Talofa Samoa and welcome back to your weekly health column! Today we look at a few words that are related to physiotherapy. Often when I’m in the clinic I have clients tell me “This part hurts when I bend it a certain way”. My job as a physiotherapist is to accurately document what that “certain way” is. These words below are how physiotherapists describe that “certain way”.

Flexion and Extension

Flexion refers to a movement that decreases the angle between two body parts. Flexion at the elbow decreases the angle between the ulna and the humerus. When the knee flexes, the ankle moves closer to the buttock, and the angle between the femur and tibia gets smaller.

Extension refers to a movement that increases the angle between two body parts. Extension at the elbow is increasing the angle between the ulna and the humerus. Extension of the knee straightens the lower limb.

Abduction and Adduction

Abduction is a movement away from the middle of your body and out to the sides – just as abducting someone is to take them away. For example, abduction of the shoulder raises the arms out to the sides of the body. Adduction is a movement towards the midline of your body. Adduction of the hip squeezes the legs together.

Elevation and Depression

Elevation refers to movement in an upward direction (e.g. shoulder shrug), and depression refers to movement in a downward direction.

External Rotation and Internal Rotation

Internal rotation is a rotational movement towards the midline. It is sometimes referred to as medial rotation. To understand this, we have two scenarios to imagine. Firstly, with a straight leg, rotate it to point your toes inward. This is the internal rotation of the hip. Secondly, imagine you are carrying a tea tray in front of you, with your elbow at 90 degrees. Now rotate the arm, bringing your hand towards your opposite hip (elbow still at 90 degrees). This is the internal rotation of the shoulder. External rotation is a rotating movement away from the midline. This is in the opposite direction to the movements described above.

Pronation and Supination

This is easily confused with internal and external rotation, but the difference is subtle. With your hand resting on a table in front of you, and keeping your shoulder and elbow still, turn your hand onto its back, palm up. This is the supine position, and so this movement is supination. Again, keeping the elbow and shoulder still, flip your hand onto its front, palm down. This is the prone position, and so this movement is named pronation. These terms also apply to the whole body – when lying flat on the back, the body is supine. When lying flat on the front, the body is prone.

Dorsiflexion and Plantarflexion

Dorsiflexion and plantarflexion are terms used to describe movements at the ankle. They refer to the two surfaces of the foot; the dorsum (superior surface) and the plantar surface (the sole). Dorsiflexion refers to flexion at the ankle so that the foot points more superiorly. Dorsiflexion of the hand is a confusing term, and so is rarely used. The dorsum of the hand is the posterior surface, and so movement in that direction is an extension. Therefore, we can say that dorsiflexion of the wrist is the same as extension. Plantarflexion refers to extension at the ankle so that the foot points inferiorly. Similarly, there is a term for the hand, which is palmar flexion.

Inversion and Eversion

Inversion and eversion are movements that occur at the ankle joint, referring to the rotation of the foot around its long axis. Inversion involves the movement of the sole towards the median plane – so that the sole faces in a medial direction. Eversion involves the movement of the sole away from the median plane – so that the sole faces in a lateral direction.

I hope these terms will help you at your next physiotherapy appointment.

Eliana Viali is a physiotherapist and can be contacted at [email protected] for further inquiries