Ankle Pathological Gait

Question 1

Influences of Muscle Weakness

Answer 1

DFs- ant tib weak effects LR and swing phase
PFs- excessive calf LR=foot slap
Inverters- post tib, FDL, FHL

Question 2

Limited Ankle Mobility Cause

Answer 2

PF contracture (15 most common/open packed)
excessive bed rest/cast causes stiffness- elastic or rigid contract

Question 3

Excessive PF
CAUSE

Term Swing- Initial contact

Answer 3

DF Weak
Calf tight/contrac
Excessive calf activity
Purposeful strategy to decrease heel rocker (weak or poor stabil)
Heel pain (plantar fascitis)

Question 4

Excessive PF
PENALTY

Initial Contact

Answer 4

Decrease stance phase progression- lack heel rocker

Slows them down

Question 5

Excessive PF
CAUSE

Midstance- Terminal Stance

Answer 5

• Calf tight/contrac
• Excessive PF activitiy
• Shortened step length (lose forefoot rock)
• Excessive calf activitation- compens for hip/knee exten weakness; “Push Off” body forward instead of hip/knee pulling from exten

Question 6

Excessive
PF PENALTY

Midstance-Terminal Stance

Answer 6

Decreased fwd progression (lack ankle rocker)
Requires compens strategies to augment fwd prog- knee hyperexten w/ fwd trunk lean, pronation, early heel rise (elevated COM)

Question 7

Excessive PF
CAUSE

Initial Swing-Mid Swing

Answer 7

DF weakness
Calf tight/contrac
Excessive Calf Activity

Question 8

Excessive PF
PENALTY/COMPS

Initial Swing-Mid Swing

Answer 8

Pen: Diminished foot clearance (foot drop/toe drag)
Comps: excessive hip flexion (illiopso, rec fem, add long) or excessive knee flexion (bicep short)

Question 9

Excessive DF
CAUSE

Initial contact-Loading Response

Answer 9

Ankle foot orthosis
Prosthetic foot (set in 5-8 deg DF)

Question 10

Excessive DF
PENALTY

Initial Contact- Loading Response

Answer 10

Excessive heel rocker

Excessive knee flexion/quad activity

Question 11

Excessive DF
CAUSE

Midstance/Termstance- Pre Swing

Answer 11

Calf weakness- tibia collapses forward

Question 12

Excessive DF
PENALTY

Midstance/Termstance- PreSwing

Answer 12

Quad overuse (tib collapsing causes knee to flex)
Excessive lower COM

Question 13

Excessive DF from Knee Flex Contracture

Answer 13

Knee flex automaticall causes ankle DF!

all the above can happen then

Question 14

Influence of Abnormal Foot Pronation

Answer 14

Excessive pronation in expected phase of gait- LR and Midstance
Movement in the wrong phase- Termstance

Question 15

Causes of Excessive Pronation

LR-Termstance

Answer 15

Limited DF- compens midfoot break
Hypomobile subtalar joint- compens midfoot motion
Hypermobile rer/midfoot
Inverter weakness
Rearfoot/forefoot weakness
Rearfoot/forefoot varus
Dynamic knee valgus- foot collapses medially

Question 16

Causes of Limited Pronation

LR-Termstance

Answer 16

Hypomobile rearfoot
Medial point of contact
Dynamic “Splinting”- overcontract inverters for stability
Cavus foot

Question 17

Penalties of Abnormal Pronation

Answer 17

-Excessive:
Stress inverters/plantar fascia
Stress inter-tarsal ligs
Hallux valgus
Increased tib rotation/stress on knee
-Limited:
Poor shock absorption