Podcast #17: Gait and Magic (and much more !)

Podcast Link:

http://thegaitguys.libsyn.com/podcast-17-magic-gait

iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

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Gait, Magic, Evolution, Foot Types, Stretching, Cases studies…… we have it all on today’s podcast.

Show Links
“How does the brain work ?”
 Nova Science Now
www.video.pbs.org   

buy this NOVA program now ! Educate the world ! :
http://www.shoppbs.org/product/index.jsp?productId=11095035&utm_source=PBS&utm_medium=Link&utm_content=nosn_nova6215_howbrainworks_covebuyit&utm_campaign=cove_buyit

Other links for today’s show:

http://www.medlink.com/medlinkcontent.asp

http://www.ncbi.nlm.nih.gov/pubmed/12763089

http://www.ajronline.org/content/184/3/953.full

1. Hi Guys,
I was wondering if you could direct me to a podcast/video or elaborate on how a fast stretch can relax a hypertonic muscle in a practical setting. Can manual stretching techniques like MET be use by altering the technique with a short fast stretch or are you just referring to high velocity low amplitude manipulation? We are often taught to find the barrier apply contraction and then ‘gently’ go to the next barrier. Is this still a good way of activating the GTO’s?Also do you have any further discussion I can check out on GTO’s?

Thanks for your time, Adrian

2. Hello, GAIT Guys!

First I want to thank you for your phenomenal work!
I work alot with athletes and there are so many that have some sort of sole into their shoes. Problem was, pretty much everyone, didn’t get the answer to WHY they needed them. Just the normal “your foot pronates” and frankly, 1 out of 40 got better.
I was driven by the question WHY, searched around in Sweden, attending lectures, orthophaedic clinics etc, but I didn’t get the answers that I was looking for.
Started to look into it deeper for myself, when I found you guys!
Now I want to bring back that knowledge to Sweden, cause frankly.. WE NEED IT!
Can you tell me more about your certification? Is it possible for a Swe to attend and get the certification?
Best Regards
Gabriel
Dr. of Naprapathy from Sweden

3. Hello Drs. Waerlop and Allen. I need some clarification on gait biomechanics. Will using a more “minimalist” running shoe or a shoe with less RF to FF delta help peroneous longus to gain mechanical advantage? If someone has a forefoot varus would recommending a lower ramp shoe be appropriate to help “retrain” the tripod at stance phase? 
John F

4. Another blog question…ivo said in podcast #15 that most people have a forefoot abnormality (during section talking about flares). Any idea Why? Is it skewed toward one way or the other?
After looking at quite a few feet since becoming shoe fit certified, I’ve noticed quite a lot of variation. If I was pressed if say I’ve seem <10% FF valgus and maybe half of the rest each neutral and varus. Is that in the ballpark of what you guys see?
How about rear foot? I feel like I see a lot of rear foot varus but maybe my frame of reference is not accurate? If I was pressed, I’d say 70% varus, 29% neutral, 1% valgus. Does that seem off?
Thanks, Eric J

Category
Educational

Neuromechanics?  This early in the morning?

It has been a while since we have done a neuromechanics post. While doing some research for one of our PODcasts, We ran across this paper: http://www.ajronline.org/content/184/3/953.full

It’s title?

Midbrain Ataxia: An Introduction to the Mesencephalic Locomotor Region and the Pedunculopontine Nucleus

Yikes! What a mouthful!

What’s the bottom line?

The paper review a condition called “gait ataxia”. In plain English this means “aberrant or unsteady” gait. Things which usually cause gait ataxia originate in an area of the brain called the cerebellum, which coordinates all muscle activity. If you drink to much alcohol, it affects your cerebellum and you have a “wobbly” gait : ).

This paper looks at another area of the brain called the midbrain. It is the top part of the brainstem and contains an important gait integration and initiation center called the “midbrain locomotor nucleus”. The paper looks at 3 different cases and has some cool MRI images to see, along with alot of fancy neurological words and pathways.

Whenever we see gait ataxia, we think of impaired proprioception (look here for a bunch of posts on that, or at this post specifically).

There are many factors to consider when evaluating ataxic (or wobbly) gait, and this just gives us all one more place to look.

The Gait Guys. Making you smarter every day!

Shoesday Tuesday:


Shoe News You Can Use: The Shank

Look at the “skeleton” in the photo on the left. Now look at the black material above the white area of the midsole (above the outsole) on the right. This is the “shank” of the shoe. The shank is the stiff area of the shoe between the heel to the transverse tarsal joint. It should correspond to the medial longitudinal arch of the foot. It is designed (along with the midsole material: see post here), to provide additional torsional rigidity to the shoe and helps to limit the amount of pronation and motion at the subtalar and mid tarsal joints. It also acts as a “plate” between the outsole and ininsole to provide protection to the foot from rocks, sticks, broken glass, shrapnel and small animals : ).


Not all shoes have a shank, so it may not always be present. We usually dissect shoes sent to us so we can see what they are all about if the manufacturer or rep is unable to provide us with an “exploded” or sectioned model. Look for our take on the new SKORA soon, complete with a dissected version!


The Gait Guys. Making sure you know what you need to so you can make more educated decisions




all material copyright 2012 The Homunculus Group/ The Gait Guys. Please ask to use our stuff. If you don’t, you have to deal with Lee. You don’t want to deal with Lee….

Turkey Training:

“A spooked turkey can run at speeds up to 20 miles per hour. They can also burst into flight approaching speeds between 50-55 mph in a matter of seconds.”

http://thanksgiving.aristotle.net/turkey-facts

The Gait Guys Response: Well of course they can. Look at hat hip extension! Wow, they must have some Creatine Phosphate stores!

Have a great bird, everyone!

Ivo and Shawn

The Dual Density Foam Running Shoe.

This goes along nicely with yesterdays post. Note the photo attached. This is a great example of something we all see everyday. A laterally tipped foot in a stability shoe.  Clearly a shoe that has been mis-prescribed for the wrong reason. Or has it ?

This client is clearly tipped laterally in the shoe, forcing supination.  Did this client self fit the shoe themselves in a discount store ? Were they fitted in a retail running store ? Where did things go wrong ? Or did they ?  The initial knee jerk reaction is to say this is the wrong shoe for this client.  Lets go a little deeper and ask some harder questions and see if you are considering some alternatives.

The assumption is frequently one of, “you are a hyperpronator so you need a stability shoe”. In this case is this person a hyperpronator ?  There is no way to know, not in the shoe.  On initial knee jerk observation this looks like a supinator in a stability shoe, a poor match.  But read on …

1. What if this person has significant flat feet, pes planus with severe pronation problems, but they find the stability they need by standing on the outer edge of the foot in the mechanically locked out position (supination).  Perhaps this is a less fatiguing posture, perhaps a less painful posture. This is often a comfort thing for hyperpronators to display.  What you see is not always what you get because there are two types of feet, those that drop or collapse into the weakness and those that fight the collapse and weakness the whole way via an alternative compensation.  You cannot tell by looking, certainly not from this picture of someone in a shoe. There must be a functional assessment and some gait evaluation. 

2. There exists the high arched flexible foot that pronates excessively, quickly and for a long time (this is the flexible cavus foot) and then there is the high arched rigid foot (the equinovarus foot).  The first described foot may need support from a stability shoe even though they have a high arch on presentation/examination and the later described foot can often go right into a neutral non-supportive shoe.  Can you tell either of these from this picture ? No you cannot.

3. Maybe the person in the photo has tibial varum (bowed lower leg) combined with a rearfoot varus and forefoot varus. This could mean they pronate heavily through the midfoot-forefoot and less so through the rearfoot-midfoot. In this case they are still a heavy pronator but not through what is typically noted or detected by significant medial arch collapse.  In this case the dual density shoe is not going to help all that much because the pronation is occurring mostly after the bulk of the shoe’s dual density stability foam has been passed through by the foot. Can this be detected by this photo ? Again the answer is no. The shoe fitter needs to be clinically aware that this type of client needs a forefoot varus posted shoe to help post up that medial tripod (1st metatarsal head).

4. Maybe, just maybe this is a typical rearfoot-midfoot pronating client, excessive mind you, and all they need is some foot and gait retraining to break their old compensation pattern of lateral weight bearing (standing or walking) and with this correct shoe they can then engage a healthier motor pattern. 

Which is it ?

Do you know how to navigate your way through these issues to make the right decision ?  There is no way to know here without seeing the foot naked and moving across the floor, and with a clinical examination to boot.

You can get all these things through our National Shoe Fit Certification program found here.

LINK:  http://store.payloadz.com/results/results.aspx?advsearch=1&m=80204

Email us and we will share the necessary info to get you started.  thegaitguys@gmail.com

Shawn and Ivo, The Gait Guys

Shoe News you can use….

The Midsole

Last time we talked about the outsole (see here and here if you missed it or need a review). Today we will focus on the midsole.

The Midsole, sandwiched between the outsole and the upper, provides torsional rigidity to a shoe. They can be single (uni) density (left picture) or multiple (middle picture).

Midsole material is very important, as it will accommodate to the load imposed on it from the person as well as any gear they may be carrying. It serves as the intermediary and transducer for load transfer between the ground and the person.  Softer density material in the heel of the shoe, like in the blue lateral side of the shoe in the bottom picture, softens the forces acting at heel strike and is good for impact and shock absorption.

Because the midsole tranduces forces and provides torsional rigidity (picture on right). The stiffer the material, the more motion control it provides.  Midsoles like the one in the center are made with materials of differing densities (white is softer, light grey more dense, dark gray, most dense) to absorb force and decrease the velocity of pronation during heel strike and mid stance, with a firmer material medially that protects against overpronation as you come through mid stance and go through toe off.


Wow. Shoe anatomy for the day. Knew this? Great! Lost? Want to know more? Download our Shoe Fit Certification program by clicking here. You can also email us for more information about becoming IFGEC certified in shoe fit: thegaitguys@gmail.com


Ivo and Shawn. Bald. Handsome. Knowledgeable. The Gait Guys!