Term
| What 3 planes dore the foot and ankle joint move in |
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Definition
ankle mostly in flex/ext
subtalar mostly in inversion/eversion
midtarsal mostly abduction/adduction |
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Term
eversion, abduction, dorsiflexion
effects in WB and NWB |
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Definition
pronation
WB --> flattening of MLA
NWB --> raising of MLA |
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Term
inversion, adduction, plantar flexion
effects in WB and NWB |
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Definition
supination
WB --> raising of MLA
NWB --> flattening of MLA |
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Term
occurs when the foot is on the ground and weightbearing
accounts for 60% of whole gait cycle |
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Definition
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Term
| 5 events of the stance phase |
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Definition
heel strike
flat foot
single leg stance
heel off
toe off |
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Term
instant the heel makes contact wiht the ground
occurs at what percent of the gait cycle |
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Definition
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Term
| what happens at all the joint at heel contact |
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Definition
hip: flexed 30-50° and IR
knee: slightl flexed or extended
tibia: laterally rotated
ankle: 90° with foot supinated
hindfoot: everted |
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Term
pain in heel at heel strike usually caused by?
how does one alter gait to releive stress on foot |
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Definition
bone spur, bonebruise, heel fat pad bruise, bursitis
pain will cause increased flex of knee and early PF |
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Term
| what happens at heel strike is the knee is weak |
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Definition
| pt will hit ground hard with heel to whip the knee into extension |
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Term
what happens at heel strike if the dorsiflexors are weak
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Definition
| foot drop, foot slaps or flops down |
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Term
the instnt the entire plantar surface of the foot comes into contact with the ground
occurs at about 8% of gait cycle
why is this a critical point in gait cycle? |
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Definition
load response (flat foot)
this is when a person decides whether the limb is able to bear the weight of body |
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Term
| What happens to the joint in the flat foot point in gait cycle |
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Definition
pelvis: drops slightly and medially rotates on side of swing leg
hip: the flexed an ER hip move toward ext
knee: flexes to 15-25°
tibia: medially rotated and begins to move over foot
ankle: is PF
hindfoot: inverted
foot: moves into pronation (allowes shock absorption) |
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Term
| what are abnormal responses to the flat foot point in gait cycle |
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Definition
| excessive or no knee motion as a result of wear quads, PR contractures or spasticity |
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Term
the point where the bodys weight passes directly over the supporting LE
the point when the LE in swing phase passes the LE in the stace phase |
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Definition
| Midstance (single leg stance) |
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Term
| what happens at the joints in the midstance phase |
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Definition
pelvis: slight drop to the swing leg side
hip: is in maz ext 10-15° with lateral rotation
knee: flexes
ankle: is locked at 5-8° of DF, rolls forward onto forefoot
forefoot: pronated
hindfoot: inverted
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Term
| what happens is the gluteus medius muscle is weak |
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Definition
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Term
| common causes of pain during the midstance phase |
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Definition
| arthritis, rigid pes planus, fallen MT or longitudinal arch, plantar fasciitis, mortons metatarsalgia |
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Term
| if pain is present how does a pt hurry through the midstance phase of gait |
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Definition
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Term
| the instant the heel comes off the ground occurs at about 40% of gait cycle |
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Definition
| terminal stance (heel off) |
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Term
| what happens at the joint in the terminal stance of gait |
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Definition
pelvis: initially level and post. rotated --> dips to swing side remaining post rotated
heel: neutral and slightly IR
knee: extended
tibia: ER
ankle: PF (critical event)
forefoot: moves from inversion to eversion
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Term
| why is PF at ankle a critical event |
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Definition
the action helps to smooth the pathway of the COG
fore foot initially in contact with floor and weight moves forward with plantar flexion so big toe can make contact with floor |
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Term
instant the toe comes off the ground
occurs at 60% of gait cycle
acceleration phase as toe pushes leg forward |
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Definition
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Term
| what happens at the joint in the toe off phase of gait |
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Definition
pelvis: post rotated
hip: ext and slightly IR
knee: flexes to 30-35°
ankle: PF
COG is anterior to hip so leg and accelerate forward |
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Term
| pain in toe off usually caused by |
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Definition
| hallux rigidus, turf toe, other pathology to hallux (MTP jnt) |
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Term
| what happens if plantar flexors are weak in the toe off phase of gait |
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Definition
push off may be absent
foot will supinate to add more rigid base for better push-off |
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Term
| if injury to joint and pt cant push off on medial aspec tof foot, what happens to allow push off? |
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Definition
| pt pushes off of lateral aspec tof foor to compensate for painful MTP jnt, MT arch from increased pressure to MT heads |
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Term
| swing phase of gait accounts for what % of the swing cycle |
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Definition
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Term
period from toe off to mid swing
from 60-75% of gait |
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Definition
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Term
| what happes to the joints at the early swing phase of gait |
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Definition
pelvis: IR and dips to swing side
trunk aligned with stance leg
forefoot: continues to supinate
hindfoot: continues to evert
ankle: continues to PF
knee: exhibits max felxion of about 60° |
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Term
| how do the dorsiflexors affect the foot in swing phase of gait |
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Definition
| contract to allow the foot to celar the ground |
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Term
| what happens if the quads are weak in the swing phase of gait |
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Definition
| the pelvis is thrusted forward by the trunk muscles to provide forward momentum |
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Term
corresponds with mid stance event of the opposite lower extrimity when the foot in swin lasses next to stance leg foot
from 75-85% of gait cycle |
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Definition
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Term
| what happes to the joints at the mid swing phase of gait |
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Definition
pelvis and trunk: same as early swing
hip: continues to flex and IR
knee: continues to flex
forefoot: supinated
hindfoot: everted
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Term
| how does a pt compensate for weak ankle DF muscles |
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Definition
| hip flexes excessively so the toes can clear the ground |
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Term
period form midswind to foot contact with ground
85-100% of gait cycle |
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Definition
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Term
| what happes to the joints at the late swing phase of gait |
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Definition
trunk/pelvis: same as other swing phases
hip: continues to flex and IR
knee: reaches max extension
ankle: DF has occured
forefoot: supinated
hindfoot: everted
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Term
| how does the hams affect the swing phase of gait and what happens if they are weak |
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Definition
they contract to slow the swing
if weak the heel strike will be excessively harsh to lock knee into extension |
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Term
| Single support and double support phase acocunt for how much of gait |
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Definition
single support is 40% for each limb
double support phase 10% |
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Term
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Definition
early, excessive or prolonged pronation
stresses MLA soft tisue
creates increased tibial IR --> increased functional knee valgus |
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Term
| over supinated foot leads to |
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Definition
decreased pronation and poor shock absorption
increased forefoot pressure
increased stress on proximal joint structures |
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Term
| Muscle action during gait |
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Definition
pretibial muscles fire at heel strike
calf muscles decelerate body motion
intrinsic muscles fire from midstance to toe off (aid in foot rigidity)
calf fires at heel off
pretibials fire again during swing to ensure toes clear ground |
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