The question of mid and forefoot stability is the key in these discussions.
If the STJ is supinated, as it should be at the push-off phase of gait,
then the longitudinal and oblique axes of the midfoot will be more
perpendicular, which stabilizes and plantarflexes the rays of the forefoot,
allowing the plantar fascia to function efficiently. Pronation of the STJ,
on the other hand, would make these axes more linear causing increased
shear of the rays, and dorsiflexing them, creating an inefficient pl.
fascia. It follows that anything that causes excess pronation, such as a
lateral forefoot post, would be detrimental to foot stability.
Martin Kidd.
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From: ashlini and daryl <[log in to unmask]>
To: [log in to unmask]
Subject: Re: taping for plantar fasciitis
Date: Friday, 17 March 2000 15:18
Douglas White, wrote:
>>Interesting discussion we have going here folks. Some thoughts.
I had not heard of posting on the lateral side of the foot to increase
plantar
flexion (PF). Seems counterintuitive. Most of the patients I see w/ plantar
fascitis have pes planus (dropped medial long. arch, excessive pronation in
weight bearing and during the gait cycle.) It would seem that putting those
patients into further plantar flexion would result in greater abnormal
mechanics. >>
The posting on the lateral side of the foot(at the forefoot) is suggested
to pronate(evert) the MTJ, not the STJ. So in the patients that you are
seeing with 'pes planus' it most logical that their forefoot would be
supinated(inverted) by ground reactive forces, caused by excessive
pronation. The taping procedure with pes planus is designed to prevent
excessive pronation(like a varus rearfoot wedge) by applying a supinatory
moment across the STJ axis. The additional forefoot valgus wedge is to
pronate the MTJ(not STJ).Therefore the foot is functioning as a more stable
unit. Simply adding a forefoot valgus wedge to the foot without applying a
supinatory rearfoot moment across the STJ axis(via tape) would most likely
create further abnormality in mechanics.
Cheers
Daryl
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