lat step-ups recruit VMO, ankle stability, minisquats w/ABD, progress to plyo & agility
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| plantarflexors | gastroc, soleus, flexor hallicus, flexor digitorum, post tib
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| dorsiflexors | ant tib, ext hallicus longus, ext digitorum
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| ankle evertors | fibularus longus, peroneus breis, peroneus longus, peroneus tertious
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| ankle invertors | post tib, flexor hallicus, flexor digitorum
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| cause of anterior shin splints (ant tib) | repeated dorsiflex
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| cause of posterior shin splints (post tib) | repeated plantarflex
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| 1st degree inversion ankle sprain | single ligament rupture-usually ant talofibular
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| 2nd degree inversion ankle sprain | ant talofibular & fibulocalcaneal
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| 3rd degree inversion ankle sprain | ant talofibular & fibulocalcaneal & post talofibular
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| eversion ankle sprain | deltoid ligament/medial collateral
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