The Foot and Ankle: Clinical Applications (A.L. Logan Series in Chiropractic Technique)

209 Pages·1994·27.27 MB·English

by  Alfred Logan

THE FOOT
AND ANKLE
Clinical
Applications
A.LL.O GANS ERIEISN C HIROPRACTTIECC HNIQUE
TheK neeC:l iniAcpapll ications
TheF ooatn dA nkleC:l iniAcpapll ications
TheL owB acka ndP elviCsl:i niAcpapll ications
THE FOOT
AND ANKLE
Clinical
Applications
A.LL.o gan
Seriiens
Chiropractic
Technique
AlfrLe.Ld o gan
AlfredL .L ogan,DC
Formerlays sociatweidt h
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and
Witcho ntribbyu tAingloo-nEur opCeoalnl egofeC hiropractic
a
BournemoutEhn,g land
LindsJa.y Rowe LindsaJy. R owe,M AppSc( Chiropractic),
MD,D ACBR (USA)F,C CR( CAN),
FACCR( AUST)F,I CC
NewcastlAeu,s tralia
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Anyone who has been to school can remember at least one teacher whose influ­
ence inspired him to learn more fully, to appreciate the subject being taught, and
perhaps to realize a life's work. I have been fortunate enough to have had several
such teachers. In high school, my biology teacher moved me into the sciences, and a
humanities teacher instilled in me the desire to think and reason. While studying
chiropractic, I found Dr. A.L. Logan. I first met him when he voluntarily did clinical
rounds at the Los Angeles College of Chiropractic (LACC).
Roy Logan had a capacity to understand how the human body works, and a curi­
osity about it that kept him constantly searching and researching for ways to help
heal it. The profession is full of personalities teaching a variety of techniques, some
insisting theirs is the only way, but it has few true professors who can cull the vari­
ous teachings, and present to the student a clear and concise way to approach a
patient, without personality and ego getting in the way. Roy had these abilities, and,
fortunately for us, he had a desire to teach others. He never missed an opportunity.
He saw the need in our profession for a way to link the rote clinical sciences and
the various ways of executing an adjustment. He gave us an answer to the com­
monly asked question of when and where to adjust. He was constantly pushing the
profession to realize the importance of effective clinical application of chiropractic
principles at a time when there seemed to be more emphasis on fitting into the health
care industry by wearing a white coat and using big words.
Around the world, students of Dr. Logan use his methods of diagnosis and treat­
ment every day and are reminded of his wonderful contributions to the profession.
He lectured repeatedly before several state associations, and taught an eight month
post-graduate course at LACC for eight years. He was Chairman of the Technique
Department at the Anglo-European College of Chiropractic for five years.
In spite of his many contributions, Roy's work remains unfinished. He passed
away in April of 1993, after fighting a terminal illness. He was working hard on his
textbooks up to the end, hoping to transfer as much of his knowledge and wisdom to
paper as he could.
Dr. Logan has a number of students dedicated to continuing his work and seeing
it evolve in the way he envisioned. There is no "A.L. Logan Technique," but rather
a compilation of various teachings, combined with a unique understanding of the
interdependencies of the human structure. We hope to do his work justice and see
more students of chiropractic become as effective as possible in the treatment of
human disorders.
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Table of Contents
SeriPerse fa.c.e. .............................................................i.x. .........................................................................................................
Prefa.c...e.... ................................... ........................................................................................................................................... xi
Acknowledgme.n.t.s. .........................................................x.i.i.i. ...................................................................................................
Chapte1-r Anatom.y.... ..................................................................... ......................................... .......................................... 1
Arches of the Foot............................................................................................................................. ................... 9
Movements of the Ankle and Foot....................................................................................................................... 10
Muscles and Tendons........................................................................................................................... ................ 12
Pulses of the Foot ................. ......... ......... ............ .......... ..... ....... ..... ................ ....... ............................ ....... ......... .... 21
Functional Anatomy. ............................................................................................................................................ 21
The Foot during Running ..... .......... ........ .......... ............ ..... ....... ..................... ..... ......... .................. ......... ......... ..... 25
Conclusion ........................................................................................................................................................... 25
Chapte2r- Examinati...o....n... .............................................................................................................................................. 27
History. ................................................................................................................................................................. 27
Observation ..... .... ..................... ............. .......... ............................. ..... ........................... ............ .................. ....... ... 27
Standing Examination ............ ... .......... .......... .......... ....... ..... ....... ..... ............ ........ .................. ........ ........ .......... ..... 27
Posterior Examination .............. .......... .............. ....... ......... ..... ......... ................... .......... ....... ... ....... ......... ............. .. 28
Anterior Examination. . ........... ............. .......... ..... ..................... .................... ......... ................. ........ ... ....... ...... ....... 30
Functional Examination ....................................................................................................................................... 31
Supine Examination ............................................................................................................................................. 33
Range of Motion ................. ..... .............. ............................... ........ ..... ...... ........ ........ ............ ........ .......... .............. 35
Chapte3r- MusclTee sti.n.g. .....................................................5.3. ..........................................................................................
Chapte4r- Imagin.g. ..........................................................6.3. ..................................................................................................
Lindsay 1. Rowe
Imaging Methods ........... ... ................ ...... ................ ........... ..... ....... ..... ...... .......... ....... ....... ....... ......... ....... ......... ... 63
Measurements ........... ........... ....... ... ................... ............ ..... ..... ...... .... .... .................. .......... ............. ............... ....... 67
Congenital Anomalies and Variants .................................................................................................................... 70
Traumatic Disorders.. ... ........ ............. .......... .................... ................. ....... ......... ....... ...... .......... .......... ............. ...... 73
Vascular Disorders ............................................................................................................................................... 78
Infections.............................................................................................................................. ................................ 81
Arthritic Disorders ............ ......... .............. ................................. ............. ....... ........ ................. ....... ........... ......... ... 82
Neoplastic Disorders ................. ............... ........... ..... ............... ....... ................ ................ ............... .... ..... .... .......... 87
Metabolic Disorders ............................................................................................................................................. 91
Chapte5r- PassivMoet ioPna lpat.i...o....n... ........................................................................................................................ 97
The Ankle Joint and Hindfoot.............................................................................................................................. 98
The Talus ............................................................................................................................................................. 99
vii
VIII THE FOOT AND ANKLE
The Tarsal Arch ....... ........... ...... .... .......... .............. ..... ......................................... ............ ................................ ..... 104
The Metatarsals..................................................................................................................... ............................... II I
Concluding Remarks ............................................................................................................................................ 114
Chapte6r- AdjustiTveec hniqu.e.s. ................................................................................1..71.. ..................................................
Long Lever Techniques ....................................................................................................................................... 117
Short Lever Techniques ....................................................................................................................................... 118
The Ankle............................................................................................................................................................. 119
The Foot............................................................................................................................ ................................... 124
Use of an Elevated Chair ..................................................................................................................................... 137
Use of an Impact Tool.......................................................................................................................................... 137
Concluding Remarks ............................................................................................................................................ 138
Chapte7r- ConditioannsdT heiTrr eatme.n.t. .........................................1..39. .......................................................................
The Unpliable, Unadaptable Foot ........................................................................................................................ 139
Shortened Triceps Surae ...................................................................................................................................... 141
Heel Pain .............................................................................................................................................................. 143
Injuries to the Ankle ............................................................................................................................................. 148
Tarsal Tunnel Syndrome (Sinus Tarsi Syndrome) ............................................................................................... 156
Pronation (Pes Planus) ......................................................................................................................................... 157
Forefoot Strains and Sprains ................................................................................................................................ 157
Hallux Valgus ...................................................................................................................................................... 159
Tendinitis ............................................................................................................................................................. 160
Compartment Syndromes ..................................................................................................................................... 162
Chapte8r- Exercis.e.s. ...........................................................................................1.65. ..............................................................
Lordotic Lumbar Syndrome Exercises ................................................................................................................ 166
Lordosis Exercise ................................................................................................................................................. 167
Sit-Ups ................................................................................................................................................................. 168
Other Postural Faults............................................................................................................................................ 168
Short Triceps Surae .............................................................................................................................................. 169
Everter Exercise .. .................. ...... ...... ........... ....... ..... .... ....... ........ ...... .......... ... ........ ...................... ........................ 169
Inverter Exercises. ................................................................................................................................................ 169
Posterior Tibialis .................................................................................................................................................. 170
Ankle Stability ..................................................................................................................................................... 171
Exercise for Circulation ....................................................................................................................................... 172
Loosening the Unpliable, Unadaptable Foot ....................................................................................................... 173
AppendiAx- OrganiPcr oblemasn dt heF oota ndA nkl.e. ...................................1.75. ..........................................................
Fixation-Organ Theory ........................................................................................................................................ 175
NVD ..................................................................................................................................................................... 176
Organ-Muscle Relationships ............................................................................................................................ :... 176
Methodology.. ......... ......... ....... ..... ......... .... ...... ....... .......... ... ............ .................. ........ ........ ......... .... ............ ........ .. 177
Opinion ................................................................................................................................................................ 178
Inde.x... ................................................................. .................................................................................................................... 181
Series Preface
". .. The application of principles ... involves From this recognition came over 20 years of teaching. It
higher mental processes than their memorizing; was his hope that his ideas would generate continued dialogue
every student should be given a thorough drill in and interest in expanding the clinical application of chiro­
clinical analysis in which he should be made to see practic principles.
the relationship which exists between the funda­ Dr. Logan did clinical rounds at the Los Angeles College of
mental facts and their clinical application. " Chiropractic, since the early seventies. He lectured often for
Francis M. Pottenger, MD various state associations, and taught at the Anglo-European
College of Chiropractic. During this time Dr. Logan continued
The education that a modern chiropractor undergoes in­ to learn and grow as a clinician and teacher. His decision to
cludes the clinical sciences and the manipulative arts. A write a series of texts on the clinical application of chiropractic
graduate doctor of chiropractic has a thorough grasp of the di­ principles came out of his experience in teaching undergradu­
agnostic and clinical skills and is trained in basic manipulative ate technique at AECC and seeing the difficulty upper division
techniques. With this knowledge, the practicing doctor begins students had in understanding when, where, and why they
to gain the experience that makes the application of this should adjust.
knowledge successful. A successful doctor is one who contin­ This series of textbooks wiLl be a comprehensive reference
ues to learn beyond what is minimally required, for he or she is on chiropractic clinical applications. Dr. Logan believed this
constantly renewed and stimulated. approach should be the basis for an undergraduate course in
Dr. A.L. Logan was a successful chiropractor, a doctor that, adjustive and clinical technique. It is, at the same time, a wel­
like D.D. Palmer, continued to expand his understanding of come addition to the knowledge of any practitioner.
the human body in health and disease. He studied the works of
many of the chiropractic profession's leading educators. He
researched and developed his own theories which he applied
in his practice, and like most chiropractors, developed a suc­ Pottenger FM. Symptoms of Visceral Disease. St. Louis:
cessful, diversified approach to diagnosing and treating his Mosby; 1953.
patients. Dr. Logan recognized the need for a practical way to
blend basic and advanced manipulative techniques with clini­ Chris Hutcheson, DC
cal skills. Auburn, California
IX