Proximal and distal contributions to lower extremity injury: a review of the literature.
Level 5 - mechanism / opinion, no new human data
Narrative literature review evaluating theoretical biomechanics and prospective evidence without systematic review methodology reported.
PubMed 22440758 · doi:10.1016/j.gaitpost.2012.02.001
What was done
The authors reviewed the theoretical biomechanical models and prospective literature evaluating how distal factors (such as excessive or prolonged foot pronation) and proximal factors (such as lumbo-pelvic hip complex muscle strength and motor control) contribute to lower limb overuse injuries and segmental dynamic coupling.
What was found
The abstract reports no numerical data. It notes that while dynamic coupling between lower limb segments exists, the directional relationship remains inconclusive. Prospective studies demonstrate a strong association between proximal lumbo-pelvic hip dysfunction (including muscle weakness and altered motor control) and lower limb injuries, challenging models that attribute these injuries solely to foot pronation.
Why it matters
This review highlights that clinicians and biomechanists must consider proximal core and hip control alongside distal foot mechanics when assessing and treating lower extremity overuse injuries.
Limits
The abstract does not report search methodology, inclusion criteria, or the total number of studies evaluated. No quantitative effect sizes, sample sizes, or risk estimates are provided.