Pathological Gait: Foot & Ankle

Question 1

Influence of muscle weakness

Answer 1

DF: Swing
PF: MSt/TSt
Inverters: LR/MSt/TSt

Question 2

PF contracture

Answer 2

lose ability to DF

Question 3

Having a 15 PF Contrature I can… I can’t…

Answer 3

CAN: PF 25-30

CAN’T: DF 10, 5, Neutral

Question 4

Excessive PF

Answer 4

Lack of normal DF

Too much PF

Question 5

Excessive DF

Answer 5

Lack of normal PF

Too much DF

Question 6

Excessive PF: TSw-IC

Causes

Answer 6

DF weakness
Calf tightness/contracture
Excessive calf activity
Strategy to reduce heel rocker
Muscle weakness/Poor balance/Instability
Heel pain

Question 7

Excessive PF: IC

Penalties

Answer 7

Decreased stance phase progression

Lack of heel rocker

Question 8

Excessive PF: MSt/TSt

Causes

Answer 8

Calf tightness/contracture
Excessive PF activity
Shortened step length
Excessive calf activation
Compensatory for hip/knee extensor weakness
Push body forward as opposed to hip/knee extension pulling body forward

Question 9

Excessive PF: MSt-TSt

Penalties

Answer 9

Decreased forward progress (lack of ankle rocker)
Requires compensatory strategies to augment forward progression
Knee hyperext
Midfoot pronation
Early heel rise and elevated COM

Question 10

Excessive PF: ISw/MSw

Causes

Answer 10

DF weakness
Calf tightness/contracture
Excessive calf activity

Question 11

Excessive PF: ISw/MSw

Penalties

Answer 11

Diminished foot clearance

Question 12

Compensations for Excessive PF: ISw/MSw

Answer 12

Excessive hip/knee flexion

Question 13

Excessive DF: IC & LR

Causes

Answer 13

AFO
Px Foot
5-8 DF: ankle/heel rocker

Question 14

Excessive DF: IC & LR

Penalties

Answer 14

Excessive heel rocker

Excessive knee flexion/quads activity

Question 15

Excessive DF: MSt/TSt/PSw

Causes

Answer 15

Calf weakness

Question 16

Excessive DF: MSt/TSt/PSw

Penalties

Answer 16

Quads overuse

Excessive lowing of COM

Question 17

Abnormal Foot Pronation: Excessive in the expected phases:

Answer 17

LR

MSt

Question 18

Abnormal Foot Pronation: Wrong phase of gait

Answer 18

TSt

Question 19

Excessive Pronation: LR/MSt/TSt

Causes

Answer 19

Limited ankle DF, compensatory midfoot break
Hypomobile subtalar joint, comp midget break
Hypermobile rearfoot/midfoot
Inverter weakness
Rearfoot/Forefoot varus
Dynamic knee valgus

Question 20

Limited Pronation

Causes

Answer 20

Hypomobile rearfoot
Medial point of contact
Dynamic “splinting”
Cavus foot

Question 21

Abnormal Pronation

Penalties

Answer 21

Excessive motion

• Stress on inverters & plantar fascia
• Stress on inter-tarsal ligs
• Hallux valgus
• Increased tibia rotation and stress on knee

Limited motion
- Poor Shock Absorption