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OPTIMAL CORE ALIGNMENT
WOCN Regional Conference
2015
SPEEDING RECOVERYthrough
IMPROVING MOVEMENT
Melanie Carlone,DPT, MS, RYT
Custom Orthotic SolutIons, Inc.
LEARNING OBJECTIVES:
1. Principles of Optimal Core Alignment and physiological effects on wound healing
Optimal Core Alignment ~unites feetbody and gravity
Alignment means better movement
Better movement promotes healing
Best Healing Possible
is supported by
Optimal fluid return
from the lower extremities…
Venous Foot Pump Mechanism
25 mL of blood ~Each step ~Healthy gait
Alignment
•Foot Core
•Body Core
And
Active client participation in the
healing journey increases
compliance
LEARNING OBJECTIVES:
2. Consider when internal and external forms of support are most useful
Internal Support
Empowers Clients
Active Client Participation
Negativity Bias is real
10-30 seconds of TAKING IN THE GOOD overcomes bias and hardwires change
R. Hanson, PhD, Hardwiring Happiness: The New Brain Science of Contentment, Calm and
Confidence.
Experience Dependent Neuroplasticity
Taking in the GOOD…
Internal physical re-education
Lasting Change
External Support
Wound Offloading Can Take Many Forms
LEARNING OBJECTIVES:
3. Know when referral for foundational evaluation and support is necessary
COLLABORATION
Optimal Core Alignment exercise
How you hold yourself in relationship with gravity?
POSTURE &
FUNCTION
We are structurally designed to be walking…NOTsitting
WhenGravity wins…
STABILIZATION BODY CORE
STABILIZATION FOOT
CORE
INTEGRATIONAN
INSIDE and
OUTSIDE JOB
CORE ALIGNMENT IS THE NAME OF THE
GAME
Rene Cailliet, MD
1917- 2015
Pioneer Physical Medicine and
Rehabilitation, US Army, WWII
UNIVERSAL TISSUE
RESPONSE
Cailliet, Rene. Pain: Mechanisms and Management Philadelphia: F.A. Davis, 1993.
Inhibition=
Mal-alignment=
PAIN=
Increasing Dysfunction
ARTHRITIS=“Itis” in your “arth”
Gait Abnormalit
y
Mal-alignment leads to
•Poor proprioception•Balance disorders•Reduced core stability•Reduced venous pump
Review of the venous foot pump mechanism
•Not active at rest
Review of the venous foot pump mechanism
•80 mm of mercury on standing
Review of the venous foot pump mechanism
•Falls to 30 mmHg walking
Review of the venous foot pump mechanism
•25 mL pumped upwards each step
Review of the venous foot pump mechanism
•Forward momentum causes the pump action deep in foot intrinsic muscles
http://www.phlebolymphology.org/the-plantar-venous-pump-anatomy-and-physiological-hypotheses/
Venous pump
deep in the arch
NOT in the sole
" Impairment of the foot muscle pump by static foot disorder is an important cause of chronic venous disorder.”
•Vaidyanathan, Subramoniam, Riju Ramachandran Menon, Pradeep Jacob, and Binni John. Chronic Venous Disorders of the Lower Limbs: A Surgical Approach.: Springer India, Print
Optimal Core Alignment System clarifies:
Support core alignment =
Support optimal function & venous
return =Speed in healing
times
MORE ON THE FOOT CORE
These feet are made
for walking
…
WINDLASS EFFECT
Passive Sub-syste
m
4 arches in the foot
Inner and outer arches
4 arches in the foot
Transverse arches
LIGAMENTOUSSUPPORT
Active subsystem
The Neural
Sub-System
Altered feedback
ALTERED FEEDBACK INCREASESFALL RISK
Optimal Core
Alignment trains and supports
inside and outside
body and foot.
ASSESSING FOOTCORE
ALIGNMENT
Talar Neutral
Talar Neutral
INTRINSIC FOOT MUSCLE TEST
TRADITIONAL FOOT
EXERCISES MAY NOT
TRAIN INTRINSIC MUSCLES
SHORTENED FOOT EXERCISE
Referral to a Core Support Team
•Biomechanics•Education •Custom Orthotics •Offloading•Apply and Reassess
WOUND OFF
LOADING
REDUCE PRESSURES
In Summary…
“I have a choice. Do I want to align with the greatest vision of myself or do I want to align with my excuses…”-Debbie Ford