The alignment of the rearfoot complex axis as a factor in the development of running induced patello-femoral pain

摘要

Excessive or prolonged tibial rotation associated with excessive or prolonged rearfoot pronation has been cited as a major factor in running induced patello-femoral pain. The degree of tibial rotation is not only governed by the extent of rearfoot motion but also on the position of the axis about which that motion occurs. This paper describes a technique to quantify the degree of tibial rotation induced by a known quantity of frontal plane heel/leg (rearfoot complex) motion during static stance, expressed as the tibial rotation (TR) rearfoot complex (RC) ratio, and use of this ratio as an indicator of the position of the rearfoot complex axis. The TR/RC ratio was determined for each limb of 12 injury free controls and for the painful and non-painful limbs of 15 runners experiencing unilateral running induced patello-femoral pain. Correlation coefficients for each TR/RC plot strongly indicated that, for the range of motion studied, a linear relationship exists between tibial rotation and frontal plane rearfoot complex motion (p < 0.01). The results indicated no significant difference between the average TR/RC ratio of the control group and that of the injured group (p > 0.05). The data has been used to determine the orientation of the average axis of the rearfoot complex, which was found to lie at 48° to the transverse plane.