Active vs Passive Insufficiency Explained Simply

[@angieangie4419]

THANK YOU!!! please don’t ever remove this video! I was so confused in lecture and this 5 min video cleared up so much for me.

[@arlennegonzalez2457]

He meant to say rectus femoris does both (hip flexion and knee extension) but said hip twice, its okay! Loved the video, helped visualize it better.

[@DrJacobGoodin]

At 03:37 I misspoke! I should have said that rectus femoris FLEXES the hip and EXTENDS the knee. 😬 Sorry about that my friends. If this short explainer video was helpful to you, check out my Structural Kinesiology lecture series here: 👉🏽 bit.ly/32kJ5zw Or head on over to my channel for more helpful biomechanics, strength and conditioning, and statistics content: 👉🏽 kzbin.info Stay safe out there and keep learning!

[@anasmahmoud5428]

Thankss 😊

[@oregonbatdorf]

I'm cramming for my PTA exam next week, this was a great explanation!

[@matthewsilva4028]

Good stuff! You were my anatomy professor back at Milligan! Now I'm in OT school at WashU and it was great to look up active and passive insufficiency and be taught by a former professor. Hope all is well, man.

[@DrJacobGoodin]

Matt! What's up my friend? So glad to hear from you and crazy that you stumbled across me on here. Dude, in those early years of teaching you were one of those students that helped me keep my passion for it even during the days I felt overwhelmed. You'll make a killer OT

[@rubens0102]

@@DrJacobGoodin love to see it

[@citylightsfade2]

this is perfect for my massage students! Thank you soo much for breaking it down to this simplified level. Also throwing the Phys of the Sarcomers and the myosin cross bridges. It's going to help them soo much

[@mohamedorayith4626]

2:50 do you mind explaining why there is passive insufficiency in hamstrings in relation to bifurcation of muscle? Wouldn't you have to be in anterior pelvic tilt to slightly taut and shorten the hamstrings to make it less flexible (long) Thank you very much!

[@DrJacobGoodin]

Definitely Mohamed. Because the hamstring is biarticulate, it is possible to stretch it by flexing the hip and extending the knee. If you "pull" the slack out of the muscle at both of these joints, you could run into a situation in which your muscle lacks the length to allow simultaneous hip flexion and knee extension. Let me know if that helps answer your question.

[@mohamedorayith4626]

@@DrJacobGoodin Yep makes sense, thank you- one more question- "to perform dorsiflexion of the foot, you mustn't fly extend the knee as that may cause passive insufficiency of the gastrocnemius" Is that true, if so, why?

[@DrJacobGoodin]

@@mohamedorayith4626 You are correct! Simultaneous knee extension and ankle dorsiflexion would cause the biarticulate gastrocnemius to be stretched at both the proximal and distal ends. It is the antagonist of these movements, so it would be passive during this.

[@LanceKummCSCSCPTCES]

@@DrJacobGoodin Explains why my Back kick was always much stronger than my front kick.

[@dominicbarnes712]

Difficult concepts, clearly explained. Thank you

[@mzvonteese]

Thanks, I love you man, you explained this better than my professors SMH

[@ianwilson4841]

What effect does passive insufficiency have on pelvic tilt and what risks are involved in an exercise like a hip extension when the hamstring is fully streched?

[@LanceKummCSCSCPTCES]

Great explanations! Wish I had these videos before I took my CSCS exam.

[@jastineabigaile4088]

very helpful! i understand it now better. please make more videos like this

[@xylialouisemagallanes5075]

I agree! A great explanation indeed. One of the best supplementary video we need in our studies.

[@plm_pesinomaryfaith3354]

True! This is an amazing video. I hope I can pass the quiz.

[@xylialouisemagallanes5075]

@@plm_pesinomaryfaith3354 Amen to that!

[@jastineabigaile4088]

@@plm_pesinomaryfaith3354 i hope so too! 🙏

[@DrJacobGoodin]

So glad it was helpful Jastine!

[@savannahsklar2886]

This helped a lot, thank!

[@DrJacobGoodin]

You're welcome Savannah, thanks for watching!

[@orlandogonzalez638]

Studying for the NPTE, wish me luck!

[@dl9120]

would the triceps brachii long head suffer from active insufficiency in an over head position when extending the elbow?

[@polevaultgirl33]

Thanks so much! NPTE in t-minus 14 days

[@DrJacobGoodin]

Good luck on the NPTE Melanie! Keep studying hard and you'll crush it.

[@sherjeelrmalik]

why is it an example of wrist extension in the begging? i don't get it ...your flex both your wrist and fingers?

[@96eman]

Thank you so much! I’ve been trying to visualize the difference!

[@gargidubey4106]

So sir, by the explanation you gave above active and passive insufficiency around hip, you mean to say that one can never do the action of full hip flexion with full knee extension due to both kind of insufficiency?

[@the_mcleod_axe]

I started watching your vids because I've gotten more interested in the PT side of things now that I do a lot of injury prehab work with youth athletes. That said, I think I disagree with your sarcomere/actin-myosin "running into each other" position for the active insufficiency part of this video. I don't think it's sarcomeres running out of room, I think it's purely a neural feedback problem. Also I'm purely posting this for discussion sake, not meant to be argumentative at all! I have a KINE degree so I love this stuff and recognize how infantile a lot of this science is. I also think it's best to discuss muscular phenomena in nerve terms since they're the ultimate source of control here, muscles are just the vehicles. If we flip the order of your hip flexion insufficiency example, and instead start with an extended knee and then start flexing the hip, the rec fem (fem nerve, really) will likely cramp before the hamstring (sciatic) stretch becomes too burdening - if you try it and your sciatic stretch kicks in before the cramp, plantar flex your foot and watch how much further you'll get despite no change to the hamstring length, and suddenly your rec fem will become the limiter. Cramping is a panick/protective response, so nerves that aren't comfortable with being fully shortened will cause muscles to cramp before they fully shorten (hence why muscles can cramp in lengthened positions) - also makes sense since you're starting the fem nerve off in a more shortened position by starting in knee extension in my example. That said, some of my athletes (especially this diver I train) can get into a full split AND touch her toes while doing so. Yet, she can't match that level of hip flexion while standing unless she flings her foot in the air meaning there is no rec fem contraction happening at the more flexed hip angle. If she tries to do it slowly, her rec fem cramps right when she hits 90 degrees of hip flexion. I'm using her as an example because despite her running into an active insufficiency in her rec fem while standing, I don't think it's due to a lack of structural room for further sarcomere shortening - case in point, her rec fem is fine with being shortend more than that, it just needs to be passive, which means the only difference between the standing vs sitting example are whether the femoral nerve is actively creating the hip flexion or passively allowing the hip flexion. I know this video is old, but I enjoyed it and all your others and you clearly are a complete nerd for this stuff like me. I've been on a journey to figure out exactly what makes muscles and nerves apprehensive, especially as it pertains to the lower body since I had nearly a full TKR in 2018 and I've just found that most muscular/tendonil problems are more neural than structural (with some caveats of course), which seems to heavily contradict the conventional wisdom from all the research I did in college.

[@MSAL1306]

Thank you ,it’s easy now

[@peperamos6896]

Thanks for this, sir! It is a help in preparing for the board exam :)

[@Amandakaymtz]

This helped me so much, thank you!!

[@DrJacobGoodin]

You're so welcome Amanda

[@nasibaulusow8642]

Thank you so much for the amazing explanation 🙏🏽🌸✨

[@DrJacobGoodin]

You're so welcome!

[@dongrekapil]

Nice explanation bro

[@thakorekirti9201]

This is helpful!

[@DrJacobGoodin]

you're welcome!

[@amr_7019]

You’re great bro thank you

[@0hdoct0rdoct0r]

super helpful, thank you!

[@DrJacobGoodin]

You are super welcome! Let me know if there are other concepts you’d like me to cover

[@karu1445]

What about passive and active insuffiencies of elbow flexion and extension during pull ups?

[@طالبخير-ق2ز]

Thanks a lot for your great efforts

[@aniketramansrivastava3490]

Beautifuly explained

[@matthewmcmillan4025]

Doesn't rectis femoris extend knee and flex hip?

[@DrJacobGoodin]

It does. I misspoke at 03:37 when I said the opposite of that. Good catch Matt!

[@christinemercado5754]

Thank you so much for this!

[@DrJacobGoodin]

You got it Christine!

[@rahafrab7052]

Yes makes perfect sense Thank you ❤

[@gabrielleruthroble607]

thank you!

[@DrJacobGoodin]

You're welcome Gabrielle! Hope it was helpful for you.

[@ameera344]

thank you so much 👍🏻

[@DrJacobGoodin]

You're welcome Amerah! Feel free to check out my other anatomy and kinesiology videos to keep learning.

[@fajrelbanna4570]

So passive insufficiency is about muscles being unable to lengthen further, while active insufficiency is about muscles unable to shorten further ?

[@bevictorious7340]

Yup

[@krista8160]

YAS love sarcomere talk

[@carlae9921]

passive insufficiency, tenodesis grasp

[@teamfalcon7734]

Ok sir

[@koolertrek]

It doesn’t make sense to me!

[@nora7916]

Thank you 🙏🏻

[@DrJacobGoodin]

No problemo Nora!