A flexed leg is a shorter leg: When loss of knee extension really matters.
/A flexed knee is a shorter leg, period.
A knee with any loss of terminal extension, is more bent knee, and thus a shorter leg, period.
Stand up, bend one knee 10 degrees, you have shortened the global top to bottom length of that leg.
So when walking, you will plunk down onto that shorter leg, and there will be a cost.
This is old hat for our long time readers, but it is a good reminder to look for loss of terminal knee extension.
I just saw a lady with a uni-knee replacement of 5 months. Failing some aspects of rehab, they are stuck. There is hip,knee and ankle pain on walking.
She had a loss of terminal knee extension, thus a short leg, true shortness.
I placed a 2mm full sole length rubber-cork lift in the shoe (*DO NOT USE JUST A HEEL LIFT, please, for the love of God and all that is beautiful on this earth stop using just heel lifts and causing plantarflexion at the ankle. Heel lifts are specific unicorns you only use when you are trying to get more plantarflexion at the ankle, or want to rush someone to the forefoot, or want a shorter posterior compartment (amongst other stupid things you probably do not want in your client mechanics)).
She put the shoe back on with the 2mm sole lift in the shoe and walked 20 steps and started to tear up. No pain.
Sometimes things are simple. We more closely restored the leg length by adding more vertical height. Yes, the problem still exists, but its global effects are somewhat muted. She stopped premature heel rise, could feel her glutes, stopped the abrupt plunk onto the leg, *stopped the sudden abrupt knee flexion loading that was crippling her.
I then took it out, "shoe'd" her up again, and she was dumbfounded, all the pain returned as did her awareness of what she was coping with.
Now, sent her away with the sole lift to accommodate for 2 weeks, and we will restart the rehab once things have time to get used to the "new norm". Now the rehab will work, we think. Time will tell
One thing is for sure, and now yesterdays post rings more clear and true, if you build strength on compensation, you earn and own that compensation.
The Gait Guys
#gait, #gaitproblems, #gaitcompensations, #strength, #heellift, #solelift, #TKA, #hippain, #shortleg
Photo courtesy of Pixabay, beautiful photo isn't it !?
