Physio knowledge

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The Empty Can Test (ECT) was first described by Jobe and Moynes. It is also known by the Jobe's Test. The jobe's or empty can test is used for the study, examination or assessment of the supraspinatus muscle and supraspinatus tendon in the shoulder complex. It is also used to assess injury to the supraspinatus muscles and supraspinatus tendon.

The supraspinatus is one of four muscles of the rotator cuff structure. The rotator cuff is made up of four muscles and their tendons. These muscles include supraspinatus and infraspinatus as well as teres major, subscapularis.

The main function of the supraspinatus muscle and the deltoid muscles is to abduct the shoulder. Supraspinatus muscle or deltoid muscle injury or pathology, can cause weakness of the shoulder abduction. The jobe's or empty can test isolates supraspinatus muscles, and tests their strength, integrity, function, and independent of the deltoid muscle.

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The sciatic nerve, however, is both the longest and largest nerve in the human body. These anatomical variations can vary from person to person.

1. In some persons, the sciatic nerve passes above the piriformis muscle.

2. While in some people, the nerve passes below the piriformis muscle.

3. Sometimes, the sciatic nerve may be divided and pass above or below the piriformis muscles.

4. Sometimes, the nerve splits in two parts above the piriformis muscles, one passes through the piriformis and the other passes  below it. This version is the most popular.

5. Sometimes in individuals, the nerve remains undivided, and it passes alone through the piriformis muscle. This will vary from person to person. That's why the problem in the piriformis muscle can lead to irritation in the sciatic nerve. 

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Ask your patient to lie in a supine lying position.

1 -The examiner then brings the affected leg's hip and knee into 90 degrees of flexion.

2 - The examiner then abducts the hip and externally rotates it so that the patient’s tested leg foot rests on the opposite leg distal thigh. This is the Faber position, or figure 4-position. That's why this test is also known as the figure four test.

3 - The examiner then places one hand on the opposite ASIS to stabilize the pelvis.

4 - The examiner then places the other hand on the flexed knee (tested leg's knee joint). The examiner gently presses the flexed leg towards the table in a downward direction.

5 - The examiner presses the flexed knee towards the table until the desired range of motion is not reached. To test for pain provocation within the end range, a few small-amplitude oscillations may be used.

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Flatback syndrome is a condition that affects the natural curvature of the spine. The human spine has four natural curves. These curves allow the individual to stand straight and be well balanced. They also make it easier to move or walk with minimal effort.

There are two lordotic and two kyphotic curves. They alternate to form an "S" shape when viewed from the lateral side. The lordotic curve refers to the spine that curves inward, while the kyphotic curve represents the spine that curves outward.

In the lumbar spine (lower back) and cervical spine (neck) - There is an inward curve (lordosis).

In the sacral spine and thoracic spine - There is an outward curve (kyphosis).

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Everyone believes that the biomechanics of the shoulder is highly complex. Yes, I accept that shoulder biomechanics can be complex. This is because studying shoulder biomechanics involves many bones and joints, ligaments and muscles.

One of the most complicated areas in our bodies is the shoulder area. The shoulder complex connects the upper extremity to the thorax. It is composed of three synovial joints, one floating joint and three bones. 

The shoulder complex involves three synovial joints and one floating joint.

Glenohumeral joint

Acromioclavicular joint

Sternoclavicular joint

The Scapulothoracic Joint - In the shoulder complex, it also functions as a joint. It is therefore considered a functional joint but not a true joint.

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This is a chronic inflammatory disorder that affects your spinal column. It can lead to stiffness, arthritis, or auto-fusion of the spine vertebral bodies. This fusion can cause the spine or backbone to become less flexible, and result in a hunched-forward posture. This type of posture can lead to flatback syndrome.

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The patient's head begins to tilt forward away from the body's midline and they have trouble standing straight. To compensate for this imbalance, the patient's spine will automatically tilt the pelvis and flex the hips and the knees to maintain a correct standing posture.

While this new adapted posture may temporarily help or allow the patient to stand straight, but it can develop severe and persistent pain over time.

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The spine, or backbone, contains intervertebral disc and vertebral bodies. These intervertebral disks are the soft tissue cushion between adjacent vertebrae of the vertebral column. Intervertebral disks work as a shock absorbers of the spine that allow for mobility. 

These IV discs are found in the lumbar spine and contribute to normal lumbar Lordosis. As people age, the intervertebral disks begin to wear down (degenerates). As the disc degenerates, the upper spine start to tilt forward and lumbar lordosis will reduce. This can lead to a deformity known as flatback syndrome.

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1 - Ask your patient to lie in a supine posture.

2 - The patient's ankle joint should be in 20deg of plantarflexion. Stabilize the anterior side of the distal leg (distal fibula and tibia) with one hand.

3 - Next, cup the palm of a second hand and grab the patient's calcaneus, and make an attempt to bring the calcaneus anteriorly observing the total amount of anterior translation in the lateral portion of the ankle and the difference in the end feel.

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Genu Recurvatum (Hyperextension of the knee): Causes, Symptoms,Treatment

What is Genu recurvatum?

Genu recurvatum is also known as “hyperextension of the knee. ” It is a deformity in which the knee goes backward, i.e., in a hyperextended position.

The normal active (by own) range of motion for knee extension is 0 degrees (fully straight), and passive knee extension up to 10 degrees is considered normal. But in genu recurvatum, there will be hyperextension of the knee.

As in this, the knee goes into hyperextended position, i.e., past beyond 5 degrees of normal knee extended position, which is 0 degrees. And this places extra stress on your knees, which is not good for your knees.

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Everything About The Lachman test - For ACL Tear

What is Lachman Test?

The Lachman test is used to check for an anterior cruciate ligament (ACL) tear or injury in the knee joint. It is considered the most sensitive and specific test for diagnosing acute ACL injuries.

There are also many other special tests like the knee anterior drawer test and pivot shift test. They are also used to diagnose ACL injury or tear, but they are not as reliable as the Lachman test. Hence, it is considered superior to both the anterior drawer test and pivot shift test.