Romain Tourillon - Assessing & Training Foot & Ankle Function

Episode 162: In this episode of the Inform Performance podcast, Andy McDonald interviews Romain Tourillon, a Physiotherapist, Researcher, Educator and Consultant on the foot and ankle complex. He is currently leading the foot-ankle service at the Swiss Olympic Medical of La Tour Hospital in Geneva (Switzerland). Romain is also involved in a PhD thesis on the role of foot muscles strength in sports performance kinetics under the supervision of JB Morin at the University of Saint-Etienne (France). In this episode Andy & Romain discuss assessing and training foot and ankle function in athletes. 

Topics Discussed

• Understanding forces in Foot and Ankle biomechanics
• Force absorption assessment & training
• Propulsive force assessment & training
• Normative Standards in foot & ankle assessment
• Developing the spring-mass-system

Key Points 

• The foot and ankle complex undergoes two primary phases during locomotion: an absorption phase to dissipate energy, followed by a propulsion phase to generate energy. This cycle of negative and positive work is crucial in activities ranging from walking to sprinting and cutting, highlighting the complex's role in various movement patterns. 
• The rear foot (comprising the subtalar and talocrural joints) and midfoot are pivotal in energy absorption, while the arch of the foot plays a significant role in energy storage and release. During the first half of the stance phase, the arch lengthens to store energy, which is then released during propulsion, demonstrating the foot's dynamic energy management system.
• Throughout the entire stance phase, the toes primarily perform negative work. This continuous absorption helps maintain ground contact and counteracts ground reaction forces that attempt to extend the toes. This mechanism is crucial for maintaining stability and control during locomotion, especially in explosive movements.
• Biomechanical studies of explosive tasks (such as acceleration, maximum speed running, and cutting) reveal that the foot and ankle complex contributes significantly more to performance than often recognized. This underscores the need for greater focus on foot and ankle conditioning in athletic training programs.
• The foot's three-dimensional deformation during movement is frequently underestimated. This complex 3D motion is particularly crucial in multidirectional tasks like cutting, linear sprinting, and curved sprinting, involving substantial frontal and transverse plane motions. Understanding this complexity is essential for comprehensive foot and ankle training and rehabilitation.
• While the soleus muscle provides crucial vertical support, other muscles like the tibialis anterior and posterior are essential for frontal and transverse plane control. These often-overlooked muscles are critical in absorbing forces and stabilizing the midfoot, particularly in sports involving rapid directional changes or uneven surfaces.
• Sport-specific considerations are vital in foot and ankle training. For instance, in track and field, the left foot experiences greater pronation moments due to always being inside the curve. This necessitates focused strength work on inverters and the tibialis posterior for these athletes, highlighting the importance of tailored training approaches based on sport-specific demands.
• The strength and stiffness of the metatarsophalangeal (MTP) joints significantly influence calf muscle positive work. Impaired force transmission through the forefoot and midfoot can hinder overall propulsion, even in athletes with strong calf muscles. This emphasizes the need for comprehensive foot strength training, not just calf muscle focus.
• Performing heel raises on an incline or with extended MTP joints (as in the "rat lift" exercise) increases midfoot moment and negative work from the forefoot. This technique enhances overall foot contribution during the exercise, potentially revealing weaknesses in foot strength that may not be apparent in standard heel raise exercises on flat surfaces.
• The foot and ankle complex, including the Achilles tendon and the arch, play a crucial role in the spring-mass model of locomotion. Their capacity to store and release energy contributes significantly to tasks like maximum velocity running and hopping. This elastic quality of the foot and ankle is often underappreciated in traditional strength and conditioning programs but is vital for optimizing performance in explosive activities.

Where you can find Romain:

• Instagram
• Twitter
• ResearchGate

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