Recent E-mails

On the Step Down Test to Determine Weakness in AF ER…

A concept that I have learned is that if you evaluate a patient’s ability to step down from a stool with their right leg and you see the left leg’s knee cross midline and femur internally rotate, you assume that their left external rotators are weak and you want to strengthen their external rotators… How does this tie in with AF ER on the left or is it a different way of thinking when it comes to PRI principles?

On the step down test observing left adduction and IR, you have to keep in mind that adduction and IR in left AF IR (pelvis turned left putting the femoral head into the socket) is different than adduction and IR in left AF ER (pelvis turned right putting the femoral head out of the socket).  If they are not shifted into the repositioned state of left AF IR, then what you see is not what you get.  It becomes very compensatory and what looks like weakness is actually the result of poor positioning for all the left side bones, joints and especially muscles (more AF positional weakness than FA weakness).  Be careful making a judgement on simple observation, when a detailed AF and FA performance analysis like the Hruska Adduction Lift Test has not been used to tell you what is actually going on biomechanically.