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Midtarsal Joint thinking 2015

Discussion in 'Biomechanics, Sports and Foot orthoses' started by mike weber, Jan 7, 2015.


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    Much of the early part of 2015 has been focused on Root especially the Midtarsal joint. And in the The Root Postulate - Part I Kevin suggested the work of Nester to the opening post by Daryl. In this paper - Scientific approach to the axis of rotation at the midtarsal joint.

    I suggested that the concept of a Midtarsal joint, maybe better if we consider postion and rotation of the two bones Navicular and Cuboid against the bones of the subtalar joint

    Ie the Calcaneo-cuboid Joint and the Talo-Navicular Joint

    Simon had this to say a little further on

    we of course have the 2 axis concept of Root et al OMTJA/LMTJA

    The function of the midtarsal joint anyone have a copy of this?

    from the outside looking in the gap between so called Podiatric biomechancis and Biomechancis of the human seems to be at it´s most distant around this joint.

    This probably ties in with the Postulate thread Part 1 and 2 but maybe not.

    So I guess the question if you were a teacher what would you teach and how?
     
  2. FWIW I would discuss Root as I understand it and then introduce The ideas of nester x,y and z axis but would focus on rotational equilibrium at the Calcaneo-cuboid Joint and the Talo-Navicular Joint as a way to model the 2 bones which make up the tradional Midtarsal joint.

    All joints have axis we know there is motion between the Cuboid and the Navicular, is seems the most scientific and right approach to me

    Comments ?
     
  3. Griff

    Griff Moderator

    Hi Mike

    Here's a link to one of my dropbox folders: The Midtarsal Joint

    You'll find key papers there

    IG
     
  4. To answer your question Mike, I present an historical perspective up to the present day, identifying the strengths and weaknesses as we go. I generally employ the X, Y, Z reference axes in further discussions of foot orthoses effects and rotational equilibrium since I have found this to be the most appropriate model for use with the post-graduate students that I generally work with.
     
  5. I agree the need to be fluid in thinking.

    and we had a great discussion using the x,y, z axis of Nester a year or so ago, I always however have this nagging issue with it, how do you explain the motion at the Cuboid-Navicular interface
     
  6. If we employ an X, Y, Z model we don't need to worry too much because it is the resultant motion across all of the joints we are thinking about. Check your inbox.
     
  7. Dennis Kiper

    Dennis Kiper Well-Known Member

    Moreover, can anyone tell me why stability might be desirable in a dynamic moving structure

    What an odd question. Considering the multitude of axis' that the foot works around, it should be reasonable to think that stability in a dynamic structure produces the least amount of motion around each axis , thus the least amount of joint and soft tissue motion as well. Stability has to be absorbed from the entire structure, just like an earthquake proof bldg.

    This equates to greater efficiency and performance of the structure and tissues. A chain is only as strong as its weakest link. Instability in one segment perpetuates instability and a breakdown of the other segments, which leads to inefficiency and lesser performance of the structure and soft tissues.

    Instability leads to a greater biomechanical wear and tear and inflammation throughout the lower extremity.
     
  8. HansMassage

    HansMassage Active Member

    I find the stiffness and flexibility to be a continuum.
    Those with flexible upper bodies generally have flexible ankles to accommodate the variations of the line of gravity they put on the foot.
    Those with inflexible upper bodies tend to have ankles resistant to motion in certain plains to accommodate the repetitive stress that they put on the ankle due to a chronic posture fixation.

    If the posture can not be improved then support the foot to take the repetitive stress.
     
  9. Orthican

    Orthican Active Member

    Just the silly orthotist thinking here but to me stability in the foot is an instantanous one.
    A dynamic structure like the foot has stability when it needs it as our nervous system would allow via feedback relative to position and pressure etc. So therefore there is no one stable position but in fact many depending on the demands placed upon it by the user. I have never looked at the foot as having one true position of stability but see it as a flexible structure that stiffens as needed depending on applied load and motion that the person needs when moving around.
     
  10. Dennis Kiper

    Dennis Kiper Well-Known Member

    I find the stiffness and flexibility to be a continuum.
    Those with flexible upper bodies generally have flexible ankles to accommodate the variations of the line of gravity they put on the foot.
    Those with inflexible upper bodies tend to have ankles resistant to motion in certain plains to accommodate the repetitive stress that they put on the ankle due to a chronic posture fixation.

    If the posture can not be improved then support the foot to take the repetitive stress.


    Hans,

    I tend to disagree with you, I don't correlate flexibility or inflexibility in the upper body with the flexibility of the foot. That said, It doesn't matter. The issue of the MTJ is supporting it in a matter that places it in dynamic ability to move comfortably and efficiently. While many pts will initially feel comfortable in a traditional orthtic, it is the inefficiency of the platform which eventually either becomes uncomfortable or even painful to the point of causing pain in the foot or an associated biomechanical segment. This indicates to me that this is not a good fitting orthotic.




    Todd

    Just the silly orthotist thinking here but to me stability in the foot is an instantanous one.

    While muscles engage to the kinetic motion, it is the ROM of the whole foot structure structure which allows for the shock absorbency of the gait cycle. Stability in my opinion is not instantaneous, because the muscles and soft tissue alone cannot hold the structure stable, that's how I understand why we naturally pronate to the end of ROM. The problem as I see it is that stability has to be throughout the structure or it's not working well enough. This is the problem I have with traditional orthotic technology. It simply does not do an effective enough job.
    Supoorting one segment of the foot well only reduces overpronation/biomechanical effects minimally.

    there is no one stable position but in fact many

    I agree, every segment and every joint within must be as stable as possible with the least amount of motion. Only an orthotic can minimize this articular motion. But it must effectively minimize every joint and segment. The more congruent the joint, the least amount of deviation of the joint axis during movement, the less the subluxation of the MTJ and it biomechanical effect on itself up through L5-S1

    see it as a flexible structure that stiffens as needed depending on applied load and motion that the person needs when moving around.

    I agree the foot stiffens under different aplliued loads, and if the available flexibility is not, minimized to its maximum capacity of reduced motion, you don't have maximum stability.
     
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