Expert Biomechanical Assessment of Foot & Ankle In Delhi NCR.
What is Biomechanical Assessment of Foot & Ankle?
A biomechanical assessment of the foot and ankle is a comprehensive examination that evaluates the structure, alignment, and movement patterns of the lower limbs. This is performed by Physiotherapists to identify underlying causes of pain, discomfort, or dysfunction in the feet, ankles, knees, hips, and even the lower back.
Why is it important?
The feet are the foundation of the skeletal system, and their position and function can significantly impact the entire body. Issues in the feet and ankles can lead to compensatory movements higher up the kinetic chain, causing pain and problems in other areas. A biomechanical assessment helps to:-
- Diagnose the root cause of pain: Instead of just treating symptoms, it aims to uncover why the pain is occurring.
- Develop personalized treatment plans: The findings guide the prescription of appropriate interventions, such as orthotics, footwear changes, exercises, or referrals to other specialists (e.g., physical therapists).
- Prevent future injuries: By addressing biomechanical imbalances, it can help prevent recurring issues, especially for athletes or individuals with specific risk factors.
- Improve performance: For athletes, optimizing foot and ankle mechanics can enhance efficiency and reduce injury risk.
What Does a Biomechanical Assessment Involve ?
A typical biomechanical assessment includes both static and dynamic evaluations, often with the following components:-
- Initial Consultation and History Taking:
- Medical history: Discussion of any relevant medical conditions, past injuries, surgeries, and medications.
- Lifestyle and activity levels: Understanding daily routines, work demands, and participation in sports or exercise.
- Presenting complaint: Detailed discussion of the pain or symptoms, including onset, duration, severity, and aggravating/relieving factors.
- Footwear assessment:</b > Examination of the patient’s typical footwear for wear patterns and suitability.
- Static Assessment (Non-weight-bearing and Weight-bearing):
- Visual examination: Observing the overall posture, alignment of the lower limbs (pelvis, knees, ankles, feet), and any visible deformities.
- Joint range of motion (ROM): Assessing the flexibility and movement of joints in the feet, ankles, and knees. This includes:
- Ankle dorsiflexion and plantarflexion.
- Subtalar joint range of motion: Assessing pronation (inward rolling) and supination (outward rolling).
- Midtarsal joint mobility.
- First metatarsophalangeal (MPJ) joint range of motion: Important for toe-off during gait.
- Muscle strength and flexibility: Testing the strength of key muscles and assessing the flexibility of muscles and tendons (e.g., calf muscles, Achilles tendon).
- Palpation: Gently feeling for tenderness, swelling, or abnormalities in the bones, muscles, ligaments, and tendons.
- Arch height and foot posture: Observing the height of the medial longitudinal arch while sitting and standing. Specific tests like the Navicular Drop Test might be used to quantify arch collapse.
- Dynamic Assessment (Gait Analysis):
- Observational gait analysis: The practitioner observes how the patient walks and/or runs, looking for abnormal movement patterns, compensations, and deviations in the gait cycle. This often includes:
- Foot strike pattern: Heel strike, midfoot strike, forefoot strike.
- Amount and timing of pronation and supination.
- Knee and hip mechanics during gait.
- Trunk and arm swing.
- Video gait analysis: Using video recordings to analyze movement in slow motion, allowing for more detailed observation of subtle deviations.
- Pressure mapping technology (force plates/pressure mats): These devices measure the pressure distribution under the feet during standing and walking, providing objective data on weight bearing patterns, areas of high pressure, and ground reaction forces. This can help identify areas at risk of injury or overuse.
- 3D motion capture (less common in routine assessments): In some specialized clinics, advanced 3D motion capture systems can provide very precise data on joint angles and segment movements during gait.
- Observational gait analysis: The practitioner observes how the patient walks and/or runs, looking for abnormal movement patterns, compensations, and deviations in the gait cycle. This often includes:
Common conditions identified through biomechanical assessment of foot & ankle-
- Overpronation/Flat feet: Excessive inward rolling of the foot during gait, which can lead to strain on various structures.
- Supination/High arches: Insufficient inward rolling, leading to poor shock absorption and increased stress on the outside of the foot.
- Plantar fasciitis: Inflammation of the plantar fascia, often related to abnormal foot mechanics.
- Achilles tendinopathy: Pain and inflammation of the Achilles tendon.
- Shin splints (medial tibial stress syndrome): Pain along the shin bone, frequently associated with overuse and biomechanical imbalances.
- Knee pain: Often related to faulty foot mechanics affecting the alignment of the knee joint.
- Hip and lower back pain: Can be influenced by compensatory movements originating from the feet.
- Bunions and hammertoes: Deformities of the toes and forefoot that can be exacerbated by poor foot mechanics and footwear.
Treatment after a biomechanical assessment of foot & ankle
- Orthotics (custom-made or prefabricated insoles): To support the foot, control excessive motion, and improve alignment.
- Footwear recommendations: Advice on appropriate shoes for daily activities and specific sports.
- Exercise prescription: Stretching and strengthening exercises to address muscle imbalances, improve flexibility, and enhance stability.
- Strapping or taping: To provide temporary support and pain relief.
- Activity modification: Adjusting training routines or daily activities to reduce stress on injured areas.
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