Gait, Running and Sound. Are you listening to your body ?

A few months ago we tried something new.  We tested your gait auditory skills while listening to a video of a runner on a treadmill. We queued you to listen to the foot falls listening for the one foot to slap or impact harder than the other at foot strike. Most of you got it right, we  got plenty of positive feedback on that piece. Here is that piece (link).

This is something we do during the initial evaluation for each and every patient that comes to see us, no matter what their issue. We ask them to walk. We ask them do they notice anything. The answer is almost always, “no”.  This is because they are accustomed to their walking habit.  The first queue we notice much of the time is that there is either a bilateral heavy heel strike (because heel strike is normal in walking) or it is  heavier on one side. We ask them to hear and feel that heavier strike once we point it out to them. Not only can they feel it, they can hear it. It is something they have rarely been aware of until that moment.  We then do the same for forefoot loading. If the anterior compartment is a little weaker on one side or if they departed abruptly off the opposite leg for some reason (decreased hip extension, tight calf, loss of ankle rocker etc), a heavier forefoot loading response will be felt and heard as well (opposite side of the mentioned issues).  These are great initial gait queues that anyone can use to gain diagnostic information.  It also draws the client into greater body awareness of their habitual patterns of movement. We then draw out the numbers and forces for them so they understand what several thousand cycles of this event can cause into their body and their clinical problems they are presenting with.  This is typically a new skill they will develop and always be aware of and be able to report to you as they progress through their care with you.  Sound and feeling are key biofeedback tools.

Just remember, they are feeling and hearing what they are doing, not what is wrong ! It is your job to take this information and figure out the “Why” it is happening, and the “how” to fix it.  This is the hard part.

Hey Folks

You know we are big Altra Fans. Check out their new commercial!

We are sure your keen eyes have picked up on the midfoot pronation at :17 and forefoot pronation at :28. This brings to mind a question we often get asked: How much pronation is too much pronation?

Some pronation is necessary, as it is one of the 4 shock normal absorbing mechanisms

  1. midfoot pronation
  2. ankle dorsiflexion
  3. knee flexion
  4. hip flexion)

We do not believe there is a perfect answer, but rather the ideal is: How much pronation can your (neuro and bio) mechanics control? Too much in one individual may be not enough in another. It has to do with foot structure, muscle competency, neuromuscular control, and a host of other things.

Remember the mantra: Skill, endurance, strength… in that order! Work to control the pronation you have and expand on that range.

The Bald Headed, Good Looking, Bringing you the facts Gait Guys.

all material copyright 2012 The Homunculus Group/The Gait Guys (except the commercial of course, which is property of Altra). If you want to use our stuff, ask nicely : )

Podcast #10: In the Running.

Podcast #10 is Live !

*Call to action ! If you like this podcast, think of some friends and colleagues who might enjoy it…… and consider sending it their way !

This link will get you a nicely laid out “show notes” and pod player.

http://thegaitguys.libsyn.com/webpage/podcast-10-in-the-running

and this one will get you to the show player of ALL of our podcasts.
http://directory.libsyn.com/shows/view/id/thegaitguys

Here are the show liner notes:

Payloadz link for our DVD’s and efile downloads: http://store.payloadz.com/results/results.asp?m=80204

1- NEUROSCIENCE PIECE: In the Running. Much thanks to our friends Nadia, Jennifer, Jad and Robert over at www.radiolab.org and “Radiolab: The Podcast” over on iTunes for giving us written permission to reproduce this awesome podcast named “Shorts: in the Running” from April 2011. Please visit their website. It is awesome !

2- Email from a Facebook Follower:

Hi there – I did a google search for “turned out foot” and came across your youtube video:  http://www.youtube.com/watch?v=-DE5VPxJOMU  I have this issue but I don’t think it is from a weak glut (although possibly could be, not sure). In the text, it mentions “looking at another case” as well as more info about this on your blog but I’m having trouble finding it. could you refer me to the right page? Also, where are you located?
thanks for the informative blog!!- Kim

3- DISCLAIMER:
We are not your doctors so anything you hear here should not be taken as medical advice. For that you need to visit YOUR doctors and ask them the questions. We have not examined you, we do not know you, we know very little about your medical status. So, do not hold us responsible for taking our advice when we have just told you not to !  Again, we are NOT your doctors !

4-  Updates and Sponsor talk:
A-  more lectures available  on www.onlineCE.com   Go there and look up our lectures
 
B- In January we will be taking on sponsors for our podcast.  We have had some interest already but we wanted to work out the quality control issues first. Early in means savings. 
Contact us if you would like to be a sponsor……If we believe your product has value to this listener community we will give you a professional and personalized company or product plug and advertisment.  From our lips to our listeners ears ! 
We will basically expose your product to our international fan base.
 The sponsors will help make our mission possible, defray costs and time to put out this podcast and blog. These things take is away from our practices a little.  Each week we will have 2 center-Stage sponsors . Your sponsorship can run as long as you want.

5-  Mail from an International Follower of our Blog:
Hi there,
I was hoping you might settle a debate I had with a physiotherapist about the efficiency of movement.

I argued that a running gait is a more efficient way of moving over distance because of less vertical ground reactive forces acting on the body during a running gait. I concluded that our natural environment requires us to run rather than walk as predation of non-sebatious hominids gives us the advantage of stamina rather than explosive speed.
The counter argument was that walking generates less metabolic demand therefore increases efficiency of movement. But I don’t think this is true in terms of calories/mile.
Any help would be appreciated.
Thanks! -Jesse, Luxumborg

http://www.runningplanet.com/training/running-versus-walking.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1283673/

running on feet: http://www.sciencedaily.com/releases/2010/02/100212092304.htm

6- EMAIL FROM A COACH: 
Do all the running form clinics have value ? It seems that you can teach someone what they believe is better form, but what if they do not have the anatomy to embrace that form you have taught ? What if they are weak in that form, might they build a compensation in that new form ?  It seems to me that merely adopting an apparently better running form does not necessarily mean one will be less injury prone.
-Thx Anonymous

TGG: midfoot strike, avoid heel strike.
Our beef is that No, not one, running form clinic we have seen talks about your anatomy such as”

– know your foot type
-know if you have tib torsion or torsional issues that will challenge patellar tracking and glute use (versions)
– know what your ankle rocker is like
– can you adopt forefoot strike ? midfoot strike?
– can you go into minimalism ? Ankle rocker ?  (patient with fusion)

vimeo: http://vimeo.com/40442384
by NakedRunnersTV Plus 5 months ago. An insight into the thoughts & experiences related to running & running barefoot, by Kenyan-based running coach, Rob Higley. Taken from the evening seminar held in Newcastle’s E10 (Hamilton Baptist) Church in Feb, 2012.

7- READER EMAIL:
    My name is Robert and am retired from the Navy.  I have chronic dorsal foot pain on my left foot and am tired of dealing with Podiatrists and Orthopedic doctors who just want to put you in orthotics.  I no longer wear orthotics just the Prokinetic 6mm inserts.  I have become extremely interested in your posts and would like to seek further help.  I live in the upstate SC and my question is could you direct me to a doctor that utilizes your techniques and would be in close proximity to my location.  I have some pretty interesting feet that I’ve ignored for far too long and am now paying the price.  Just from watching your video’s I have multiple issues that I need to address, I just don’t know how. (Collapsed arch and Mallet Toe on left foot,  Hammer Toes, Crossover Toe (No Bunion yet), Splayed 4th & 5th Meta on the right foot). I have Morton Foot Anatomy with 1st MPJ being about ½ inch shorter than 2nd meta.  All this together with low back pain, neck pain, forward head posture, and I waddle when I walk.  I’m really looking for someone to help me put it all together so I can figure out how to fix myself.  Getting a lot harder to run around with my 10 year old boy.  Any referrals or help would be greatly appreciated.

8- Blog post we liked recently:

The Pedograph

09- Our dvd’s and efile downloads
Are all on payloadz. Link is in the show notes.
Link: http://store.payloadz.com/results/results.asp?m=80204
 

10 – Email from a Field Doctor
Hi guys,
Do you have any clever exercises for getting someone to initiate swing phase with abs instead of psoas?
I wanted to check and see if you had any suggestions.
Hope you’re well!
We withheld the name

OUR RESPONSE:

1- first trick is to make sure they can supinate the stance foot and initiate external rotation from lower in the stance leg
2- make sure all external rotators are available……otherwise the hip-pelvis and abdominals will not get the clean signal to prepare
3- look for any functional or anatomical limitations to #1 and #2……such as forefoot varus, valgus, sustained pronation issues, genu valgus etc……
4- seated marches……..  sit in neutral spine/neutral pelvis…..ie. neutral lordosis……sit on two points of ischeal tuberosities……..hands in front like frankenstein…….. press one foot into the ground while the other thigh is lifted…….this must be done on an exhale to help drop the ribcage…….be sure the lift leg thigh does not rock back the pelvis on that side or lose the lordosis.  Doctor finger on the lordosis will queue them not to change spine angle……..if they do it right they will feel the lower abdominal fire first…….if they lose the pelvis or lordosis (ie. let them drop into lumbar kyphosis slump) they will only feel the hip flexor and quad lifting the leg which for most is easier but wrong
5- add challenge………put hands over head and repeat…..
6- pray  🙂

The Consequences of Overstriding.

Consequences of Over Striding: “Call me Ishmael”.

Have you ever wondered what would happen if you were running and impacted the foot at foot strike at the end range ankle rocker (full dorsiflexion) with the knee extended ? Can you even imagine this ?  It is hard isn’t it.  (Be patient, we are about to show you, but for now just try to imagine it.)
Where would the shock absorption go ?
How could  you progress over the limb other than through hip rotation?  Because there certainly would be no pivot over the ankle joint, like a client with a fused ankle joint. The ankle and lower leg would be like a wooden peg leg, “Call me Ishmael ! “.

And if the forces were moving up from the ground through the locked ankle mortise (which is again,terminal dorsiflexion) and a locked knee (again, in full extension) the forces through the hip would follow from the ground upwards. Creating a vaulting phenomenon. “Call me Ishmael”.
Can you picture this ?
If not, here is the video piece (VIDEO LINK) today very nicely depicting this awful biomechanical event.
You see, if you know your biomechanics, this stuff can virtually be created in your brain……. but it is always nice to see an athlete try it out.  That is why they get the big bucks !  Did you watch the video link yet ? He sure put the ACL and PCL in the octagon on that one !

Shawn and Ivo, the Biomechanics nerds……. as strange as Ishmael in the Octagon.

http://sports.yahoo.com/blogs/mlb-big-league-stew/houston-marwin-gonzalez-turns-most-spectacular-injury-season-144210692—mlb.html

Classic Crossover Gait Case.

Here is a client with a uncompensated forefoot varus (ie: the forefoot is inverted with respect to the rearfoot) and a cross over gait, secondary to incompetence of the medial tripod of the foot (he cannot descend the head of his 1st metatarsal to form the medial tripod due to the uncompensated forefoot varus) and weak right lower abdominal external obliques which we discovered on examination (perhaps you can detect a subtle  sag of the right side during stance phase on that side).

Note how he circumducts the lower extremities around each other. This takes the cross over to another level and it can occur when a client is pronating through the medial tripod such as in this forefoot varus case (we know this from the examination, it cannot be detected for sure from the video with the foot in the shoe, that would be an assumption).

How do you fix this?

  • tripod standing exercises
  • core stabilization exercises with attention to the right lower oblique (see our core series available for download on Payloadz here and here
  • foot manual therapy to improve motion of the 1st ray
  • see our crossover gait series on youtube here: part 1, part 2, and part 3
  • form running classes such as Chi Running

The Gait Guys. Bringing you the meat, without the fat.

all material copyright 2012 The Gait Guys/ The Homunculus Group: all rights reserved

More research on Forefoot Running: Forefoot Varus and the toe extensor muscles.

Lately we have all seen much in the news about the forefoot strike loading in runners and many of the proposals and rebuttals regarding injury rates.  Our dialogue less than 2 weeks ago on some of Lieberman’s recent comments (our blog article “Dear Dr.…

View Post

shared via WordPress.com

Speed Matters: Brief Thoughts on Gait and Running.

The journal article below sparked a few thoughts for a blog post today. Have you ever tried to walk slower than your normal pace ? How about running slower than your normal pace (  you know, running with that person who is clearly a minute slower pace) ?…

View Post

shared via WordPress.com