Painful Gait

Question 1

4 types of foot/ankle pain

Answer 1

Heel
Metatarsal
Medial arch
Achilles tendon

Question 2

Heel Pain from Avoidance

Answer 2

• Why: to minimize heel rocker
• How: excessive PF TS-LR
• Penalty: decrease forward prog

Question 3

Heel Pain from Cause

Answer 3

• From: high impact forces
• How: inadequate knee flexion LR
• Penalty: decrease shock absorb, increase reliance on passive shock absorb

Question 4

Metarasal Pain from Avoidance

Answer 4

• Why: minimize forefoot rocker
• How: Avoid terminal stance (short step), Inad PF PS
• Penalty: decreased prog COM beyond foot

Question 5

Metatarsal Pain from Cause

Answer 5

• From: excessive forefoot pressure
• How: excessive PF MSt, TSt
• Penalty: lack ankle rocker, upward displacement COM

Question 6

Medial Arch Pain from Avoidance

Answer 6

• Why: walk on lateral border foot

- How: supinated during stance phases

Question 7

Medial Arch Pain from Cause

Answer 7

• From: stress/strain on medial structures

- How: excessive PF during stance

Question 8

4 types of Knee Pain

Answer 8

Anterior (patellafem jnt, patellar tendon)
Media
Lateral
Intra-articular

Question 9

Anterior Knee Pain from Avoidance

Answer 9

• Why: minimize quad demand
• How: Inad knee flexion LR
• Penalty: decreased shock absorption

Question 10

Anterior Knee Pain from Cause [Saggital]

Answer 10

-From: quad overuse
-How: Backward trunk lean LR (comp for hip exten weak),
Inad knee exten M/TSt (hip/knee flex contrac or weak calf)

Question 11

Anterior Knee Pain from Cause [Frontal/Trans]

Answer 11

• From: dynamic knee valgus

- How: excessive hip add/IR stance; secondary to weak abd/ER

Question 12

Lateral Knee Pain from Cause

Answer 12

• From: Dynamic knee varus
• How: Pelv drop owing to weak abd, Genu Varum LR-TSt
• *Pelv drop influences frontal plane knee movement**

Question 13

Intra-articular Knee Pain from Cause

Answer 13

-How: Inad knee flex LR
Dynam knee varus Stance (medial compartment)
Dynam knee valgus Stance (lateral compart)

Medial more prev- force on knee always VARUS

Question 14

3 types of Hip Pain

Answer 14

Anterior pain: capsule or flexors
Lateral pain: greater trochanter
Posterior/Butt pain: piriformis

Question 15

Anterior Hip Pain from Avoidance

Answer 15

• How: inad hip exten TSt
• Penatly: decreased stride length and forward prog

-How: inad hip flexion P/ISw (rec fem/adductors)

Question 16

Anterior Hip Pain from Cause

Answer 16

• How: excessive hip flexorion/overuse

- Comps for: PF contracture to clear foot

Question 17

Lateral Hip Pain from Cause

Answer 17

• From: Pressure on greater trochanter (goes w/ med knee pain)
• How: excessive hipp add/pelv drop during stance
• From: Weak hip abductors

Question 18

Posterior Hip Pain from Cause

Answer 18

• How: excessive hip IR during stance

- From: weak ERs (glute max)

Question 19

Reasons for Low Back Pain

Answer 19

• Inad knee flex LR- increases spine compression
• Pelve drop during stance- paraspinal overuse/facet compress
• Lat trunk lean stance- paraspinal overuse/facet compress
• Back trunk lean- increase lordotic curve
• Inad hip exten- comp with pelvic anterior and back rotation

Question 20

Low Back Pain from excessive Pelv Drop

Answer 20

Stance phases

• Cause: hip abd weakness
• Penalty: increased spine stress/ facet comress, muscle overuse- paraspin, quad lumb, ipsilat work hard to stabalize pelvis

Question 21

Low Back Pain from Back trunk Lean

Answer 21

LR

• Penalty: Increased lumbar lordosis
• Comp for hip exten weakness

Question 22

Low Back Pain from Hip Flexor Tightness

Answer 22

Term Stance

• Penalty: Increased stress/strain L5-S1
• Comps: excessive pelvis motion, anterior pelv tilt and transverse rotation