OPTIMAL CORE ALIGNMENT

WOCN Regional Conference

2015

SPEEDING RECOVERYthrough

IMPROVING MOVEMENT

Melanie Carlone,DPT, MS, RYT

Custom Orthotic SolutIons, Inc.

LEARNING OBJECTIVES:

1. Principles of Optimal Core Alignment and physiological effects on wound healing

Optimal Core Alignment ~unites feetbody and gravity

Alignment means better movement

Better movement promotes healing

Best Healing Possible

is supported by

Optimal fluid return

from the lower extremities…

Venous Foot Pump Mechanism

25 mL of blood ~Each step ~Healthy gait

Alignment

•Foot Core

•Body Core

And

Active client participation in the

healing journey increases

compliance

LEARNING OBJECTIVES:

2. Consider when internal and external forms of support are most useful

Internal Support

Empowers Clients

Active Client Participation

Negativity Bias is real

10-30 seconds of TAKING IN THE GOOD overcomes bias and hardwires change

R. Hanson, PhD, Hardwiring Happiness: The New Brain Science of Contentment, Calm and

Confidence.

Experience Dependent Neuroplasticity

Taking in the GOOD…

Internal physical re-education

Lasting Change

External Support

Wound Offloading Can Take Many Forms

LEARNING OBJECTIVES:

3. Know when referral for foundational evaluation and support is necessary

COLLABORATION

Optimal Core Alignment exercise

How you hold yourself in relationship with gravity?

POSTURE &

FUNCTION

We are structurally designed to be walking…NOTsitting

WhenGravity wins…

STABILIZATION BODY CORE

STABILIZATION FOOT

CORE

INTEGRATIONAN

INSIDE and

OUTSIDE JOB

CORE ALIGNMENT IS THE NAME OF THE

GAME

Rene Cailliet, MD

1917- 2015

Pioneer Physical Medicine and

Rehabilitation, US Army, WWII

UNIVERSAL TISSUE

RESPONSE

Cailliet, Rene. Pain: Mechanisms and Management Philadelphia: F.A. Davis, 1993.

Inhibition=

Mal-alignment=

PAIN=

Increasing Dysfunction

ARTHRITIS=“Itis” in your “arth”

Gait Abnormalit

y

Mal-alignment leads to

•Poor proprioception•Balance disorders•Reduced core stability•Reduced venous pump

Review of the venous foot pump mechanism

•Not active at rest

Review of the venous foot pump mechanism

•80 mm of mercury on standing

Review of the venous foot pump mechanism

•Falls to 30 mmHg walking

Review of the venous foot pump mechanism

•25 mL pumped upwards each step

Review of the venous foot pump mechanism

•Forward momentum causes the pump action deep in foot intrinsic muscles

http://www.phlebolymphology.org/the-plantar-venous-pump-anatomy-and-physiological-hypotheses/

Venous pump

deep in the arch

NOT in the sole

" Impairment of the foot muscle pump by static foot disorder is an important cause of chronic venous disorder.”

•Vaidyanathan, Subramoniam, Riju Ramachandran Menon, Pradeep Jacob, and Binni John. Chronic Venous Disorders of the Lower Limbs: A Surgical Approach.: Springer India, Print

Optimal Core Alignment System clarifies:

Support core alignment =

Support optimal function & venous

return =Speed in healing

times

MORE ON THE FOOT CORE

These feet are made

for walking

…

WINDLASS EFFECT

Passive Sub-syste

m

4 arches in the foot

Inner and outer arches

4 arches in the foot

Transverse arches

LIGAMENTOUSSUPPORT

Active subsystem

The Neural

Sub-System

Altered feedback

ALTERED FEEDBACK INCREASESFALL RISK

Optimal Core

Alignment trains and supports

inside and outside

body and foot.

ASSESSING FOOTCORE

ALIGNMENT

Talar Neutral

Talar Neutral

INTRINSIC FOOT MUSCLE TEST

TRADITIONAL FOOT

EXERCISES MAY NOT

TRAIN INTRINSIC MUSCLES

SHORTENED FOOT EXERCISE

Referral to a Core Support Team

•Biomechanics•Education •Custom Orthotics •Offloading•Apply and Reassess

WOUND OFF

LOADING

REDUCE PRESSURES

In Summary…

“I have a choice. Do I want to align with the greatest vision of myself or do I want to align with my excuses…”-Debbie Ford