Podcast
Questions and Answers
What is the function of ligaments in the body?
What is the function of ligaments in the body?
Hold bones together at articulations and restrict excess movement/allow reasonable movement for function.
Which of the following statements accurately describe bones?
Which of the following statements accurately describe bones?
__________ muscles are under voluntary control and produce movement.
__________ muscles are under voluntary control and produce movement.
Skeletal
Match the following limb anatomy terminology with their descriptions:
Match the following limb anatomy terminology with their descriptions:
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What is the definition of Biomechanics according to Joseph Hamill?
What is the definition of Biomechanics according to Joseph Hamill?
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What are the major tissues types in the lower limb?
What are the major tissues types in the lower limb?
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Range of motion assessment involves determining the entire amount of movement available in any given joint.
Range of motion assessment involves determining the entire amount of movement available in any given joint.
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Biomechanics in Podiatry involves gait analysis, functional tests, joint ROM, muscle testing, and postural/alignment ________.
Biomechanics in Podiatry involves gait analysis, functional tests, joint ROM, muscle testing, and postural/alignment ________.
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Match the following actions with their corresponding planes of motion for the foot:
Match the following actions with their corresponding planes of motion for the foot:
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What is the function of ligaments in the body?
What is the function of ligaments in the body?
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Define 'Biomechanics'.
Define 'Biomechanics'.
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What is the name of the fibrous tissue that connects muscle to bone?
What is the name of the fibrous tissue that connects muscle to bone?
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Skeletal muscles are under involuntary control.
Skeletal muscles are under involuntary control.
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What is the definition of Biomechanics according to Joseph Hamill?
What is the definition of Biomechanics according to Joseph Hamill?
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What does ROM stand for in Range of Motion assessment?
What does ROM stand for in Range of Motion assessment?
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In Biomechanical assessment in Podiatry, providing tailored exercises and advice are not part of the process.
In Biomechanical assessment in Podiatry, providing tailored exercises and advice are not part of the process.
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_______ are structures attached to two (or more) bones to prevent excessive joint movement and aid stability.
_______ are structures attached to two (or more) bones to prevent excessive joint movement and aid stability.
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Match the action with the corresponding plane of motion:
Match the action with the corresponding plane of motion:
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Study Notes
Introduction to Podiatry
- Podiatry is a field of study that focuses on the diagnosis, treatment, and prevention of disorders and conditions of the feet and lower limbs.
Fundamental Lower-Limb Anatomy
- Anatomical terminology is essential for health professionals to communicate effectively and describe locations accurately.
- Understanding anatomical terminology enables the description of a location easily, especially when the precise tissue name is unknown.
- All anatomical terminology assumes the anatomical position.
- Key terms:
- Medial: towards the midline of the body
- Lateral: further from the midline of the body
- Superior: nearer to the head of the body
- Inferior: further from the head of the body
- Anterior: front of the body
- Posterior: back of the body
- Superficial: nearer to the skin surface
- Deep: further from the skin surface
- Proximal: nearer to the attachment point
- Distal: further from the attachment point
- Dorsal: back of hands or top of feet
- Palmar: palm of hands
- Plantar: sole of foot
- Unilateral: one side
- Bilateral: both sides
- Ipsilateral: same side
- Contralateral: opposite side
Bones
- Description: firm, rigid tissue composed of collagen and calcium phosphate with varying shapes and functions.
- Functions:
- Structural support for soft tissue
- Protection of internal organs
- Facilitation of specialized cell formation
- Mineral reservoir
- Lower limb bones:
- Thigh: 1 bone
- Leg: 2 bones
- Foot: 26 bones (7 tarsals, 5 metatarsals, 14 phalanges)
Ligaments
- Description: fibrous, collagen, connective tissue that connects bone to bone.
- Functions:
- Holding bones together at articulations
- Restricting excess movement and allowing reasonable movement for function
- Lower limb ligaments:
- Over 100 ligaments in the lower limb
- Multiple ligaments in each joint
Skeletal Muscle
- Description: contractile tissue under voluntary control that produces movement.
- Functions:
- Producing movement
- Stabilizing joints
- Maintaining posture and balance
- Storing nutrients
- Regulating body temperature
Muscle Groups
- Thigh: anterior (quadriceps) and posterior (hamstrings)
- Leg: anterior and lateral (peroneals)
- Posterior leg: superficial (calf) and deep (tibialis posterior)
Tendons
- Description: strong, fibrous, connective tissue that attaches muscle to bone.
- Functions:
- Transferring muscle force to produce movement
- Storing energy
Biomechanics
- Definition: the study of forces that act on a body and the effects they produce.
- Application in podiatry:
- Gait analysis
- Functional tests (squatting, hopping, up-down stairs)
- Joint ROM assessment
- Postural and alignment assessment
Planes of Motion
- Description: three planes of motion that describe movement in the body.
- Planes of motion in the foot:
- Frontal plane: inversion and eversion
- Transverse plane: adduction and abduction
- Sagittal plane: plantarflexion and dorsiflexion
Range of Motion Assessment
- Definition: a method of determining the entire amount of movement available in any given joint.
- Importance: limited or excess ROM may contribute to pain and pathology.
- Methods:
- Active ROM: the patient moves their own joint.
- Passive ROM: the practitioner moves the patient's joint.
Pathology
- Restricted ROM: hypomobile joint(s) with lower ROM than the population norm.
- Excessive ROM: hypermobile joint(s) with higher ROM than the population norm.
- Impact on function and potential for injury.
Principles of ROM Assessment
-
Isolate the joint and move it through its typical plane(s) of movement.
-
Interpretation: decide if the ROM is normal, hypomobile, or hypermobile.
-
Use clinical experience and measurement tools to aid interpretation.### Range of Motion (ROM) Assessments
-
ROM assessments are used to evaluate the range of motion in different joints
-
Three joints are typically assessed: Ankle Joint, 1st Metatarsophalangeal Joint (MTPJ), and Subtalar Joint
Ankle Joint ROM Assessment
- Dorsiflexion and plantarflexion are the two main movements assessed
- ~10° of dorsiflexion is required for normal gait
- To test, one hand stabilizes the leg and the other hand pushes the forefoot in the direction of the patient's head
- The foot is perpendicular to the leg at 0°, and a tractograph can be used to estimate the ROM
1st MTPJ ROM Assessment
- Dorsiflexion and plantarflexion are the two main movements assessed
- ~65° of dorsiflexion is required for normal gait
- To test, one hand stabilizes the 1st metatarsal and the other hand pushes the hallux (big toe) in the direction of the patient's head
- The toe is parallel to the metatarsal at 0°, and a tractograph can be used to estimate the ROM
Subtalar Joint ROM Assessment
- Inversion and eversion are the two main movements assessed
- Typically, there is 2-3 times more inversion than eversion
- The normal combined motion is ~30°
- To test, one hand stabilizes the lower leg and the other hand grasps the calcaneus (heel) and glides it through the frontal plane
Manual Muscle Testing (MMT)
- MMT is used to assess muscle strength and function
- Muscle pathology may be the specific cause of pain, and muscle weakness may contribute to dysfunction and lead to pathology such as joint or foot pain
- MMT assists in diagnosis and supports management plans
Principles of Manual Muscle Testing
- Clinician grasps the limb to isolate a muscle
- Clinician directs the patient to perform an action by contracting the muscle
- Clinician applies resistance in the opposite direction
- Strength is graded as per the Kendall grading system
Kendall Grading System
- A 5-point scale from 0-4 is used to grade muscle strength
- 0: no contraction detected
- 1+: partial ROM against gravity
- 2+: can raise part against gravity and has full ROM
- 3+: can overcome gravity and slight resistance
- 4+: can overcome resistance
Manual Muscle Testing in Practicals
- We will practice MMT on 4 muscles acting on the foot: Tibialis Anterior, Tibialis Posterior, Gastrocnemius, and Soleus
Introduction to Podiatry
- Podiatry is a field of study that focuses on the diagnosis, treatment, and prevention of disorders and conditions of the feet and lower limbs.
Fundamental Lower-Limb Anatomy
- Anatomical terminology is essential for health professionals to communicate effectively and describe locations accurately.
- Understanding anatomical terminology enables the description of a location easily, especially when the precise tissue name is unknown.
- All anatomical terminology assumes the anatomical position.
- Key terms:
- Medial: towards the midline of the body
- Lateral: further from the midline of the body
- Superior: nearer to the head of the body
- Inferior: further from the head of the body
- Anterior: front of the body
- Posterior: back of the body
- Superficial: nearer to the skin surface
- Deep: further from the skin surface
- Proximal: nearer to the attachment point
- Distal: further from the attachment point
- Dorsal: back of hands or top of feet
- Palmar: palm of hands
- Plantar: sole of foot
- Unilateral: one side
- Bilateral: both sides
- Ipsilateral: same side
- Contralateral: opposite side
Bones
- Description: firm, rigid tissue composed of collagen and calcium phosphate with varying shapes and functions.
- Functions:
- Structural support for soft tissue
- Protection of internal organs
- Facilitation of specialized cell formation
- Mineral reservoir
- Lower limb bones:
- Thigh: 1 bone
- Leg: 2 bones
- Foot: 26 bones (7 tarsals, 5 metatarsals, 14 phalanges)
Ligaments
- Description: fibrous, collagen, connective tissue that connects bone to bone.
- Functions:
- Holding bones together at articulations
- Restricting excess movement and allowing reasonable movement for function
- Lower limb ligaments:
- Over 100 ligaments in the lower limb
- Multiple ligaments in each joint
Skeletal Muscle
- Description: contractile tissue under voluntary control that produces movement.
- Functions:
- Producing movement
- Stabilizing joints
- Maintaining posture and balance
- Storing nutrients
- Regulating body temperature
Muscle Groups
- Thigh: anterior (quadriceps) and posterior (hamstrings)
- Leg: anterior and lateral (peroneals)
- Posterior leg: superficial (calf) and deep (tibialis posterior)
Tendons
- Description: strong, fibrous, connective tissue that attaches muscle to bone.
- Functions:
- Transferring muscle force to produce movement
- Storing energy
Biomechanics
- Definition: the study of forces that act on a body and the effects they produce.
- Application in podiatry:
- Gait analysis
- Functional tests (squatting, hopping, up-down stairs)
- Joint ROM assessment
- Postural and alignment assessment
Planes of Motion
- Description: three planes of motion that describe movement in the body.
- Planes of motion in the foot:
- Frontal plane: inversion and eversion
- Transverse plane: adduction and abduction
- Sagittal plane: plantarflexion and dorsiflexion
Range of Motion Assessment
- Definition: a method of determining the entire amount of movement available in any given joint.
- Importance: limited or excess ROM may contribute to pain and pathology.
- Methods:
- Active ROM: the patient moves their own joint.
- Passive ROM: the practitioner moves the patient's joint.
Pathology
- Restricted ROM: hypomobile joint(s) with lower ROM than the population norm.
- Excessive ROM: hypermobile joint(s) with higher ROM than the population norm.
- Impact on function and potential for injury.
Principles of ROM Assessment
-
Isolate the joint and move it through its typical plane(s) of movement.
-
Interpretation: decide if the ROM is normal, hypomobile, or hypermobile.
-
Use clinical experience and measurement tools to aid interpretation.### Range of Motion (ROM) Assessments
-
ROM assessments are used to evaluate the range of motion in different joints
-
Three joints are typically assessed: Ankle Joint, 1st Metatarsophalangeal Joint (MTPJ), and Subtalar Joint
Ankle Joint ROM Assessment
- Dorsiflexion and plantarflexion are the two main movements assessed
- ~10° of dorsiflexion is required for normal gait
- To test, one hand stabilizes the leg and the other hand pushes the forefoot in the direction of the patient's head
- The foot is perpendicular to the leg at 0°, and a tractograph can be used to estimate the ROM
1st MTPJ ROM Assessment
- Dorsiflexion and plantarflexion are the two main movements assessed
- ~65° of dorsiflexion is required for normal gait
- To test, one hand stabilizes the 1st metatarsal and the other hand pushes the hallux (big toe) in the direction of the patient's head
- The toe is parallel to the metatarsal at 0°, and a tractograph can be used to estimate the ROM
Subtalar Joint ROM Assessment
- Inversion and eversion are the two main movements assessed
- Typically, there is 2-3 times more inversion than eversion
- The normal combined motion is ~30°
- To test, one hand stabilizes the lower leg and the other hand grasps the calcaneus (heel) and glides it through the frontal plane
Manual Muscle Testing (MMT)
- MMT is used to assess muscle strength and function
- Muscle pathology may be the specific cause of pain, and muscle weakness may contribute to dysfunction and lead to pathology such as joint or foot pain
- MMT assists in diagnosis and supports management plans
Principles of Manual Muscle Testing
- Clinician grasps the limb to isolate a muscle
- Clinician directs the patient to perform an action by contracting the muscle
- Clinician applies resistance in the opposite direction
- Strength is graded as per the Kendall grading system
Kendall Grading System
- A 5-point scale from 0-4 is used to grade muscle strength
- 0: no contraction detected
- 1+: partial ROM against gravity
- 2+: can raise part against gravity and has full ROM
- 3+: can overcome gravity and slight resistance
- 4+: can overcome resistance
Manual Muscle Testing in Practicals
- We will practice MMT on 4 muscles acting on the foot: Tibialis Anterior, Tibialis Posterior, Gastrocnemius, and Soleus
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Description
This quiz covers the fundamental lower-limb anatomy and biomechanics, focusing on anatomical terminology, tissue types, and major bones and muscles in the lower limb.
