After
being exposed to the Movement LinksⓇ approach to the tripod foot position, I began
applying it in the clinic to patients who would benefit from getting better
foot centration and stability during their
home exercise program (HEP), as well as in their daily activities.
As
with all programming, some patients will readily accept anything you say while
others might be more hesitant. This blogpost
serves to give you some strategies that I have found helpful with the latter
population.
After
introducing and setting up the patient for the foot tripod position (see video below), here are some options that
reinforce its functionality to get the buy-in so that the patient is more
likely to carry over the training at home.
Tripod Foot Training
Standing
Isometric Contractions
The patient begins in standing, I
then ask for a near maximal quadriceps contraction, and direct the patient’s attention
to the quality and intensity of the contraction. After ensuring a good
foot tripod, I will ask for a second maximal quadriceps contraction, and ask if
there's a difference.
I will repeat the position, but this
time with gluteal activation.
Step
Up
The patient will perform a 12"
step-up, both with and without the tripod in place. I will direct the patient to compare the
effort it takes and the power perceived in the legs between the step up with
and without the tripod position of the foot.
Half-Lunge
The patient performs a forward lunge, with attention to the lead
knee and thigh. Should the movement
result in a dynamic valgus (excessive pronation leading to tibial internal
rotation distally concurrent with hip adduction and internal rotation
proximally), cue the foot into a tripod position. This centration tripod position should
mitigate this dynamic valgus significantly.
I
won't necessarily use all three strategies. I will pick and choose based on what the
patient has issues with and what I think will get the most buy-in.
Blogpost
by Locatelli Rao, DPT
Movement Links Certified Clinician
Pasadena Physical Therapy
Movement Links Certified Clinician
Pasadena Physical Therapy
