WK 2- ORTHOTICs Flashcards
Is pronation bad?
Some evidence that suggests it may increase injuries but its very weak
It’s when tissues or structures are taking too much load that it becomes an issue but that’s not all pronating/pronated foots
Tissue damage is due to increase in force/load not motion
What do orthoses do
Evidence suggests it can have a small Change on kinematics in the rearfoot slightly by 2deg
Everyone responds differently
They change the force and load of structures but they don’t change foot structures
What is the manual supination resistance test (MSRT)
Arch pulled upward by 2 fingers
Measures the force needed to resupinate the foot, helps pick density of the orthotic to support arch
Relationship with:
1. Body weight
2. FPI
3. Distance from 5th met
Some pathologies associated with pronagtion
- plantar fasciitis/ fasciopathy
- post tib tendon dysfunction
- patellofemoral pain syndrome
-sinus tarsi syndrome - etc
What is the purpose of biomech forms
- identify mechanical issues/ dysfunctions
- use as outcome measures
- use for interventions such as orthotics, stretching, manual therapy, strengthening
What do clinical examinations need to be
- Valid
- Repeatable
- Correlation to dynamic function
- Potential to alter intervention
Kinetic tests
MSRT
Hamstring tension test
Jacks test
Lunge test
Facial cord tension test
If MSRT is high, what can you do for orthotic
Medial wedge
Kirby skive
Medial heel skive
Inverted orthotic
Jacks test
Force required to dorsiflex hallux with tips of fingers
Testing force (high, medium, low) and timing (immediate, delayed, none)
It can’t be used to diagnose functional hallux limitus
What does it mean if high force for jacks test
Great effort for the body to move over the foot which increases loads through tissue and can cause injury
Allow 1st ray to plantarflex through rearfoot wedge, forefoot valgus posting, reverse Morton’s extension, met dome, 1st ray cut out
If the timing is delayed in jacks test what does that mean
The foot may not be supported when the heel is unloading.
Heel raise or fluffy wedge to bring on windlass earlier (tension earlier)
MSRT reliability
Fair
Validity and reliability of jacks test
Nil but can alter treatment options
Lunge test
Measures weight bearing ankle dorsiflexion
Longest toe is touching wall, other foot is one foot length behind. With heel down and hips square, move knee toward wall. Keep moving the foot back until heel can’t stay down. Clinician to hold heel
> 9cm distance. 25-30deg
Lunge test is a good predictor for what?
Injury
