Download Common Biomechanical Abnormalities

The Sports
Injuries
&
Fitness
Clinic
The Sports Injuries & Fitness Clinic
Common
Biomechanical
Abnormalities
Strength
Exercises
Part 1
And Their Associated Lower Limb Injuries
Produced by Paul A. McKenzie Dip. FTST, Dip. FN, MFHT
www.thesportsinjuries-fitnessclinic.co.uk
Email: [email protected]
Mobile: 07768 660077
v 1.1
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This is a list of Common Biomechanical Abnormalities (in bold) and the injuries that they can
give rise to. I have provided very basic information on each one on the following pages.
1. Over pronation
Sesamoiditis, Plantar fasciitis, Achilles tendinopathy, Medial shin splints, Patellar tendinopathy,
Patellofemoral pain, Metatarsal stress fracture, Navicular stress fracture, Fibular stress fracture
2. Abducted gait
Sesamoiditis, Plantar fasciitis, Medial shin splints, Patellofemoral pain,
3. Limited first ray range of motion
Sesamoiditis
4. Forefoot valgus
Sesamoiditis,
5. Plantarflexed first ray
Sesamoiditis,
6. Pes cavus
Plantar fasciitis
7. Ankle equinus
Plantar fasciitis, Achilles tendinopathy, Medial shin splints, Hamstring strain, Navicular stress
fracture
8. Pronated foot at toe off
Peroneal tendinopathy
9. Over supination
Metatarsal stress fracture, Fibular stress fracture
10.Varus alignment
Medial shin splints, Patellar tendinopathy, Patellofemoral pain, ITB syndrome, Navicular stress
fracture, Fibular stress fracture
11.Tight quadriceps
Patellar tendinopathy
12.Tight hamstrings
Patellar tendinopathy
13.Tight calves
Patellar tendinopathy
14.Anterior pelvic tilt
Patellar tendinopathy, Patellofemoral pain, Hamstring strain
15.Lateral pelvic tilt
ITB syndrome
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Common Biomechanical Abnormalities
This is a brief overview of each of the abnormalities.
1.
Over pronation: a flattening of the medial arch of the foot and rolling in of the ankle so as to turn the
sole of the foot outwards.
2.
Abducted gait: a walking / running stance wider than optimal (with an increased base of gait).
3.
Limited first ray range of motion: restricted dorsi flexion of the big toe and 1st metatarsal.
4.
Forefoot valgus: an abnormal position of the forefoot towards the little toe
5.
Plantarflexed first ray: a position in which the big toe and the 1st metatarsal point slightly
downwards.
6.
Pes cavus: a high medial foot arch.
7.
Ankle equinus: limited dorsi flexion of the ankle in the region of less than 10 - 20°.
8.
Pronated foot at toe off: a position during running / walking in which the sole of the foot is turned
outwards as the big toe start to leave the floor.
9.
Over supination: an excessive lifting of the medial arch of the foot and rolling out of the ankle so as
to turn the sole of the foot inwards.
10.
Varus alignment: a bow legged stance.
11.
Tight quadriceps: shortening of the muscles at the front of the upper leg resulting in limited or
inhibited knee flexion and hip extension and a probable anterior pelvic tilt and increased compression
under the patellar (knee cap).
12.
Tight hamstrings: shortening of the muscles at the back of the thigh resulting in limited or inhibited
knee extension and hip flexion and a probable posterior pelvic tilt.
13.
Tight calves: shortening of the muscles at the back of the lower leg (gastrocnemius & soleus)
resulting in limited or inhibited dorsi flexion and knee extension.
14.
Anterior pelvic tilt: a rolling forward of the pelvis that increased the curvature in the lower back that
is often caused by tight hip flexors and lower back muscles and weak lower abdominals and
hamstrings.
15.
Lateral pelvic tilt: a position in which the pelvis is not level when viewed from the front or back and
this can be the result of a weak or overactive adductor, gluteus medius or quadratus lumborum (in the
lower back).
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Associated Lower Limb Injuries
This is a brief overview of the associated injuries.
Sesamoiditis: inflammation of the small bones under the base of the big toe. Pain is usually felt during toe
off in running resulting in weight being transferred to the outer edge of the foot to avoid pain.
Plantar fasciitis: inflammation and pain in the fascia in the sole of the foot and heel. Pain is often felt first
thing in the morning and on excessive loading of the plantar fascia (running, jumping, hoping etc).
Achilles tendinopathy: any pathology of the Achilles tendon e.g. tendonitis (inflammation) and tendinosis
(collagen disarray and degeneration).
Medial shin splints: pain and inflammation along the medial border of the tibia often as a result of over use
of the tibialis posterior muscle through e.g. overpronation.
Patellar tendinopathy: any pathology of the patellar tendon e.g. tendonitis (inflammation) and tendinosis
(collagen disarray and degeneration).
Patellofemoral pain: pain behind the patellar (knee cap) which is generally the result of mistracking of the
patellar for various reasons e.g. over pronation, tight quadriceps, tight hamstrings and an increased Q angle.
Metatarsal stress fracture: pain as a result of a hair line fracture in any of the mid foot bones.
Navicular stress fracture: hair line fracture of the navicular bone just beyond the medial malleolus (inner
ankle bone).
Fibular stress fracture: hair line fracture of the outer most of the two lower leg bones often as a result of
excessive traction forces developed by the muscles attached to it.
Peroneal tendinopathy: any pathology of the peroneal muscles along the outside of the lower leg e.g.
tendonitis (inflammation) and tendinosis (collagen disarray and degeneration).
ITB syndrome: pain on the outside of the knee where the distal iliotibial band rubs on the lateral femoral
condyle due to misalignment of the knee joint or tightness in the ITB.
Hamstring strain: over stretching / tearing (to varying degrees) of the muscles fibre in the hamstrings at the
back of the upper leg.
The Kinetic Chain
Movement is a relationship between the various joints (links) in the body and optimal movement occurs
when these links function smoothly and pain free, however a fault in any one link or part of the chain can
lead to misalignment and pain elsewhere so while the common biomechanical abnormalities highlighted
have local affects (affects on the lower limb) they also have remote effects i.e. elsewhere in the body. A
simple example being an over pronated foot. Over pronation is the excessive lowering of the medial arch of
the foot during the stance phase of gait. The ankle roles inwards, the forefoot abducts and dorsiflexes while
the rear foot everts. This causes the tibia to internally rotate. This in turn pulls the femur into internal
rotation. This internal rotation pulls the pelvis into an anterior pelvic tilt which shortens the hip flexors and
thus lengthens and inhibits the hip extensors. It also shortens the lumbar muscles, puts tension through the
thoracolumbar fascia thus causing the latissimus dorsi to become shortened. Because this muscle has
attachments at the scapula and humerus, the scapula becomes misaligned due to a change in the length
tension relationship of the latissimus dorsi and the shoulder joint becomes unstable, weak and painful.
So you see a biomechanical fault in your foot can cause pain in your shoulder and / or decrease the
efficiency of your shoulder girdle / joint. The solution in this scenario is to correct the faulty foot
biomechanics rather than to look to the shoulder for the answer.
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