Name: Goniometry: Hip External Rotation at 90 Degrees of Hip Flexion (90/90 Hip ER)
Uploaded: 2023-04-26T01:02:06.000Z
Duration: 6 min 58 s
Description: This video guides viewers through a hip external rotation goniometry exercise. Learn how to set up and assess the joint action at 90 degrees of hip flexion and how to modify the plane of motion for a patient's specific needs.

English captions

https://stream.mux.com/lQs01TBAzfLy100fUxic2WVuNEnsVFod024BpEGemv19IY.m3u8

This video guides viewers through a hip external rotation goniometry exercise. Learn how to set up and assess the joint action at 90 degrees of hip flexion and how to modify the plane of motion for a patient's specific needs.

Introduction to Hip External Rotation Assessment

Performing the Goniometric Assessment

Muscle Restrictions Affecting External Rotation

Interventions for Improving Hip External Rotation

Importance of Consistent Assessment Techniques

Goniometry: Hip External Rotation at 90 Degrees of Hip Flexion (90/90 Hip ER)

This is Brent of the Brookbush Institute at the Independent Training Spot, doing another goniometric assessment video. In this video we're going to do hip external rotation at 90 degrees, so if you just watched our last video on internal rotation you are all set for this video. I'm going to have my friend Melissa come out. Once again we're setting up the same two lines we've had in the previous three videos. actually. So my stabilization arm is going to be perpendicular to the edge of the table, that's going to be my eyeline. Or it's going to be more appropriately, perpendicular with a line that goes straight down the center of Melissa's body. The movement arm goes straight through the middle of the knee, and I told you guys how I like to line up through the tibial tuberosity, because the tibial crest is not a straight line. So as I did in the previous video, I'm going to go ahead and take Melissa's knee and leg up to 90 degrees, put her knee directly over her hip, no adduction no abduction, no flexion or extension, just right there. I'm going to go into external rotation as far as I can, once again looking for a firm end feel. I'm going to have Melissa hold that for me. I'm going to do the same thing I did in the previous one, I'm going to hold my movement arm and her leg, try to give her a little bit of stability so she can relax a little bit, and I can get a true passive range of motion. Line up straight through that line, and we got 32 degrees. Alright 32 degrees it's a little tight right, passive range of motion 40 to 50 degree with firm end feel. She's a little tight through external rotation. Let's try that one more time, one more time. So I'm going to bring her up, hip directly sorry, knee directly over her hip, no adduction, no abduction, no flexion extension, just directly over. Bring her to her end range, good hold that one. I'm trying to hold her leg a little bit with the movement arm, get my stabilization arm set up, and 32 degrees once again. How's that for some intra-tester reliability, thank You Melissa. So you guys see how to do the technique, now the question is what to do with the technique? Why would I do hip external rotation goniometry? Well obviously if I am measuring flexibility end range and probably thinking more towards restrictions and my flexibility techniques. So what muscles would restrict external rotation with hip flexed to ninety? We start with the piriformis, and I know what you guys are thinking I thought the piriformis was an external rotator, but above 90 degrees it actually becomes an internal rotator which I know gets a little confusing, it makes our last couple of graphs seem a little backwards, but nonetheless piriformis will restrict this range of motion. Once again we have the adductors and I talked about this in the previous video, but the adductors because of this position I'm not going to try to differentiate whether it's the anterior adductors, or the posterior adductor Magnus. I'm just going to go ahead and say that the adductors will restrict this range of motion due to the position of the hip. I have the TFL and glute minimus, again these muscles end up on both sides of the graph. I talked about how arthro- kinematically they could restrict hip internal rotation, in this case they are internal rotators so they will restrict hip external rotation. If I release all of these muscles which is probably going to be my first go to right, work on flexibility of these muscles, i'm going to go back to joint. Kind of mentioned in the previous video that these 90-90 hip internal and external rotations, to me are a big sign of arthrokinematic dysfunction at the hip. I'm going to go and check out my posterior inferior capsule, look at maybe the self-administered hip mobilization techniques i showed in the previous video, or i'm going to start looking at some of my manual techniques. Do i need to do a posterior glide, do i need to do that lateral distraction technique that i know a lot of therapists and ATC's are very familiar with. If i get through these two and i still don't have my range of motion back, well what about my fascia, what about that posterior hip and sacral fascia, all this back here that could be restricting that range of motion. I want to maybe loosen that up or reduce adhesions, or or help to improve the extensibility through that range of motion with maybe my pin and stretch, or my instrument assisted soft tissue mobilization. And of course I don't want to forget about if Melissa had some sort of sign like paresthesia of nerve involvement, I know that my sciatic and posterior femoral cutaneous nerve can be lengthened in that position. Or in the case of sciatic nerve impingement between the piriformis and gemellus superior. I want to go ahead and differentiate with further neuro- dynamic tests. Now once again these 90 90 hip internal and external rotation assessments I know look very similar to the prone hip internal and external assessments, but I think if you go back through some of these graphs, I think if you practice these these different assessments, try an intervention and go back to the assessments, you're going to find that the restrictions there implying are different. I do happen to use the supine internal and external rotation assessments probably more than anything else for the hip. I find that if I can get these guys back to normal, and if I can get 40 to 50 degrees in both directions, I've done a pretty good job of getting my arthrokinematics and my length tension relationships straight at the hip; and then I can move on to whatever joint or muscular imbalance, other joint or muscular imbalance i think is affecting this person's movement compensation. I hope you guys have learned a lot from this video. I hope you understand how to do this goniometric assessment and feel comfortable with it. It will take a little practice but get on it with a partner, a peer, a co-worker before you try it on your patients and clients. And then of course try to start thinking through your functional anatomy, because every test you do should affect your intervention, affect your exercise selection. You should be doing your assessment to try to improve your outcomes. I look forward to seeing you guys soon. 

Home

Videos

Goniometry of the lower body, including ankle dorsiflexion, knee extension, knee flexion, hip internal rotation, hip external rotation, hip abduction, hip flexion and hip extension goniometric assessments. A list of potential muscles, fascia, and neural structures that may restrict motion at the hip, knee, and ankle joints.

Goniometry: Hip External Rotation at 90 Degrees of Hip Flexion (90/90 Hip ER)

Cervical Lateral Flexion Goniometry

Shoulder Internal Rotation Goniometry

Shoulder External Rotation Goniometry

Shoulder Extension Goniometry

Shoulder Flexion Goniometry

Hip Abduction Goniometry

Hip Flexion Goniometry

Hip Extension Goniometry

Goniometry: Hip Internal Rotation at 90 Degree of Hip Flexion (90/90 Hip IR)

Goniometry Hip External Rotation (in Prone)

Comments

Guest