proactive physiotherapy

We see in routine practice when time to check EHL MMT. Patient fails to distinguish many time and they do ankle dorsiflexion along with toe extension. There is lack of disassociation of toe extension and ankle dorsiflexion.

Many patient  when asked to lift their toes, will drive into ankle dorsiflexion; ask them to just purely toe dorsiflex and the mental games begin, a wrinkled brow, intense concentration. If you cannot extended the toes sitting, how are you going to find them in swing phase of gait when balance, and other things, are more important?

Stand and lift your toes. That  you have engaged the Windlass Mechanism of gait. If you do not have toe extension unconsciously , your arch is not all that it can, and should, be. If you cannot raise your toes, followed by  raise the arch, plantarflex the first metatarsal, In gait cycle , you cannot properly position the sesamoids when foot planted on the ground. You should get properly terminal ranges of hallux dorsiflexion at toe off, properly position the foot for loading and unloading phase, adequately achieve ankle dorsiflexion, adequately offer the hip range of motion. This phase  to help control spin of the limb during loading and unloading of gait cycle.

if you failed in doing isolated toe extension , both in an unloaded and loaded foot (on the ground), then achieved control of both long and short extensor muscles to the toes. Concentrate on  disassociation of toe extension and dorsiflexion of ankle joint. So, if your feet hurt, hips hurt, or other problems that you are trying to fix with orthotics. Start with toe extension .It is a piece of the puzzle, trust me.

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