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Disharmonic Feet… a Postural Evaluation
Earlier this week I performed a postural eval on a young hockey player 12 years old, already playing in the elite division. Lately he was complaining about having some mild knee pain and lower back pain when he was playing back to back games or when the team made them run or jump too much during dryland training.
His parents were concerned because he never complained before . I explained to them that we’ll find out what’s the cause of the symptoms by doing a postural evaluation . I explained to them that i need to establish his center of mass compared to the gravity line. On a normal individual, the center of mass should be about 2 cm behind the gravity line. In his case it was about 2 cm in front of the gravity line. How did I evaluate that?
I took a plumb line and I did a Sagittal plane exam,
On a normal subject the scapular plane is aligned with gluteal plane.
In this case his body was displaced at least 2 cm in front and to his right. I explained to them the consequences of having that kind of postural imbalance.In the Posturology language , we call this imbalance
Anterior Scapular Plane
The subject, was feeling abnormal of tension in his feet. He mentioned that he plays a lot of soccer in the summer and he felt a lot of tension on his calves when running on the soccer field and that he also sprained his right ankle twice. When skating, he also felt a lot of tension in his feet and felt off balanced. He also was pushing more with one leg when skating at high speed.
I explained to him that having his center of mass moved forward and to his right , will most likely create a gripping of the toes in his skates , creating a short stride when accelerating.
I made him remove his shoes. We could clearly see the imprint of the tip of his toes into the insole of his shoes. He was gripping the toes . I then explained to them, that the fact of gripping the toes will create a lot of tension in the plantar fascia and will transfer tension to the achilles tendon, which also creates tension in the soleus muscle, the gastroc (gastrocnemius muscle) and also behind the knee, Popliteus muscle. This is exactly where he was feeling a lot of discomfort near the popliteus muscle right behind the knee. It also created abnormal tension and solicitation on the SI joint (sacroiliac joint). And this is exactly where he had a bid of numbness and also discomfort when he was skating on a too frequent basis.
I then did a full evaluation of his feet.
First by having him stand on one leg, which verified the level of balance of his feet. When he stood on the right leg, his foot went in supination = “varus“. His weight was shifted outward on the lateral part of the calcaneum, which is basically his heel.
When he stood on his left leg, his foot went in pronation= “valgus”. His weight was shifted inward on the medial part of the calcaneum.
This a case of disharmonic feet
One foot is going outward, varus and one is going inward, valgus. When playing hockey, you’re always transferring your weight from one leg to the other. The fact that that he had disharmonic feet, created high amounts of torque at the knee and also at the SI joint level
I then did some dynamic testing.
On the Overhead squat test, he was leaning forward and his pelvis shifted to the right at the 90 degrees hip flexion mark, again a consequence of anterior scapular plane imbalance and disharmonic feet.
On the 1 legged vertical jump, his left knee went in valgum. which is internal rotation.
His 2 legged vertical jump was pretty weak, 18 inches, again in direct correlation with his posture and his feet.
On our next session, I will address and correlate his postural evaluation and dynamic testing results, for a specific corrective exercises program
The goal of the program, is to rebalance his postural system.
He will perform numerous segmental specific exercises and myofascial stretches, to increase his segmental strength and flexibility. Also, he will need specific orthotics for his training shoes and his skates. These orthotics will help him use his foot in a more balanced and powerful way.
His parents were really happy about the whole evaluation process. They mentioned that no one ever evaluated their kid’s feet before, even though he is an elite athlete. It was very important to have them understand the consequences of these imbalances is the key to being proactive to correct it.