Term
| what are the 3 types of abnormal pronation |
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Definition
failure to resupinate
late pronation
early excessive pronation |
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Term
| describe failure to resupinate |
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Definition
| from terminal stance to preswing the subtalar and midtarsal jts remain pronated resulting in a loss of a rigid lever |
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Term
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Definition
| little to no pronation occurs from initial contact to midstance with sudden pronation occuring from terminal stance to preswing. Results in a loss of shock absorption and rigid lever |
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Term
| Describe early excessive pronation |
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Definition
| subtalar and midtarsal jts are pronated throughout the entire stance phase of gait. Shock absorption and rigid lever are lost |
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Term
| Abnormal pronation wear pattern |
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Definition
| Heel, medial arch to ball of foot, to big toe |
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Term
| (6) intrinsic causes of abnormal pronation |
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Definition
forefoot varus
rearfoot varus
ankle jt equinus
trauma
ligamnetous laxity
bony abnormalities |
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Term
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Definition
| inversion of the forefoot on the rear foot with the subtalar jt in neutral |
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Term
| what range is considered WNL for forefoot varus |
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Definition
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Term
| Forefoot Varus compensation looks like what (2) |
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Definition
evert calcaneus
abduction of MTJ in transverse plane |
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Term
| Forefoot varus compensation has this "sign" |
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Definition
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Term
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Definition
| varus position of the calcaneus (rearfoot) when the subtalar jt is positioned in neutral |
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Term
| what is considered a normal range for rearfoot varus |
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Definition
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Term
| rear foot varus will lack what ROM |
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Definition
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Term
| rearfoot varus compensation |
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Definition
| at initial contact the calcaneus moves from varus to a vertical position in an attempt to pronate the STJ |
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Term
| when does rearfoot varus compensation become a problem |
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Definition
| if compensatory pronation occurs |
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Term
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Definition
| PF position of the foot occuring at the AJ or midtarsal/forefoot |
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Term
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Definition
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Term
| dorsiflexion range needed for normal gait |
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Definition
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Term
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Definition
| unable to dorsiflex at AJ results in increased/compensatory pronation at the STJ or MTJ |
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Term
| traumatic flatfoot is a result of what |
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Definition
| rupture or overstretching of the posterior tibialis tendon |
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Term
| Tibialis posterior role/action (3) |
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Definition
strong supinator
rearfoot stabilizer
eccentrically controls STJ eversion |
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Term
| clinical dx of traumatic flatfoot (3) |
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Definition
excessive pronation
too many toes sign
inability to raise up on the toes |
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Term
| Ligamentous laxity: 4 ligaments to consider |
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Definition
long plantar ligament
short plantar ligament
spring ligament
plantar fascia |
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Term
| Ligamentous laxity may occur secondary to what (3) |
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Definition
abnormal development
excessive weight
systemic conditions (RA, diabetes) |
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Term
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Definition
| weak osseous support of the talar head at the anteromedial facet during weight bearing |
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Term
| Extrinsic Causes of Abnormal Pronation (4) |
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Definition
rotational deformities of the LE
Leg length discrepancy
Genu varum
genu valgum |
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Term
| Extrinsic Causes of Abnormal Pronation: ROtational deformities of the LE include (3) |
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Definition
femoral anteversion
tibial internal rotation
tibial external rotaiton |
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Term
| what is the normal range for femoral anteversion |
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Definition
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Term
| what is considered abnormal femoral anteversion |
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Definition
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Term
| How is abnormal femoral anteversion ID'd? |
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Definition
Craig's test
ROM asessment may reveal significant decrease in ER and increase in IR |
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Term
| Genu valgum creates what type of moment at the foot and ankle |
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Definition
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Term
| Genu valgum creates a pronation moment at the foot and ankle with associated tension to what structures |
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Definition
| medial structures of the knee |
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Term
| Genu varum is associated with what |
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Definition
| inversion at calcaneus and forefoot creating compensatory excessive pronation |
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Term
| Causes of anatomic LLD (5) |
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Definition
fx's
uneven development
epiphyseal irritation
coxa vara
abnormal pelvic development |
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Term
| causes of functional LLD (3) |
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Definition
pelvic malalignment
unilateral mm tightness
ligamentous laxity |
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Term
| Abnormal forces to the foot with abnormal pronation: what leads to anterolateral ankle pain |
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Definition
| increased compression laterally |
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Term
| Abnormal forces to the foot with abnormal pronation: increased distraction forces medially leads to what (3) |
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Definition
posterior tibialis tendinitis
achilles tendinitis
traction of the posterior tibial nn |
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Term
| Abnormal forces to the foot with abnormal pronation: what leads to plantar facsitis |
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Definition
| increased tensile stress on the plantar fascia |
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Term
| Consequences of Abnormal pronation: progressive |
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Definition
| tissue breakdown resulting in hypermobility of the foot |
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Term
| Consequences of Abnormal pronation: loss |
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Definition
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Term
| Consequences of Abnormal pronation: trauma (3) |
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Definition
to tendons that support and control the medial arch
to achilles tendon
to plantar fascia |
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Term
| Consequences of Abnormal pronation: Increased (2) |
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Definition
dorsiflexion of the 1st ray
IR of LE |
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Term
| Consequences of Abnormal pronation: compression/impingement of what structures |
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Definition
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Term
| abnormal supination causes (6) |
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Definition
high arched or pes cavus foot
inability of the foot to pronate during the stnace phase of gait
LLD
tight PF and intrinsicts of the foot with associated weakness of DF and contracture of plantar fascia
forefoot valgus
rigid PF first ray |
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Term
| abnormal supination results in what |
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Definition
| a rigid structure that is unable to adapt to uneven surfaces or absorb shock |
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Term
| abnormal supination has an increased risk of what |
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Definition
| lateral ligamentous sprains |
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Term
| abnormal supination has what potential associated pathologies (2) |
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Definition
tissue inflammation
possible jt destruction |
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Term
| forefoot valgus presentation |
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Definition
| eversion of the forefoot with the rearfoot in subtalar neutral |
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Term
| compensated forefoot valgus: what aspect of the foot hits first |
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Definition
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Term
| compensated forefoot valgus: medial aspect of the foot hits first, creates what? |
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Definition
| rapid supination at the STJ |
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Term
| compensated forefoot valgus: associated ____ _____ and _____ _____ _____ commmon |
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Definition
ankle instability
progressive tissue contracture |
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Term
| presentaiton of rigid PF first ray |
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Definition
| first ray is positioned plantarly in relation to other 4 MT's |
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Term
| Rigid PF first ray compensation: |
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Definition
similar to forefoot valgus
results in excessive supination at the STJ |
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Term
| Biomechanical consequences of excessive supination: what leads to metatarsalgia (2) |
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Definition
increase PF rays
Increase forefoot loading |
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Term
| Biomechanical consequences of excessive supination: contracture of the plantar fascia leads to what (2) |
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Definition
plantarfascitis
heel spurs |
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Term
| Biomechanical consequences of excessive supination: lateral ligament sprains are a result of what |
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Definition
| increased tension on lateral ligaments |
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Term
| Biomechanical consequences of excessive supination: pronation occurs terminal stance. midfoot unstable leads to what (2) |
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Definition
decreased shock absorption at Heel strike
overload to tissues |
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