Hi,
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I am a podiatry student and have a few questions re: a 10 y.o male patient I had.
He visited the clinic with his mother because she had noticed that lately he was walking flat footed and seemed a little more uncoordinated than othe kids in his sporting teams. He also seemed to tire more after activity than others although the child himself hadn't noticed this.
Measurements showed his Rfoot was pronated beyond normal values (RCSP= 8ev in the left and 2ev in the right) but my tutor thought the excessive pronation was coming from else where.
She performed a Jacks test (Hubscher maneuver) and found his arch height did not increase in either foot.
She also placed her hands on the childs hips and roted him to the right and then left while he kept his feet planted on the ground. She instructed me to check his MLA while she did this. The arch barely increased in height.
My tutor seemed to expect this and told me that the pronation was coming from post tib. and tib ant. insufficiency.
*** Is there anyone who can explain to me the mechanics of how these tests helped her come to this diagnosis?? ***
- Is it becasue by externally rotating the femur (and hence tibia) this should engage tib ant and post tib to pull the put up off the ground and into supination?
- Also, does peroneus longus play a part in any of this? Perhaps this may be overpowering tib ant.??
Thanks for any help!
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