REIDER PART 2
07

Chapter 7_Lower Leg, Foot, and Ankle 267

Figurę 7-30. Multiple toe deformities Associated with rheumatoid arthritis.

spring ligament. The plantar fascia contributes morę mechanical support to the arch than the spring ligament, plantar ligaments, or intrinsic muscles.

Gait

Observation of the lower leg, the ankle, and the foot dur-ing normal gait reveals a predictable pattern. At heel strike, the heel hits the ground with the foot in a supinated position. As the limb progresses into the first half of stance phase, the planted leg intcrnally rotates, the heel everts, and the foot pronates. During toe-off, the leg extcrnally rotates, the heel inverts, the longitudinal arch rises, and the foot then supinates. Overall, the stridc length and the time spent in stance phase should be equal in both lower limbs.

Antalgic Gait. An antalgic gait is an intuitive, self-pro-tective adaptation to pain generated during the stance phase of gait. Pain that is induccd by weightbearing any-where in the lower extremity can produce a similar pattern, so the examiner needs to observe carefully and

Figurę 7-31. A, Residual forefoot adduction from a clubfoot dcformity of the left foot. B, Rocker bottom deformity.