Module: Masterclasses

impairments of the lower leg


Knee, shin, foot impairments and gait are viewed from the perspective of movement control impairments and restrictions of normal function. The evaluation and diagnosis of movement control impairments are explored. Identifying and mobilising relevant restrictions along with retraining movement control and efficiency and functional recovery are explored.


Course Outline

Movement control impairments of the lower leg commonly present with symptoms and functional restrictions which result as compensation strategies for various restrictions. These uncontrolled compensations can present as mal-alignment and rotational strain dysfunctions. Movement control impairments 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 movement control impairments in the region.  These movement control impairments present as altered recuitment and strenght in the neuromotor system.

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

Specific tests of movement control impairments 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  specific retraining programmes to regain functional control of the lower limb is based on a clinical reasoning framework. This course is orientated to a ‘hands on’ practical application of movement control assessment and 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 impairment-specific retraining programmes to regain functional control of the  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 movement control impairments
  • 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 movement control impairments
  • 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 - assessment & retraining
  • Uncontrolled movement at the foot & ankle - assessment & retraining


Kinetic Control courses are designed for medical health professionals such as physiotherapists, osteopaths, chiropractors, podiatrists etc registered with the HPC. In exceptional circumstances experienced non medical health professionals may be allowed to attend Kinetic Control courses but these participants MUST be able demonstrate that the course material is within their scope of practice and that they have appropriate professional liability insurance to cover them for their attendance at the course and the course content.

This course has both theortical and practical elements. Please come prepared for the practical work.