CLINICAL IMPLICATIONS OF PROBLEMS WITH BALANCE AND RECOVERY

Impaired balance and recovery are just another manifestation of how the changes caused by malalignment can interfere with everyday activities and sports. The following are some of the ways they can present a problem in certain sports.

SPORTS INVOLVING JUMPS AND DISMOUNTS

Balance and recovery play a major role in ensuring a stable landing on a jump or a dismount (Fig. 17). For example, when a gymnast sways momentarily on landing or has to take a small step to aid recovery, we talk in terms of the athlete having lost their footing. Those who are less fortunate may end up falling. When malalignment is present, the problem could, in fact, be caused by an unstable or seemingly weaker leg, the one the athlete may also prove to have trouble with when trying to stand on just one leg. A momentary “giving way” of the hip, knee, or ankle on account of the malalignment is another possible explanation to consider.

Fig 17

Fig 10

SPORTS IN WHICH THE ATHLETE HAS TO LAND ON ONE LEG

A good example is that of the figure skater who consistently has a problem landing on the right or left leg during a free program. A sensation of instability on the right side, for example, may lead to a left-leg preference in performing certain routines in order to avoid a mishap that might otherwise occur (Fig. 10).
The skater may also develop a habit of always approaching a jump the same way to ensure landing on the more dependable left leg. Compulsory figures may prove to be more difficult as they require a set performance that allows little leeway for any modification to accommodate a leg preference. Limitations of this kind caused by the presence of malalignment may, in fact, cut short the skater’s and other athletes’ ambitions to advance in their chosen sport.

Fig 25

Fig 26

SPORTS INVOLVING “LUNGING”

Sports such as fencing, karate, and judo involve lunging: rapidly moving one foot forward in a straight line (Figs. 25, 26). Maximum stability derives from the placement of the knee directly over the advancing foot. A malalignment-related shift of the knee off-centre, to either right or left of midline, decreases stability and may prove costly at a time when this foot is supporting most of the athlete’s weight (Fig. 3: R and L). In fencing, it has also been linked to a thrust ending up off the intended target.

Fig 3

Fig 27

SPORTS REQUIRING RAPID ROTATION

Some moves in sports such as karate and judo require a rapid rotation of the body at times when the athlete is supported on just one leg. The “roundhouse kick,” for example, requires balancing on one foot while, at the same time, rotating the body to develop the momentum required to deliver a good blow with the other foot (Fig. 27).

Again, malalignment may cause the athlete to develop a leg preference when it comes to making a turn supported on just one leg. This preference is more likely to relate to a feeling of stability when supported on that leg, rather than leg dominance (i.e., being “right” or “left-footed”). Another factor may be the asymmetry of pelvic, trunk, and leg ranges of motion, increasing the degree of movement possible in certain directions on one side while decreasing it on the other.

SUMMARY

Malalignment changes the body biomechanics and, in addition to predisposing to certain injuries, creates some unwanted stresses that may:

  • Hinder the athlete’s ability to do well in a given sport
  • Trigger or perpetuate overuse injuries, given the repetitive movement patterns inherent to many sports
  • Prolong the time required to recover from an injury or even prevent full recovery
  • Interfere with the athlete progressing in a chosen sport and reaching their maximum potential