On Pronation following a Right ACL Reconstruction…
I have been having an issue with a patient who had ACL reconstruction on the right side who is a pronator. They don’t have right glute max FA ER/AF ER. Please let me know what you think about these patients if you have some time!
Your right knee ACL reconstruction patient that has a very “pronated” right foot poses some interesting challenges.
The first issue is that he must be able to maintain support of his right calcaneus in the frontal plane when he shifts his weight over to the right into right mid-stance. He is going to need a good stable shoe with a good stable base and a good heel counter (lateral support of heel motion). He will also need adequate right arch support to help hold his mid-foot and heel in a near neutral position when he begins stance phase on the right side.
This neutral controlled foot with a good arch will allow him to actively evert his right foot so he can inhibit his right adductor magnus and shift away from his right lateral hip into left AFIR and AFADD. You will need to teach him to actively evert his right foot, but as he learns it, he will be learning to shift his right hip into AF ER and AF ABD. This will kick in his right glute max and the posterior aspect of his right glute medius. Besides the necessary left AF IR strength required of all Left AIC patterned patients, this right hip training will be a key to your success controlling the right knee joint.