Thursday, 30 October 2008

A different view on 'tight' hips

The resting position of the feet when weight bearing can provide great insight as to the cause of many compensations found in the lower extremities.

It is common to see externally rotated feet bilaterally or unilaterally. If the compensation begins at the foot, externally rotated femurs and adaptively shortened piriformis will follow. Feet held in this position usually present with an everted calcaneus, collapsed longitudinal arch and a relatively abducted, inverted externally rotated forefoot, elevated first ray and abducted 1st MTPJ.

The compensations that can occur from this is an inability of the foot to wind up and unload during propulsion. Through toe off, the heel may whip medially, remaining everted and the entire load of the body is forced to roll over the medial aspect of the 1st MTPJ, missing the importance and benefit of the windlass mechanism.

An inability to roll through the 1st-3rd toes can result in an early heel lift and subsequently poor hip extension of the ipsilateral hip. An early heel lift means poor inversion, a short stride length and a heavy heel strike.

Without the appropriate proprioceptive information being fed to the pelvis via the pressure sensors in the soles of the feet, the psoas may adaptively shorten to the range in which it is being asked to load. Due to the relative femoral external rotation, you may also find that the lateral hamstrings are tight. Poor hip flexion follows poor hip extension.

With this chain of events in mind, being driven from the ground up, it is fair to say that traditional single plane, static stretching might not fix the problem. Tri-plane mobility drills will will help to temporarily improve the mechanics of the pelvis, but still wont be addressing the cause of the compensation.

Improving the function of the 1st MTPJ and subsequently the windlass mechanism will give the correct feedback to the pelvis, allowing it to load through a greater range of motion.

To find out more about kinetic chain assessment and how to fix these problems, book on to the next available 'Aim' seminar, or go to: