Lower Leg

Gait, Assessment of Uncontrolled Movement and Motor Control Retraining of the Lower Leg

Gait and Lower leg pain viewed from perspective of Uncontrolled Movement and restriction. Identify uncontrolled rotation, and flexion-extension in the knee shin and foot. Learn how to mobilize these restrictions and restabilise the uncontrolled compensations and integrate this retraining back into function.

Course Outline

Mechanical dysfunctions of the lower leg commonly present as uncontrolled motion which result as compensation strategies for various restrictions. These uncontrolled compensations can present as mal-alignment and rotational strain dysfunctions. Motor control dysfunction within the lower leg musculature contributes significantly to insidious onset, chronicity and recurrence of these problems. Pain in the knee, lower leg and foot is commonly related to musculoskeletal dysfunction in the region. When symptoms are produced from mechanical dysfunctional in the regional tissues, consistent patterns of motor recruitment dysfunction are evident. These recruitment patterns present as motor control inhibition of muscle function and imbalance between stability and mobility roles within the global musculature.

Gait and lower limb alignment are analysed from the perspective of restriction and compensation (muscle imbalance) developing into uncontrolled movement. Issues associated with uncontrolled rotation at the femur, tibia and the rearfoot / midfoot complex are emphasised. The relationship of these imbalances to leg and thigh pain, patello-femoral pain, shin pain and foot pain is discussed.

Specific tests of stability function have been developed for biomechanical musculoskeletal dysfunction of the lower leg along with strategies for muscle system retraining and integration into functional gait. The potential for dysfunctions in the lower leg to cause compensation at the hip and lumbo-pelvic region is also presented.
The development of dysfunction specific retraining programmes to regain functional stability of the lower limb is based on a clinical reasoning framework. This course is orientated to a ‘hands on’ practical application of dysfunction assessment and stability retraining using patient examples where possible

Key Features

• Gait and lower limb alignment analysed from the perspective of restriction and compensation developing into uncontrolled movement


• The development of dysfunction-specific retraining programmes to regain functional stability of the hip and lower leg based on a clinical reasoning framework

Learning Outcomes

At the end of this course the student should be able to:

• Understand the development of uncontrolled movement and stability dysfunction
• Analyse the inter-relationship between restriction and compensation in articular and myofascial tissues
• Classify muscles roles based on function & dysfunction
• Understand the normal control mechanisms of the lower leg in gait
• Discuss the development of uncontrolled movement with respect to alignment influences, sagittal control and rotatory control
• Understand key points to evaluate when analysing gait
• Clinically assess lower leg (knee, ankle and foot) motor control strategies to identify and diagnose the uncontrolled movement
• Identify and correct global imbalance in stabiliser - mobiliser function of the lower leg

The participant should demonstrate the ability to apply principles of assessment and motor control retraining to:

• Follow a systematic and logical approach to the assessment of stability dysfunction
• Develop an integrated management plan
• Apply rehabilitation strategies to retrain specific dysfunction and manage uncontrolled movement and pain in the lower leg
• Use re-assessment tools to guide the rate of progression of an individual patient through their rehab programme

Programme Outline

Gait

• Functional implications of double and single leg support
• Dysfunction during gait
• The 'sagittal blockade'

Alignment

• Static & dynamic lower quadrant alignment

Structural vs functional faults and tests of the lower leg

Uncontrolled movement at the knee

Uncontrolled movement at the foot & ankle