Mid-foot bone stress injuries can be tricky to manage.
People often make the mistake of treating them as an ankle injury.
To achieve successful outcomes it is vital to challenge the foot and be progressive through an isolate then integrate approach.
🧵on our rationale 1/11
Footballer - Midfoot bone stress injury.
Video 1: Peroneus brevis.
In plantarflexed positions peroneus brevis produces ankle eversion prior to heel strike.
Video 2: Peroneus longus.
Stabilises the 1st ray and transverse arch during full weight bearing.
Video 3: FHL
FHL strength has correlated with CoD speeds and agility tests.
The 1st MTPJ has to withstand relatively large dorsiflexion moments during running / jumping.
Withstanding medial column load is key following this injury.
Video 4: Short foot anti inversion.
EMG suggests that foot intrinsics reduce stress at the medial longitudinal arch.
Video 5: FHL / intrinsics
Focus on controlling the medial longitudinal arch / hindfoot during toe-off.
Video 6: Plate raises
Tibialis anterior strengthening with overall robustness of the foot / ankle as the aim, whilst also having anecdotal benefits for improving calf strength.
Video 7: Standing plantar push
Replicating the demands of running stance phase.
Although holding isometrics may better replicate running demands, pushing isometrics allow the individual to self-select the intensity, which is helpful during early reloading of bone stress.
Video 8 Impact loading 1
Static loads even with high stress/strain do not initiate osteogenesis.
High impact exercises producing a larger rate of bone matrix deformation are most effective.
Videos 9: Impact loading 2
Static loads even with high stress/strain do not initiate osteogenesis.
High impact exercises producing a larger rate of bone matrix deformation are most effective.
We believe in a Physiotherapy which combines clinical assessment with targeted manual therapy & clinically reasoned progressive overload.
The gym is an extension of the treatment room for the delivery of bespoke rehabilitation programs matched to pathology and future tasks.
Follow us for more rehabilitation tips and inspirational patient journeys.
Save this thread for help with midfoot injuries.
R4P LIVERPOOL - BETTER EVERYDAY
#bonestressinjury #footinjury #physiotherapy #rehabilitation
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