SPORT SPECIFC BIOMECHANICAL ASSESSMENT

Why do you need a Sport Biomechanical Assessment?

The biomechanics of sport differ dependant on the sport and the movements required within the sport. In running the forces going through the foot increase significantly than when walking. Normally in walking the force being applied by the foot to the ground is around 1-1.5 times body weight.

In running the load going through the foot increases to around 4-5 times body weight. As such there is more likelihood that even small biomechanical issues will become more prevalent when people take up running. It is important that when people who are new to running have an awareness of this and the potential for injury.

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Heel Pain (Plantar Fascitis)

Plantar fasciitis typically presents as pain in the heel (mostly on the inside fron of the heel) or in the arch foot. The classic description from patients is that the pain is worst when first getting out of the bed in the morning and then eases when walking a few steps. However, once up and about the issue returns when getting up to walk when sitting down.

 

It commonly presents in adults and is often related to stesses and strains from activity. Through time the plantar fascia becomes injured through wear and tear and eventually leads to what some people feel is an extremely debilitating heel pain or arch pain.

Foot biomechanical issues are very often a contributary factor and need to be considered as part of any treatment programme

The plantar fascia is like a huge elastic band running from your heel bone (calcaneus) along the bottom of your foot and up to your toes. The plantar fascia is one of the main stabilising structures in the foot when walking or running. Biomechanical issues put extra stress on the plantar fascia and through time can become inflamed and painful. Plantar fasciitis is extremely common, and effects a large percentage of the population at some point in their lives.

If you experience any of the issues described above it is very important that you seek qualified professional advice from an Orthotist or Podiatrist around how you should manage this issue. In extreme cases plantar fasciitis can develop and become more stubborn. Plantar fasciitis is in essence a soft tissue problem, but left untreated can develop into a heel spur, which is much more difficult to treat.

Our biomechanical assessment clinic in Hamilton (near Glasgow) can help you with advice and treatment for plantar fasciitis.

Within the clinic we will confirm the diganosis for you and also assess and advise how we could help address the pain and discomfort caused by Plantar fasciitis.

Flat Feet (Over Pronation)

Over pronation, hyper pronation or "flat feet" are all terms used for feet that give the appearance of rolling in excessively.

Pronation is often assumed to be a bad thing and regularly will be suggested that it should always be prevented. However, during walking and running it is quite normal for the foot when first hitting the ground (shock absorption phase) for the foot to pronate or roll inwards slightly.

Pronation is only normally an issue if this rolling in is excessive and the patient is complaining of symptoms often related to over pronation, such as: Arch or Heel Pain, Toe Joint Pain, Shin Splints or Knee Pain

High Arch (Under Pronation)

Under pronation, supinated or the high arched type foot are all terms used for feet that give the appearance of rolling outward onto the outside edge of the foot.

The under pronated foot, high arched or supinated foot is a little more unusual in comparison to the supinated foot. It is generally a "stiif" foot and often patients have less movement around some of the key joints that allow the foot to work normally.

The high arched foot often has too little shock absorption as the foot does not pronate or roll in (normally to absorb the shock on impact) as it should when first making contact with the ground in walking or running.

The high arched foot oftem means that less of the foot is in contact with the ground, meaning some areas of the foot take more pressure than normal. the conditions relating to the high arched foot are often similar in nature to those in the over pronating foot, simple due to the altered biomechanics both conditions cause.

Front or Ball of Foot Pain

Pain at the forefoot (or front of the foot) can be caused be due to a number of different issues and conditions. A few of these conditions will be described below such as:

Metatarsalgia
Pain at the forefoot generally underneath the foot in the area of the joints of the toes. It can be across all joints or on one single area of the forefoot. The pain is worsened when either in barefoot or in shoes with a slight heel, due to the lack of cushioning in appropriate shoes. In basic terms, metatarsalgia is caused by excessive point loading of an area, often due to an alignment or biomechanical issues.

Morton's neuroma
Involves pain and numbness in the areas between the 2nd-3rd or 3rd-4th toes.  The cause of a Morton's neuroma is related to nerve impingement which leads to pain and numbness in this area.

Hallux valgus
Commonly known as bunions. In this condition the big toe joint is often inflamed and painful. The big toe is deviated to varying degrees towards the 2nd toe with the 1st MTP joint more pronounced. There are a number of reasons for hallux valgus such as Overpronation and Bio Mechanics.

Hallux limitus
Issues with the motion of the 1st toe and it is reduced impacting on it's ability to move upwards (dorsiflex) when walking. The big toe has an extremely important function in walking to aid in stability and propulsion when pushing off from one foot to the next. When the foot cannot do this either due to arthriitis or poor foot biomechanics compensatory movements take place. This is likely to cause secondary issues.

Knee Pain

There are a wide variety of issues that can result in knee or thigh pain. Some of which relate to isses with wear and tear or conditions such as arthritis, but also relating to imbalances or alignment issues causing pain on activity.

Often patients report no ongoing history of knee pain but pain starts when they increase their activity e.g. running or walking more. Pain in particular areas of the leg can be related to different problems.

Shin Splints

Shin splints is an over use injury which relates to muscles in your legs working harder than they are able to do. This results in them becoming strained, inflamed and in more chronic situations can lead to stress fractures in you tibia (lower leg bone) if untreated.

There are 2 main areas where people experience shin splints. Both of which can be extremely painful during and after running and can feel like the tibia itself is sore due to the pulling from the muscles which originate in this area. Or alternatively, the muscle belly on the outside of the lower leg

What happens at an biomechanical assessment

The biomechanical assessment has 4 main stages similar to a general biomechanical assessment, however more movement specific analysis takes place e.g. video gait analysis of running to understand any changes in biomechanics when running.

Our clincial specialists in biomechanics at our clinic will assess the most appropriate way to assess your movement

Defining the Problem

The most important part of the biomechanical assessment is listening to the patient to understand the problem. It is vital that we understand the issue you have come to see us about from your persective. 

Often other clincians are keen to give patients their view of the problem when really they are not the person living with it. Instead we need to hear it from your side to understand how your problem impacts on you.

We take a history of the current and previous issues you may have as well as a full medical history to inform what may be important factors to consider before starting our assessment. Equally, we need to understand what the patient is expecting from us.

Static Alignment & Range of Motion

Once we have have taken a history we assess your body alignment including, your feet/ankles. legs, knees, hips, spine and shoulders usually standing to check for any alignment issues. We then also assess the alignment and movement of your joints when moved (passive and active movement) to check against normal limits.

Any signs of potential alignment issues, muscle weakness or imbalances are recorded and discussed with you as the assessment takes place.

Sometimes it easier if you bring shorts or leggings, however it is not always necessary dependant on where your issues are

Dynamic Alignment & Video Gait Analysis

Sometimes the problem you have with the way you walk (your gait) is not always obvious to the human eye. This is why after the assessment of your alignment we look to see what happens when you move. 

This in essence a way of confirming our findings from the static aligment and range of movement assesment. Particuarly in Sport Assessments, your gait is analysed using video gait analysis equipment to allow us to look in more detail at exactly what happens when you both walk and run. 

Often with biomechanical issues you will see compensatory movements or "trick" movements that your body adopts (without you being aware of it) to try to overcome your underlying problem. Video gait analysis as part of the assessment helps identify these.

Patient Feedback, Diagnosis & Prescription

The final part of the process is feeding back the findings of the biomechanical assessment through slow motion video gait analysis and the assessment findings.

A full and honest view of the possible treatment we can offer you, or alternatively we will advise on the possibility of us referring you to other members of our team for treatment.

For any orthotics/insoles that we may prescribe we make these on site and discuss your options as to how these may may be made to best fit your needs.