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Pronation: is the impact absorption phase of gait.
We either pronate too much, not enough or just right.
As weight is transferred from the outside of the foot to the inside of the foot, the leg internally rotates. As weight shifts from inside to out, external rotation of the leg occurs.
P. Longus
P. Brevis
P. Tertius
Ext. Digitorum Longus
Ext. Hallucis Longus
Tib. Anterior
Tib. Posterior
Flex. Digitorum Longus
Flex. Hallucis LongusAchilles
Tendon
Pressure in comp.
Volume demands in Compartment.
Compromise of capillary profusion.
Muscle swells and dumps fluid.
Muscles are attempting in work in a hypoxic environment. Not only is this difficult, it is painful and muscles continue to swell in a hypoxic environment.
Sensory deprivation to plantar foot.
Pain on palpation middle to lower third of postero-medial tibia.
Deep Posterior
It is not how high the pressure is during running; it is how long it takes to return to normal.
20
Ideal
Bad
Insertion
GENERAL TREATMENT GUIDELINES
Stretching, gradual motion before activity.
Icing after activity.
Stretching, stretching
Modification of activity
PERIOSTITIS: an inflammation of the outer covering of the bone.
FASCIITIS: and inflammation of the fascial covering of the muscle.
Shin Splints and M.T.S.S…..History of excessive weight bearing (jumping,running, or standing for prolonged periods of time, in combination with improper shoes.
Shin Splints and M.T.S.S.
Associated with varus alignment (bowlegs) of the lower extremity and excessive pronation. Improper footwear may be a factor.
SHIN SPLINTSTibialis Posterior is eccentrically working to slow down the internal rotation of the leg on the foot during pronation of the foot. Muscle thought to pull away from bone.
MEDIAL TIBIAL STRESS SYNDROME
Soleus muscle slows down the internal rotation of the tibia on the foot during pronation. Pain in lower medial third.
Grade III
Pain and stiffness before activity.
Pain limits quality and quantity of activity.
Very painful after.
Stretching of Achilles.
Squeezing lump out of tendon.
Curtail injurious activity and substitute other fitness activities.
Heel lifts in shoes.
Achilles ParatenonitisIrritation of the paratenon.
Caused by overuse.
Rubbing of paratenon on the achilles tendon.
Pain, crepitation.
STOP! Icing, stretching.
Ruptured Achilles Tendon
Tear 1” above heel or at musculotendinous junction.
Palpate for gaps.
Manually test for strength.
Have athlete do single leg toe raise.
Impact absorbed by shoe, muscles, bones (joints).
Too strong of a muscle pull on
one sideof the bone
ACTIVITY PAIN
s.p.
Pain at onset, reduced on warm-up, after pain
c.s. Pain escalates as activity continues.
s.f. Pain before activity, same during and the same after.
REPEATED MUSCLE CONTRACTIONS
s.p. No effect.
c.s. Cause a slowing and a weakening of contraction (x10)
s.f. No effect.
SENSORY CHANGES
s.p. No Changes.
c.s Potential changes corresponding to compartment.
s.f. No Change.
MUSCLE STRETCH
s.p. No change.
c.s. Stretching a muscle within the affected compart. will increase pain.
s.f. No change.