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28 Cards in this Set
- Front
- Back
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cardinal planes of movement @ the ankle
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-DF/PF (sagittal)
-inversion/eversion (frontal) -abduction and adduction (transverse) |
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tri-planar motion @ the ankle
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-pronation/supination
-involves all 3 functional segments of F/A |
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closed chain pronation
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-calcaneus everts
-talus slides down toward calcaneous, forward and medially (adducts and plantar flexes) -tibia internally rotates |
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closed chain supination
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-calcaneus inverts
-talus slides up and backwards (abducts and dorsiflexes) -tibia externally rotates |
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clinical evaluation of foot types/tendencies
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-done in prone
-foot hanging off end -palpate/measure STJ neutral -observe rearfoot-on-leg relationship -observe forefoot-on-rearfoot relationship |
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problems associated w/ foot types/tendencies
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-over-pronators
-under-pronators/supinators |
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overpronation
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-usually flexible foot type (good accomodation to various surfaces)
-less rigid lever for push off |
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foot pathologies associated with overpronation
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-pes planus
-rearfoot varus -ankle joint equinus |
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pes planus
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-"flat feet"
-flattened longitudinal arches -plantar soft tissues are overstretched -can become fixed |
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causes of pes planus
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-trauma
-muscle weakness -ligamentous laxity -overpronated feet |
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rearfoot varus
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-aka calacaneal varus, subtalar varus, hindfoot varus
-excessive calcaneal inversion in STJ neutral -STJ needs to excessively pronate for the medial aspect of the calcaneus to reach the ground during mid-stance |
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forefoot varus
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-supination (inversion) of the forefoot on hindfoot in STJ neutral
-STJ may compensate by overpronating to bring medial aspect of forefoot to ground in midstance |
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ankle joint equinus
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-foot is in a PF position w/ ankle DF limited to <10 degrees
-may be bony block or gastroc/soleus shortening -can occur @ TMT or midtarsal joint -may compensate during gait w/ pronation of STJ and/or midtarsal joint |
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musculoskeletal conditions related to overpronation
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-plantar fasciitis
-metatarsalgia -morton's neuroma -metatarsal stress fractures -tibialis posterior tendinitis -fibularis longus tendinitis -pinch callus -tarsal tunnel syndrome -PFPS |
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PT management of overpronation
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-improve dynamic support AND/OR
-provide external support -for ankle equinus....stretch |
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outsole
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-rubber
-where tread is -contacts ground |
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upper
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-where laces are
-wraps around top |
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midsole
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-made of foams : EVA, PU
-provides cushioning or support -determines category of shoe -determines how much motion control the shoe has |
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heel counter
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-plastic
-rigid -helps provide motion control to rearfoot |
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last
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-not part of shoe
-form upon which shoe is built -3 types : straight, curve, semicurve (implications for how much motion is allowed) |
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shoe categories
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-cushioning
-stability -motion control |
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cushioning shoe
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-curved last
-less rigid heel counter -midsole is soft, provides cushion |
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stability shoe
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-straight last
-rigid heel counter -stiff midsole (arch built in, rigid enough that it will limit pronation) |
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underpronation
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-may be associated w/ pes cavus or forefoot valgus
-usually more rigid foot type (poor accomodation to various surfaces) -rigid lever for push off -higher forces transmitted up kinetic chain |
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pes cavus
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-high arched foot
-exaggerated longitudinal arches -shortened plantar soft tissues |
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forefoot valgus
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-pronation (eversion) of the forefoot on the hindfoot in STJ neutral
-medial forefoot loading occurs too early in stance -STJ remains relatively supinated throughout stance |
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musculoskeletal conditions related to underpronation
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-lateral ankle sprain and chronic instability
-tibial stress fractures/"shin splints" |
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PT management of underpronation
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-footwear (cushioning shoe)
-stretching/joint mobilization |
