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The foot and ankle

Dr Youssef masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

Dr Youssef Masharawi

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Dr Youssef Masharawi

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Dr Youssef Masharawi

PRONATION - triplanar movement consisting of: calcaneal eversion dorsiflexion of the talus abduction of the talus

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Dr Youssef Masharawi

SUPINATION triplanar movement consisting of: calcaneal inversion plantar flexion of the talus adduction of the talus

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Dr Youssef Masharawi

Talocrural joint - ankle joint Normal range is considered to be approximately 20 of DF, and up to 50 of plantarflexion. At least 10 of dorsiflexion and 20 of plantarflexion is considered necessary for normal gait and obviously a lot more than this for athletic activities. The primary function of the talocrural joint is to smooth the pathway of the knee.

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Dr Youssef Masharawi

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Dr Youssef Masharawi

Subtalar joint
O.K.C. sup = cal inversion adduction plantarflexion O.K.C. pron = cal eversion abduction dorsiflexion C.K.C. sup = cal inversion abduction dorsiflexion C.K.C. pron = cal eversion adduction plantarflexion

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Dr Youssef Masharawi

Pronation at the STJ is accompanied by internal rotation of the tibia Supination is accompanied by external rotation of the tibia The total range of movement in this joint is thought to be approximately 18 , with 1/3 being into pronation from neutral and 2/3 into supination
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The primary functions of the STJ are to:


To absorb transverse plane rotation of the lower extremity during stance phase of gait Act as a shock absorber a. directly, by shortening of the limb at heel strike (up to 1cm) b. indirectly, as IR of the tibia is faster than IR of the femur, thus unlocking the knee joint and allowing the necessary rapid knee flexion c. converting th foot into a mobile bag of bones during pronation

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Dr Youssef Masharawi

Direction of physical examination depends on which type of foot problem


Acute sprained ankle: find most restricted movement differentiate broadly which joint most involved Single spot pain / 2 separate areas of pain: localize area very finely differentiation very important must be precise focus quickly on local area Post immobilization: multiple joint and movement involvement P/E gross movements > which joints/movements predominate differentiate which joint is major problem with each movement
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