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The concept of the “closed Kinetic Chain” describes the important interrelation of the feet and lower extremities with the pelvis and spine. Altered foot function and structural imbalance can result in significant changes to gait and posture. These changes will inevitably impact the pelvis and spine, resulting in chronic spinal complaints and poor response to therapeutic care. An understanding of the gait cycle and an awareness of the pronation movements of the feet will help your therapist provide effective, quality patient care.
The gait cycle is divided onto the stance phase and swing phase. The stance phase (62% of the gait cycle) describes what happens to foot mechanics during weight-bearing. The swing phase is the non-weight-bearing part of the cycle (38%).
As therapists, we are concerned most with the stance phase, which can be divided into 3 periods:
Pronation during contact helps to absorb stock and compensate for walking surface irregularities. Supination then stiffens the foot for spring-off from mid-stance to propulsion.
Biomechanical problems due to hyperpronation are among the most common therapists see.
Excessive Pronation - Symptoms.
Flat feet Arch pain Bunions Neuromas Heel spurs
Medial rotation of patella - knee pain Anterior pelvic tilt - lower back symptoms (adjustments are not holding)
Heel of shoe wears off on lateral side
Functional scoliosis
Flared foot - walks with toes out
A runner with a size 10 shoe and 25 degrees of foot flare runs an extra 31.3 yards per mile due to the foot flare aspect of pronation. When the biomechanical fault is corrected, performance will improve!
Achilles tendon bowed inward - tendonitis
Hyperpronation is a coIIapse of the inside (medial) structure of the foot resulting in an outward (lateral) rotation of the foot's Iongitudinal axis.
This rotation to the Valgus Position causes a lateral shift in the point of impact on the patient's heel.
Support and control from a medial heel wedge are indicated to decrease the excessive tilt of the calcaneus (heel bone). Exercises to increase anterior tibialis, psoas, and abductor muscle strength will aid in the return of the foot to proper balance.
Therapeutic adjustments to correct pelvic and spinal subluxations and conscious effort by the patient to correct the gait also prove beneficial.
DIAGNOSIS – in 30 seconds
Step 1: Identify patients with a gait dysfunction
Step 2: Establish proper and effective treatment protocol
Step 3: Digital foot assessment using 3D BodyView* imaging Measurement-Based Analysis
Using highly precise and accurate 3D laser technology, the 3D BodyView takes
proprietary measurements to immediately highlight to the patient just how much their feet are impacting their gait, their problem, and their Kinetic Chain.
TREATMENT – in 30 seconds
Patients should be scanned or cast and Foot Levelers Orthotics ordered to correct the pronation problem.
You Might Expect Results This Dramatic to Take Weeks.