Patho - Ankle

Question 1

Excessive Plantarflexion

Answer 1

Lack of normal Dorsiflexion

Too much Plantarflexion

Question 2

Excessive Dorsiflexion

Answer 2

Lack of Normal Plantarflexion

Too much Dorsiflexion

Question 3

Phases of Excessive Plantarflexion

Answer 3

Terminal Swing-Initial Swing
Midstance- Terminal Stance
Initial Swing - Midswing

Question 4

EP Terminal Swing-Initial Contact Causes

Answer 4

Dorsiflexor Weakness
Calf Tightness/PF Contracture
Excessive Calf Activity
Purposeful Strategy to reduce the heel rocker (Muscle Weakness, Poor Balance/Stability).
Heel Pain

Question 5

EP Terminal Swing-Initial Contact Penalties

Answer 5

Only in Initial Contact:

Decreased stance phase progression = Lack of heel rocker.

Question 6

EP Midstance-Terminal Stance Causes

Answer 6

Excessive Calf Activation - could be compensatory for hip and/or knee extensor weakness. OR to “push” the body forward as opposed to hip and knee pulling the body forward.

Question 7

EP Midstance-Terminal Stance Penalties

Answer 7

Decreased Forward Progression - Lack of ankle rocker.
Requires Compensatory strategies to augment forward progression. Strategies are knee hyperextension, midfoot pronation, early heel raise and elevated COM.

Question 8

EP Initial Swing-Midswing Causes

Answer 8

Dorsiflexor Weakness
Calf Tightness and/or Contracture
Excessive Calf Activity

Question 9

EP Initial Swing-Midswing Penalties

Answer 9

Diminished Foot Clearance

Question 10

ED Initial Contact-Loading Response Causes

Answer 10

Ankle foot orthotics (AFO)
Prosthetic foot (Typically set is 5-8 degrees of DF)

Question 11

ED Initial Contact-Loading Response Penalties

Answer 11

Excessive Heel Rocker

Excessive Knee Flexion and Quadriceps Activity

Question 12

ED Midstance, Terminal Stance and Pre-Swing Causes

Answer 12

Calf Weakness

Question 13

ED Midstance, Terminal Stance and Pre-Swing Penalties

Answer 13

Quadriceps Overuse

Excessive lowering of center of mass.

Question 14

Excessive Pronation (Frontal) Loading Response-Terminal Stance Causes

Answer 14

Limited ankle dorsiflexion - (Compensatory midfoot break).
Hypomobile Subtalar Joint - (compensatory midfoot motion.
Hypomobile rear foot/midfoot
Inverter weakness
Rearfoot/forefoot virus
Dynamic knee valgus.

Question 15

Abnormal (Either excessive or limited) Pronation (Frontal) Loading Response-Terminal Stance Penalties

Answer 15

Excessive Motion causing stress on inverters and plantar fascia, stress on inter-tarsal ligaments, hallucinating valgus and increased tibia rotation and stress on knee.

Limited Motion - poor shock absorption.

Question 16

Limited Pronation Causes

Answer 16

Hypomobile rearfoot
Medial point of of contact
Dynamic splinting
Caves foot.