Members do not see these Ads. Sign Up.Lady 46 years old - Arthritis knees and wrists. hypothyroid (but doesn't admit to thyroxine) auto immune disorder unspecified - meds, sertraline and Rebeprazole (antacid)
She has plastic orthoses made by osteopath.
Complains of lateral column pain left
Only pain elicited in clinic is by pressure to distal end of 4th metatarsal. maybe slight pain to pressure plantar cuboid left.
left lateral column very stiff, mob and manip lateral column and cuboid complex = much improved compliance to dorsiflexion. She reports reduced pain on walking now.
in walking the left knee sometimes flexes excesively and prolonged thru stance phase - left foot toe in - with rectus foot and hallux adducted, suspect to resist pronation moments - foot pronates rapidly and early and appears to now bear weight thru medial column (NB did not view barefoot walk before mobs on left) NB both feet rectus.
Good ankle roms both - left foot has elevated 1st ray /mpj. good hip roms external and int roms. no LLD noted in stance or sitting.
both feet f/foot supinatus flexible right a little stiffer left, stiff 5th lateral column and midfoot roms both when stabilising STJ open chain. left had very medially rotated STJ axis with projection from mid lateral heel to distal shaft 1st Ray. right has central stj axis. heavy supination test both
AM3 pressure mat scan shows both have FncHL and left foot CoPP progresses very quickly to forefoot and lateral.
Take coach's eye vid walking in clinic - tends to keep left foot pronated thru swing - probs to avoid lateral instability and heel strike. Sometimes has foot drop and drags the hallux on floor.
Podotrack prints-
Temp till new orthoses - Add poron 1st ray ext to met toe sulcus to left.
Goto bespoke orthsoes - probs salts - maybe eva. plenty of volume in hi top shoes.
Query: See attached/linked vid and pic - she sometimes drag the left big toe thru swing phase - any ideas as to why? I'm thinking perhaps she adducts the hallux to increase supination moments by GRF from the ground and she also supinates the foot early in swing phase, probably to reduce lateral instability at heel strike. Both these action also tend to plantar flex the 1st ray and hallux and so sometimes it catches on the ground and the frictional force plantarflexes the hallux more. Also excessive knee flexion thru stance phase may not allow enough time for the CoM to get high enough or enough hip flexion for foot ground clearance.
https://www.coachseye.com/v/f23dac1ed3e347afacb7e334c8cc84f8
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Looking for the 1984 Green and Carol paper on Planal Dominance
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Advice plantar flexed first ray
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Looking for the 1984 Green and Carol paper on Planal Dominance
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Advice plantar flexed first ray
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