Welcome everyone, to the next episode of the Redefining Physical Therapy Podcast. I’m your host, Dr. Gray. Today, I want to just elaborate on how muscles really do function.
That’s a long-winded answer, but my team and I, we were doing a staff training thing, an event the other day, and it came up, well, what everts the foot in function.
What makes foot going to pronation when we step.
Everyone said the peroneals and that’s not true. The peroneals can evert and pronate the foot in an open kinetic chain, but in a closed kinetic chain, it’s actually done by momentum, ground reaction forces.
That was really a big breakthrough for me in my clinical practice, and I think it’s important for anyone practicing to understand that.
I’m going to give you a couple of different scenarios, because not only is it with the eversion of the foot, but we’ll talk about a golfer and that sort of thing.
What causes maybe hip internal rotation, external rotation, and that sort of thing.
Let’s talk about it. When you take a step in the gate, when I first land heel strike, my foot is relatively supinated.
But to get my foot flat, the earth gives us these natural forces called ground reaction forces that are pushing back up on the foot and basically creates momentum and causes the foot to go through pronation.
It’s not the peroneals, as I alluded to.
Now, similarly, if I’m a golfer, a right-handed golfer and I’m going into my backswing, my right hip is going through fluxion internal rotation in adduction.
Conversely, my left hip is going through extension and abduction and external rotation, and so which muscles do that? Is it your glutes on the left side, those extra rotators causing it to contract?
Is it on the right side of my hip? Is it my hip internal rotators, flexors, and adductors that are doing that?
No, it’s not. It’s momentum. That’s the difference between you actively moving it and you just reaching your hand.
That’s something that we just have to understand in function.
If someone lacked that motion in your golf assessments, so many times I see just young clinicians or clinicians that maybe don’t understand function. They will lay them on their side. They’ll have them adduct their hip, and they’ll say, “Well, why aren’t you adducting your hip?”
But the hip’s saying, “No stupid, and that’s not how I function. I get that through momentum and no muscles are doing that.
My momentum is carrying me into that position.”
The same thing goes with the left hip on that backswing. So many people will say, Oh, you got to strengthen that left glute and the external rotators hip extensors to get that.
That’s not true. It’s just not how a function works, and that’s a good paradigm shift, the way I practice understanding function.
Case in point, so where I’m going with this is, if you’re trying to get the foot to pronate in function, don’t do eversion exercises, They’re not going to help with it potentially.
You’re going to want to use a strategy of creating mass and momentum and how it’s given to us.
Something you can maybe do is put their foot, to get more momentum and ground reaction forces, is on a more everted surface.
As I step and I put weight on it, my momentum is going to drive that into that motion.
You could also take a step forward with your right foot, for instance, and then you can reach across your body to the left.
If you’re stepping with the right foot, that’s going to cause that foot to go through more pronation and get more momentum.
I could also if I’m a golfer trying to get that hip internal rotation, adduction in fluxion, I may, again, speed up and reach a little bit faster with a hand, so I’m getting more momentum.
I could even step and rotate to get more momentum. I could bias certain planes so I could reach down more. I could reach more into adduction to get the hip to adduct more, or I could reach more into the interpretation.
I could also add more load, whether it be with a dumbbell, a band, to pull me into that motion a little bit more.
In a nutshell, your muscles, a lot of times they don’t work the way we think they work in function.
It’s usually momentum and the ground reaction forces and things like that that are really causing the motion, not the muscle.
It’s, again, this is a new paradigm shift, I think for a lot of clinicians out there.
But once you do understand who’s driving what motion and how that motion is turned on and functioning, it’s going to be a big breakthrough in the way that you treat your patients.