Cheatography
https://cheatography.com
Presentation, management etc
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Biomechanics
Foot pronation is: Eversion, abduction and dorsiflexion, begins at heel strike to mid stance
Limited by: Ligamentous and bony integrity + eccentric contraction of tibialis posterior |
Chronic hyperpronation - causes laxity of calcaneonavicular ligament and talonavicular joint capsule, elongated plantar fascia, posterior tibial tendinopathy and posterior tibial nerve irritation |
- Hyperpronation causes internal rotation of the tibia, resulting in internal rotation of femur (moves femoral head and acetabulum backwards, anterior tilt of the pelvis then hyperextension of lx) |
- Internal tibial rotation: Causes valgus stress on the knee, MCL and ACL stressed, causes a lateral displacement of the patella |
- Internal femur rotation: Also causes lateral displacement of the patella, quads, hip adductors/abductors - weakness of gluts causes excessive hip adduction, increases the foot arch during ambulation, also causes weakening of gluteal and abdominal muscles and tightening of hip flexors |
Presentation
- Look for lower chain dysfunction |
- Excessive forefoot abduction (too many toes ) |
- Calcaneal eversion (bowing of achilles tendon) |
- Navicular drop >10mm (6-8mm normal) |
- Posterior tibial weakness (excessive calcaneal eversion when performing a heel raise) |
- TTP: Posterior tibialis tendon |
- Weak hip abductors (+ve Trendeleberg, single leg squat) |
- Flexibility of soleus and gastroc |
Management
- Arch supports |
- Address leg length inequalities |
- Stretching and myofascial release in gastrocnemius and soleus |
- Strengthening of posterior tibialis and hip abductor (posterior lunge, clam with a band and side bridge) |
- Single leg and Vele's then lungers on unstable surface |
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