Mobility is a must for movement, and where it is lost it is mostly found in its neighbouring joints. During stance phase you have three ‘rocker mechanisms’: 1. Heel Rocker 2. Ankle rocker 3. Forefoot rocker. You could say these rocker/hinge type/pivotal movements allow the body to effectively ‘roll’ or ‘rock’ over the foot.

Dorsiflexion in the ankle is a huge player during gait. It fits into the Ankle Rocker mechanism and will be the first movement example we look at. Watch this Gait Guys video of how the body would get around limited dorsiflexion in gait with these 6 compensation strategies:

1. Negative progression angle (pigeon toed gait) with forefoot compensation (neighbouring joint).

2. Positive progression angle (charlie chaplin type) with over-pronation compensation (neighbouring joint) with increased risk of bunion formation.

3. Premature forefoot rocker (bouncy gait type), early plantar flexion (use of neighbouring joint).

4 + 5. Hyper-extension of the knee (teenage girl dominant) with anterior pelvic tilt to combine and assist with anterior weight shifting. Use of neighbouring joint again except more proximal.

6. Hyper- supination of the foot with some frontal plane deviations at the hip in gait.

So a lot happens and maybe looks familiar from that video! The body is an expert compensator and being able to read these compensations takes you one step closer to finding the origin of the pathology.

Treatment options:

An MWM – a Mobilisation With Movement, this useful MWM uses tibial internal rotation to facilitate dorsiflexion…a commonly restricted movement in gait.

Did you know your cuboid bone could restrict dorsiflexion of the 4th/5th metatarsal/lateral forefoot? This mobilisation instantly improves dorsiflexion.

References:

http://thegaitguys.tumblr.com/post/7044373557/gait-cycle-basics-part-3-as-promised-the