12] Advanced Gait Analysis And Biomech Foot Orthoses Flashcards
Normal Fick angle
5-18 degrees is normal
Normal femoral torsion angle
8-15 degrees
Normal tibial torsion angle
12-18 degrees
Sign of pronation
Too many oes sign
Midtarsal joint for pronation approach
Parallel
Which foot is rigid vs flexible
Pronation = flexible foot Supination = rigid foot
Rearfoot varus heel strike
Increased calcaneal inversion and pronation
Rearfoot varus at midstance
Supination from pronated position
- level arm less stable
Shearing for rearfoot varus
Callus under 2nd met head
Associated pathologies with rearfoot varus
Post tib tendonitis
Plantar fasciitis
Tarsal tunnel syndrome
Achilles tendonitis
Forefoot varus at heel strike
Calcaneal normal
Forefoot varus at midstance
Stays pronated
- lever arm less stable
Callus where for forefoot varus
Medical hallux at push off
Associated pathos for forefoot varus
HAV Plantar fasciitis 2nd met stress Fx Metatarsalgia (Morten’s neuroma) Achilles tendonitis PFPS
Abductors twist observed when
Between flat foot and heel rise
What happens in abductors twist
Heel moves medially and forefoot ABDucts
- midtarsal it unlocks and STJ fails to resupinate so its flexible
Abductory twist is compensation for
Reduced ER higher up
What is HAV
Hallux abductovalgus aka a bunion on the outside of your big toe
During supination, midtarsal joints approach
Perpendicular
Toe deformities seen with supination
Claw toe
Mallet toe
Hammer toe
Forefoot valgus heel strike
Normal calcaneus but increased supination
Forefoot valgus at heel strike
Begins pronating when it should be supinating
- lever arm less stable at push off
Shearing for forefoot valgus
1st and 5th met heads
What is there b.c of rigid foot with supination
Decreased shock absorption
Associated pathos with forefoot valgus
Lateral ankle sprains
Peroneus longus tendonitis
Sesamoiditis
SI joint probs
PF 1st ray is
Dropped 1st met - increased loading on 1st met
Metatarsalgia
Pain at distal end of one or more metatarsals
Metatarsalgia happens from ?
Overuse injury common in athletes who run and jump
Signs and Sx of metatarsalgia
Gradual onset
Increased pain with walk/run
Calluses present
Predisposing factors Of metatarsalgia
Prominent met heads Tight toe ext Weak toe flex Tight Achilles’ tendon Excessive pronation Cavus foot (high arch) Morton toe (long second toe)
Treatment for metatarsalgia
Metatarsal pads
Important points of doing a slipper cast
Maintain subtalar neutral and neutral DF
Hold pts foot at 4th and 5th met heads which locks and loads DTJ
Goal of biomechanical foot orthoses
To compensate for foot deformity
Which shape is best for met pads?
Met dome shape b/c it reduced peak plantar pressures during running in ppl with flat feet
Optimal placement of met pad
6-10 mm proximal to met heads (middle 3)
Thomas heel promotes and limits?
Promotes RF varus and supports medial arch
Limits pronation
Support under cuboid does what
Promotes ABDuction of foot
Metatarsal bar does what?
Decreases pressure on met heads
Rocker sole
Decreases pressure on met heads and used for decreased ankle lotion
- also helps assist in gait with propulsion
Running shoes need minimal
Heel to toe drop
6 mm or less to allow normal loading
