Loss of terminal knee extension: How quickly can you process the facts ?

Some quick thoughts that must go through your mind on your examination. These thoughts must be ingrained, so that you can quickly juggle the other issues you client is coming in with that may very likely be related to the loss of left knee terminal extension.

more knee flexion may likely mean more ankle dorsiflexion , and that means more more anterior shin compartment strength is necessary to stop a quick progression to the forefoot (consider their clinical symptoms), this may mean pronation occurs more quickly (consider their clinical symptoms), it may mean more abrupt quadriceps loading since the loading does not start in more reasonable knee extension which means the quad is short now and that means increased patellofemoral compression possibilities (consider their clinical symptoms), this may mean more hip flexion on initiation of stance phase (consider their clinical symptoms), this may lead to more anterior pelvis tilt posturing and thus increased lordosis (consider their clinical symptoms), this flexed knee means that the leg is shorter which will through off pelvis symmetry (consider their clinical symptoms), this may mean more work for the contralateral hip abductors (consider their clinical symptoms), this may mean more frontal plane pelvis drift to the short leg side (consider their clinical symptoms), it will also mean 2 different step lengths which means 2 different hip extension patterns which means 2 different heel rises, and it will likely mean altered arm swing on both sides which can create changes into thoracic rotation (and of course the cervical spine sits on top of that) etc etc etc, so consider their clinical symptoms . . .

just wanted to quickly rattle off how fast your brain must juggle things, otherwise your exam is going to be knee-centered and tunnel visioned. Keep in mind, your client may not even have knee complaints, perhaps one or more of the above. But this is a perfect example of why you must examine the WHOLE client.

Perhaps this gives you even deeper understanding (combined with yesterdays "parallax binocular vision 2D post" as to why we will not give online corrective homework or consultations. There is just no way all of these things can be considered over video, Skype, Zoom or anything of the sort. Gait analysis must be done in person and encompass a hands on exam, if you do not want to miss something possible critically important, in our opinion, for what that is worth.

Shawn Allen, the other gait guy

#kneeextension, #gait, #gaitanalysis, #gaitproblems, #gaitanalysis, #gaitcompensations, #correctiveexercises, #thegaitguys