Too much potential gait pathology all in one sport ? Racewalking … . 
Do not underestimate this title, you may learn more about normal running form from today’s blog post than you think.
 
For the best clips start watching at the 4:15 mark. 
The sport of race walking is an interesting one to say the least.  We had the pleasure for years of treating and working closely with one of our countries best race walkers and she taught me so much, not only about the sport but about the strange mechanics of the sport and the functional pathologies the sport drives from its unique requirements driving abnormal gait mechanics on each step.
Racewalking is a long-distance event requiring one foot to be in contact with the ground at all times (and a couple of other unique and wacky rules that we will discuss in a moment). Stride length is thus reduced and so to achieve competitive speeds racewalkers must attain cadence rates comparable to those achieved by Olympic 800-meter runners for hours at a time. Most people cannot truly appreciate how fast these folks are going, most folks will have to move into at the very least a gentle run to keep up with these folks.
 

There are really only two rules that govern racewalking:

1-The first rules states that the athlete’s trailing foot’s toe cannot leave the ground until the heel of the leading foot has created contact. The rule violation is known as "loss of contact". 

2-The second rule specifies that the supporting leg must straighten, essentially meaning knee extension (and for some, terminal extension, ie. negative 5-10 degrees !) from the point of contact with the ground and remain straightened until the body passes directly over it. Again, essentially meaning full range knee extension for the entire stance phase of gait (early, mid and late midstance phases). For those who do not study the details of gait, this may not seem like a huge issue, but it is because full lockout really never occurs in either walking or running.  And there is nothing like impacting a joint in full extension lock and heavy heel strike to take away all of the natural shock absorbing mechanisms of the lower limb. (watch the video at the 4:30 mark, Dang ! the dude in the red looks like his knees are going to fold backward there is so my knee extension !) There is some great slow motion technique breakdown at the 6:28 minute mark of the video. 

In getting around these 2 major rules:

– the hips must rotate a tremendous amount, with full pelvis rotation, to prevent the frontal plane pelvis motion which would be a loss of sagittal power. This produces the visually painful waddle that is classic to the sport.

– the arms are used aggressively to generate power and to help the lower limbs move through the cycle because of the unnaturally apropulsive nature of the overall technique. The arms also often move excessively into the frontal plane since they mirror the lower limb

– excessive lateral heel strike quite often ensues help keep the knee extended and in an attempt to keep the foot on the ground longer, to avoid getting red carded. 

– there is plenty of cross over gait and severe lack of ankle dorsiflexion for everyone to observe, both of these components combined with the above characteristics give the “Close to the ground” appearance that is attempted by all racewalkers.

– want to see some seriously gut wrenching biomechanics, forward the video to the 7:55 mark. Tell us that won’t cause problems down the road !

Breaking the Rules:

The rules are entirely subjective and enforced by real-time human eye (not video) judges along the course (3 red card violations render an event disqualification). Interestingly, and we have seen this first hand, athletes quite regularly lose contact (meaning initiating a float phase, which is what dictates the difference between running and racewalking) for a few milliseconds per stride.  This float can be detected on film/video which can be caught on film, but such a short flight phase is said to be undetectable to the human eye. Disqualifications (losing contact or bent knee) are routine at the elite level as evidenced by the famous 2000 Summer Olympic case of Jane Saville who was disqualified on her way to a gold medal.

Racewalking … .  a highly technical sport, more so than running.  If you ever get a chance to see someone do this sport first hand, it is truly engaging to a gait geek. Lots of eye candy, gait geek eye candy that is !

Shawn and Ivo… … the gait guys. 

Too much potential gait pathology all in one sport ? Racewalking … . 
Do not underestimate this title, you may learn more about normal running form from today’s blog post than you think.
 
For the best clips start watching at the 4:15 mark. 
The sport of race walking is an interesting one to say the least.  We had the pleasure for years of treating and working closely with one of our countries best race walkers and she taught me so much, not only about the sport but about the strange mechanics of the sport and the functional pathologies the sport drives from its unique requirements driving abnormal gait mechanics on each step.
Racewalking is a long-distance event requiring one foot to be in contact with the ground at all times (and a couple of other unique and wacky rules that we will discuss in a moment). Stride length is thus reduced and so to achieve competitive speeds racewalkers must attain cadence rates comparable to those achieved by Olympic 800-meter runners for hours at a time. Most people cannot truly appreciate how fast these folks are going, most folks will have to move into at the very least a gentle run to keep up with these folks.
 

There are really only two rules that govern racewalking:

1-The first rules states that the athlete’s trailing foot’s toe cannot leave the ground until the heel of the leading foot has created contact. The rule violation is known as ”loss of contact”. 

2-The second rule specifies that the supporting leg must straighten, essentially meaning knee extension (and for some, terminal extension, ie. negative 5-10 degrees !) from the point of contact with the ground and remain straightened until the body passes directly over it. Again, essentially meaning full range knee extension for the entire stance phase of gait (early, mid and late midstance phases). For those who do not study the details of gait, this may not seem like a huge issue, but it is because full lockout really never occurs in either walking or running.  And there is nothing like impacting a joint in full extension lock and heavy heel strike to take away all of the natural shock absorbing mechanisms of the lower limb. (watch the video at the 4:30 mark, Dang ! the dude in the red looks like his knees are going to fold backward there is so my knee extension !) There is some great slow motion technique breakdown at the 6:28 minute mark of the video. 

In getting around these 2 major rules:

– the hips must rotate a tremendous amount, with full pelvis rotation, to prevent the frontal plane pelvis motion which would be a loss of sagittal power. This produces the visually painful waddle that is classic to the sport.

– the arms are used aggressively to generate power and to help the lower limbs move through the cycle because of the unnaturally apropulsive nature of the overall technique. The arms also often move excessively into the frontal plane since they mirror the lower limb

– excessive lateral heel strike quite often ensues help keep the knee extended and in an attempt to keep the foot on the ground longer, to avoid getting red carded. 

– there is plenty of cross over gait and severe lack of ankle dorsiflexion for everyone to observe, both of these components combined with the above characteristics give the “Close to the ground” appearance that is attempted by all racewalkers.

– want to see some seriously gut wrenching biomechanics, forward the video to the 7:55 mark. Tell us that won’t cause problems down the road !

Breaking the Rules:

The rules are entirely subjective and enforced by real-time human eye (not video) judges along the course (3 red card violations render an event disqualification). Interestingly, and we have seen this first hand, athletes quite regularly lose contact (meaning initiating a float phase, which is what dictates the difference between running and racewalking) for a few milliseconds per stride.  This float can be detected on film/video which can be caught on film, but such a short flight phase is said to be undetectable to the human eye. Disqualifications (losing contact or bent knee) are routine at the elite level as evidenced by the famous 2000 Summer Olympic case of Jane Saville who was disqualified on her way to a gold medal.

Racewalking … .  a highly technical sport, more so than running.  If you ever get a chance to see someone do this sport first hand, it is truly engaging to a gait geek. Lots of eye candy, gait geek eye candy that is !

Shawn and Ivo… … the gait guys. 

What do we have here and what type of shoe would be appropriate?

You are looking at a person with a fore foot varus. This means that the fore foot (ie, plane of the metatarsal heads) is inverted with respect to the rear foot (ie, the calcaneus withe the subtalar joint in neutral). Functionally translated, this means that they will have difficulties stabilizing the medial tripod (1st MET head) to the ground making the forefoot and arch unstable and likely rendering the rate and degree of pronation increased.

Having trouble with terminology? check out this post on FF varus.

The incidence of this condition is 8% of 116 female subjects (McPoil et al, 1988) and 86% of 120 male and female subjects (Garbalosa et al, 1994), so it happens more in males.

Fore foot varus occurs in 3 flavors:

  • compensated
  • uncompensated
  • partially compensated

What is meant by compensated, is that the individual is able to get the head of the 1st ray to the ground completely (compensated), partially, or, when not at all, uncompensated.

What this means from a gait perspective ( for partially and uncompensated conditions) is that the person will pronate through the fore foot to get the head of the 1st ray down and make the medial tripod of the foot (ie, they pronate through the subtalar joint to allow the 1st metatarsal to contact the ground). This causes the time from mid-stance to terminal stance to lengthen and will inhibit resupination of the foot. We will have an upcoming additional post on this soon and will put a link here when we do.

Today we are looking at a rigid, uncompensated forefoot varus, most likely from insufficient talar head derotation during fetal development and subsequent post natal development. They will not get to an effective foot tripod. They will collapse the whole foot medially. These people look like severely flat-footed hyperpronators.

So, what do you do and what type of shoe is appropriate? Here’s what we did:

  • try and get the 1st ray to descend as much as possible with exercises for the extensor hallucis brevis and short flexors of the toes (see our videos on youtube)
  • create more motion in the foot with maniipuulation, massage mobilization to optimize what is available
  • strengthen the intrinsic muscles of the feet (particularly the interossei
  • increase strength of the gluteus maximus and posterio fibers of the gluteus medius to slow internal rotation of the leg during initial contact to midstance
  • put him in a flexible shoe for the 1st part of the day, to exercise the feet and a more supportive, medially posted (ideally fore foot posted) shoe for the latter part of the day as the foot fatigues
  • monitor his progress at 3-6 month intervals
  • a rigid orthotic will likely not help this client and they will find it terribly uncomfortable because this is a RIGID deformity for the most part (the foot will not accommodate well to a corrective orthotic. Besides, the correction really has to be made at the forefoot anyways. We will talk about medial forefoot postings again at a later date.)

Lost? Having trouble with all these terms and nomenclature? Take our national shoe fit program, available by clicking here.

The Gait Guys. Uber foot geeks. Still bald and good looking. Separating the wheat from the chaff, with each and every post.

Bigfoot Gait. Part 2. The Patterson Video: Human or Gigantopithecus ?

Last week on the blog we discussed some of the unique gait characteristics we saw in the famous Patterson Bigfoot video and how many of them are seen in humans as compensatory strategies. Today we will mention a few more interesting things that will have you think about your human gait assessments a little differently.

Renowned chimpanzee researcher Jane Goodall last year surprised an interviewer from National Public Radio when she said she was sure that large, undiscovered primates, such as the Yeti or Sasquatch, exist.”

Why does Jane believe this ? Well, Gigantopithecus blackiwere, the largest apes that ever lived (10 feet tall, 1000+ lbs), lived as recently as 100,000 years ago. Giganto can be placed in the same time frame and geographical location as several hominin species. Its means of locomotion are uncertain since no pelvis or leg bones have ever been unearthed however the dominant view is that it walks on all fours like modern day gorillas and chimpanzees.  There are those however that believe that Gigantopithicus also walked bipedally just like many of today’s apes do.  There was a fascinating theory brought to light by Grover Krantz who made the bipedal assumption from jaw bones which were U-shaped and widened posteriorly leaving room for the windpipe to be located within the jaw, just like in humans.  This had to translate to bipedal ambulation to afford the skull to squarely sit upright on a completely erect spine as compared to being carried anteriorly (when on all four limbs) as in the great apes and chimpanzees.  It is a fascinating theory, but none the less, there are researchers on either side of the debate and proof may never occur … .  until perhaps one day we find a full skeleton or the real life version. Maybe someday we can get a team of Gait Geeks together and create a “Squatching Team” to head out deep into the Pacific northwest on a discovery mission.

1- Vertical Oscillations:

Today, in the video above, we draw your attention to the lack of vertical oscillations of the head.  Take a moment to watch this in the video once again. You should see that there is very little vertical displacement of the body (focus on the head). This minimal vertical type gait can only occur with a continuous slightly bent knee gait and we could make the case that a midfoot strike will dampen the vertical parameter even further. In humans, and in bigfoot here, limiting terminal hip extension also buffers some of the vertical movement, just as you see in the video.   Humans use a slight degree of knee flexion at foot strike to accomplish the same task, it is partly a strategy to keep the eyes steady on the horizon and some anthropological papers have suggested that this was a necessity in order to be able to run, visually track and accurately launch a spear at prey back in our plains hunting days. 

2. Heel Strike vs Heel Contact

A midfoot strike and heel strike are different.  A midfoot strike is often accompanied by a heel contact phase, which is different than a heel strike. With heel strike, the heel is the first point of contact, whereas heel contact can occur if the entire foot is placed flat all at once or it can occur after a forefoot or midfoot strike occurs (ie. placing the heel down).

By many sources, only great apes exhibit a true heel-strike, other primates present with a heel contact after a midfoot strike first occurs. As determined in this study heel contact is a by-product of an active posterior weight-shift mechanism involving highly protracted hindlimbs at touchdown.

 From the Schmitt study a variety of primates (32 species) were viewed walking on the ground and on simulated arboreal supports at a range of natural speeds.

“The study’s results indicated that Pongo as well as the African apes exhibit a “heel-strike” at the end of swing phase. Ateles and Hylobates make “heel contact” on all supports shortly AFTER mid-foot contact, although spider monkeys do so only at slow or moderate speeds.  No other New or Old World monkey or prosimian in this study made heel contact during quadrupedalism on any substrate. Thus, heel contact occurs in all apes and atelines, but only the great apes exhibit a heel-strike.”

Schmitt also concluded that “although heel contact and heel-strike may have no evolutionary link, it is possible that both patterns are the result of a similar weight shift mechanism. Therefore, the regular occurrence of heel contact in a variety of arboreal primates, and the absence of a true biomechanical link between limb elongation, heel contact, and terrestriality, calls into question the claim that hominid foot posture was necessarily derived from a quadrupedal terrestrial ancestor.”

So, in the Patterson video above, we see a lack of vertical oscillations just as in man. Apes also tend to waddle side to side, much more so than what we see in the Patterson video.  We also see a heel strike, which is know to occur in great apes but also in man.  
So, is this a man or is this a great ape ? It points to a human in an ape suit, unless this is actually Gigantopithicus who over 100,000 years has improved upon the skill and coordination of bipedal gait, just as modern day man has done.
Nothing shocking  here today. This was kind of fragmented a little but we just wanted to bring up the vertical oscillation and heel strike components to human and ape gaits. And then, let you decide for yourself about the Patterson video.

Shawn and Ivo……. when not making crop circles we are just two guys in ape suits……. walking the night forests, keeping folks believing…..

PS: here is an interesting excerpt on vertical oscillations from an old blog post we did. It seems pertinent here.

This study’s findings findings clearly demonstrate that human walkers consume substantially more metabolic energy when they minimize vertical motion.

Anyhow, the summary of this peer reviewed article by Ortega concluded that :

“in flat-trajectory walking, subjects reduced center of mass vertical displacement by an average of 69% but consumed approximately twice as much metabolic energy over a range of speeds . In flat-trajectory walking, passive pendulum-like mechanical energy exchange provided only a small portion of the energy required to accelerate the center of mass because gravitational potential energy fluctuated minimally. Thus, despite the smaller vertical movements in flat-trajectory walking, the net external mechanical work needed to move the center of mass was similar in both types of walking. Subjects walked with more flexed stance limbs in flat-trajectory walking, and the resultant increase in stance limb force generation likely helped cause the doubling in metabolic cost compared with normal walking.Regardless of the cause, these findings clearly demonstrate that human walkers consume substantially more metabolic energy when they minimize vertical motion.”

J Appl Physiol. 2005 Dec;99(6):2099-107. Epub 2005 Jul 28. Minimizing center of mass vertical movement increases metabolic cost in walking. Ortega JDFarley CT. Source— 

 References:

-http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409101/

Am J Phys Anthropol. 1995 Jan;96(1):39-50.
-Heel contact as a function of substrate type and speed in primates. Schmitt DLarson SG.. Department of Anatomical Science, School of Medicine, State University of New York, Stony Brook 11794, USA.

-http://thegaitguys.tumblr.com/post/46851286689/more-on-the-great-debate-does-decreased-step-height

-http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1571309/

To orthotic or not to orthotic, that is the question

A concerned mother of this 3 year old boy came in, wondering if her son should have orthotics. What do you think?

Pros for orthotics:

  • will make calcaneii more vertical
  • will make feet look better
  • will decrease progression angle while walking
  • will halt most of the midfoot pronation you see on the single leg standing views
  • will make left calcaneal valgus better that we see on the post view

Cons for orthotics:

  • may interfere with derotation of the talar head, causing a permanent forefoot varus deformity or Mortons foot (need to more about development? click here)
  • will make the child use their intrinsic muscles less, weakening the feet, causing problems later on in life
  • will inhibit descent of 1st ray, and peroneus longus function (if you don’t use it, you lose it. More on peroneus here)
  • will alter gait and affect motor development

What did we do?

  • have the mother have the child walk barefoot more, especially in the sand
  • have the child hop on one leg and do tandem gait walking
  • have the child balance on one leg at a time
  • place the child in flexible shoes
  • recheck the child in 6 months to assess progress

Does this mean kids should NEVER be in orthotics? No, certainly not, but we fell this is neither the time or the place. A lot of development (and learning) occurs in the 1stf five 5 years of life. How about we let nature do its thing, try and stay out of the way of normal development and monitor?

The choice is yours

The Gait Guys. Offering firm, but gentle clinical guidance through the maze of gait information out there.

Bigfoot Gait. Yup, taking a look at the “big guy”.  The famous Patterson video.

Man or Ape? That is the question ! Lets see what can be noticed :

  1. protracted head, shoulders and a forward and downward drop of the anterior rib cage through probable weak upper abdominals
  2. internally rotated upper limbs with excessive forward arm swing (overswing, likely pulling/flexing too much from the pectorals to drive arm swing as opposed to driving normal pendular arm swing from triceps extension)
  3. no hip extension during gait, (see #2 above. Without adequate triceps use/posterior arm swing the degree of hip extension/gluteal use cannot be optimized.

These are clearly attributes of a animal that has moved from quadipedal gait to bipedal before they have earned the postural right to do so.

Just like any modern man,  as evidenced by clear observance of said gait in the local mall or airport, most of modern man has difficulties with the degree of motor coordination and postural control necessary to walk with clean upright biomechanics.  Most modern gait exhibits the pathologies we discussed above. So, this must be a man in an ape suit then, right ? The only problem is that this film was from 1967 ! Clearly we know that Bill Gates and Steve Jobs were not doing their thing at that time, and people were not driving that much nor sitting in board rooms as much as they do now. So the question remains, if this is a man how did he get so posturally imploded ? Unless of course, he was trying to walk like a bipedal monkey.  The only problem there is that ape contra-body movements (symmetrical fluid opposite arm-leg swing) are not this clean even though this is pretty poor gait for a human.  So, either this is a non-computer age man trying to walk like an experienced ape, or, this is bigfoot.

There you go, we successfully made no progress in our forensic analysis to help in the mystery of bigfoot.  Then again, no one has.  National Geographic has a something else to say……. read on.

articleForensic Expert says Bigfoot is real. (click for link)

From the article…..”It’s been the subject of campfire stories for decades. A camera-elusive, grooming-challenged, bipedal ape-man that roams the mountain regions of North America. Some call it Sasquatch. Others know it as Bigfoot.

Chilcutt says one footprint found in 1987 in Walla Walla in Washington State has convinced him that Bigfoot is real.

“The ridge flow pattern and the texture was completely different from anything I’ve ever seen,” he said. “It certainly wasn’t human, and of no known primate that I’ve examined. The print ridges flowed lengthwise along the foot, unlike human prints, which flow across. The texture of the ridges was about twice the thickness of a human, which indicated that this animal has a real thick skin.”

Renowned chimpanzee researcher Jane Goodall last year surprised an interviewer from National Public Radio when she said she was sure that large, undiscovered primates, such as the Yeti or Sasquatch, exist.”

click the link above to read the whole article.

Shawn and Ivo……. when not making crop circles we are just two guys in ape suits……. walking the night forests, keeping folks believing…..

Holy Late Cretaceous Therapods. Those Veliciraptors were twisted!

The dinosaur made famous by Jurassic Park (We never understood why they put this dinosaur in the movie, the Jurassic period was many millions of years earlier, but that’s another story).

Dr Ivo was able to take some pictures of a rare, preserved skeleton from Mongolia at the dinosaur museum in Fruita, CO, while visiting with his family.

These bad boys (and girls) were fast predators, and one of the things that made them that way, was the fact that they were built for speed!

Take a look at theses hips! Note the extreme retro torsioned angle of the femur heads. We remember that femoral retro torsion limits internal rotation of the hips (OK, so you don’t remember? click here for a review).

Now lets think about this. Externally rotate your thigh and lower leg. What do you notice? Hopefully you notice it puts your foot in more supination. This makes it into a more rigid lever, better for pushing off and better for sprinting!

Have you ever seen a sprinter? do they run on their toes? Is their foot more supinated? Ever see a velociraptor run? Check out this sequence from the “Dinosaur Planet” series. Remember, only their toes are on the ground and the thing that looks like a backwards knee is actually their ankle. 

Since their legs are so close to the body, there is little need for internal rotation, so why not maximize the effect and assist in supination?

Wow! Are you finally convinced that torsions are cool? After all, they appear to have been around for at least the last 75 million years and probably longer. 

The Gait Guys. Quarternary Geeks of the Cenozoic Era. Yes, we study dinosaur gait too…