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Foot Course

The FOOT: Physical Therapy Evaluation and Management of Common Disorders

Tom McPoil, PT, PhD, FAPTA

March 9-10, 2012
Pittsburgh, PA
Direct Access CEUs: 3
General CEUs: 11.5
Total CEUs: 14.5
Cost: $400

 Course Objectives: 
At the completion of this course, the participant will be able to:
1. Describe the joint mechanics required in the foot and ankle during walking.
2. Describe the typical pattern of rearfoot motion during walking.
3. Discuss the factors in the foot, ankle, and lower extremity responsible for causing or contributing to abnormal mechanical function of the foot. 
4. Describe and perform a thorough static and dynamic physical examination of the foot and ankle.
5. Assess static foot posture using the Foot Posture Index (FPI)
6. Describe the use of adhesive strapping as a "treatment direction test" to determine if foot orthoses are indicated.
7. Determine the amount of orthotic posting based on a functional assessment using adhesive tape.
8. List and describe the functions of a foot orthosis.
9. Perform an augmented low-dye with reverse 6 taping technique.
10. Describe the current evidence to justify the use of night splints, stretching regimes, and foot orthoses for the management of chronic heel pain.

Course Description
The purpose of this workshop is to present to the practicing physical therapist the theory and techniques required to understand foot mechanics, normal and abnormal foot motion during walking, as well as perform a physical examination of the foot when assessing lower extremity dysfuntion as a result of overuse in an orthopaedic/sports population.  A review of the principles of foot orthotic prescription will be provided as well as the evidence to support the use of both prefabricated and custom foot orthoses.  The use of the "treatment direction test" will be presented as a tool to determine if foot orthoses are indicated as well as to guide the orthotic prescription.  Assessment and management principles for chronic heel pain will be discussed.  Clinical management technqiues will focus on adhesive strapping and the modification of pre-molded foot orthoses.

Speaker Bio:
Tom McPoil, PT, PhD, FAPTA, is a Professor of Physical Therapy in the School of Physical Therapy at Regis University, Denver, CO.  Dr. McPoil has specialized in the evaluation and management of foot and ankle disorders since 1979.  He has published more than 100 referred manuscripts and 85 published abstracts, written five book chapters, and conducted over 180 workshops/lectures on the subject of foot and ankle evaluation and conservative treatment.  Dr. McPoil has also presented over 100 research papers, both nationally and internationally, on various topics related to foot and ankle mechanics, evaluation, and management.  In addition to seeing private patients at the University, he serves as a consultant for lower extremity disorders for the Department of Athletics. Dr. McPoil currently serves as Vice President of the Orthopaedic Section, APTA an and previously served as the Chair of the Foot& Ankle Special Interest Groups.  His current research activities include the development of a static lower extremity measurement protocol that is both reliable and predictive of dynamic movement. 

Course Schedule:
Friday, March 9, 2011
7:30-8:00 Registration
8:00-8:15 Introduction
8:15-9:45 Functional Anatomy of the Foot & Ankle
9:45-10:00 Break
10:00-11:00 Typical Pattern of Rearfoot Motion During Walking
11:00-12:00 Current Evidence to Support the Use Foot and Ankle Examination Protocols
12:00-1:00 Lunch
1:00-3:00 Physical Examination Procedures for the Foot and Ankle
3:00-3:15 Break
3:15-5:30 Physical Examination Lab session (shorts required)

Saturday, March 10, 2011
8:00-9:00 Treatment Direction Test
9:00-10:15 Taping (lab session)
10:15-10:30 Break
10:30-12:00 Foot Orthoses: Design, Prescription, & Effectiveness
12:00-1:00 Lunch
1:00-2:00 Use of Pre-molded Foot Orthoses
2:00-3:30 Physical Therapy Management for Heel Pain
3:30-4:00 Question Period & Course Evaluations
Course Readings

Anatomy and Biomechanics

  1. Huson, A: Biomechanics of the tarsal mechanism.  Journal of the American Podiatric Medical Association, Vol. 90, 2000, pages 12-17.
  2. McPoil TG, Cornwall MW: Relationship between three static rearfoot angles and the pattern of rearfoot motion during walking.  Journal of Orthopedic and Sports Physical Therapy, Vol. 23, 1996, pages 370-375.

Evaluation

  1. McPoil, TG, Hunt, GC: Evaluation and Management of Foot and Ankle Disorders: Present Problems and Future Directions.  Journal of Orthopaedic and Sports Physical Therapy, Vol. 21, 1995, pages 381-388.
  2. McPoil, TG, Cornwall, MC: The relationship between static lower extremity measurements and the pattern of rearfoot motion during walking.  Journal of Orthopaedic and Sports Physical Therapy, Vol. 24, 1996, pages 309-314.
  3. Cornwall, MW, McPoil, TG, Fishco, WD, et al: The relationship between forefoot alignment and rearfoot motion during walking.  Australasian Journal of Podiatric Medicine, Vol. 38, 2004, pages 35-40.
  4. Cornwall, MW, McPoil, TG: Influence of rearfoot postural alignment on rearfoot motion during walking.  The Foot, Vol. 14, 2004, pages 133-138.
  5. McPoil, TG Cornwall MW: Use of the longitudinal arch angle to predict dynamic foot posture in walking.  Journal of American Podiatric Medical Association, Vol. 95, 2005, pages 114-120.

Management

  1. Martin, RL, Irrgang, JJ, Burdett, RG, Conti, SF: Evidence of validity for the foot and ankle ability measure (FAAM).  Foot & Ankle International, Vol. 26, 2005, pages 968-983
  2. Lockard, MA: Foot Orthoses. Physical Therapy, Vol. 68, 1988, pages 1866-1873.
  3. McPoil, TG: Footwear. Physical Therapy, Vol. 68, 1988, pages 1857-1865.
  4.   Brown, GP, Donatelli, R, Catlin, PA, Wooden, MJ: The effect of two types of foot orthoses on rearfoot mechanics.  Journal of Orthopaedic and Sports Physical Therapy, Vol. 21, 1995, pages 258-267.
  5.  McPoil, TG, Cornwall, MW: The effect of foot orthoses on transverse tibial rotation during walking.  Journal of the American Podiatric Medical Association, Vol. 90, 2000, pages 2-11.
  6. Stacoff, A, Reinschmidt, C, Nigg, BM, van den Bogert, AJ, et al: Effects of foot orthoses on skeletal motion during running.  Clinical Biomechanics, Vol. 15, 2000, pages 54-64.
  7. Ferber, R, Davis, IM, Williams, DS: Effect of foot orthotics on rearfoot and tibia joint coupling patterns and variability.  Journal of Biomechanics, Vol. 38, 2005, pages 477-483.
  8.  Nurse, MA, Hulliger, M, Wakeling, JM, et al: Changing the texture of footwear can alter gait patterns.  Journal of Electromyography and Kinesiology, Vol. 15, 2005, pages 496-506.
  9.  Vicenzino, B: Foot orthotics in the treatment of lower limb conditions: a musculoskeletal physiotherapy perspective.  Manual Therapy, Vol. 9, 2004, pages 185-196.
  10. Nigg, BM: The role of impact forces and foot pronation: A new paradigm.  Clinical Journal of Sports Medicine, Vol. 11, 2001, pages 2-9.
  11. Collins N, Bisset L, McPoil TG, Vicenzino B: Foot orthoses in lower limb overuse conditions: A systematic review and meta-analysis.  Foot & Ankle International, Vol. 28, 2007, pages 396-412. 

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