1. Foot & Ankle

2. Anatomy

3. Anatomy - Medial

4. Anatomy - Lateral

5. Talocrural Joint

6. Subtalar Pronation – Closed Chain

8. Subtalar Supination – Closed Chain

9. Subtalar Pronation & Supination Model – Closed Chain

10. Gait Review

11. Subtalar Pronation & Supination during Gait

12. Transverse Tarsal/Midtarsal/Chopart’s Joint Calcaneocuboid Joint Talonavicular Joint

13. Midtarsal Joint Pronation zSTJ unlocks MTJ Supination zSTJ locks up MTJ

14. Midtarsal Joint Motion - Closed Chain PronationNeutralSupination

15. Abnormal Biomechanics zBreakdown of CT zReduced muscle efficiency zChange in muscle function zPoor alignment – Osseous Deformity zDysfunction and Pathology zReduced ability to attenuate GRFs

16. Pronation Closed Chain zCalcaneus eversion (valgus) zTalus adduction (IR - vertical axis) zTalus plantarflexion zTibial IR

17. Normal Pronation in Gait Normal Range: z6 - 10 0 Excessive: z13 0 +

18. Abormal Pronation in Gait zExcessive in magnitude zExcessive in duration zOccurs at wrong time Causes: zIntrinsic deformities zExtrinsic deformities

19. RF/Subtalar Joint Varus zInversion deformity of calcaneus zNo change in relationship of RF on FF Etiology zCongenital/developmental zfailure of talus to derotate

20. RF/Subtalar Joint Varus – Compensated ST Varus

22. Forefoot Varus zMost Common zInsufficiency of 1st ray zDorsiflexed/hypermobile 1st ray zCongenital deformity zInversion of forefoot (metatarsals) relative to rearfoot in STJ neutral

23. Forefoot Varus

24. Forefoot Varus - Compensated

25. Forefoot Varus (Compensated) - Pathomechanics zDuring WA - excessive pronation to get 1st ray on ground zMax. pronation occurs @ HO zPronation remains thru propulsion zFoot never becomes rigid lever zInstability

26. Forefoot Varus - Compensation zProlonged / excessive pronation zCalcaneal valgus zUnlocking of forefoot during propulsion zInsufficient pulley system

27. Forefoot Varus - Pathology zHypermobile 1st ray zExcessive forces on 2 nd MET zProlonged / excessive tibial torsion and/or IR zExcessive anteversion of hip

28. Forefoot Varus - Uncompensated

29. zRigid Foot zLateral ankle sprains zS.I. Joint Dysfunction zITB Dysfunction

30. Subtalar Varus and Compensated Forefoot Varus FF Varus zacquired soft tissue contracture at MTJ z2 0 compensatory pronation for a STJ varus

31. Subtalar Varus and Compensated Forefoot Varus

32. Subtalar Varus and Forefoot Varus, Compensated

33. Ankle Joint Equinus zFixed limitation of DF @ TCJ z< 10 0 of DF when in STJ neutral and knee / Etiology ztight gastrocnemius zspasticity zflattened dome of talus zFx, arthritis, trauma

34. Ankle Joint Equinus

35. Ankle Joint Equinus - Compensated

36. Ankle Joint Equinus - Pathomechanics z  pronation 2 0 to  DF zloss of ankle rocker ztibia unable to move anterior to talus  tibia and talus move anterior to calcaneus zDF of RF at FF z  and prolonged pronation during propulsion

37. Compensated Ankle Joint Equinus zExcessive STJ pronation zCalcaneal valgus/eversion zInefficient pulleys zDF of RF on FF

38. Uncompensated Ankle Joint Equinus zGenu Recurvatum zEarly heel rise zExcessive abduction and ER of LE