NEUROLOGICAL CAUSES

Question 1

what are the types?

Answer 1

Neurological disorders:
direct
indirect

paralysis:
flaccid paralysis
muscle hypertonicity

tonic spasm:
peroneus brevis
preoneus longus
gastroc
anterior tibialis

Question 2

Neurological disorder

▪ Neurologically create an imbalance between the supinator and pronator muscles of the STJ
▪ Only gastroc and soleus can have direct effect on STJ due to insertion in calcaneus

• They supinate the STJ
• Can affect ability to slow pronation during contact

Answer 2

Direct neurological disorder

Question 3

Neurological disorder

▪ May be caused by a neurological disorder which produces a muscular imbalance anywhere in
the lower extremity
▪ Muscle imbalance moves some part of the extremity to a position which forces the STJ to compensate for abnormal position by pronating

• Loss of PT contraction allows peroneals to take over and cause abnormal pronation

Answer 3

Indirect neurological disorder

Question 4

paralysis

o Healthy antagonistic muscles shorten into a contracture state due to agonist not functioning

▪ When antagonist shortens it pulls body part into abnormal position and fixes it into position

Answer 4

Flaccid paralysis

Question 5

paralysis

o Hypertonic muscles eventually overpower antagonistic muscles

▪ Part controlled by the involved muscles is pulled into an abnormal position

Answer 5

Muscle Hypertonicity

Question 6

tonic spasm

o Results in limited ankle dorsiflexion
o Compensation is STJ and MTJ pronation if heel can contact ground

▪ If heel can’t contact ground, it wont experience GRFs and foot will remain supinated

o Most commonly occurs to splint knee pain

Answer 6

Gastrocnemius

Question 7

tonic spasm

o Occurs in response to pain occurring with:
▪ Plantarflexion of 1st ray
▪ Pronation of the MTJ about the LMTJ (forefoot eversion)

o Spasm dorsiflexes 1st ray and inverts forefoot
▪ Results in pronatory compensation at STJ
▪ Imitates forefoot varus

Answer 7

Anterior Tibialis

Question 8

tonic spasm

o Strongest pronator of STJ
o Long term spasm termed “peroneal spastic flatfoot”
o Usually caused by inflammation within or around STJ or MTJ (pronation relieves pain)

Answer 8

Peroneus Brevis

Question 9

tonic spasm

o Mild pronator of STJ
o Strong plantarflexor of 1st ray and a stronger pronator of LMTJ
▪ When it goes into spasm, the forefoot remains everted causing STJ to go into supination
o Common cause is inflammation of basal joints of 1st ray
o Inflammation of MTJ producing pain on supination of the LMTJ

Answer 9

Peroneus Longus