Dear All

Sorry if I got where Dr. Nester came from. I thought we lived in the
global village.

The statements I made regarding what he found and what you refute
reagrding the calcaneous and cuboid was not that was discussed by several
of us at lunch after the paper was presented.

The four of us thought he said what I wrote.

I believe that the cuboid and calcaneous are not part of the foot motion
after heel strike during motion in a gravity field, they are for standing
upon.

Regarding my statement regarding the biceps femoris.

There is no written paper yet. I have been working on this for a period of
several years.

I have had several discussions with Professors of Anatomy regarding this.
Professor Bogduk from Newcastle University (Australia) agrees with me.

When a fibula is mobile at both joints (VIP)
at the superior joint will translate in the sagittal plane about 3 to 5
mm. In some individuals over 1cm motion is available to them.

In the superior/inferior (right angles to ground) it will translate on
average 5mm.

The inferior pole is connected the lateral calcaneous via the External
Lateral Ligament's middle fascicle.

This fascicle runs from the tip of the fibula in a posterior direction to
the middle of the os calcaneous.

The anterior fascicle of the External Lateral Ligament travels from the
inferoanterior margin of the fibula to the talus (in an anterior
direction) to attach just infront of the talus.

The final fascicle the posterior fascicle runs from the inner side of the
tip of the lateral malleolus to the talus and attaches just behind the
facet joint.

Now, some time ago I was rehabbing an athletes biceps femoris using a TEMS
(trans epidermal electrical stimulator) so as to induce muscle recruiting
as well as coordinated contraction when the muscle was unloaded prior to
the athlete performing antigravity exercises, that is loading the muscle.

This particular athlete has the biggest hamstrings that I or any other
athlete have seen. he is 6 foot 3inches, is 98Kg and has a sixpack. There
is no fat on him he, like many others is a freak of nature.

While working with him I noted his ankle would evert slightly on
occassions when there was a large electrical stimulus given to the muscle.
I was concerned that he had turned to machine up (as athletes do) and was
now activating the peroneal muscles.

This was not the case.

I then inverted his foot while he was in the supine position and at each
pulse there was an eversion moment made at the calcaneous.

I havew repeated this many times, including on myself as I write this.

Thus with the fibula head moving cephalward with the biceps contraction
and knowing my anatomy I started to put 2 and 2 together.

I believe the fibulas cephalard motion is to:
- evert the heel and
- pull the talus medially and posteriorly so as to keep the medial foot
from locking so as to allow the walking/etc. foot to adapt to the terrain
and this is finalised just before total tibial weight is placed upon the
talus when the talus is then promoted in a screwlike fashion (eg. right
foot anticlockwise). Just after total weight on the talus the
sustentaculum tali causes the breaking of the standing foot and the
locking of the walking/etc. foot is permitted and thus forces (propulsion
forces; ground reaction forces; etc.) are directed towards the base of the
great toe so as the FLH can do its job.

Since that time I have yet to see an injured biceps that did not have an
immobile fibula/calcaneous/talus attached at the other end.

As my late mother used to say, "if you have a peice of string a foot long
and tie a knot in it, it will be short at one end!". She was not wrong.

I am certain that if the fibula was a tendon we would have all come to
this conclusion many a century ago. To me the fibula is just a calcified
tendon.

Another role for the fibila is via the interosseous membrane. When it
moves cephalwards (should) it changes the orientation of the fibres of the
tib posterior and the others in the calf.

The aim of this is to stop a sheering motion at their attachment. There is
some interesting work being done in NZ regarding where tears/injuries
occur when the muscle fibres are not correctly orientated during loading
both eccentric and concentric.

Again I see posterior tibial muscle problems in individuals who have
fibula motion problems. To me they go hand in hand.

This is a brief oversight of how I think the foot works are studying it
for over 16 years.

Thanks for reading.
Regards,

Paul Conneely www.musmed.com.au

-----------------------------------------------------------------
This message was distributed by the Podiatry JISCmail list server

All opinions and assertions contained in this message are those of
the original author. The listowner(s) and the JISCmail service take
no responsibility for the content.

to leave the Podiatry email list send a message containing the text
leave podiatry
to [log in to unmask]

Please visit http://www.jiscmail.ac.uk for any further information
-----------------------------------------------------------------