ART Lower Extremity Treatment Protocols 3 — Questions and Answers
Question 1: In ART lower extremity protocols, 'nerve entrapment triad' refers to decreased nerve glide combined with which two other findings?
- Muscle weakness and joint instability
- Altered sensation and muscle tension (Correct answer)
- Edema and skin discoloration
- Tendon thickening and bursitis
Correct answer: Altered sensation and muscle tension
ART defines the nerve entrapment triad as decreased nerve glide, altered sensation (paresthesia/numbness), and increased muscle tension around the entrapment site.
Question 2: A cyclist with anterior knee pain is found to have adhesions between the vastus intermedius and the femoral shaft. The ART active motion used to release this interface is:
- Active hip extension with knee flexion
- Active knee extension from 90 degrees of flexion (Correct answer)
- Active hip flexion with knee in full extension
- Active knee flexion from full extension
Correct answer: Active knee extension from 90 degrees of flexion
Moving from 90 degrees of knee flexion to full extension causes the quadriceps to slide over the femur, breaking adhesions at the bone–muscle interface.
Question 3: During ART treatment of tarsal tunnel syndrome, the practitioner's thumb contact is placed on the flexor retinaculum while the patient performs which active motion?
- Toe flexion and ankle plantarflexion
- Toe extension and ankle dorsiflexion (Correct answer)
- Ankle eversion with toe spread
- Ankle inversion with toe curl
Correct answer: Toe extension and ankle dorsiflexion
Active toe extension combined with dorsiflexion tensions the flexor tendons and tibial nerve distally, creating a glide through the tarsal tunnel against the stationary contact.
Question 4: The 'pin-and-stretch' for the medial gastrocnemius head begins with the knee in what position to shorten the muscle before applying the contact?
- Full extension
- 30 degrees of flexion (Correct answer)
- 60 degrees of flexion
- 90 degrees of flexion
Correct answer: 30 degrees of flexion
Beginning with approximately 30 degrees of knee flexion shortens the gastrocnemius sufficiently to allow firm tissue contact before the active knee extension and ankle dorsiflexion elongates it.
Question 5: When releasing the sural nerve in the posterolateral calf, the patient's active motion moves the ankle into:
- Dorsiflexion and inversion (Correct answer)
- Plantarflexion and eversion
- Dorsiflexion and eversion
- Plantarflexion and inversion
Correct answer: Dorsiflexion and inversion
Dorsiflexion with inversion tenses the sural nerve distally, creating movement through the adhesion as the contact holds the nerve entrapped proximally.
Question 6: In ART protocol sequencing for patellofemoral syndrome, which structure is treated FIRST because it most directly alters patellar tracking?
- Iliotibial band
- Vastus lateralis (Correct answer)
- Patellar retinaculum
- Hip external rotators
Correct answer: Vastus lateralis
The vastus lateralis is treated first because its direct attachment to the lateral patellar border most immediately contributes to lateral patellar tilt and tracking dysfunction.
Question 7: An ART practitioner treating Achilles tendinopathy applies contact to the musculotendinous junction. The correct active motion is:
- Active ankle plantarflexion from dorsiflexion
- Active ankle dorsiflexion from plantarflexion (Correct answer)
- Active toe flexion with neutral ankle
- Active toe extension with neutral ankle
Correct answer: Active ankle dorsiflexion from plantarflexion
Starting in plantarflexion (shortened) and actively dorsiflexing moves the tissue from short to long under the fixed contact, breaking adhesions at the musculotendinous junction.
ART Lower Extremity Treatment Protocols 3
In ART lower extremity protocols, 'nerve entrapment triad' refers to decreased nerve glide combined with which two other findings?