Key moment during my knee exam:
/Key moment during my exam:
Today, a small slice of the Sagittal plane:
Here are just a few of the things going through my mind as i go through the lower limb sagittal plane. Everyone has a different way, this is a piece of mine. . . . .
Do they have sufficient ankle dorsiflexion, active passive?
Are the ankle dorsiflexors strong enough to achieve sufficient ankle dorsi and rocker, and are the ankle plantarflexors long enough, to allow said sufficient ankle dorsiflexion.
And to match with that in terms of gait cycles and loading patterns, do they have sufficient hip extension?
Meaning, are the hip extensors strong enough, and the hip flexor groups (hip flexors and quads of course) long enough, to allow sufficient hip extension.
Are the abdominals strong enough to anchor the pelvis from dropping into uncontrolled or excessive anterior pelvis tilt and paraspinal loading? Because when then do drop into APT, they will convert, likely, into quad dominance and paraspinal dominance (instead of glute-abdom). In otherwords, can they adequately control the hip into the pelvis (acetabulum) and the pelvis into the spine?
When there is a conflict between the foot/ankle and hip in the sagittal plane, problems may occur at these joint levels, and/or above and/or below these joints (ie, low back, knee, or deeper into the foot).
To be clear, none of these joints exclusively work in just the sagittal plane. That many of these joint complexes are multiaxial, and there is always the issues of protective stability in other planes that ensure another planes clean function. This is what makes more deeply explaining how to fix something very difficult on the internet, because it is in fact complex and requires juggling many clinical insights all at once to determine where things have gone wrong in an injured client. And, this was only discussing the sagittal plane today, on the most simple and crudest of levels. What about deeper issues?
And then , of course, how are they doing in frontal and transverse planes? And then how do the 3 planes come together, functionally or dysfunctionally? And, if they cannot control sagittal, are they dumping it into frontal hip or transverse hip ? (ie. see the FB post last week that had a few people all in a butt clench of the runner with the right leg internally rotated/torsional questions).
These are the balls i am juggling when i examine people, slowly building a puzzle from a fresh open box.
Today was just a slice of the pie on lower limb sagittal assessment, just a blip into my mindspace.
And so, if you are not adding an assessment to training or corrective work, and there is a problem that is left unaddressed, then we can be adding strength to dysfunction.
