The unhappy triad

The unhappy triad?

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-internal tibial torsion, femoral retro torsion, tibial varum. We often see these three things occurring together which can create patellar tracking problems or, as in this lower back pain. We know that things often occur in threes and congenital abnormalities are no different. 

–The femoral retro torsion limit internal rotation of the hip so when that foot is planted on the ground, the patient rotates to that side, the hip stops and the lumbar spine keeps going. 

–The lumbar spine should only have about 5° of rotation from top to bottom so this often puts undue stress into the lumbar spine resulting in lower back pain.

The remedy?

– Things which we can do to utilize or help internal rotation of the hips such as chair exercises with internal rotation, the 90/90 seated stretch as well as patient education to keep shoulders and hips in the same plane when rotating or carrying a load as well as externally rotating the foot when spinning to that side (To create the range of motion that is not available).

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#itt #internaltibialtorsion #internaltibialrotation #femoralretroversion #femoralretrotorsion #limitedhipmotion #gait #tibialvarum