ASSESSING THE RUNNER IN THE CLI NIC

Scientific considerations in developing a clinically meaningful biomechanical profile

Chris Bishop, University of South Australia
1. Understand the plane of movement is more important than understanding pronation
2. Whats the purpose:
Joint/muscle injury are due to forces, load and impact rather than the foot position
Joint moves according to the load and direction of forces
3. Take home messages
Slight varus in our leg(foot?) from double limb support to single limb support
COG should sit slightly anterior to S2, not moving our body out of COM This is contributed by the pelvic structures
Heel/foot strike at last 20% of swing is not dictated solely by foot structure. A person with rectus or supinated foot
type may act as an over pronator due to the lack of lproximal (hip) muscles strengths and control
4. What controls gait
Top down, and bottom up (load) approach
Cricket player with hyperextension leg at bowling, no shock attenuation capability : 9x body weight on their limb
hence more lower back injury L4,L5. Advise the player to reduce extension by 5%, allow increase shock absorption
capability reduce 9x bw to 4x
5. Key considerations : need to work out whether the foot is affecting the hip, or is the hip is affecting the foot, or both?
6. Single limb squat
Bisection to align GVF to COM, instead of angling it towardsor award from midline
Gluts and piriformis strength exercise for rehab : allow easier control of lower limbs
SLS should be used more
Watch out for pelvis level : dropping the pelvis to the same level moves COM towards midline
7. Star excursion test??
8. Teen girls with anterior knee pain
Pelvis widening without increase strength of hip muscles
9. Biomechanical profile of the runner
10. Footwear
Marathon runner wears minimalist shoes increase efficiency
When we w/b there is a medial and lateral displacement of the heel fat pad. Hence heel fitting is very important, if
there is not enough room how can expansion occurs
Hallux kinematics : Limit hallux dorsiflexion, increase ankle plantarflexion
11. Orthotics
12. Taping
Increase proprioception