You only have to see a young Fijian boy rapidly climb a tree to see how the foot stillmaintains its grasping function.
Our current foot
shape dates 40 to 100,000
years. We now stand perched on a ledge(the sustentaculum tali of the calcaneus) and topple frequently on the sporting field tosprain the lateral ligament conylex (Fig. 1).
Even worse where there is a high medial arch( eg pes cavus).Design problems remain.
The foot and ankle is commonly injured in sport; such injuries account for 25% of allsporting injuries (Fig. 2).
allows 25° dorsiflexion, 35° plantar flexion and 5° of rotation.The instant centre of motion lies on a line along the tips of the malleoli and postero-laterallyon the talar dome. Up to 5 times body weight is transmitted across this joint.
is gained by the talar mortise and ligament support. The subtalar joint functionslike a hinge and allows eversion and inversion. The mid-foot permits abduction andadduction. The forefoot flexion and extension. Pronation of the foot (5°) is coupleddorsiflexion, eversion and abduction, supination (up to 20° is coupled plantar flexion,inversion and adduction. The foot transmits 3 times body-weight with running and hasarches (medial, lateral, transverse). The second metatarsal is the keystone of the mid-footin gait (the first metatarsal in the stance phase).
(walking – one foot is always on the ground; running – both feet off the ground at onepoint) has two phases (stance and swing) (Fig. 3).
The usual gait cycle has gained credence through repetition but is well over due for a reexamination and re –thinking.
Video analysis allows documentation and correction of abnormal running postures (Fig. 4).