INFLUENCE OF FOOT POSTURE ON THE FUNCTIONING OF THE WINDLASS MECHANISM
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Rachel Lucas, Mark Cornwall
The Foot; Article in Press
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They also raise an important point of th etest - they note that this is currently often used to assess functional hallux limitus rather than per se windlass and perhaps the latter is a more valid use as we know this test is not reflective of dynamic 1st MTPJ motion
(Halstead & Redmond, J Orthop Sports Phys Ther, 2006). We generally use the test as one of our evaluations for the effect of our orthoses albeit a static test.-
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Last edited by a moderator: Jan 18, 2017
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Three-dimensional variations in the lower limb caused by the windlass mechanism.
Manfredi-Márquez MJ, Tovaruela-Carrión N, Távara-Vidalón P, Domínguez-Maldonado G, Fernández-Seguín LM, Ramos-Ortega J. (2017)
PeerJ 5:e4103 https://doi.org/10.7717/peerj.4103
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If Simon Spooner was here he might be writing something about windlass does not just occur at the 1st.
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Trevor,
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The Influence of the Windlass Mechanism on Foot Joint Coupling
Lauren Rose Williams
Thesis; Brigham Young University 2021
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Foot arch rigidity in walking: In vivo evidence for the contribution of metatarsophalangeal joint dorsiflexion
Daniel J Davis, John H Challis
PLoS One. 2022 Sep 8;17(9):e0274141
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Study of Windlass Mechanism in the Lower Limb Using Inertial Sensors
María José Manfredi-Márquez et al
Int. J. Environ. Res. Public Health 2023, 20(4), 3220; https://doi.org/10.3390/ijerph20043220
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Three-Dimensional Analysis of the Windlass Mechanism Using Weightbearing Computed Tomography in Healthy Volunteers
Takumi Kihara et al
Foot Ankle Int. 2023 Mar 24
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I will also use a lateral forefoot post but with different reasoning. The Kogler study showed that there is decrease in tension in the plantar fascia with a lateral post. My theory is that you prevent overload of the medial slip of the plantar fascia by distributing the load over wider area. It is interesting to see to different theories come up with the same treatment plan.
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Hey Eric. Im not familiar with "The Kogler study" I will have a look.
"I'm not sure what you are thinking in terms of what the peroneus longus does. I've had a paper in the works, for over 10 years on peroneus longus function. Tension in t the tendon will create different actions depending on where the STJ axis is. Only in the most lateral STJ axis position does the peroneus longus crate supination of the STJ. With a medial axis the peroneus longus causes late stance phase pronation"
- I theorised that the incidence of 1st met head ulceration in patients with a laterally deviated STJ was driven by strong peroneus longus activity plantarflexing 1st met, which in combination with large amounts of tension in the medial slip of plantar fascia due to elevated medial arch/calc inversion, reduces saggital plane motion through the 1st MPJ and increases transverse plane movement as the leg externally rotates. These ulcers (almost) always present as sheer type pressure areas prior to deteriorating. I find lateral posting stops re-ulceration but over time also (entirely subjectively) seems to improve the plantarflexion of 1st ray as though the contracture is resolving.
You mentioned that in lateral deviation peroneus longus can cause supination. Therefore will the lateral posting still be achieving the desired effect of increasing pronation by shortening the muscle belly and reducing its contribution to further supination? I tend to find things that work but then as I try to find out why I discover it is for entirely different reasons ♂️
Also in medially deviated STJs with forefoot supinatus contracture, for which I would post lateral to forefoot and medial to rearfoot. Is elevating the lateral column really doing anything to transfer pressure medially/evert the forefoot. Or is the success in this treatment approach driven by reducing late stance pronation and therefore improving functionality as a whole.
Any time frame for your paper on p.longus as I think it would go a long way to answering a lot of my confusion. Cheers -
The increased pronation moment, would create less need for peroneal activiation.
You do have to know the exceptions to the rule. A medially deviated STJ axis foot may not have enough eversion range of motion available to get significant load on the medial forefoot in static stance. (You may see medial roll off in late stance) These feet should not have a lateral forefoot post. This is why I like the maximum eversion height measurement. If they can't lift their lateral forefoot off of the ground then you should not add a forefoot valgus wedge.
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Eric.
That's given me a good deal to think about. I'll go do some further reading.
Appreciate you -
Evaluation of the relationship between truss/windlass mechanisms and foot stiffness while walking
Daiki Yamagiwa et al
Journal of Bodywork and Movement Therapies; Volume 37, January 2024, Pages 265-270
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Analysis of windlass mechanism according to
one walking cycle
Takashi Shiroshita
J. Phys. Ther. Sci. 36: 155–160, 2024
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Minimising risk of injury and illness in youth runners
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Management of plantar heel pain: a best practice guide
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