Many critics have claimed unfair advantage to South African
runner Oscar Pistorius as he uses Cheetah Blades as
a prosthetic for is double leg amputation
Watching his gait in running, I noticed that
he is likely not getting the full benefit from his high performance, carbon
fiber prosthetic.
As seen in this picture, his left lower
extremity is in external rotation. Given the energy storing capabilities of
the Cheetah, he is not gaining the full recoiling properties. To gain
improvement in his mechanics we need figure out the cause of the left lower
extremity external rotation. When evaluating patients, my bias is to attribute
external rotation to a lack of dorsiflexion, for this individual it is clearly
not the cause.
Since there is no foot and hasn’t been one
before ambulation began for Oscar (he was 11 months old at the time of
amputation). The cause is likely a limitation at the femur, hip, innominate or
sacrum causing him to compensate with femoral external rotation due to a lack
of extension at the hip on push off. When you watch him walk he does not
externally rotate on the left, this is why I do not think there is a limitation
in hip or innominate internal rotation.
To test I would look at the following:
1.
Open Chain knee flexion- To rule out rotation
at stump.
2.
Femoral extension: Should be 10 degrees
without compensation above or below
3.
Innominate extension: With the femur should
total 20 degrees without compensation above or below.
4.
Sacral Extension: With the femur and
innominate should total 30 degrees without compensation above or below.
5.
Pelvic depression- He may lack range in pelvic
depression causing him to compensate with external rotation at the hip.
To learn more about evaluating and treating
gait dysfunction check out our course;
Restoring Efficient Balance and Gait
Through Targeted Evaluation and Treatment Strategies
Greenville, SC September 15th and 16th, 2012
Greenville, SC September 15th and 16th, 2012
