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Objective The objective of this study was to determine the relative contributions of work activity (time spent standing, walking or sitting), floor surface characteristics, weight, BMI, age, foot biomechanics, and other demographic and medical history factors to the prevalence of hip disorders.
Methods A cross-sectional observational study design was used to engine assembly plant workers. The main outcome measure was the finding of a hip disorder. The independent variables included baseline demographics, medical history, ergonomic exposures, psychosocial factors, shoe characteristics and foot biomechanics.
Results Logistic regression revealed that increasing age, female gender, pes planus, smoking, history of a knee or hip injury, and a history of rheumatoid arthritis were significant risk factors while time on carpeted surfaces was protective.
Conclusions Hip disorders are associated with a history of biomechanical trauma to the hip but also from gait abnormalities such as pes planus.
But wouldn't a maximally pronated STJ and everted rear and midfoot and or Pes Planus cause an internal moment/ rotation of hip and femur? in turn leading to reduced function/ deactivation of the internal hip rotators, namely glutes min and med and ITBs. In turn after time spent in this position lead to abnormal wearing at Hip and trochanter, and weakness of muscles??
would also be interested to know whether the study showed orthoses to be advantages in the Rx of said problems, I know my pts seem to improve when I improve function and issue stretching programmes.
Well I totally agree, postural stability is totally associated with foot function. If we consider the degree of internal rotation produced by pronation together with the momentum factor of weight transfer coeficient then we realize that the lower acetabulum is compromised in the compensatory mechanism, as seen in most MRI images. If we can reduce the internal rotation of the lower limb then we reduce the compensatory mechanism and lower the forces within the pelvis and lumbar region. This also reduces the trapezius over activity thus reducing stresses in the thorasic/cervical areas.
Power flow is directly related to the momentum produced by
1 the forward momentum
2the weight transfer coefficient
3 the muscle activity of peronei and the deacceleration of anterior muscle group
4 propulsive phase of tricept surae
5 the cuboid close compact position
6 the standard deviation of the mean coefecient of weight distribution
7 the q angle and soft tissue restaining mechanism of each individual joint being investigated
8 the compensatory/proprioceptive responce to gavitational and GRF effect
9 C of G
10 the path of perpendicular force through all considered joints
11 the axis of all considered joints and
12 the vector associated with those joints
Having considered your other threads the power flow is totally dependant on the base of support, if the STJ is stable while the MTJ is unstable then the force coeficient is reduced poroportionally. This is also dependant on if it is the long axis or oblique axis. In either case the power produced by the tricept surae is reduce on it's transfer to the ground if the foot structure is unstable. As indicated in R. Whitmans work in the early 20th Century.
This is also noted by Lewis and Oxnard in the 70's and 80's.
For any force to be transfered without loss it must pass through a stable structure
yes, long axis is the talar navicular and the oblique is the calc/cuboid.
The principle axis that generates the abduction of the forefoot on rear foot. Often associated with abducted gait. When the cuboid presents with an early impaction of the CCP we see the classic abduction of the foot to allow weight bearing through the first met head.
The oblique axis is the last compensatory mechanism prior to propusion phase and it's action often sees further unlocking of the STJ and producing the abductory twist through propusion.
A two axis model for the mid tarsal joint, and unlocking of the sub talar joint...hmmm... this does sound familiar...I think I read it somewhere once... but I'm going back years...
Naturally I'm being sarcastic - the cornerstone of any Brits sense of humour. Nothing personal, just filling gaps between patients. But give this (4 year old) thread a once over when you have a spare 5 - be interested to hear your thoughts on it: The Midtarsal joint
LOL I get it,
The debate is over a single axis to allow ease of understanding, and simply is not true.
Having personally researched the mid tarsal joint for the past 20 yrs and dissected over 100 mid tarsal joints, sectioned the various joint surfaces histologically and examined the chondrocytes and there alignment for functional relationships, I can assure you there are two axis' of the MTJ. As more an anatomist my observations are often regected by many of my Australian colleagues( Podiatrists).
I have used my observations to manufacture a device that mimics the two axis model and having manufactured and issued over 6000 devices with money back garrentee I have had excellent results, still in business LOL.
LOL I get it,
The debate is over a single axis to allow ease of understanding, and simply is not
true.
Having personally researched the mid tarsal joint for the past 20 yrs and dissected over 100 mid tarsal joints, sectioned the various joint surfaces histologically and examined the chondrocytes and there alignment for functional relationships, I can assure you there are two axis' of the MTJ. As more an anatomist my observations are often regected by many of my Australian colleagues( Podiatrists).
I have used my observations to manufacture a device that mimics the two axis model and having manufactured and issued over 6000 devices with money back garrentee I have had excellent results, still in business LOL.
Alex,
I can understand why you'd be reluctant to accept a single axis model... particularly when you have manufactured a device which mimics a two axis model... amazing what a financial interest can do
I'm interested in something - how can you assure me there are two axes merely from dissection? (Given that joint axes are essentially imaginary lines which move continuously in space?)
Ian, well not from dissection but also by measuring, if we were to consider a single axis then the motion around that axis would be uniform, be it in three dimension, however when we stabilize the rear foot motion can be measure around the two axis', the calc/cuboid joint is where the cuboid moves about a stable calcaneous being pushed by the peroneous longus tendon, yes that's not common knowledge, but is in fact the case. The motion of the talar/navicular motion occur as the foot enters foot flat stage. This produces a function to stabilize the first ray allowing the p.longus tendon to stabilize thus 'pushing' the cuboid about the calc. This then produces close packed position of the medial process of the cuboid into the inferior aspect of the sutentaculm tali, inferior to the spring ligement. This is seen in histological cross section of the area.
I have to admit it would be nice if it was a single axis but the anatomy and motion would indicate two.
Cheers
Alex
Flat foot as a risk factor for hip problems
Linear Mode
