So you think you are tough ? This guy was tough. A marathon a day for over 120 days…..on one leg, with cancer.
Today, a Tribute to Terry Fox. Every year we post a reminder of perhaps one of the toughest dudes who ever lived.
Today , this day, 1981 Terry Fox died.
Half of The Gait Guys grew up in Canada. We were barely a teenager when Terry began his plight. His mission, 26 miles a day, every day, until he had crossed the expanse of Canada. He made it an amazing 120+ days in a row, 3339 miles, before his cancer returned. The whole country stood cheering watching him do something no mortal man would attempt, let along with one leg, and cancer. Today we pay a tribute to this rockstar.

Rest in Peace Terry.

Cheating the Ankle Rocker: a review post of Anothony Bourdain.

Today seems like the perfect day to link you to this old blog post because it parlays beautifully with yesterdays video and blog article.

Once again, we present “The Chef: Anthony Bourdain, Cheating the ankle rocker”. We hope he won’t get upset we snipped this little clip from his old show No Reservations. He is a smart reasonable guy, we think that if he knew he was helping others that he would say “go for it”.

Here is a rewind of our blog post:

http://thegaitguys.tumblr.com/post/21713480315/the-chef-another-abnormal-gait-pattern-in

PS: we follow Bourdain on Twitter……one prolific guy and great TV shows too. Did you see his recent show (on CNN) on the Congo? We are huge fans of The Chef ! One guy we would someday definitely love to meet and share a beer with. Even if he has some impaired gait mechanics. But hey, who doesn’t !?

The Gait Guys

Cheating the Ankle Rocker: a review post of Anothony Bourdain.

Today seems like the perfect day to link you to this old blog post because it parlays beautifully with yesterdays video and blog article.

Once again, we present “The Chef: Anthony Bourdain, Cheating the ankle rocker”. We hope he won’t get upset we snipped this little clip from his old show No Reservations. He is a smart reasonable guy, we think that if he knew he was helping others that he would say “go for it”.

Here is a rewind of our blog post:

http://thegaitguys.tumblr.com/post/21713480315/the-chef-another-abnormal-gait-pattern-in

PS: we follow Bourdain on Twitter……one prolific guy and great TV shows too. Did you see his recent show (on CNN) on the Congo? We are huge fans of The Chef ! One guy we would someday definitely love to meet and share a beer with. Even if he has some impaired gait mechanics. But hey, who doesn’t !?

The Gait Guys

The Power of Observation: Part 2

Let’s take a closer look at yesterdays post and the findings. If you are just picking up here, the post will be more meaningful if you go back and read it. 

The following are some explanations for what you were seeing:

torso lean to left during stance phase on L?

if he has a L short leg, he will need to clear right leg on swing phase. We have spoken of strategies around a short leg in another post. This gentleman employs 2 of the 5 strategies; torso lean is one of them

increased progression angle of both feet?

Remember he has femoral retroversion. You may have read about retrotorsion here. He has limited internal rotation o both thighs and must create the requisite 4-6 degrees necessary to walk. He does this by spinning his foot out (rotating externally).

decreased arm swing on L?

This is most likely cortical, as he seems to have decreased proprioception on both legs during 1 leg standing. Proprioception feeds to the cerebellum, which in turn fires axial extensors through connections with the vestibular system. Diminished input can lead to flexor dominance (and extensors not firing). Note the longer stride forward on the right leg compared to the left with less hip extension (yes, we know, a side view would be helpful here).

circumduction of right leg?

This is the 2nd strategy for getting around that L short leg.

clenched fist on L?(esp when standing on either leg)

see the decreased arm swing section. This is a subtle sign of flexor dominance, which appears to be greater on the right.

body lean to R during L leg standing?

This is again to compensate for the L short leg. He has very mild weakness of the left hip abductors as well, more when moving or using them in a synergistic fashion (ie functional weakness) than to manual testing.

Well, what do you think? Now you can see how important the subtle is and that gait analysis may complex than many think.

We are and we remain, the Geeky Guru’s of Gait: The Gait Guys

OK, quiz time. The Powers of Observation.

Perhaps you have been following us for a while, perhaps you are just finding us for the 1st time. Here is some back ground on this footage. Let’s test you observation skills.

Watch this gait clip a few times and come back here to read on.

This triathlete presented with low chronic low back pain of about 1 years duration. The   pain gets worse as the day goes on; it is best in the early am. Running and biking do not alter its intensity or character and swimming makes it worse. Rest and analgesics provide only temporary relief.

Physical exam findings include limited internal rotation of both hips (zero); a left anatomical short leg (tibial and femoral, 5mm total); diminished proprioception with 1 leg standing (<30 seconds). MRI reveals fatty infiltration of the lumbar spinal paraspinals and fibrotic changes within the musculature; degenerative changes in the L4 and L5 lumbar facet joints, degeneration of the L5-S1, L3-L4 and L2-L3 lumbar discs.

Now watch his gait again and come back here for more.

Did you see the following?

  • torso lean to left during stance phase on L?
  • increased progression angle of both feet?
  • decreased arm swing on L?
  • circumduction of right leg?
  • clenched fist on L?(esp when standing on either leg)
  • body lean to R during L leg standing?

How did you do? If you didn’t see all those things, then you are missing pieces of the puzzle. Remember, often what you see is not what is wrong, but the compensation

The powers of observation of the subtle make the difference between good results and great ones.

Try some of these tips.

  • break down the gait into smaller parts by watching one body part at a time: right leg, left leg, right arm, left arm, etc
  • watch for shifts in body weight in the coronal plane (laterally) and saggital plane (forward/backward) as weight transfers from one leg to another
  • watch for torso rotation (watch his shoulders. Did you notice he brings his torso more forward on the left than right when walking toward us?)

We are (and have been) here to help you be a better observer and a better clinician, coach, athlete, sales person, etc. If you haven’t already, join us here for some insightful posts each week; for our weekly (almost) PODcast on iTunes; follow us on Twitteror on Facebook: The Gait Guys