Thank you for your question. Although there are lots of tight hip flexors in our society, they can also be weak. And we also must be able to differentiate between a client’s sense that they feel tight and what their assessment(s) tell us.

We can look at postural assessments of pelvic tilt, hip joint alignment relative to the plumb line, passive ROM, active ROM and functional movement patterns of hip extension to assess tightness and/or weakness.

Posturally, if the hip joint axis is forward of the plumb line when a client is standing that is a reflection of a posturally lengthened hip flexor muscle group and an indication of structural weakness. This can be seen in the Form 1 in the Pain-Free Program.

What I described is not inaccurate. Multiple authors refer to this position as supination of the rear foot and mid foot or just as supination of the foot that is occuring.

I had a meeting with Dan Cipriania Phd., P.T. this morning on an unrelated matter and ran our conversation by him for his input. And he agreed that it is a matter of real and relative motion and that the midtarsal joint is in fact supinated at that point if the anatomical is our point of reference.

He also added that it is the closed packed position for the mid tarsal joints which adds to the foot stability (something I had not considered).

But I had considered the effects of the opposing pulls of the posterior tib and the peroneus longus. Their counter forces create a stirrup effect on the plantar surface of the foot adding to its stability.

I did not say there was “none to very little force”-I specifically said GRF (ground reaction force). Stability can be generated without GRF’s as in any tensegrity model. Stability that occurs via tension versus compression.

Thank you for posting this exercise! This is no doubt a beginner’s question, but will you kindly explain why we want to strengthen the hip flexors here? I’ve always been taught the hip flexors are already chronically tight in most people from hours of sitting. I do understand that muscles can be both tight and weak. I am just wondering why strengthen first? Why not elongate first?

Thank you so much!
Tracy

Shawn

Are you saying EVERSION occuring is real or relative to the subtalar joint?

I agree with most of what you said that this is what happens during normal gait. Keep in mind that the locking and unlocking at the longitudinal axis of the midtarsal joint occurs as a response to the body’s center of mass moving from behind the calcaneus, over the midfoot and then eventually to the metatarsal heads.

Ideally in normal gait the talocrural joint is dorsiflexing before heel rise and the pending inversion that will take place at the calcaneus. This would also be coupled with knee and hip extension and the tibia and femur would be externally rotating.

No movement of the body’s COM, dorsi flexion or hip/knee extension is happening during this exercise. The tibia is just moving up and down vertically and the only ground reaction forces that come into play are at the met heads and toes at the top of the movement. And very little GRF’s at that.

The client is instructed not to push too much with the toes and instead initiate the motion with the hips. This is almost akin to open chain supination until the top of the movement.

So after all of this very good dialogue, we may be doing a little comparing of apples to oranges.

Great stuff though and I appreciate all your input. If you want to discuss more on the phone, let me know.

Thanks again.

Thanks for clarifying. Ok, the only way to keep all five met heads on the ground, as demonstrated by Wendy, while the rearfoot (calcaneus) is inverting at the subtalar joint, is for EVERSION to happen at the longitudinal axis of the midtarsal joint. This, along with plantarflexion of the 1st ray, plantarflexion at the oblique axis of the midtarsal joint, and dorsiflexion at the MTP joint, is what creates the “locking mechanism” and a rigid foot to propulse over.

Shawn

Yes, at the top of the movement, the rear foot, mid foot and forefoot are all rotating laterally along a longitudinal axis relative to normal weight bearing or mid stance in gait. Real and relative motion being accounted for between the different areas of the foot.

My point in saying it is not a calf exercise was not meant to imply that the plantar flexors are not being used. In fact, at the very top of the movement when the heels are maximally raised from the floor this can only be done with the plantar flexors as I’m sure you know.

The movement at first glance looks very much like what occurs on the seated calf raise machine. And Corrective Exercise 17 can be done incorrectly from a corrective exercise perspective by just raising the heels and not engaging the hip musculature.

Therefore, the functional purpose of the exercise is not about working the calves in the traditional sense, but they are involved.

Thanks for helping me clarify for others if I wasn’t clear in the video.

Anthony