Top Down, Bottom Up: A Course Review

The foot and ankle joints are a neglected component of movement assessments as well as general joint care routines.  The fact that our feet are placed in shoes and people find them repulsive tells us all we need to know about our foot health habits.  


This is what attracted us to the Top Down, Bottom Up course.  We wanted to gain a deeper understanding of how the foot works, how to better evaluate it, and how to treat it in the context of the patient as a whole.

Joe Lavacca and Courtney Conley have done a great job putting this course together. They are able to perfectly meld both of their movement philosophies together while adding humor into the mix.  The course covers the biomechanics of the foot and ankle, the gait cycle, foot mapping, pain science, and assessment of the lower quarter to create a well-rounded approach to solving foot, ankle, and lower extremity dysfunction.  

Joe and Courtney exceeded our expectations and gave us the value we hoped to get when we signed up for the course.  They provide an endless stream of knowledge that is digestible and applicable to the movement specialist which helps guide you into applying these same principles when treating your patients on Monday.

Here are just a few of the game-changing quotes they shared during the course:

  • “Give your patients permission to move”

  • “Gait assessments take you to the stadium, not to the seat”

  • “Passive limitations lead to active compensations”

  • “A medial heel whip with gait is an anterior chain restriction”

  • “Orthotics are not bad, but more of a temporary solution to getting out of pain”

  • “Bunions occur in pronators”

Gait assessments take you to the stadium, not the seat.

Gait assessments take you to the stadium, not the seat.

Another fun addition to their course was the usage of foot mapping.  This is a small device that you can have someone step on to capture their footprint.  This gives you a snapshot in time of how this person is placing weight on their foot while walking.  Now, this does not give us all the answers, “it simply takes us to the stadium”. But in combination with a gait assessment and movement evaluation, we can get a strong picture of how we can help the individual in front of us.

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One thing we did wish they covered during this course was shoe wear.  It would have been great to gain further insight into what shoes are useful for certain types of feet and injuries.  But all-in-all this seminar is worth it and highly recommended as you will have a better idea of how to identify dysfunction and some guiding principles to how to make someone’s foot more like an actual foot.

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“I have been to several PT practices over the years, and Perfect Stride deserves five stars. I worked with Vikash, who was knowledgeable and thorough and got me back on my feet – literally! Although I did not work with any of the other therapists, I observed they maintain the same high standard as Vikash. And Austin does a great job of keeping everything running smoothly. I am glad my doctor recommended Perfect Stride!”


– Brian C

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