1. The foot by being a flexible adapter allows the rest of the body to be eccentrically loaded in all three planes through the entire CChhaaiinn RReeaaccttiioonn.
2. The foot by being a stable propeller allows the rest of the body to be concentrically unloaded in all three planes through CChhaaiinn RReeaaccttiioonn.
3. The foot demonstrates tremendous stability while it is mobile and provides for tremendous mobility while it is stable . . . mostability.
4. We need to design the functional environment with a conscious understanding of function to facilitate the desired subconscious reaction of the foot as a part of the CChhaaiinn RReeaaccttiioonn.
5. There are many specialized tests for the foot, such as gait analysis and excursion tests, that will help analyze the foot in all planes of motion.
6. Foot analysis should include both controlled and natural environments.
7. We must create the environment to treat the cause of an injury as well as its symptomsand compensations.
8. A key functional strategy is to consciously direct the training exercises in order to make the reaction subconscious.
9. The 3D Jumping Jack Matrix and all its possible tweaks, is one of the best ways to use the hips, trunk and shoulders to increase foot speed.
10. Training reactively rather than rhythmically requires the athlete to load more functionally.
11. The most active part of the golf swing is the feet.
12. Although the motion of the feet are not as great as the hips, trunk and shoulders, their proportional significance as a teammate for an effective golf swing is of even greater significance than any other body part.
13. PEAK PE is a Healthier Physical Education founded upon our understanding of function.
14. Research supports the top-down, bottom-up approach to function.
15. Valid foot studies include measurement systems that measure not only foot move-ments, but also related movement at the hip and at the knee.
v1.4 THE FOOT Our Foundation
By: Gary Gray, PT
OBJECTIVES FOR THE FOOTFFUUNNCCTTIIOONNAALL GGUUIIDDEE
To assimilate up-to-date information and knowledge about the foot and it’s dependencies on the rest of thebody.
To learn how to apply effective functional techniqueswhen testing, training and rehabilitating the foot.
To understand and appreciate the tri-plane CChhaaiinnRReeaaccttiioonn principles as they apply to the foot.
HOW TO USE THIS FFUUNNCCTTIIOONNAALL GGUUIIDDEE
This functional guide can be used as a convenientsummary of the program’s contents to take with youafter viewing. You can also use this guide as a notebook; space has been provided so that you canmake notes on relevant tracts as you watch them.
Strategy 1 - Bottom-Up/Top-DownWhen dealing with the foot, it is essential to understand the function of the footand then relate its function to its influence on the function of the rest of the body.It is just as important to understand the function of the body and then relate thatfunction to its ability to influence the foot.
Strategy 2 - Mobile Stability (Mostability)The magic of the foot is its ability to quickly transform from a mobile adapter to astable propeller. The functional strategy to take advantage of is the realizationthat the foot demonstrates tremendous stability while it is mobile, and providesfor tremendous mobility while it is stable . . . mostability.
Strategy 3 - Simple ComplexityThe function of the foot is complex. The function of the body is complex. Wemust understand these complexities so well that they provide us with a simpleand functional understanding of what is really going on and why.
Strategy 4 - Consciously SubconsciousFoot function is 100% subconscious. What the foot does is entirely reactive.There is no time for any thought processes whatsoever. We, therefore, mustknow what the foot reacts to and how it reacts to those forces in order to functionally evaluate, test and train. We need to design the functional environment with a conscious understanding of function to facilitate the desired subconscious reaction of the foot as part of the CChhaaiinn RReeaaccttiioonn.
Introduction: The Miraculous Feet Bones . . . ligaments . . . tendons . . . muscles . . . nerves . . . proprioceptors . . .It is really amazing to understand that when the foot makes contact with theground it becomes a shock absorber and it allows, through the CChhaaiinn RReeaaccttiioonn,the knee to also be a shock absorber and the hip to be a shock absorber as wellas the trunk in all three planes of motion. Through transformation a ChainReaction occurs that causes the foot to become a rigid lever and facilitates anunloading of the entire chain. We will be taking a detailed practical look at thefoot, a remarkable tool in our functional success.
Two Responsibilities of the Foot
1. Becomes a flexible loader the body uses to absorb shock
2. Becomes a stabilizer the body uses to propel
Dual Approach to consider when evaluating, rehabilitating, training and conditioning.
“It is very important that we appreciate the foot, not only from the ground up,what it does to the knee, what it does to the hip and the rest of the body, but it isjust as important what the rest of the body is doing for the foot.” - Gary Gray
Top Down Approach (Body reaction forces) Effective evaluation and treatmentof foot function is enhanced by considering the wisdom of looking at the functionof the entire body as it relates to the foot.
Bottom Up Approach (Ground reaction forces) Effective evaluation and treatmentof foot function is enhanced by considering the wisdom of looking at the functionof the foot as it relates to the rest of the body.
Basics of Foot Function Reviewed
• The foot by being a flexible adapter, because of ground reaction, body weight, gravity, and momentum, allows the rest of the body to be eccentrically loaded in all three planes through the entire CChhaaiinn RReeaaccttiioonn.
• The foot by being a stable propeller, through its body reactive transformation, allows the rest of the body to be concentrically unloaded in all three planes through the CChhaaiinn RReeaaccttiioonn.
Simple Complexity
“On the surface the foot is fairly complex, but when you truly understand what itdoes and why it does it, it becomes fairly simple and it becomes an integral partof your whole functional process to benefit those that you have the opportunityto work with.” - Gary Gray
Case Presentation with Bill Kenyon
History - Intermittent chronic left calf strain with recent (1 1/2 weeks ago) acute strain• Unable to train• Long time runner with proper shoe wear• Wants to run in a race real soon • Does “traditional” calf stretches after one-mile jog warm-up and after training run
Gait Analysis• Fast Normal Walk Focus: quick glance at symmetry, angle, base of gait• Toe-In Walk Focus: how feet and body deal with internal rotation position of hips• Toe-Out Walk Focus: how feet and body deal with external rotation position of hips• Long Stride Walk Focus: exaggeration of sagittal plane requirements• Low Ceiling Walk (Squat Walk) Focus: ability to ambulate while in flexed posture• Low Ceiling Walk/Toe In Walk Focus: flexed posture with internally rotated position(Note: early heel lift left side)
Excursion Tests• Knee flexion excursion right and left• Knee flexion excursion right and left with arm rotation• Ankle dorsiflexion excursion right and left• Ankle dorsiflexion excursion with hip driver to externally rotate and invert foot(Note: lack of ankle dorsiflexion on left with foot “locked up”)
Supine Examination of Feet• Mid-tarsal joint motion (locked and unlocked)• 1st ray position and motion• Hallux motion • Calf and tendon palpation
Hip Hiker Test Focus: checking for symmetry
TrueStretchTM Exam• Right foot everted on platform with facilitation of additional internal rotation by trunk
and arm position / right knee extended and flexed• Left same as right (mirror image)
(Note: decreased left knee flexion with tightness / tenderness in calf)• Right foot inverted on platform with facilitation of additional external rotation by trunk
and arm position• Left same as right (mirror image)
(Note: lift of left heel, lack of ankle dorsiflexion with knee extended and knee flexed• Repeat of mini right knee squat (knee flexion eversion) with arm rotation• Repeat of mini left knee squat (knee flexion eversion) with arm rotation
(Note: decreased trunk rotation with left sided test)
Analysis Debrief with Bob Wiersma• A “quicker” examination with certain assumptions because of previous familiarity• However, assume nothing before the evaluation process begins
Why We Typically See Calf Strains• Prolonged sitting• Different types of shoe wear• Variable ground surfaces• The calf controls many parts of the body besides the foot, ankle and knee• Disuse (improper use) syndrome
Key Elements of Every Foot/Ankle Evaluation• Gait with and without shoes, properly tweaked• Foot structure and foot dynamics• Full body functional profile• Bottom-up drive, top-down drive• All three planes of motion• Controlled environment evaluation, i.e., TrueStretchTM
• Normal environment evaluation i.e., Balance Reach Tests
Discussion of Functional Documentation
Problem Presentation
Rehabilitation is integrated into the analysis with the presentation and demonstrationof the problem.
Key Problem
1. Lack of proper warm-up, training and conditioning of calf group in preparation for hills and uneven terrain.
2. Lack of calf group eccentric flexibility with ankle dorsiflexion, mid-tarsal joint “locked-up”, heel inverted and leg externally rotated (requirement just prior to heel lift during running, especially on hills and uneven ground) and hip extended.
Plan
• Teach more functional warm-up during one-mile warm-up jog
• Teach proper and more functional calf stretch
Demonstration and Teaching of TrueStretchTM Calf Stretch and Wall CalfStretch
Emphasis
• Hands high to get hip extension
• Drive knee to wall
• Drive knee back and forth
• Create sagittal plane load along with transverse and frontal plane load in foot, ankle, calf and knee
Explanation of 3D Walk/Jog Matrix Warm-Up
For detailed demonstration of all 3D Walk/Jog Matrix warm-up exercises referto: 3D Walk/Jog Matrix Video by Gary Gray at Functional Design Systems. Call: 800-230-8300 or log on to functionaldesign.com (Quest Videos)
Home Workable Exercises with Goals and Expectations
Scheduled Follow-up
Rehabilitation Debrief with Bob Wiersma, Executive Director, FunctionalRehabilitation Network
• The assumption of being either right or wrong
• Creating the environment to treat the cause / symptoms / compensations
• Offer honest advice as part of the treatment
• List of challenging questions
• Sometimes the answer is, “I have no idea”
Gary Instructing Doug’s Foot Quickness Workout
Goal of Training Session - Take advantage of Doug’s hip, trunk and shoulder powerto develop increased foot quickness.
Functional strategy of Training Session (consciously subconscious)“The best way to get quickness is not to think about quickness.”The strategy is to consciously direct the training exercises in order to make the reactionsubconscious. “Get the mind out of the act.” - G. Gray
Functional Process - Begin with simple (known) exercises and move away from thetargeted part (feet) with more complex movement in all three planes of motion withspeed and task oriented tweaks. Let the body generate the force to move the feet morequickly and effectively so the feet can move the body with more power and efficiency.
Primary Functional Goal - Have fun while enhancing function
3D Jumping Jack Matrix ExercisesLegs ArmsFrontal - out of sync -Frontal - in sync -Sagittal - out of sync -Sagittal - in sync -Transverse - out of sync -Transverse - in sync -Frontal - out of sync Frontal - out of syncFrontal - out of sync Sagittal - out of syncFrontal - out of sync Transverse - out of syncFrontal - out of sync Transverse - in syncFrontal - in sync Transverse - in syncFrontal - in sync Transverse - in syncSagittal - out of sync Transverse - out of syncSagittal - out of sync Frontal - out of syncSagittal - out of sync Sagittal - out of syncTransverse - in sync Sagittal - out of syncTransverse - in sync Frontal - in syncTransverse - out of sync Transverse - out of syncThere are multiple variations for the 3D Jumping Jack Matrix
Speed Ladder Drills• Frontal and sagittal plane drive - two in and two out each way• Sagittal anterior and frontal plane drive - one out (hold) and two in• Sagittal posterior with frontal plane drive -one out (hold) and two in • Sagittal anterior with frontal plane drive - one out and two in• Sagittal posterior with frontal plane drive - one out and two in• Sagittal anterior with frontal plane drive - double speed ladder - one out and two in -
frontal plane transition • Sagittal anterior with frontal and rotational plane drive - double speed ladder - one out
and two in - transverse plane transition (forward and backward rotation)• Sagittal anterior reactive with frontal plane drive - one out and two in - react and
explode forward (Note: Create patterns with the speed ladder that are predictable as well as more reactive in all three planes of motion)
Circle Hoop Drills - Create any pattern with the circle hoops
Exercises• Two in and get to next hoop• Two in with rotation transition to next hoopDiscussion of adding tweaks to the above drill
(For a list of and discussion of Tweakology by Gary Gray, log on tofunctionaldesign.com and click on to the Wynn Marketing Function Junction)
Functional Key - Progress with additions and changes in unpredictable way so the athlete will load and unload feet and the rest of the body in all possible ways. Thisrequires the athlete to react as opposed to rhythmically loading. This kind of loading is more functional. In addition, it requires the athlete to load by taking great advantageof the hips, trunk and shoulders. The natural outcome is enhanced balance, quicknessand power in desired functional movement patterns.
The Feet in Golf
“The most active part of the body in the golf swing is the feet.” Sam Sneed
Sam Sneed understood the golf swing and function so well that he knew thefeet had to give everything they had to make the rest of the body successful in order to accomplish a proper and effective golf swing.
Tri-plane foot motion is required to create the proper CChhaaiinn RReeaaccttiioonn all theway up the body, especially the hips, trunk and shoulders, for greater transformationof the golf swing from the complete back swing (loading) to a powerful down-swing (unloading) to a balanced follow through (loading).
Right Foot CriteriaDorsiflexion, eversion and internal rotation on the ground to allow effectiveloading up the chain
Left Foot CriteriaSame as right foot but even more motion in all three planes to actually causeeffective loading up the chain
Foot Waggle Drill“A waggle is a counterbalance movement in order to facilitate an effective loading movement.” - G. Gray
Plane Tweak Tweak in/out Foot Position WaggleLoading
Frontal In Everted InversionSagittal In Dorsiflexed Plantar flexionTransverse In Internally rotated External rotationTransverse Out Externally rotated Internal rotationSagittal Out Plantar flexed DorsiflexionFrontal Out Inverted Eversion
The Functional Concepts“The whole idea of any functional rehabilitation, training and conditioning programis to effectively evaluate, come up with a strategy based on success, understandhow to utilize tweakology, create the proper environments to allow for successthat will transform into desired function.” - G. Gray
“A range drill (exercise) is the right range drill (exercise) if it facilitates a moreeffective swing (function) out on the course (in the real world).” - G. Gray
The right and left foot must have the right 3D motion at the right time (mostability)to become an effective teammate. Even though the motion of the feet are notas great as the hips, trunk and shoulders, their proportional significance as ateammate for an effective golf swing is of even greater significance than anyother part of the body.
Many times the least noticed teammates are the ones that consistently revealthe greatest significance when it comes down to team success.
Our personal pursuit to understand function began over thirty years ago at the foot. The pursuit continues today as we learn more effective ways to take care of ourpatients, clients and athletes . . . and especially our kids!
Introducing PEAK PE . . . Promoting Encouragement and Athleticism in Kidsthrough Physical Education.
PEAK PE is a Healthier Physical Education founded upon our understanding of FunctionPEAK PE is functional testing. PEAK PE is functional training.PEAK PE is consistent encouragement.PEAK PE is building on functional success.PEAK PE is you vs. you.PEAK PE is creating the environment so the best you wins.PEAK PE is earned awards and recognition.PEAK PE is developing successful habits for a lifetime of health and physical fitness. For more information on PEAK PE go to ppeeaakkppee..ccoomm
Functional ResearchDr. David Tiberio, friend and functional research specialist discusses what we are learningabout function from the foot to the body and from the body to the foot.
Research Article“FFrroonnttaall PPllaannee KKnneeee AAnnggllee AAffffeeccttss DDyynnaammiicc PPoossttuurraall CCoonnttrrooll SSttrraatteeggyy DDuurriinnggUUnniillaatteerraall SSttaannccee” by John Nyland, Dr. David N. M. Caborn: Division of SportsMedicine, Department of Orthopeadic Surgery, University of Louisville, Louisville,KY; and Sports Medicine Section, Univ. of Kentucky, Lexington, KY
This article describes a comparative analysis of separated groups of people, one groupdemonstrating less than 5% varus or valgus in their knees and another group demonstratingmore than 5% varus or valgus in their knees. The study evaluates the influences on thefoot.
FindingsThe study found that those people with the larger angles at the knees demonstrated significantly more foot activity. The activity changed the pressure underneath the foot on a force platform. This supports the top down, bottom up approach to understandingfunction.
Discussion• “Chicken and the egg”• The use and effect of foot orthoses• Understanding motion, starting point, direction, amount and speed
Research Article“KKiinneemmaattiiccss UUssiinngg OOnnee aanndd TTwwoo SSeeggmmeenntt FFoooott MMooddeellss” by Brian Heiderscheit, Des Moines University, demonstrates that using the wrong model of the foot orplacing the markers incorrectly leads to significantly altered results. Presented at the Fourth World Congress of Biomechanics, Calgary, Alberta. Aug. 2002
FindingsLack of coupling the legs and the feet in a research study produces inaccurate results.
Discussion• Orthoses are a tweak to allow the entire body to be more successful• Critical research requires the combined efforts of the researcher and clinical specialists• Designing foot orthoses to enhance hip function that can be immediately tested• The use of balance reach tests*• Looking at the simple side of complexity through foot and body function
*From the Total Body Functional Profile by Gary Gray PT and Team Research. Available through functionaldesign.com
