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  1. #3
    Join Date
    Dec 2015
    Wilton Street Glasgow

    Re: Windlass mechanisms - plural - and diabetes

    So can footwear contribute to ongoing problems with plantar fasciitis ? I believe it can and that the problem may in part be due to the inhibition of the primary Windlass mechanism .

    The primary Windlass mechanism ,as described in my previous posts on this thread , occurs just prior to, and during the weight acceptance phase of gait ,when the toe extensors first actively dorsiflex the toes ,prior to foot contact ,then eccentrically resist toe plantar flexion caused by ground reaction forces ,thus substantially reducing the forces the plantar fascia is subjected to . (loading of the fascia is more gradual )

    So one question which has arisen in respect to this theory is , does the anatomy of the foot lend it's self to the mechanics suggested ?

    Well ,I believe it does since the active tensioning component on the top (the extensor muscles ) and the passive band on the bottom (the plantar fascia ) are directly connected to each other via their attachments the the base of the proximal flange .

    As a simple thought experiment think of a flexible . shatterproof 12 inch ruler with a small roller placed at one end . Now imagine a thin leather belt lying along the underside of the ruler ,over the roller and then back along the top of the ruler .Imagine also the base of the ruler and the underside section of the belt are fixed in place in a vice of some description . Ok ,now pull on the upper free end of the belt . The ruler will curve upwards .

    However if you start off with a ruler which is already configured in an arch shape ,similar to the foot (apex uppermost) , then you will find that the arch deepens as you pull on the upper end of your belt .It will not invert back the other way . The arch / belt system will become better at resisting forces acting the straighten out the ruler -it is more rigid .

    So it is with the arch of the foot ,the extensors and the plantar fascia .

    So there are 2 windlass phases . A primary phase which involves active dorsiflexion of the toes before heel contact then plantar flexion during weight acceptance , and a secondary windlass phase which starts with passive dorsiflexion during later stance then moves to active plantarflexion of the toes during toe off .
    The primary plantar phase is likely affected by footwear unless a spacious toe box is present .

    If you have a primary Windlass phase as well as the accepted secondary Windlass phase ,then can the efficiency of the primary phase be improved by increasing the range of motion of the toes in dorsiflexion .
    Might an increased range of motion of the toes produced by Rathleff's exercises be the key component of his treatment regime ?

    High-load strength training improves outcome in patients with ... - NCBI

    1. Similar

    by MS Rathleff - ‎2015 - ‎Cited by 39 - ‎Related articles
    Scand J Med Sci Sports. 2015 Jun;25(3):e292-300. doi: 10.1111/sms.12313. Epub 2014 Aug 21. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Rathleff MS(1), Mølgaard CM(2), Fredberg U(3), Kaalund S(4), Andersen KB(3), Jensen TT(4) ...
    Gerrard Farrell


    , Yesterday at 6:30 PM

    And Finally-

    Here is a good slow motion film showing what I am presently calling the primary and secondary Windlass mechanism phases .

    I have no idea who Ken Bob is , but bet he does not know he may have a fine example of a primary Windlass going on , which may be preventing excessive loading of his plantar fascia !
    Barefoot Ken Bob slow-motion on treadmill - YouTube

    ▶ 0:40
    17 Aug 2010 - Uploaded by Ken Bob Saxton
    Harvard University, Dr Daniel Lieberman's Skeletal Biology lab Note the subtle fore-foot landing. I'm not ...
    Last edited by Gerrard Farrell; 03-09-2018 at 05:44 AM. Reason: typo / clarity

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