Full resolution (JPEG) - On this page / på denna sida - Active Movements - II. Bound - A. With Help of Apparatus - Stretching and Bending of the Knee
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94 ACTIVE MOVEMENTS:
object at the same level. Why should the arms be stretched
horizontally forwards ? Because the patient then stands erect,
and we have the normal distance between the two attachments
of the hamstring muscles. In fig. 57 this distance is increased
because of the bending forward. As we see, this may serve
as a position in which to give tapotement of the perinteum,
sacral and gluteal regions. The operator, while giving this
tapotement, stands on the opposite side to that of the raised leg.
In such a case, therefore, as represented in fig. 57, he would take
up his position on the left side.
When the knee-joint is stifif, he must be on the same side as
the affected limb. The patient has to stretch the leg to the
utmost of his ability, and when he has reached the limit, we
produce a greater extension at the knee-joint by laying one hand
on it, placing the other below the buttock, and by drawing back-
wards we extend passively the hamstring muscles, at the same
time as the hand on the knee presses it down. .1 have often seen
a knee stretched completely straight, where from stiffness in the
muscles the patient himself was entirely unable to effect this
movement.
The patient keeps it extended for a little, and then he bends it
until thigh and leg are at least at right angles to each other, and
complete relaxation of the muscles is produced. Sometimes, of
course, we must begin with the foot, quite low down at the flooi",
and gradually work upwards as the patient improves, until he can
straighten his knee, when the foot is placed at the same height
as the hip-joint.
The action on the muscles, blood-vessels, and nerves on tlie
posterior part of the thigh and leg—particularly on the former—is
very great. The effect of the movement, especially on the muscles
of the calf, is much increased by depressing the heel after the
knee has been extended.
The limb on which the patient stands must be kept completely
straight, otherwise the exercise loses a good deal of its effect.
This movement is more especially used in contraction of the
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