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Hi Colleagues,

Been stewing over this one for a while but need your collective opinion in this case.

I have a power-lifter who typically walks like a rugby prop, you know the one, excessively abducted feet, externally rotated lower limb, shortened stride length, glutei insufficiency and forward momentum lean when running or walking.

In lifting he wears lifting shoes with a significant heel raise to allow for a deeper squat depth.

His Osteopath asked my opinion as during his landing, his right leg which hold most of the weight lands wide and loads into valgus with the foot sitting abducted. We then looked at hos walking a running and noted excessive pronatory load through the foot landing abducted with the rotational torque progressing though the CKC. Thereby limiting Achilles/posterior calf stretch and contributing to posterior chain tightness.

This got me thinking, as the foot lands in an already abducted positioning, orthoses aren't as effective as I'd like as the load still progresses medially across the medial deviation of the STJ.

So in an instance, (and I guess at all instances) of an excessively abducted gait leading to pronatory rotation, would it be an issue of hip adduction strength, posterior chain stretching.

I guess I'm asking how do we encourage or allow the foot to initiate contact with the ground without being so abducted.

Just not sure where to start on this one, and the realisation that the weight-lifting requires this positioning as optimal but limiting when he's trying to run or play other sports.

Cheers - any thoughts or discussions appreciated.

 

That gait in weightlifters is not unusual --- just watch YouTube videos on the "world's strongest man" competitions and see them try and run!

The problem is most likely proximal in the hip. As he is good at weightlifting, then there is some normal variation in femoral neck alignment behind the gait and also behind him lifting well.

Have a read of some of these refs: https://duckduckgo.com/?q=why+people+squat+differently&t=braveed&ia=web

 

Cheers for that Craig!

 

I agree with Craig. Abducted gait can be from the available range of motion at the hip. If on the table, when you try an internally rotate the hip and at maximun internal rotation he is still external, there is no way he is going to get his knee, or foot straight ahead.

Does he have a foot problem? Is his only problem his "abnormal" gait. There are different ways to approach treatment of the foot. One way is to try to make the foot normal (whatever that means). Another way is to try to make the foot better than it is. Tissue stress approach.