Foot & Ankle Flashcards
The healthy foot offers stability for both _____ and ______.
loading; propulsion
The healthy foot provides ________ input that helps to coordinate movement (feedback for feedforward)
somatosensory
_______ or _____ movement = muscle activity that allows for stability of one part and mobility of another
dissociated/ selective
_______ producing _______ = somatosensory feedback to SC and CNS that produced feedforward response resulting in appropriate muscle activity
feedback; feedforward
What type of joint is distal tip-fib?
syndesmosis
What is the most stable position of the foot?
full DF
Medial bones of foot?
talus, navicular, cuneiforms, first 3 MT’s and corresponding phalanges
Lateral bones of foot?
calcaneus, cuboid, lateral 2 MT’s and corresponding phalanges
What are the 3 cuneiforms shaped as? Why?
an arch; putting pressure through the keystone increases the stability
What are the two ligaments on the lateral side of the foot that provide a lot of stability?
short and long plantar ligaments
When heel striking, where do you want your COM to be? Why?
slightly lateral; due to strong short and long plantar ligaments and bc calcaneo-cuboid joint is very stable
What type of joint is the calcaneocuboid ?
modified seller
_____ ______ = very important in providing support for foot when toes are in extension
plantar fasciitis
The muscular stability from the front of the leg for the foot is quite _______ oriented, whereas the muscular support from the back of the leg is quite _______
vertically; rotary
Why is having muscles providing support in a rotary orientation beneficial?
Provides support in multiplanar directions
As you heel strike and your COM moves forward, the lateral side of the foot provides _______ whereas the medial side of the foot provides ______
stability; mobility
As you push off and the COM moves towards your big toe, the medial side will move to (close packed/loose packed) position, and lateral side of foot will move to (close packed/loose packed) position
close packed; loose packed
Average walking speed? Average strikes per minute?
3.6- 4.5 km/hr; 60
5 phases of gait?
- initial contact
- loading response
- midstance
- terminal stance
- swing
At IC, GRF is through the ______ ______
posterior calcaneus
At IC, the subtalar joint is i the ________ position
supinated
Muscle activity at IC?
- tib ant
- EDL
- EHL
During LR, ankle begins to ____ to allow toes to come to ground
PF
During LR, subtalar joint begins _______ to come out of supinated position
pronating
During LR, the load is transferred onto _______ foot
lateral
Main supports during LR?
long and short plantar ligaments
Muscle activity during LR?
- gastroc
- soleus
- TP
- FDL
- FHL
- Intrinsics
What muscle group decelerates pronation during LR?
posterior tibial
During mid stance, COM travels from position poster to the ankle joint axis to in front of it thereby loading the ______ region
tarsal
During mid stance, COM travels from the ________ side of the foot to the _____
lateral; medial
During midstance, there is a lengthening of the ____ from heel contact to 10% of stance; and the _____ will drop
MLA; navicular
During mid stance, ST joint reaches max ______ and begins to ______
pronation; supinate
Main 3 muscle groups on during mid stance?
- gastrocs and soleus
- deep post tib group
- peroneii
During TS, there is ST ______
supination
During TS, the TC jt ______, the TMT’s ____, and toes extend, tightening the PF
PF; PF
PF is associated with ______, whereas DF is associated with ______
folding; fanning
During TS, there is a posterior glide of the 1st MT head on the _____
sesamoids
During TS, the 1st MT head moves _____ the common transverse plane of the lesser MT heads
below
During TS, the proximal phalanx glides ______ and 1st MTP extends
dorsally
Toe off occurs through a stable extended 1st MTP at ~ ___ deg extension
65
Muscle activity during TS?
- gastrocs
- soleus
- peroneii
- tib post
- FHL
- intrinsics
4 functional tasks during gait?
- weight acceptance
- SLS
- limb advancement
- propulsion
Initiation of walking is via ___ _____ firing
hip flexor
During mid stance, use kinetic energy from loading response to go into most vertical orientation into ____
SLS
_____ is the most unstable position during gait and therefore need all body parts stacked on top of one another to use force produced by gastroc and soleus
TS
Trunk follows displacement of COM in a ______ and ______ orientation
vertical; horizontal
Trunk has rotation that occurs around a _______ axis that is in the ______ direction to that of the pelvis
vertical; opposite
Total rational excursion of the trunk is __ degrees and is one of the determinants of efficient gait
7
Evidence suggests that the trunk is an active component of postural control preceding the initiation of ______
stepping
Max backward swing of the ipsilateral arm occurs at ___
HC
Shoulders are _____ at SLS
neutral
Max forward swing ipsilateral arm at HC of ________ leg
contralateral
Arms moving across the body is often a sign of ______ instability
lateral
There is moderate evidence suggesting lowered max vertical GRF when running ______
barefoot
There is mod evidence suggesting barefoot running is associated with increase ____ frequency, shorter ____ length and less ground ____ time
stride; stride; contact
Mod evidence suggestive of decreased foot and ankle _______ at IC when barefoot
DF
Mod evidence suggesting increased knee _____ at ground contact and less knee ___ during stance when barefoot or in minimalist shoes
flexion
3 indications of orthotics?
- to act as a SPLINT to take pressure or strain off an injured structure to allow healing
- improve function of foot thereby decreasing stress on the lower quadrant
- to balance intrinsic foot deformities
3 cautions for orthotics?
- no attempt has been made to improve function through other treatment options
- sensory impairment
- poor footwear
Present research suggests _______ orthotics are as effective as custom made
accommodative
2 movements to check when assessing orthotics?
- knee flexion with and without orthotics (drop into squat, how does knee track over foot?)
- extend the 1st MTP and see how much resistance there is to movement with and without orthotic (less = better!)
