Shoe Review: The Brooks Pure Project Line.

Ok, we have been meaning to get to this for months but are just getting around to it now. So for those of you who have been hounding us for the data, sorry, but thanks for keeping us on it.  Here are the specs for the EVA midsole thicknesses and ramp numbers. Remember, ramp angle can only be given if the length of the foot is known, so those numbers will not be given here.  What is good to know is that we have another shoe in the category of the Saucony Kinvara, the Brooks Pure Project line.  Below you will see the specs for all 4 in the line up.  All have a 4 mm forefoot to rearfoot rise, in other words……the heel is only 4 mm lifted compared to the plane the forefoot is resting on.  This still changes the biomechanics and neuromechanics that we were all given at birth that would really prefer the rear and forefoot to be on the same plane 1:1 ratio although a 4 mm rise is pretty darn close !  Our man beef with the Saucony Kinvara is that they did not use much black rubber outsole on the shoe other than the small thin layer glued to the traction lugs  throughout the mid and forefoot.  We have found that these shoes barely get 200 miles on them (give or take) and we and all our clients are already into the EVA midsole which wears down as fast as bubble gum might.  This is a serious design flaw in our opinion. We like this shoe and like it for many clients but we are having to explain that they will burn through them in under 350 miles most likely.  So, we are excited for the October Release of the Brooks Pure Project line……in the hopes that they have not made this same design choice.  Remember, if you are new to this line of shoes, the 4mm lift variety, wean down from your old 12-20mm rear-foot lift trainers and try these with your shorter runs until skill, endurance and strength are achieved in this new foot orientation.  It is gonna take some people some time to accomodate.  (remember, there is no substitute for a doctor’s exam and watchful eye to see if you can even entertain this shoe type with your foot type). (Do not be fooled into believing there is going to be much stability provided by these shoes.  They are all pretty neutral. If you have a  forefoot varus, you better look in another direction !)

Here is the data …….

Brooks Pure Connect

lightest and most flexible shoe in the line, the PureConnect puts as little as necessary between the runner and road. 7.2 oz men, 6.5 oz women – 14 mm heel:10 mm forefoot

Brooks Pure Flow

For runners who want to connect with the run without losing the comfort
of dynamic cushioning. 8.7 oz men, 7.5 oz women – 18 mm heel :14 mm forefoot

Brooks Pure Cadence

Runners who need more supportive features can still experience the feel
of a more natural stride. 9.5 oz men, 8.3 oz women – 18 mm heel:14 mm forefoot

Brooks Pure Grit

Trail runners will love the hug-your-foot upper, slim midsole, and pliable
yet protective outsole. 8.9 oz men, 7.6 oz women – 15 mm heel:11mm forefoot

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Good Morning, everyone!

Here is another cool take on Trinity from “The Matrix” that we did for our buds at The Natural Running Center.com and Zero-Drop.com. Click on the photo to be transported……

http://naturalrunningcenter.com/2011/07/24/trinity-outruns-agent-brown-the-matrix-gait-guys-movies/

Deano !

It is Friday here on the Gait Guys and we try to keep things light.  No Antetorsion or forefoot varus stuff here today………. today is Footloose Fridays !

Today we leave it up to good old Dean Martin to bring out the relatives !

Here we see Uncle Leonard doing the wild thing !

have a good weekend everyone.

Photographs of a 6 yr. old.

What do you see ? How does the alignment look ? Are they developing normally ?
At what point should you intervene to ensure proper alignment and
development occurs in this child ? Can we standardize our visual
screen to fit all cases in all children ?  So many questions !

* this case goes very nicely with a prior case on the blog published on July 15th.

Click back and forth between the two photos above on the blog.  Youcan see that in the first photo that when the feet are parallel, the patellae point inward (normal compensation).

In photo 2, we can see that when we put the patellae in the saggittal plane (pointing
forward) the foot progression angle is severely positive (externally postured or out-toed).  

This is a severe case of FEMORAL ANTETORSION
with compensatory EXTERNAL TIBIAL TORSION.  The external tibial
torsion is an external spin along the long axis of the shaft in a
response to try to correct alignment.  You can see that in this case
there is no happy medium.  The torsion in the long bones is so extreme
that either the knees are positioned inwards when the feet are
normally aligned or the feet are spun outwards when the knees are
properly aligned.  Regardless, there is much abnormal stress on the
hip and knee joints and the labrum of the hip and menisci of the knees
not to mention the challenges into the foot mechanics and gait.

______________________________

Taking this into a gait perspective:

Patients with antetorsion are forced to externally rotate the limbs to bring the knee forward to a normal alignment from an internally rotated position.

This takes up some, occasionally all, of the lateral (external) rotation needed for the hips to function normally during gait causing compensatory rotation of the spine during single leg stance; the spine being really the only place the rotation can be achieved.

Normally, during gait the hip rotates laterally from toe off through to heel strike and is present during the initial loading response.

When this rotation does not occur in the hip, it must occur as a compensatory motion somewhere else in the kinetic chain and this is usually the pelvis or lumbar spinal joints.

Furthermore, the abnormal alignment of the femoral head in the acetabulum can repetitively irritate the hip joint and labrum let alone place abnormal torque on the tib-femoral joint (knee).

Antetorsion patients who compensate and realign the feet to a normal progression angle via tibial external torsion will force the femoral head anteriorly into the anterior hip capsule and this is a common source of pain.  It is a “hammocking effect” into the anterior capsule and it can leave the femoral head and it’s cartilage uncovered and uncompressed thus advancing arthritis degeneration. 

This is a similar symptom phenomenon as in “anterior femoral glide syndrome” as described by Shirley Sahrmann.  It is not uncommon to see a sway back lumbar posture in these clients.

These patients may have anterior contractile tissue deficits, namely stretch-weak iliopsoas as described by Kendall.

Remember to check for limb length symmetry in these clients who’s anteversion is not symmetrical. 

Watch for a future series on torsions and versions

We may be twisted, but the last time we looked, we are still …… The Gait Guys

1 + 1 usually = 2

take yesterdays tibialis posterior dialogue……. translate that to the resultant foot structure that can occur when there is complete insufficiency in that muscle (a valgus heel, midfoot collapse and an abducted forefoot) and then understand that this resultant foot will have a first ray complex insufficiency whereby 1st metatarsal head anchoring will be compromised. Now watch todays video by Dr. Waerlop and put the two together.  Yes, tib posterior insufficiency can be a cause of bunion-hallux valgus formation.

1 + 1 = 2   

not only are we foot geeks, but as you can see we missed our calling in mathematics as well !

Shawn and Ivo …….. 

[Sequential lateral soft-tissue release of the big toe: an anatomic trial]. Z Orthop Unfall. 2007 May-Jun;145(3):322-6. Roth KE, Waldecker U, Meurer A.Source: Abteilung für Orthopädie, Universitätsklinik Mainz. roth@orthopaedie.klinik.uni-mainz.de ___________ Summary:  Dr. Ivo in his brief video today discussed the altering of the origin/insertion effects on the adductor hallucis and the big toe.  When the first metatarsal is not anchored on the ground the lateral toes cannot be pulled towards the medial foot, instead the lateral foot acts as the anchor and the big toe/hallux is pulled laterally towards the anchor rendering the all famous bunion/hallux valgus. This surgical study pretty much proves this principle. This study showed that when the soft tissues (capsule, tendon and ligament) are surgically released, the contractile affects on the joint angle of the bunion/hallux valgus are released and the hallux valgus angle was predominantly and significantly improved.  A significant correction of the intermetatarsal angle did not take place however. Kind of a radical procedure ultimately destabilizing the joint and medial foot structure…….but hey……whatever floats your surgical boat.  To each his own.  We suppose that on a case by case basis all options need to be considered. ……we’re still the gait guys…….. with no scalpels, but with big oars

More on Bunions: proof we know what we are talking about

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Welcome to Neuromechanics, a regular weekly feature here at The Gait Guys. Join Dr Waerlop on this neurological journey as he discusses the formation of Bunions.