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78 Cards in this Set
- Front
- Back
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what are the types of ground reactive forces
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vertical and linear shear forces
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what direction does the center of gravity pass relative to the foot
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in a linear progression above the foot
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where does the center of gravity begin in contact phase
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behind the foot
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what are the two peaks of the center of gravity or vertical ground reactive forces
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at the end of contact when the body weight is supported by one foot
midway through propulsion when all weight is being supported by the ball of one foot |
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what does the first peak in vertical ground reactive force result from
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the elevation of the center of body weight being lifted over the weight bearing limb
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what does the second peak in the vertical ground reactive force result from
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kinetic energy from the falling trunk and muscle function that elevates the heel and provides a push to the center of gravity during propulsion
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where do these forces peak at
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above normal body weight
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what is shear force
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when on part slides over another
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when during gate do we see shear forces
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during contact and propulsion
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what king of shearing does heel strike cause
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posterior shearing
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what is posterior shear a result of
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the moving foot being suddenly stopped by friction from the ground as contact is made
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when is soft tissue better able to distribute and absorb posterior shear
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when it is thicker
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what causes anterior shear
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heel lift and the push off of propulsion
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when does anterior shear make its peak
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when the other foot contacts the ground
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what is the result of wasting or displacement of the fat pad
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soft tissue trauma
hemorrhage fibrosis hyperkeratotic lesions or even ulcers |
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when does torque develop in gait
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between ground and foot during stance phase
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what does internal rotation of the tibia due to the foot when it hits the ground
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causes the STJ to pronate
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what is one of the jobs of the STJ
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torque converter
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what happens to torque by the end of contact period
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its eventually eliminated
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what causes second torque to develop in the foot
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external rotation of the tibia starting in midstance
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when does second torque reach its peak
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just prior to heel lift
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what produces lateral shear
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side to side motion of the trunk
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when does lateral shear peak
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at end of contact and also again during propulsion
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what are two primary factors in stability
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osseous structure and muscle activity
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what causes abnormal shearing
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abnormal subtalar joint pronation leads to hypermobility and shoe gear fixes soft tissue against bones
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what is the medial column
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cuneiforms and 1-3 metatarsals
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what is the lateral column
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4th and 5th metatarsals
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what is the primary role of the medial column
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shock absorption
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what is the primary role of the lateral column
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balance
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what is planal dominance
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if axis of a joint is deviated to become more perpendicular to a certain body plane then motion in that plane will be the dominant plane
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where is the planar dominance if the OMTJ is more vertically oriented
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in the transverse plane
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what motion will be seen in the OMTJ is more vertically oriented
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more abduction and adduction with pronation and supination around the OMTJ
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if STJ is more vertically oriented where will planar dominance be
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in the transverse plane
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what are the effects if the STJ gets more vertically oriented
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ankle, knee, and hip will have to compensate for the deviation of the axis
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if the STJ is more horizontally oriented where will planar dominance be
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in the frontal plane
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what motion will be seen if the STJ is more horizontally oriented
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more inversion and eversion
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what are the affects of frontal planar dominance at the STJ
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more angulation between joints and greater instability which will lead to hypermobility and subluxation
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where will compensation and pathology be seen if the STJ is more horizontally oriented
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in the foot
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what happens if the STJ is deviated more medially in the transverse plane
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more pronation
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what happens if the STJ is deviated more laterally in the transverse plane
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more supination
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what things lead to lateral instability
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short lateral column
forefoot valgus |
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what muscles may be part of the plantar fascia
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abductor hallucis and abductor digiti minimi
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what is the windlass mechanism
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when we dorsiflex the digits we see an increase in height of the medial arch as the medial slip of the central band tightens plantarflexing the first metatarsal we also see inversion of the calcaneus
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what is a result of the windlass mechanism
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passive supination
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what was elftmans idea about MTJ
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each of the components have two axis
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what was elftmans idea about pronation of the MTJ
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that the TN-1 axis lines up with the CC-1 axis resulting in an unlocked MTJ
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what was elftmans idea about supination of the MTJ
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each of the four axis contribute movement to align the foot and lock it at any given point during supination
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what was roots idea about the locking position of the MTJ
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that the plantar surface of the forefoot is perpendicular to a vertical bisection of the calcaneus
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what was husons idea about the MTJ
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that the MTJ actually consists of the navicular and cuboid rotating around the talus and calcaneus
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what was nesters and finlows idea about the MTJ
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navicular and cuboid move as a single unit
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what is the axis of motion for the lesser MPJ's
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same as the first MPJ
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how much dorsiflexion do we need at the lesser MPJ's
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62 degrees +/- 10 degrees
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how do we get 62 degrees in the lesser MPJ's
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metatarsals must plantarflex
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why do we need less dorsi from the lesser MPJ's
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because they lift off the ground before the 1st MPJ
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what happens when the lesser digits are dorsiflexed
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windlass mechanism and the STJ is supinated
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what happens when forefoot varus in uncompensated
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excessive weight is born on the lateral forefoot
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what happens when forefoot varus is compensated
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pronation into propulsion
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what happens when forefoot varus is partially compensated
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some eversion but not enough to equalize ground reactive forces on the forefoot
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what is equinas
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foot cannot dorsiflex the 10 degrees needed at midstance in relation to the tibia
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what things will you see with equinas
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pronation at heel contact
patient walk with knee flexed to relieve tension on gastrco early heel off in midstance |
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where do we see compensation for forefoot valgus at
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MTJ by dorsiflexing the first ray
STJ by supinating the STJ or both |
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If MTJ compensation for forefoot valgus what do we see
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lesions sub 2
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if STJ compensation for forefoot valgus what do we see
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lesions sub 1 and 5
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what is a plantarflexed first ray
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plane of met heads 1 and 5 everted to rearfoot first ray plantar flexed in relation to met heads 2-5
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what is compensation for plantarflexed first ray
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STJ Supination
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what do we see with plantarflexed first ray
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lesions under first and fifth metatarsal heads
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what might a plantarflexed first ray be due to
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contracture state of peroneus longus or tight medial slips of plantar fascia
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what causes medial loading
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external forces
widened base of gait for heavy lifting obesity tibial or heel valgus |
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what does medial loading cause
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pronation of the STJ
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what causes lateral loading
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STJ varus
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what is the compensation for lateral loading
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STJ pronates to get rest of foot on ground
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what is high gear
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a transverse axis made up of met heads 1 and 2
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when does high gear operate
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for high speed motion or propulsion, sprinting
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what is low gear
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obilque axis made up of a line from met heads 2 through 5
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when does low gear operate
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low speed power
uphill climb, carrying heavy loads |
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what happens with low gear and high gear with propulsion
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initially we are using low gear but we shift medially to the high gear axis for propulsion
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when is the foot a beam
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at contact
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when is the foot a truss
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during propulsion
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