The Forward Transition Paradigm. Implications for Clinicians

Following part one, Pronation & Frontal Plane Motion: The Forward Transition Paradigm, this second part, “The Forward Transition Paradigm. Implications for Clinicians”, is open for discussion to promote thought. Over the past 20 years, there have been about 6 really important paradigms presented to help explain foot function, gait and the influence of footwear on…

Simon Bartold
Director of Bartold Clinical

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4 responses to “The Forward Transition Paradigm. Implications for Clinicians”

  1. Energy loss via compensation…energy conservation via appropriate movement strategies for the task at hand.
    Clinically what is possible with this Paradigm? Do we apportion more of our clinical effort on ankle ROM and 1st MPJ ROM? What interventions are valuable and achievable? In some patients a heel lift will influence STJ pronation…so is the influence on the ankle or the STJ as regard to clinical outcomes. Finally Foot Posture and intrinsics in relation to midfoot fatigue or collapse and the fine tuning of forward transition.
    Great read and happy to find that I am not the only one that is sick of “Pronation”…and don’t get me started on “I need more arch support to stop rolling in”.

    • Thanks very much for chiming in Colin, and great comments. Personally I do believe the clinical exam needs to focus more on looking at key sagittal plane joints, but maybe more importantly, focusing on dynamic investigation and trying to figure out THE load that caused the problem.I think the FTP does not discount anything, because of course the sagittal plane joints will have a major influence over the STJ and pronation/supination. But, like you, I just think we got so bogged down with a theory presented as fact that we missed some really important examination tricks. I hope the FTP might be able to reset a few things in peoples minds! best Simon

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