CCEP Lower Extremity Treatment 3 — Questions and Answers
Question 1: Which orthotic modification best addresses a patient with a rigid forefoot valgus deformity causing lateral column overload?
- Medial forefoot post
- Lateral forefoot post (Correct answer)
- Heel cup deepening
- Medial longitudinal arch raise
Correct answer: Lateral forefoot post
A lateral forefoot post fills the gap under the lateral forefoot in rigid forefoot valgus, distributing load more evenly.
Question 2: A positive Tinel's sign at the medial ankle posterior to the medial malleolus indicates compression of the:
- Superficial peroneal nerve
- Sural nerve
- Tibial nerve within the tarsal tunnel (Correct answer)
- Saphenous nerve
Correct answer: Tibial nerve within the tarsal tunnel
Tinel's sign at the tarsal tunnel reproduces tingling along the tibial nerve distribution indicating tarsal tunnel syndrome.
Question 3: Which of the following best describes the close-packed position of the hip joint?
- Flexion, abduction, and external rotation
- Extension, abduction, and internal rotation
- Full extension, internal rotation, and abduction (Correct answer)
- Flexion, adduction, and internal rotation
Correct answer: Full extension, internal rotation, and abduction
The hip's close-packed position is full extension with internal rotation and slight abduction, creating maximum ligamentous tension.
Question 4: During a chiropractic lateral recumbent adjustment of the hip, the primary movement imparted to the femoral head is:
- Inferior glide (Correct answer)
- Posterior glide
- Superior glide
- Anterior glide
Correct answer: Inferior glide
The lateral recumbent hip adjustment uses body weight and leverage to impart an inferior glide, decompressing the acetabular cartilage.
Question 5: A patient reports lateral knee pain worsening at the 30-degree flexion point during stair descent. This is characteristic of:
- Lateral collateral ligament sprain
- Iliotibial band friction syndrome (Correct answer)
- Biceps femoris tendinopathy
- Common peroneal nerve entrapment
Correct answer: Iliotibial band friction syndrome
ITB friction syndrome peaks at approximately 30 degrees of knee flexion where the band crosses the lateral femoral epicondyle.
Question 6: Which manual therapy intervention is most evidence-supported for reducing pain in greater trochanteric pain syndrome?
- High-velocity thrust to the hip joint
- Lateral hip soft tissue therapy and gluteus medius strengthening (Correct answer)
- Passive stretching of the hip flexors only
- Ultrasound over the greater trochanter
Correct answer: Lateral hip soft tissue therapy and gluteus medius strengthening
Current evidence supports addressing gluteal tendinopathy with load management, soft tissue work, and progressive gluteus medius strengthening.
Question 7: The valgus stress test of the knee evaluates the integrity of the:
- Lateral collateral ligament
- Medial collateral ligament (Correct answer)
- Anterior cruciate ligament
- Posterior cruciate ligament
Correct answer: Medial collateral ligament
Applying valgus force to the knee stresses the medial collateral ligament; gapping or pain at the medial joint line indicates MCL injury.
CCEP Lower Extremity Treatment 3
Which orthotic modification best addresses a patient with a rigid forefoot valgus deformity causing lateral column overload?