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The thoracolumbar fascia (lumbodorsal fascia or thoracodorsal fascia) is a complex, [1]: 1137 multilayer arrangement of fascial and aponeurotic layers forming a separation between the paraspinal muscles on one side, and the muscles of the posterior abdominal wall (quadratus lumborum, and psoas major [1]: 1137 ) on the other.
Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas
The Ober test is used in physical examination to identify tightness of the iliotibial band (iliotibial band syndrome). During the test, the patient lies on his/her side with the unaffected leg on the bottom with their shoulder and pelvis in line. The lower hip and knee can be in a flexed position to take out any lordosis of the lumbar spine. [1]
The test caught on because of its simplicity, and now, it’s often used to assess muscle tightness. “It’s easy to reproduce between clinicians and patients,” says Ferrara.
Tight latissimus dorsi has been shown to be a contributor to chronic shoulder pain and chronic back pain. [10] Because the latissimus dorsi connects the spine to the humerus , tightness in this muscle can manifest as either sub-optimal glenohumeral joint (shoulder) function which leads to chronic pain or tendinitis in the tendinous fasciae ...
A fascia (/ ˈ f æ ʃ (i) ə /; pl.: fasciae / ˈ f æ ʃ i i / or fascias; [1] adjective fascial; from Latin band) is a generic term for macroscopic membranous bodily structures. [ 2 ] : 42 Fasciae are classified as superficial , visceral or deep , and further designated according to their anatomical location.
The Thomas test is used to detect excessive tightness of the iliotibial band. In this test the patient holds the unaffected leg to their chest while the examiner straightens and lowers the other leg to a horizonal position, inability to fully straighten and lower the leg indicates excessive band tightness. [13] [14] [15]
The nerves then pass through an osteofibrous tunnel created by the thoracolumbar fascia and rim of the superior iliac crest. [6] Cadaver studies have noted that some patients have boney grooves along the rim that house the superior cluneal nerves. On average, these grooves are found between 5–7 cm from the midline.