ANKLE JOINT Bony arrangement = stabilityBony arrangement = stability Ligaments play major role in stabilityLigaments play major role in stability

flexion = dorsiflexionflexion = dorsiflexion extension = plantar flexionextension = plantar flexion

FIG 6.13page 207

taxing theEccentric Strength

ofInversion Muscles

SUBTALAR JOINT

allows foot to navigate uneven surfacesallows foot to navigate uneven surfaces inversion (sole in) and eversion (sole out)inversion (sole in) and eversion (sole out) inversion with plantar flexioninversion with plantar flexion eversion with dorsiflexioneversion with dorsiflexion

FIG 6.15page 209

Inversion during Plantar Flexion

Muscles of Ankle & Foot

Strength important on all sidesStrength important on all sides Muscular imbalance = misalignmentMuscular imbalance = misalignment misalignment = line of g eccentric to jointsmisalignment = line of g eccentric to joints weak dorsiflexors may cause shin splintsweak dorsiflexors may cause shin splints overdeveloped inversion/plantar flexion muscles overdeveloped inversion/plantar flexion muscles

= prone to lateral ankle sprains= prone to lateral ankle sprains

Stretching Achilles Tendon

Preventative measure for shin splintsPreventative measure for shin splints

Achilles tendon = extension of both Achilles tendon = extension of both gastrocnemius and soleus muscles gastrocnemius and soleus muscles

2 dorsiflexion stretches:2 dorsiflexion stretches:1. with knee extended1. with knee extended2. with knee flexed2. with knee flexed

Plantar Fasciitis

Overuse Syndrome injuryOveruse Syndrome injury

overload of stress at insertion of plantar surface overload of stress at insertion of plantar surface fascia on calcaneousfascia on calcaneous

chronic therapy involves:chronic therapy involves:1. Strengthen plantar & dorsiflexors1. Strengthen plantar & dorsiflexors2. Increase ROM in dorsiflexion 2. Increase ROM in dorsiflexion

see page 210 re Kibler et al studysee page 210 re Kibler et al study

LOCOMOTION Walking Running

Long support phase Long support phase [65%][65%]

always support phasealways support phase

Shorter support phaseShorter support phase

non-support phasenon-support phase

F vertical = 3 x body wtF vertical = 3 x body wt

Ideal Alignments: LEG

Lower extremities like columns Lower extremities like columns supporting a roofsupporting a roof

Ideally as vertically aligned and Ideally as vertically aligned and as straight as possible to support as straight as possible to support the forces from abovethe forces from above

FIG 6.19page 213

Ideal Alignments: FOOT

FIG 6.20page 214

a is Ideal FIG 6.21

Leg Length Inequities

Anatomical - due to bone structureAnatomical - due to bone structure

Functional - due to tilted pelvisFunctional - due to tilted pelvis

Environmental - due to uneven groundEnvironmental - due to uneven ground

TORSION Femoral Tibial

Femur rotated medialFemur rotated medial medial facing patella medial facing patella frequent in FEMALES frequent in FEMALES treatment:treatment:1. Strengthen lateral hip 1. Strengthen lateral hip

rotatorsrotators2. Stretch medial hip 2. Stretch medial hip

rotatorsrotators

Tibia rotated lateralTibia rotated lateral lateral facing patellalateral facing patella frequent in MALESfrequent in MALES treatment:treatment: - muscular balance in all - muscular balance in all

3 hamstrings must be 3 hamstrings must be developed developed

VARUS INWARD angle INWARD angle from proximal to from proximal to distaldistal

lateral stress is lateral stress is proximalproximal

medial stress is medial stress is distal distal

VALGUS OUTWARD angle OUTWARD angle from proximal to from proximal to distaldistal

medial stress is medial stress is proximalproximal

lateral stress is lateral stress is distaldistal

Key Features of Good Shoes

Heel well cushionedHeel well cushioned Heel Counter firmHeel Counter firm Arch Support firmArch Support firm Sole Width reasonable for stabilitySole Width reasonable for stability Forefoot flexibleForefoot flexible Toe Box with reasonable roomToe Box with reasonable room Traction, Durability, PermeabilityTraction, Durability, Permeability