Tuesday, May 3, 2011

Home on the Range of Motion-Redux, or, Tilt-a-whirl is My Middle Name

I've spoken about the concept of range of motion before, mostly to highlight how us clubbies don't have much to play with. The thing about feet is, they are (usually) a rather remarkable adaptation by the organism known as Prince, er, humans. They are extraordinarily adaptive to changing conditions, both on the ground, and, like most amphibious critters, in the water, as well. But that adaptability is highly dependent on an adequate range of motion. When that range is restricted, well, lest just say it leads to a life of mischief. No?

OK, how's this? When you can't adjust to changes in ground contour sufficiently, your body has two choices - compensate, or fall down. Most of us, with the possible exception of skateboarders, would opt for number one - compensate. But compensation, while not that problematic in the short term, can be very problematic over time. For example, you walk down the same sidewalk every day, when going to work, with your right side pointing toward the street, and when returning in the evening, with your left facing the street. Now, nearly all sidewalks have some degree of "cant," that is, they tilt toward the street, for the obvious purpose - to shed water more effectively. But this means walking on that sidewalk off-centers your body, with one side acting longer than the other.

Now, a truly adaptive foot can accommodate this imbalance with little strain, but feet with poor, or limited range of motion are forced to use joints other than those of the feet to achieve any degree of compensatory function, meaning the ankle, knee, hip, back, and shoulder/cervical spine complexes. Depending on the duration of this forced compensation, meaning both number of such encounters, and the amount of time each such encounter takes, the compensation can create both acute (short term), and chronic (long-term) changes to the entire body. And this can be further complicated by the quality of the ligamentous tonality. That is, people with a loose ligament tonality will generally compensate to a higher degree than people with tighter tonality. But looser tonality usually permits more levels of compensation to occur at a quicker rate than will happen with tighter tonality, while having a lower likelihood of pathological impact, and tighter tonality's compensations have a higher likelihood of producing a greater pathological impact. Not the best tradeoff, but there it is.

In some respects, this may explain why some clubbies have fewer long-term issues, especially if they have a loose ligamentous tone. It might also explain why some clubbies get other gait and postural issues as they age - tight ligamentous tonality will more likely cause up-chain pathomechanics (above the feet.) If you are wondering about your own ligamentous tone, there is a simple test to at least ball-park it for you: Take your right (or left) thumb with the opposite hand, and bend the thumb down toward your forearm.  If you can get it close to, or even touch the thumb to the forearm, you have a loose tone, whereas if you can't get it much past 90 degrees, you run tight. (The phrase, "double-jointed" usually refers to someone with very loose tone.)

In my experience, I've found that people with tight tone need to be evaluated for any possible discrepancy in the functional and/or anatomical length of their legs relative to each other. Because they cannot usually compensate as readily, they will benefit the most from both orthotic and lift therapy, to help offset the trauma of poor compensation. And as for post-club feet specifically, even where there is loose tonality, there may be little benefit over tight tone. Especially where there have been many surgeries, as the more surgeries, the higher degree of scar tissue potential that further tightens the structures of the foot. This is usually a good candidate foot for rocker sole therapy.

Now, obviously, these are generalizations, but in my experience, they show themselves in these manners more often than not. I simply point out that, having a better understanding of your own ligamentous tone can help explain your won particular development over time. And while it wasn't me that originally said, "hey, its all downhill from here," it probably applies. Most clubbies I know find they have a harder time walking off paved surfaces, or on canted paved surfaces, and especially, on sand. Meaning Cabo is probably better appreciated from the cabana bar.


No comments:

Post a Comment

Welcome to The Truth About Talipes! Your comments are welcome, and strongly encouraged. We with post-club feet are the best sources of information about the issues we face. Join in! (If your comment fails to appear, make a second attempt - Blogger is known to have "issues" with Comment upload from time to time.) And right now, it seems it does not want to display comments on the main page, but it will show them for individual posts, so don't give up yet!!!