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"Trick" Questions for new Physio grads

Discussion in 'Biomechanics, Sports and Foot orthoses' started by canuckfeet, Nov 22, 2013.

  1. canuckfeet

    canuckfeet Member


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    Hi all,

    I will be delivering a presentation to a small group of recent MSc. Physiotherapy grads next week and I'm looking for some "trick" questions to ask them. My goal with these "trick" questions is to generate some discussion and "out of the box" thinking.

    An example that comes to mind is the one about tibialis anterior function: Is it an inverter or an everter? Can anyone offer up any similarly stimulating questions?

    Thanks in advance!
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Is tibialis anterior an inverter or everter of the foot?
     
  3. canuckfeet

    canuckfeet Member

    It's a good one to ask, right?
     
  4. Lab Guy

    Lab Guy Well-Known Member

    If it's a small group maybe you make it a workshop. Have them do the Supination Resistance test, Jack's test, Maximum Pronation test and Single Heel Raise test on each other. Find out what their level of understanding and then discuss to extend their level of understanding.

    Find a person with pes planus and another with pes cavus. Discuss the difference, show how the Supination Resistance test and Jacks test is usually easier on the cavus foot and explain why. Discuss STJ axis location differences with these two foot types. Have them open a door close to the hinges verses the door knob to understand how much more force a tendon is exerting when the moment arm is short (opening door close to hinges/axis of rotation. Have them practice the Maximum Eversion Test and discuss it.

    Go through the main points of gait analysis and what to look for. We all like to learn while getting hands on experience to bring forth greater understanding. You don't need trick questions. Good luck with it.

    Steven
     
  5. Rob Kidd

    Rob Kidd Well-Known Member

    I am not sure what your objective is here, but trick questions, IMHO, are rarely a good strategy. Tib ant is a mild invertor, unless you can show me differently. Rob
     
  6. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Tib ant can be an everter if its insertion is lateral to a more medial STJ axis --- thats why I use it as a "trick" question --> stimulate thinking and discussion about the impacts of anatomical variability.
     
  7. Rob Kidd

    Rob Kidd Well-Known Member

    To clever for me. That would have to be a VERY medially deviated axis. And that begs the question - was it always like that - or did pathomechanics make it so.....?
     
  8. wdd

    wdd Well-Known Member

    So you-ve got a lever arm, a fulcrum, a force and a direction and time, etc of application of the force.
    Personally I'd want to be focusing on the effects that variations of the above elements could have on function and highlight it with examples including hands on.

    Bill
     
  9. Rob Kidd

    Rob Kidd Well-Known Member

    The point I am making is that typically, TA is a mild invertor. If on occassions, this is not the case as a result of an abberant ST axis, is this cause, or effect? That is, has pathomechanics caused the abnormal axis, and thus the abnormal TA action? We are quick to forget Wolf
     
  10. The anterior tibial (AT) muscle action is dependent on its location relative to the subtalar joint (STJ) axis. If the AT is medial to the STJ axis, then the muscle will exert a STJ supination moment. If the AT is lateral to the STJ axis, then the muscle will exert a STJ pronation moment. While not common, I routinely see patients where the AT can easily exert a STJ pronation moment since their STJ axes are significantly medially deviated.

    Therefore, the AT muscle can be either a supinator or pronator, depending on the STJ axis location. That is the reality of the variability of the human foot.
     
  11. RobinP

    RobinP Well-Known Member

    I have seen a number of patients with STJ statically more medially rotated than the Tib Ant insertion. Tends to be even more so dynamically

    I always find an interesting question, especially to physios, depending on their biomech knowledge is to define overpronation(a term I never use except to argue against the very usage of the word

    Good info here for the grads http://content.yudu.com/A1w1fo/32DY...Url=http://www.sportspodiatryinfo.co.uk/blog/
     
  12. Rob Kidd

    Rob Kidd Well-Known Member

    But as I said earlier - but the world has shied away from it: cause or effect? RE: Wolf. Is pathomechanics caused by the abnormal (medially deviated) s/t axis, or is it the cause of the abnormal function. Wolf is insidious, life long, and happens of a timescale that most people would not recognise. We did some work years ago on the IT tract and hip prosthetics with regard to how they potentially migrated out of the femoral shaft. But that was years ago. Rob
     
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