løb www.netfysioterapi.dk Valgfag 2010 Lars Henrik Larsen Del 3 - løbestil og løbestilsanalyse
Feiss line Mediale malleol – navicula medialt – grundled I
Achillessene Da Achillessenen ”knækker” ved pronation vil hyperpronation kunne forårsage et ”piskesmæld” af Achillessenen og dermed udløse en irritation. Et indlæg kan reducere: hastigheden af pronationen størrelsen af pronationen og dermed aflaste Achillessenen Langberg, H.
Navicular drop test ”Our results suggest that ND Measurements taken with the methods described have very good intrarater and interrater reliability, especially when 3 measurements are averaged. Shrader et al . Physical Therapy . Volume 85 . Number 7 . July 2005
Navicular drop test Navicular drop measurement is defined as the difference in height of the most prominent aspect of the navicular tuberosity when the subtalar joint is placed in “neutral” as compared with when the foot is positioned in a relaxed standing foot posture Sell KE, Verity TM, Worrell TW, et al. Two measurement techniques for assessing subtalar joint position: a reliability study. J Orthop Sports Phys Ther. 1994;19:162–167. Brody DM. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982;13:541–558.
Navicular drop test 1: Find naviculares mest prominerende punkt medialt – marker punktet 2: mål afstanden fra punktet til gulvet I siddende stilling 3: mål afstanden fra punktet til gulvet I stående stilling 4. Fortolkning af data: Hyperpronation eller kollaps af den mediale svangbue: - =10 eller >10 mm forskel mellem 2 og 3 - tydelig assymmetri mellem hø/ve. Kommentar Varians på 7 mm eller mere kræver ofte indlæg. Selv varianser på 5 mm drop kan være indikation for orthoser til atleter eller andre der udsættes for vægtbæring over længere tid. Reference Brody D. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am 1982;13:541-548. Picciano AM, et al. Reliability of open and closed kinetic chain subtalar neutral positions and navicular drop test. J Orth Sports Phys Ther 1993;18:553-558.
EMG in pronators EMG research has shown that excessive pronation affects the timing and magnitude of extrinsic muscle activity. This study was designed to investigate the relationship between excessive pronation and isokinetic strength of the ankle. The following measures were performed on 24 subjects (12 pronators, 12 normals) matched for gender and weight: 1) plantarflexion, dorsiflexion, inversion and eversion strength, both eccentrically and concentrically, determined by isokinetic peak torque at 30 degrees/sec; and 2) excessive pronation determined by navicular drop. Subjects with excessive pronation were found to have no difference in invertor strength, but decreased concentric plantarflexion strength when compared to normals. This finding agrees with biomechanical theory suggesting that a pronated foot is less rigid and generates less torque. Differences in strength ratios in excessive pronators were also observed and attributed to the decrease in plantarflexion strength. Snook AG. Foot Ankle Int. 2001 Mar;22(3):234-40. The relationship between excessive pronation as measured by navicular drop and isokinetic strength of the ankle musculature.
New worn shoes Comparing the kinetics and kinematics of running in new and worn shoes was investigated. Three types of footwear using different cushioning technologies were compared. Participants: 24 runners (14 men and 10 women) Interventions: 200 miles of road running in the same pair of shoes. Within-group factor: shoe condition (new/worn); between-group factor: footwear type (air/gel/spring). Results: Stance time increased (p = 0.035) in worn shoes. The torso displayed less maximum forward lean (p<0.001) and less forward lean at toe-off (p<0.001), while the ankle displayed reduced maximum dorsiflexion (p = 0.013) and increased plantar flexion at toe-off (p<0.001) in worn shoes. No changes in the hip and knee angles. No between-group difference among the three footwear groups or condition by type interaction was found in any measured variables. Conclusions: As shoe cushioning capability decreases, runners modify their patterns to maintain constant external loads. The adaptation strategies to shoe degradation were unaffected by different cushioning technologies, suggesting runners should choose shoes for reasons other than cushioning technology. P W Kong et al 2010. Running in new and worn shoes: a comparison of three types of cushioning footwear. Br J Sports Med 43:745-749
Barefoot shod Barefoot running is characterized by a significantly larger external loading rate than the shod condition. The flatter foot placement at touchdown is prepared in free flight, implying an actively induced adaptation strategy. In the barefoot condition, plantar pressure measurements reveal a flatter foot placement to correlate with lower peak heel pressures. Therefore, it is assumed that runners adopt this different touchdown geometry in barefoot running in an attempt to limit the local pressure underneath the heel. A significantly higher leg stiffness during the stance phase was found for the barefoot condition. The sagittal kinematic adaptations between conditions were found in the same way for all subjects and at the three running velocities. However, large individual variations were observed between the runners for the rearfoot kinematics. Biomechanical analysis of the stance phase during barefoot and shod running. Journal of Biomechanics, Volume 33, Issue 3, Pages 269-278B.De Wit
Foot Posture Index http://www.leeds.ac.uk/medicine/FASTER/FPI/FPI%20manual-%20formatted%20August%202005v2.pdf
Foot Posture Index 2 1 3 4 5 6 http://www.leeds.ac.uk/medicine/FASTER/FPI/FPI%20manual-%20formatted%20August%202005v2.pdf
Foot landing in elite runners Foot Strike Patterns of Runners At the 15-Km Point During An Elite-Level Half Marathon Hasegawa et al., J Strength & Cond., 2007, (21), 888-893
Supplerende undersøgelser • Fodundersøgelse • Balance & postural kontrol • Nervetension • Global / Core stability • Lokal stabilitet • ledbevægelighed • lokal muskelstyrke – obs excentrisk • andet
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