OPTIMAL CORE ALIGNMENT WOCN Regional Conference 2015

SPEEDING RECOVERY through IMPROVING MOVEMENT Melanie Carlone,DPT, MS, RYT Custom Orthotic SolutIons, Inc.

LEARNING OBJECTIVES: 1. Principles of Optimal Core Alignment and physiological effects on wound healing

Optimal Core Alignment ~unites feet body and gravity

Alignment means better movement

Better movement promotes healing

Best Healing Possible is supported by Optimal fluid return from the lower extremities…

Venous Foot Pump Mechanism 25 mL of blood ~Each step ~Healthy gait

Alignment Foot Core Body Core

And Active client participation in the healing journey increases compliance

LEARNING OBJECTIVES: 2. Consider when internal and external forms of support are most useful

Internal Support Empowers Clients

Active Client Participation Negativity Bias is real seconds of TAKING IN THE GOOD overcomes bias and hardwires change R. Hanson, PhD, Hardwiring Happiness: The New Brain Science of Contentment, Calm and Confidence.

Experience Dependent Neuroplasticity Taking in the GOOD…

Internal physical re-education Lasting Change

External Support

Wound Offloading Can Take Many Forms

LEARNING OBJECTIVES: 3. Know when referral for foundational evaluation and support is necessary

COLLABORATION

Optimal Core Alignment exercise

How you hold yourself in relationship with gravity?

POSTURE & FUNCTION

We are structurally designed to be walking… NOT sitting

When Gravity wins…

STABILIZATION BODY CORE

STABILIZATION FOOT CORE

INTEGRATION AN INSIDE and OUTSIDE JOB

CORE ALIGNMENT IS THE NAME OF THE GAME

Rene Cailliet, MD Pioneer Physical Medicine and Rehabilitation, US Army, WWII

UNIVERSAL TISSUE RESPONSE Cailliet, Rene. Pain: Mechanisms and Management Philadelphia: F.A. Davis, 1993.

Inhibition = Mal-alignment = PAIN = Increasing Dysfunction

ARTHRITIS= “Itis” in your “arth”

Gait Abnormality

Mal-alignment leads to Poor proprioception Balance disorders Reduced core stability Reduced venous pump

Review of the venous foot pump mechanism Not active at rest

Review of the venous foot pump mechanism 80 mm of mercury on standing

Review of the venous foot pump mechanism Falls to 30 mmHg walking

Review of the venous foot pump mechanism 25 mL pumped upwards each step

Review of the venous foot pump mechanism Forward momentum causes the pump action deep in foot intrinsic muscles

and-physiological-hypotheses/ Venous pump deep in the arch NOT in the sole

" Impairment of the foot muscle pump by static foot disorder is an important cause of chronic venous disorder.” Vaidyanathan, Subramoniam, Riju Ramachandran Menon, Pradeep Jacob, and Binni John. Chronic Venous Disorders of the Lower Limbs: A Surgical Approach.: Springer India, Print

Optimal Core Alignment System clarifies: Support core alignment = Support optimal function & venous return = Speed in healing times

MORE ON THE FOOT CORE

These feet are made for walking…

WINDLASS EFFECT

Passive Sub- system

4 arches in the foot Inner and outer arches

4 arches in the foot Transverse arches

LIGAMENTOUS SUPPORT

Active subsyste m

The Neural Sub- System

Altered feedback

ALTERED FEEDBACK INCREASES FALL RISK

Optimal Core Alignment trains and supports inside and outside body and foot.

ASSESSING FOOT CORE ALIGNMENT

Talar Neutral

INTRINSIC FOOT MUSCLE TEST

TRADITIONAL FOOT EXERCISES MAY NOT TRAIN INTRINSIC MUSCLES

SHORTENED FOOT EXERCISE

Referral to a Core Support Team Biomechanics Education Custom Orthotics Offloading Apply and Reassess

WOUND OFF LOADING

REDUCE PRESSURES

In Summary… “I have a choice. Do I want to align with the greatest vision of myself or do I want to align with my excuses…” -Debbie Ford