Figure 2 . Calf raise ( bent leg ). Note strength and quality .
Assessing the kinetic chain The foot will usually follow the pelvis and femoral position during loading tasks such as hop , single leg and lunge type positions , hence identifying dysfunction is paramount . A pelvic drop in single leg stance – Trendelenburg sign ( Figure 4 ) - drives the femur into internal rotation and tibial rotation ,
Figure 3 . Jacks test . Note ability of the plantar fascia to wind up and lift arch .
and winds up the plantar fascia , asking more of energy storage and release . In the same manner a femoral anteversion is a normal anatomical variant that may produce increased load on the plantar fascia . The latter finding is harder to address but movements that encourage gluteus medius strength and co-contraction of the GOGO muscles
Figure 4 . Trendelenburg ( positive ) will drive lumbopelvic issues to the lower limb and foot
( piriformis , gemellus superior , gemellus inferior , quadratus femoris , obturator internus and obturator externus ) will offload the structures in the lower limb . Manual therapy is an ideal skill set dealing remotely with overactive soft tissues to restore function around the lumbo-pelvis region .
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