Of course.
You don't often see anyone standing or walking with their foot off of the floor, but how many people can achieve this task without compensation?
The other day in clinic I decided to passively evaluate my patient's feet and ankles moving them into a neutral position to see if their foot could articulate with the floor without compensation.
None of my patient's, age range 18-84 could achieve this motion without mobilization.
Restoring it helped to elicit an improvement in posture as well as function.
Compensations up the kinetic chain for a lack of neutral dorsiflexion in standing include the following:
- Genu recurvatum
- Anterior innominate rotation
- Knee flexion in standing (think of your elderly patients)
- Elevation of the rib cage a sternum
- Forward head rounded shoulders posture
- Thoracic kyphosis
- Rotation of the tib/fib
- Rotation of the femur
To evaluate place the patient in prone or supine and passively move the toes, metatarsals (where most the structural restrictions are), mid tarsals and ankle joint to see if the patient can achieve a neutral position in all.
As you do this look up the kinetic chain as you do this to see if there is movement including, rotation of the lower leg or femur and/or hyperextension or flexion of the knee.
In my classes I always say that I could make the world a better place, physically if I could restore dorsiflexion in my patients.
See what happens to yours when you take a close look.
