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On the Hruska Adduction Lift Test…
I have a question about the Adduction Lift Test grade of a 0 that demonstrates ‘obturator weakness’. Do you feel that this test reflects both obturator externus and internus at the same time? The inability to raise the lower ankle off the mat or table reflects either weakness of FA external rotators or AF stability (see level 1, inability statement). However, a level 0 where no ability exists to raise lower ankle off the mat, is suggestive of a forward pelvis on that same side or possibly both sides. When the ischial tuberosity moves up (anterior pelvic tilt) the obturator internus looses it’s tensile strength and the quadratus femoris and obturator externus become more taught, because of their proximal attachments. Since the glute max and piriformis are more abducting oriented muscle during contraction and since the mat will not let the leg abduct; good external rotation is now required from the short external rotators in a neutral or adducted position. Adduction (position) of the femur allows the short external rotators to function more effectively (Hume). Therefore, in the sidelying tested position the glute max and piriformis are not in an optimal position to ER the femur with or without an anterior pelvic tilt. These are better acetabular femoral external rotators in this position than femoral acetabular rotators. The gemelli muscles may also be weak if the level 0 exists…so you may have weak obturator and gemelli because of proximal attachment position. But since I try very hard to reinforce satisfactory obturator position and obturator foramen control, I usually draw attention to the obturator internus, instead of the gemelli. |
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