Foot/Ankle/Gait

Question 1

Initial Contact

Answer 1

• Ankle = neutral
• STJ = slightly supinated
• GRF posterior to ankle creating PF torque
• Anterior Tibialis and EDL are eccentrically contracting

Question 2

Loading Response

Answer 2

• 5 degrees PF
• Eccentric anterior tib and post tib mm action(tib pulled forward)
• Knee flexes

Question 3

Subtalar joint during LR

Answer 3

-Calcaneus everts 5 degrees
SHOCK ABSORPTION:
  -Calcaneal Eversion
  -Talus adducts
  -Tibia/femur IR
  -Knee flexes

Question 4

Midstance

Answer 4

• Ankle DF to 5 degrees

- Gastroc and Soleus eccentric to control forward tibial advancement (also stabilizes the knee)

Question 5

Terminal Stance

Answer 5

• Ankle DF to 10 degrees
• Peak DF torque
• 1st MTP extends 30 degrees
• Calf muscles activity peaks (prevents fwd tibial advancement and allows the heel to rise)
• 1st Ray support controlled by Peroneus longus

Question 6

Ankle joints during TS

Answer 6

-STJ and MTJ go into supination towards end = RIGID LEVER for push off

Causes:

• Calcaneal Inversion
• Talar abduction
• Tibial/femur ER
• Knee extension

Question 7

Pre-Swing

Answer 7

• Ankle to 15 degrees PF
• Knee rapidly fleing
• 1st MTP 60-70 degrees ext
• calf m. activity ceases
• Post/ant tibialis concentric for foot clearance
• STJ neutral

Question 8

Initial Swing

Answer 8

• Ankle 5degrees PF

- Concentric Anterior tibialis, EHL, EDL

Question 9

Midswing

Answer 9

• Ankle neutral

- Concentric pretibial muscles

Question 10

Terminal Swing

Answer 10

• Ankle neutral

- Pretibial muscles are active

Question 11

Ankle DorsiFlexion

Answer 11

• Active in Swing

- Passive in Stance

Question 12

Soleus Strengthenin

Answer 12

• Dominant decelerating force

- Largest plantar flexor muscle

Question 13

Functional Ankle Instability

Answer 13

• Chronic lateral instability develops in 20-30% of pts.

- Increased risk of sprain recurrence due to delayed proprioceptive response of the peroneals

Question 14

Acute Inflammatory Rehab

Answer 14

Goals: reduce pain, swelling, restore ROM

• PRICE
• PF/DF ROM
• Cardio

Question 15

Fibroblastic-Repair Rehab

Answer 15

Goals: increase ROM all planes, restore NMC and proprioceptioin

• PRICE prn
• ROM all planes
• Strengthen
• FWB

Question 16

Maturation Rehab

Answer 16

Goals: no pain or swelling, full ROM and strength, restore proprio

• Progress ROM, strength, proprio
• Progress walk-jog-run
• protect w/ brace/tape
• Progress with functional activities