Thanks for the comments on the hip's relationship to PFSS. Comments help jog my brain, so do so frequently. SPG made a comment about placing the heels of the squatter on a barbell plate as a diagnostic tool. You would think that it would exacerbate symptoms, but not necessarily. If there is a deficit in dorsiflexion, the foot will bail out in the frontal or transverse plane, or both. Elevating the rear foot creates pseudo dorsiflexion during the squat, and will alleviate PF pain, if the TP or FP is creating the dysfunction. Of course, it is not a fix.
Oh, and thank you JH for mentioning the contribution of the contralateral hip to PFSS, and using a leg driver to sniff it out.
If you get a chance, take a look at the August issue of JOSPT. I will be commenting on the PFSS article.
7 comments:
Joe is this the article you were referring to?
"Proximal and Distal Influences on Hip and Knee Kinematics in Runners With Patellofemoral Pain During a Prolonged Run"
I read the abstract I don't have access to the jounral's full article.
I'm not sure how the weight plat ero 2X4 creates dorsiflexion when placed under the heel or rear foot. When the rear foot is elevated, the foot becomes plantarflexed taking out dorsiflexion?? Am I not understanding this right?? If I'm correct...doesn't this also place the center of mass more posterior shifting the knees, tibia, femur, etc posteriorly as well? Just want to make sure I'm seeing this accurately.
Thanks for tolerating my questions!!
Jonathan
"pseudo dorsiflexion"= more knee excursion in the sagittal plane. You are correct- the actual foot position is plantar flexion. Don't agree with the posterior shifting of the mass; maybe if the athlete feels off balance and sits back on their heels.
Joe,
Thanks for answering my questions. I have one more.
The "excursion in the saggital plane" does that excursion occur forward or backward or both in the saggital plane?
JH- Place a couple rolls of tape beneath your heels and do a few prisoner squats. Then try it without the tape. Which one places more stress on the patellar tendon? That will tell you in which direction the excursion is going.
Joe,
I did the prisoner squats like you said, first with the tape under my heels and second without the tape. To be honest I really didn't feel a difference either way until I got past 90 degrees of knee flexion. And to be honest I felt it more with the tape than withouit the tape once I got past 90 degrees of knee flexion. So why the increase of tapellar tension? I'm not sure, My co-worker was not able to identify any type of excursion visually and although I felt it more with the tape that could be due to an increase of teh joint angle rather than an actual excursion? (Just thinking out load)
However I think I am an anomoly as I can SL squat to the floor and back up again on either leg.
In general, the torso angle is greater with the heels on the floor, making for less knee excursion. For MOST. UE-to-LE symmetry has a lot to do with how much excursion elevating the heels will give you. OK, discussion closed, I have to prepare for my next post. Those who wish to indulge further can go to the NSCA's website and search some of the journals on the subject.
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