Anatomy 101: The windlass mechanism & great toe extension

Last month there was a strong focus on the foot and ankle complex and it is time to come back to an old biomechanical concept - the windlass mechanism. This time we look back at 1954, when J.H Hicks wrote about the plantar aponeurosis and proposed a biomechanical model explaining how diverse the function of the joints of the foot are between weight bearing and non weight bearing. 

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Calving it up

The first aim for this blog was to highlight how we can break down the components of a dynamic balance test such as the SEBT, or understand the requirements for normal gait and stair navigation. The second is to emphasise the importance of making sure that our early stages of rehabilitation allow for sufficient time to help our patients develop the range of movement, muscle length and neuromuscular control to allow them to be successful when integrating these components together. I recognise that these exercises aren't radically new or fancy, heck they can be just down right boring, but when done right and combined with the education as to why, they can be hugely impactful

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Hacking into your own rehab

This is a first for Rayner & Smale, which I hope paves the way for future discussions about optimising patient recovery, and involves a open dialogue between myself and my client Sophie. The idea stems from my continual drive to ensure that patient's feel engaged in their own rehabilitation and empowered to drive their own journey. But more than that, they need to know how and they need to want to do it.

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Finding your stride

I've always considered gait to be important, but even more so now, I feel that gait is one of the most important parts of my assessment. It is really important to build rehabilitation programs from the ground up and that means starting with gait observation.These are some of the questions that I go through with my patients while breaking down their gait pattern. I try to use as many external cues as possible and not talk about specific muscles because the ultimate goal is not to think while walking.

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Anatomy 101: Ankle Syndesmosis - Distal Tibiofibular Joint

This rugby season, I have treated nine players who sustained ankle syndesmosis injuries. To familiarise myself with the anatomy, I pulled out my trusty Moore Anatomy textbook, however found the information available very limited. The goal of this blog is to detail the anatomy and function of the ankle syndesmosis, to allow more effective and efficient treatment of this region.

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