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Rocker sole influence on hallux and first metatarsal kinematics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Petcu Daniel, Jul 9, 2012.

  1. Petcu Daniel

    Petcu Daniel Active Member


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    Hi,

    Do you know any article studying the influence of the rocker sole on hallux and first metatarsal kinematics ? I would like to see how useful could be a rocker sole in the case of functional hallux limitus !
    Thank you in advance,

    Daniel
     
  2. Bill Bird

    Bill Bird Active Member

    Hi Daniel.
    I have an English translation of Der Orthopädische Schuh - Indikation und Rezeptur Munzenberg K.J , Bonn F R Germany 1983. There is a number of articles on Rocker bottoms and Hallux rigidus. There are no studies of the influence, the book takes it as a given. There can be problems around Hallux Limitus caused by the Windlass effect which can be made worse by a rocker. The book does not mention that. If you would like to see some of the pages from the book, I can scan them for you.
     
  3. efuller

    efuller MVP

    I know of several looking at pressure on the hallux and met head, but that's not kinematics. Why are you interested in kinematics? Most rocker soled shoes are relatively rigid and if there is an upper with laces over cunieforms then it will be pretty hard to get much motion of the 1st MPJ. Speaking from experience, with my functional limitus and structural limitus a rocker sole does help it feel better.

    Eric
     
  4. efuller

    efuller MVP

    Yes, the toe doen't dorsiflex, but is that a problem? What problems are you referring to?

    Eric
     
  5. Bill Bird

    Bill Bird Active Member

    Hi Eric.
    The straight forward solution is to raise the whole of the foot under the shoe by lifting the heel height by the same amount as the height of the rocker. This lets the distal hallux drop down in front of the rocker so it does't have to bend. This is particularly useful for Hallux Rigidus where there is no movement. It is also a very economical solution, but visible to other people which the wearer may want to avoid.

    Hallux Limitus, is where there is insufficient dorsiflexion of the Hallux at heel lift to allow the foot to bend without causing pain in the 1st MPJ, often forcing dorsiflexion of the distal phalange and causing hard tissue build-up under the distal Hallux. There can be many reasons for this but one of them is that the medial band of the Plantar Facia, which insert into the base of the proximal phalange of the Hallux can be tight and prevent the hallux dorsiflexing unless the 1st MPJ is allowed to plantarflex during heel lift. This is called the Windlass Effect as described by Hick at La Trobe in 1954. The rocker does the opposite by preventing the plantarflexion because it is right underneath the MPJs.
    I think I see where you are coming from Eric and you are right to ask, is that a problem? The rocker will deal with the problem. However, I think if the Limitus can be eliminated by allowing the 1st MPJ to plantarfelx by using an insert that raises the 2,3,4 met heads but allows the 1 met head to bend down into a well sink, it would be a simpler solution and less visible.
     
    Last edited: Jul 9, 2012
  6. Petcu Daniel

    Petcu Daniel Active Member

    As the rocker soles is limiting the need for sagittal plane motion, I 'm supposing this kind of profiles doesn't act in order to facilitate the proper functioning of the foot mechanisms in order to treat in a functional way the Fhl.. Depending on the rocker parameters, it will eliminate more or less, the possibility for the blockade of hallux to appear. In this case, the functional tasks of foot orthoses [designed for Fhl] are not canceled by the rocker ?

    In "The influence of two different types of foot orthoses on first metatarsophalangeal joint kinematics during gait in a single subject" , http://www.ncbi.nlm.nih.gov/pubmed/16396732 , the authors are analyzing kinematically the hallux-metatarsal coupling using only orthoses - without footwear. It is interesting for me to see in which measure the rocker act against the functional role of orthoses in the case of Fhl.

    Daniel
     
    Last edited: Jul 10, 2012
  7. efuller

    efuller MVP


    Not necessarily. The orthotic can reduce tension in the fascia inside of a rigid shoe that does not allow the hallux to dorsiflex. In some feet, in static stance the plantar fascia can be quite taught with the hallux parallel to the ground. The hallux does not have to dorsiflex to make the windlass "hold up the arch." A rocker bottom shoe can be used in conjunction with an additive effect in relieving 1st MPJ pathology.

    Eric
     
  8. pgcarter

    pgcarter Well-Known Member

    Hi Eric,
    What are we teaching our plantar fascia?.......I think the word that means tight rather than teachable has a different spelling? unless eye merember impropply?
    Happy to be corrected if necessary
    regards Phill
     
  9. efuller

    efuller MVP

    Physics I know, spelling not so much.
     
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