“When you run up a hill, most of the cross over gait disappears. Runners will tend toward beautifully stacked lower limb joints.”- Dr. Allen

Are people running up a hill more likely to tend towards a cross over gait style, in other words tend toward a more narrow gait step or a wider gait step ?

Watch people run up hill closely. Even if they are cross over (narrow foot fall) runners, when running up hills a few things will negate much of the narrow foot fall.

1- Running up hill requires more gluteals, more power is needed for all that extra required hip extension to power up the hill. More gluteal max use can, and will, spill over into the posterior fibers of the gluteus medius and this will tend to abduct the leg/hip and reduce some of the cross over tendency.

2- When one runs up a hill, there is a forward pitch of the upper torso, often with a some degree of forward pitch occurring at the hips. More importantly, because one is running up hill, they are stepping up and so more than normal hip flexion is necessary than in normal running. The forward pitch of the body and the greater degree of hip flexion is the culprit here. If the hip/leg is adducted in a cross over style, adding this to a more than normal flexing hip, it will create a scenario for anterior hip impingement and risk of femoral acetabular impingement (FAI) syndromes. Go ahead, test it for yourself. Lie on your back and flex your hip, drawing your knee straight up towards your shoulder.  Pretty good range correct ?  Now, flex the hip drawing your knee towards your navel, adducting it a little across your body. Feel the abrupt range of motion loss and possible pinch in the front of the hip ?  FAI.  This is what would happen if you utilized a cross over gait, narrow foot strike gait. The goes for mountain/sleep hill hikers as well. 

This is why, if you are a narrow foot striker, a near-cross over type of runner, you will see it disappear when you run up hills.  

If you get anterior hip pain running up hills, force a wider step width and reduce the possible impingement at the anterior hip joint. Just make sure you have enough ankle dorsiflexion to tackle the hill in the first place. If not, you may welcome some foot and ankle stuff to the table along with the hip.  

Likely obvious stuff to most of the readers here, but sometimes it is nice to point out the obvious.  Hills, just because they are there, doesn’t mean you have the parts to run them safely.

Dr. Shawn Allen

Do you have enough in the anterior tank ? Dr. Allen’s quiz question and lesson of the week.

One of my favorite sayings to my clients, “Do you have enough anterior strength to achieve and maintain posterior length?”  

Translation, do you have enough anterior lower leg compartment strength (tibialis anterior, long toe extensor muscle group, peroneus tertius) to achieve sufficient ankle dorsiflexion in order to achieve posterior compartment length (gastric, soleus, tibialis posterior, long toe flexor muscle) ?  You see, you can either regularly stretch the calf-achilles complex or you can achieve great anterior compartment strength, to drive sufficient ankle dorsiflexion, in effect EARNING the posterior compartment length. This is a grounded principle in our offices. It is the premise of the Shuffle Walk exercise (link) and many others we implement in restoring someones biomechanics.

Now on to today’s quiz question.

In this photo, both people are just mere moments before heel strike. 

1. Who is gonna need to have more eccentric strength in the anterior compartment ? And what if they don’t have it ? Repercussions ?  

2. Who is toeing off the lateral forefoot ? 

3. Who is crossing over more and thus could have more gluteus medius weakness ?

A picture is worth a thousand words. Answers and dialogue below.

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1. The lady in the high heeled shoes. If she heel strikes first, the larger longer heel on her shoe will mean she will need more of a prolonged eccentric loading of the anterior compartment to lower the forefoot to the ground. I hope she shortens her strike so she can get close to mid foot strike, it will negate most of this issue.  Repercussions? Forefoot pain, clenching/hammering of her toes from use of the long flexors to dampen loading of the metatarsal heads, and even possibly anterior shin splint like pain.

2. The lady is clearly in more lateral toe off, this is from the intoe’ing we see. This is low gear toe off. She may have limb torsion, internal tibial torsion to be specific, or insufficent external hip rotation control as a possibility. There are several possibilities here.

3. Hard to say, but the man seems to be crossing over more.

There is also no arm swing, hands are in the pockets, this is a big hit to gait economy. We have discussed these numbers in previous blog posts, the numbers are significant and real.  Step width is also a real factor, reduced step width leads to joint stacking challenges and is found with weaker hip abductors and changes in the iliotibial band length.

A picture can be worth a thousand words. I am a few short of the mark today, but I wanted to keep it short.

Dr. Shawn Allen, one of the gait guys

Which sports burn the most calories?

Photo: Gallo Images/iStockphoto  

Look at this photo. Do you see it ? How much posterior rotation (left rotation) is being driven through that left shoulder/torso rotation. That is nuts! We have a hard time believing that is not a compensation. We would be assessing for stability and mobility issues elsewhere. Heck, the elbow practically crosses the spine posteriorly ! Sheesh ! When you cannot put the movement where it should be, or control it (stabilize) where it should be controlled, sometimes you try to get it or put it elsewhere. We would love to see this lady run, we bet there is a host of clean gait problems down below. We would bet some cross over gait is present as well, after all, that left arm swing is largely predicated off of the right leg swing. Arm swing is far less independent than people think, we have written about that here on our blog numerous times. Just search “arm swing” over on our Tumblr blog.

Remember this, and if you need to go back to read about phasic and anti-phasic gaits head over and search our blog, but the amount of shoulder “girdle” (essentially thoracic rotation) is typically met by the same amount of pelvis rotation. These should be symmetrical. And, when they are not, we can drive it through various means, even as in this case, through more arm swing unilaterally. We wish we could see some axial photos from above to see how much pelvis rotation is noted  here.

Just some brief thoughts from Dr. Allen

Photo link attributed to owner: http://africanspotlight.com/wp-content/uploads/2016/03/CdBVhTzUkAELVp6.jpg

Which sports burn the most calories?

Heat Exertion and Gait Decline

Changes in gait characteristics are found when exertional heat stress is experienced during prolonged load carriage.  As heat stress increased, step width decreased while percent crossover steps increased. Reduced stance time variability, step width variability, and percent crossover step were observed.  These are frontal plane gait parameters for the most part. 

Think about these things during your long summer run or as you go deeper into those last miles of your long run.  Simple muscular fatigue in the frontal plane hip-pelvis stabilizers are going to render the same results.  This is quite possibly why many problems and injuries crop up in the latter miles of your run. 

Reference:

Gait Posture.

2016 Jan;43:17-23. doi: 10.1016/j.gaitpost.2015.10.010. Epub 2015 Oct 23.Using gait parameters to detect fatigue and responses to ice slurry during prolonged load carriage. Tay CSLee JKTeo YSQ Z Foo PTan PMKong PW

Part 2: How relaxed, or shall we say “sloppy” is your gait ? The Cross over gait /Frontal plane drift gait.

In this photo (*credit below) the blurred right swing leg tells you this client has been photographed during gait/running motion. Can you see it ? Have we educating you well ?

Human gait is cyclical. A problem on one side will corrupt the other and the cycle begins, and usually continues until the cycle is broken. 

We wish to remind you of our time hammered principle that when the foot is on the ground the glutes are heavily in charge, and when the foot is in the air, the abdominals are heavily in charge.  For us to move cleanly and efficiently one would assume that the best way to do that would be to ensure that the lower 2 limbs are capable of doing the exact same things, with the same timing, same skill, same endurance and same strength. This goes for the upper 2 limbs as well, and then of course the synchronizing of the four in a cohesive antiphasic effort. This would be perfect and clean gait, a gait that would unlikely ever suffer pain or problems. Symmetrical durability wins every time. 

This photo demonstrates the cross over gait and we are beating it to a pulp here, again.  In this running gait photo, this momentary snapshot of global movement, it shows this client is engaging movement into the left frontal plane excessively, they have drifted to the left far outside the vertical plumb line from the foot. The question is, it is excessively enough to present as painful pathology or is it a painless problem at this time? We call what you see here a frontal plane drift, but more so, the cross over gait. You can even see suggestion of the left frontal drift as evidenced by the concavity of the lumbar spine curve to the left.  It should be clear that the right pendulum leg will scrape the left calf on its way through its oblique pendulum swing (instead of a pure forward sagittal swing) to a foot strike somewhere near to the line they are closely running on (a theoretical line). This is the cross over gait.  After this left frontal plane drift and right cross over, there will likely be a corresponding right frontal plane drift and left cross over to compensate on the very next step. Thus, the cycle begins, each on feeding and compensating off the other. To prevent it, it means you have to have an extra bit more of lateral line strength in the gluteus medius and lateral abdominal sling to fend off pathology. You have to  have the stability from S.E.S (skill, endurance, strength) to stack the hip, knee and foot over top of each other.  You have to have enough ankle stability and a host of other clean and strong and skilled layers to fend it off to be precise. One must be able to find functional stability in the stacked posture, and this can take some training and time.  Make no mistake, this is a faulty movement pattern, even if there is not pain (yet), this is not efficient motor patterning and something will have to give. Whether that is lateral foot pain from more supination strategizing, more tone in the ITB perhaps causing lateral knee or hip pain, posterior ischeofemoral impingment syndrome, a compensation in arms swing or thoracic spine rotation or head tilt etc … .  something has to give, something has to compensate.

To complicate the cyclical scenario, the time usually used to move sagittally will be partially used to move into, and back out of, the frontal plane. This will necessitate some abbreviations in the left stance phase timely mechanical events. Some biomechanical events will have to be abbreviated or sped through and then the right limb will have to adapt to those changes. These are simple gait problems we have talked about over and over again here on the gait guys blog. (Search “arm swing” on our blog and you will find 50+ articles around this topic.) These compensation patterns will include expressed weaknesses in various parts of the human frame as part of the pattern

Are you able to find the problem in the never ending loop of compensations of your clients and find a way to unwrinkle their system one logical piece at a time, or will you just chose to strengthen the wrinkled system and hope that the new strength on top of the compensations is adequate for you or your client ? One should not be forever sentenced to daily or weekly rehabilitative sessions or homework to negate and alleviate symptoms, this is a far more durable machine than that. Fix the problem.  Merely addressing things locally can be a crime.  If you are seeing an arm swing change, you would be foolish not to look at the opposite lower limb and foot at the very least, and of course assess spinal rotation, lateral flexion and hinging as well as core mobility and stability. 

For you neuro nerds, remember what Dr. Ivo says, that the receptors from the central spine and core fire into the midline vermis of the cerebellum (one of the oldest parts of our brain, called the paleo cerebellum); and these pathways, along with other cerebellar efferents, fire our axial extensor muscles that keep us upright in the gravitational plane and provide balance or homeostasis through stability.  It is why they assessed and addressed.  

Or, if this is too much thinking for you, … you can just train harder and get stronger . .  . in all your compensation patterns, after all, it is easier than figuring out why and how a right ankle for example started the whole mess, if in fact that is even the first piece of the puzzle.  No one said this would be easy. 

So, how sloppy is your gait ?

Dr. Shawn Allen, one of the gait guys

________________________

References and Credits

Note: photo linked to this article. Photo credit/property: REUTERS/Eduardo Munoz (Copyright Reuters 2016).  

Article: Workouts focused on motor skills may help ease lower back pain

 http://www.foxnews.com/health/2016/01/14/workouts-focused-on-motor-skills-may-help-ease-lower-back-pain.html

How relaxed, or shall we say “sloppy” is your gait ?

Look at this picture, the blurred left swing leg tells you this client has been photographed during gait motion. 

Now, visualize a line up from that right foot through the spine. You will see that it is clearly under the center/middle of the pelvis. But of course, it is easier to stand on one leg (as gait is merely transferring from one single leg stance to the other repeatedly) when your body mass is directly over the foot.  To do this the pelvis has to drift laterally over the stance leg side.  Sadly though, you should be able to have enough gluteal and abdominal cylinder strength to stack the foot and knee over the hip. This would mean that the pelvis plumb line should always fall between the feet, which is clearly not the case here.  This is sloppy weak lazy gait. It is likely an engrained habit in most people, but that does not make it right. It is pathology, in time something will likely have to give. 

This is the cross over gait we have beaten to a pulp here at The Gait Guys over and over … . . and over.   This gait this gait, this single photo, means this client is engaging movement into the frontal plane too much, they have drifted to the right. We call it frontal plane drift. To prevent it, it means you have to have an extra bit more of lateral line strength in the gluteus medius and lateral abdominal sling to fend off pathology. You have to be able to find functional stability in the stacked posture, and this can take some training and time.  Make no mistake, this is a faulty movement pattern, even if there is not pain, this is not efficient motor patterning and something will have to give. Whether that is lateral foot pain from more supination strategizing, more tone in the ITB perhaps causing lateral knee or hip pain, a compensation in arms swing or thoracic spine rotation or head tilt  … … something has to give, something has to compensate. 

So, how sloppy is your gait ? 

Do you kick or scuff the inside of your opposite shoe ? Can you hear your pants rub together ? Just clues. You must test the patterns, make no assumptions, please.

Shawn Allen, one of the gait guys

Podcast #99: How foot placement, the glutes and cross over gait all come together and make sense.

Topics: Plus, How foot placement, the glutes and cross over gait all come together and make sense. Plus, discussions on vibration,proprioception, cerebellum and movement.

Show Sponsors:

*newbalancechicago.com

*Rocktape.com

A. Link to our server: http://traffic.libsyn.com/thegaitguys/pod_99final.mp3

Podcast Direct Download: http://thegaitguys.libsyn.com/podcast-99-how-foot-placement-the-glutes-and-cross-over-gait-all-come-together-and-make-sense

Other Gait Guys stuff

B. iTunes link:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138
C. Gait Guys online /download store (National Shoe Fit Certification & more !)
http://store.payloadz.com/results/results.aspx?m=80204
D. other web based Gait Guys lectures:
Monthly lectures at : www.onlinece.com type in Dr. Waerlop or Dr. Allen, ”Biomechanics”

-Our Book: Pedographs and Gait Analysis and Clinical Case Studies
Electronic copies available here:

-Amazon/Kindle:
http://www.amazon.com/Pedographs-Gait-Analysis-Clinical-Studies-ebook/dp/B00AC18M3E

-Barnes and Noble / Nook Reader:
http://www.barnesandnoble.com/w/pedographs-and-gait-analysis-ivo-waerlop-and-shawn-allen/1112754833?ean=9781466953895

https://itunes.apple.com/us/book/pedographs-and-gait-analysis/id554516085?mt=11

-Hardcopy available from our publisher:
http://bookstore.trafford.com/Products/SKU-000155825/Pedographs-and-Gait-Analysis.aspx

Show notes:

Evaluating the Differential Electrophysiological Effects of the Focal Vibrator on the Tendon and Muscle Belly in Healthy People ARTICLE in ANNALS OF REHABILITATION MEDICINE · AUGUST 2014 DOI: 10.5535/arm.2014.38.4.494 · Source: PubMed

J Neurophysiol. 2014 Jul 15;112(2):374-83. doi: 10.1152/jn.00138.2014. Epub 2014 Apr 30. A neuromechanical strategy for mediolateral foot placement in walking humans.  Rankin BL

J Neurophysiol. 2015 Oct;114(4):2220-9. doi: 10.1152/jn.00551.2015. Epub 2015 Aug 19.

Hip proprioceptive feedback influences the control of mediolateral stability during human walking.

Roden-Reynolds DC1, Walker MH1, Wasserman CR1, Dean JC2.

Eur Spine J. 2015 May 26. [Epub ahead of print]
Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls.
Cooper NA1, Scavo KM, Strickland KJ, Tipayamongkol N, Nicholson JD, Bewyer DC, Sluka KA.

Prog Brain Res. 2004;143:353-66. Role of the cerebellum in the control and adaptation of gait in health and disease. Thach WT1, Bastian AJ.

You’d have to be smart to walk this lazy, and people are

Research suggests that humans are wired for laziness

http://www.sciencedaily.com/releases/2015/09/150910131451.htm#.VfWquNKaf3s.facebook

Jessica C. Selinger, Shawn M. O’Connor, Jeremy D. Wong, J. Maxwell Donelan. Humans Can Continuously Optimize Energetic Cost during Walking. Current Biology, 2015; DOI: 10.1016/j.cub.2015.08.016

The “Dodgy Foot”, a UK runner’s dilemma.

We get “help me” emails from all over the world on a regular basis. Recently we received this photo from a runner in Oxford, UK,  The runner was frustrated, explaining a “dodgy foot”.  We like the word. 

dodg·y    däjē/

-dishonest or unreliable; potentially dangerous; of low quality.

We can guarantee you that the solution here to this runner’s form issue is not wholly at the foot which appears “in toed” and slanted and appears ready to kick the back of the right heel, not to mention the knees that are about to brush together.  Thus, merely working on their foot strike would be so remedial and corrupt that it would a crime. 

Ivo and I do not take on cases via the internet because we cannot give all the information because we cannot examine the client, many do offer such services but people are not being given the whole story and we pledged long ago not to be part of the problem.  Anyone who recommends exercises from things they see on a video gait analysis are basically doing the same disservice in our opinion. But sometimes, as in this case, their inquiry is simple, there is a photo or video and it allows us to highlight an important component of an individuals gait which can lead them on a road to appropriate discovery. This is one of those cases.  I will not be presenting a solution, because I do not have the examination information I need, but I will propose a solid thought process that further investigation may afford progress towards resolution.

This is a non-pathologic cross over gait in my mind until proven otherwise, there may be other sources, causes and components, but when it quacks like a duck you’d be silly not to check for webbed feet. This runner even confirmed upon questioning that the left foot scuffs the inside of the right ankle/shin often, both sides scuff in fact but more left shoe on right shin. No Einsteinian epiphany there. 

  • This means a narrow swing through  (adducting) left limb. 
  • This means stance and swing phase gluteus medius communication problems. 
  • This means swing leg foot targeting problems. 
  • This often suggests right, but sometimes both right and left, frontal plane pelvis sway problems which means pelvis control is challenged which means core lumbar stability control is challenged. 
  • This means adaptive arm swing changes from the clean norm.  
  • This does NOT mean this runner has pain, or pain yet, or maybe never will have pain but there are many determinants of that which I will discuss below. 

But, make no mistake, this is flawed gait mechanics. The left swing leg is clearly targeting a more medial placement, meaning limb adduction (active or passive or both is to be determined) and this is a product of the cross over gait (unfamiliar with the cross over gait ? SEARCH our blog for the term, you will need a few hours of free time to get through it all).  Some would call the cross over gait a lazy gait, but I would rather term it an efficient gait taken too far that it has now become a liability, a liability in which they can no longer stabilize frontal plane sway/drift. A wider gait on the other hand, as in most sprinters, is less efficient but may procure more power and the wider base is more stable affording less frontal plane drift. Just go walk around your home and move from a very narrow line walking gait to a wide gait and you will feel a more powerful engagement of the glutes. Mind you, this is not a fix for cross over gaits, gosh, if it was only that simple !

This runner must investigate whether there is right frontal plane drift, and if it is in fact occurring, find the source of the drift.  It can come from many places on either limb. (This client says they are scuffing both inside ankles, which is not atypical and so we likely have drift on both right and left). We have discussed many of them here in various places on the blog over the years. Now as for “Why” the foot looks in toed, well that can also come from many places. Quite simply the adducted limb once it leaves toe off can look like this. But, perhaps it is also a product of insufficient external rotation maintenance occurred during that left stance phase, affording more internal rotation which is being unchecked and observed here during early swing.  Remember though, if this is in fact a cross over gait result, in this gait the limb approaches the ground unstacked (foot is too far inside a left hip joint plumb line) the foot will greet the ground at a far lateral strike and in supination.  Pronation will thus be magnified and accelerated, if there is enough time before toe off. However, and you can try this on your own by walking around your home, put yourself in terminal stance at toe off. Make sure you have the foot inverted so you are toeing off the lateral toes (low gear toe off). Does this foot not look like the one in the photo ? Yes it does, now just lift the foot off the ground and you have reproduced this photo. And when combined with a right pelvis drift, the foot will sneak further medially appearing postured behind the right foot. 

Keep this in mind as well, final pronation and efficient hallux (big toe) toe off does often not occur in someone who strikes the ground on a far lateral foot. I am sure this runner will now be aware of how poorly they toe off of the big toe, the hallux.  They will tend to progress towards low gear toe off, off the lesser toes. This leaves the foot inverted and this is what you are seeing in her the photo above. That is a foot that is inverted and supinated and it carried through all the way through toe off and into early swing. It is a frequently component of the cross over gait, look for it, you will find it, often. 

Final thoughts, certainly this can be an isolated left swing phase gluteus medius weakness enabling an adducted swing limb thus procuring a faulty medial foot placement, but it is still part of the cross over phenomenon.  Most things when it comes to a linked human frame do not work in isolation.  But i will leave you with a complicating factor and hopefully you will realize that gait analysis truly does require a physical exam, and without it you could be missing the big picture problem.  What if she has a notable fixed anatomic internal tibia torsion on that left side. Yup, it could all be that simple, and that is not something you can fix, you learn to manage that one as a runner.  

* Side bar rant: Look at any google search of runners photos and you will see this type of swing limb foot posturing often, far too often.  And yes, you can take the stance that “I do it as well and i have no injuries or problems so what is the big deal?”.  Our response is often “you do have an issue, it may be anatomic or functional, but you do have an asymmetrical gait and you think it is not a problem, YET”. And maybe you will run till you are 6 feet under and not have a problem because you have accomodated over many years and you are a great compensator, yes, some people get lucky. Some people also do not run enough miles that these issues express themselves clinically so lets be fair. But some of these people are reality deniers and spend their life buying the newest brace or gadget, trying a different shoe insert, orthotic or new shoe of the month and shop over and over again for another video gait analysis expert who can actually fix their pain or problem. And then there are those who have a 45 minute home exercise program that they need to do to keep their problems at bay, managing, not fixing anything.  Or, they spend an hour a week on the web reading article after article on what are the top 4 exercises for iliotibial band syndrome for example. They shop for the newest Graston practitioner, the newest kinesio taping pattern, Voodoo bands, breathing patterns, compression socks etc.  And sometimes they are the ones that say they still dont have a problem.You get the drift.  Gosh darn it, find someone who knows what the hell they are doing and can help you fix the issues that are causing the problem.  And yes, some of the above accoutrements may be assistive in that journey. 

I have dealt with this unique toe off issue way too many times not to roll my eyes at it any longer. It is to the point that it is an automated evaluation and solution program that begins to run in my head. Once you see something enough times, you learn all of the variations and subtle nuiances that a problem can take on. But, trying to fit everyone into a similar solution model is where the novice coach, trainer or clinician will get into trouble. Trust us, it all starts with an examination, a true clinical physical examination.  If one leaves the investigatory process to a series of screens or functional movement patterns, “activation” attempts, digital gait analysis or strength tests one is juggling chainsaws and the outcome you want is often not likely to occur. There is nothing wrong with making these components part of the investigation process, but on their own, they are not enough to get the honest answer many times.  Of course, Ivo and i were not able to jump the pond and examine this runner with our own eyes and hands so today’s dialogue was merely to offer this runner some food for thought to open their mind to our thought process, in the hopes that they can find someone to help them solve the underlying problem and not merely make the gait look cleaner. Making someone’s walking or running gait look cleaner is not hard, but making it subconsciously competent and clean (without thought or effort) requires a fix to the underlying problem. We can ALMOST guarantee you that the solution here to this runner’s form issue is not wholly at the foot that looks in toed and slanted. Merely working on their foot strike would be so remedial and corrupt that it would a crime.

Dr. Shawn Allen, one of the gait guys

Medial or lateral foot placement ?

Foot placement matters. We have repeatedly beaten this topic in our dialogues on “the cross over gait” for years now.
Lack of Stability often, if perhaps not always, limits mobility.
Mediolateral stability can be efficiently controlled through appropriate foot placement. This study hypothesized that humans control mediolateral foot placement through swing leg muscle activity, basing this control on the mechanical state of the contralateral stance leg. Thus, obviously, if thestance phase limb has sensory-motor deficiencies, which might be easily translated into “balance” or control issues in single leg stance evaluation, this will impact the swing leg and thus subsequent foot placement.
In this study, “During Unperturbed walking, greater swing-phase gluteus medius (GM) activity was associated with more lateral foot placement.”
“The Perturbed walking results indicated a causal relationship between stance leg mechanics and swing-phase GM activity. Perturbations that reduced the mediolateral CoM displacement from the stance foot caused reductions in swing-phase GM activity and more medial foot placement." 

The swing leg is taking cues from the stance leg mechanics. If stance phase has challenges, the swing limb will be forced to accommodate and adapt, and that means altered foot placement.  

Once again, remember, (broken record moment)……. "what you see is not your client’s problem, it is their strategy to get around/compensate for the problem”. Don’t you dare correct your client’s foot placement without examining why they are doing what they are doing. Get to the root of the problem you are “seeing”.

-Dr. Shawn Allen

http://www.ncbi.nlm.nih.gov/pubmed/24790168

J Neurophysiol. 2014 Jul 15;112(2):374-83. doi: 10.1152/jn.00138.2014. Epub 2014 Apr 30.A neuromechanical strategy for mediolateral foot placement in walking humans.Rankin BL1, Buffo SK1, Dean JC2.

Unique adaptations to arm swing challenges: the one armed runner.  Welcome to Luke Ericson, an amazing athlete and man.

Written By Dr. Shawn Allen

Human gait is cyclical. For the most part, when one limb is engaged on the ground (stance phase), the other is in swing phase. Before I continue, you should recall that there is a brief double limb support phase in walking gait, that which is absent in running gait. Also, I wish to remind you of our time hammered principle that when the foot is on the ground the glutes are heavily in charge, and when the foot is in the air, the abdominals are heavily in charge.  

For one to move cleanly and efficiently one would assume that the best way to do that would be to ensure that the lower 2 limbs are capable of doing the exact same things, with the same timing, same skill, same endurance and same strength. This goes for the upper 2 limbs as well, and then of course the synchronizing of the 4 in a cohesive effort. For this clean seamless motor function to occur, one must assume that there would be no injuries that had left a remnant mark on one limb thus encouraging a necessary compensation pattern in that limb (and one that would then have to be negotiated with the opposite limb as well as the contralateral upper or lower limb).  

Removing a considerable mass of tissue anywhere in the body is going to change the symmetry of the body and require compensations. One can clearly see the effects of this on this athletes body in the video above. He even eludes to the fact that he has a scoliosis, no surprise there.  There is such an unequal mass distribution that there is little way the spine had any chance to remain straight.  Not only is this going to change symmetry from a static postural perspective (bulk, weight, fascial plane changes, strength etc) but it will change dynamic postural control, mobility and stability as well as dynamic spinal kinematics.  I have talked about this previously in a blog piece I wrote on post-mastectomy clients display changes in spatiotemporal gait parameter such as step length and gait velocity.

-mastectomy post: http://tmblr.co/ZrRYjx1XB8RhO

If you have been with The Gait Guys for more than a year you will know that impairing an arm swing will show altered biomechanics in the opposite lower limb (and furthermore, if you alter one lower limb, you begin a process of altering the biomechanical function and rhythmicity of the opposite leg as well.) You can search the blog for “arm swing part 1 and part 2″ for those dialogues.

Arm swing impairment is a real issue and it is one that is typically far overlooked and misrepresented. The intrinsic effects of altering the body through subtraction of tissue are not all that dissimilar to extrinsic changes into the system from things like  walking with a handbag/briefcase, walking with a shoulder bag, walking and running with an ipod or water bottle in one hand. And do not forget other intrinsic problems that affect spinal symmetry, for example consider the changes on the system from scoliosis as in this case.  It can cycle back on its own feedback loop into the system, either consciously or unconsciously altering arm swing and thus global body kinematics.  

There is a reason that in my practice I often assess and treat contralateral upper and lower limbs as well as to address remnants from old injuries whether they are symptomatic or not. It all comes together for the organism as a concerted effort in optimal locomotion.

Here on TGG, and in dialogues with Ivo on our podcast, I have long talked about phasic and anti-phasic motions of the arms and shoulder-pelvic blocks during gait and locomotion/sport activity.  I have written several times about the effects of spine pain and how spine pain clients reduce the anti-phasic rotational (axial) nature of the shoulder girdle and pelvic girdle. In the video above, you can see anything but anti-phasic gait, to be clear, this is a classic representation of a phasic gait. The shoulder block and the pelvic block show little if any counter rotation, they are linked together which is not normal gait. Furthermore, if you look carefully, the timing of the right arm swing is variable and cyclically changing in its timing with the left leg. Look carefully, you will see the cyclical success and failure at the beginning of the video.  This is pathologic gait, he must be constantly fighting frontal plane sway because there is no axial anti-phasic motion. He is also constantly fighting the unidirectional rotation that the absence of an entire limb and limb girdle is presenting, you can see him struggle with this if you have looked at enough gait samplings. There is essentially frozen torso movements.  Want to see more of our work on arm swing ? search the gait guys blog.

There is so much more here to discuss, so I will likely return to this video another time to delve into those other things on my mind. Luke is an amazing athlete, he gets much respect from me.

I hope this dialogue helps you to get a deeper grip on gait and gait problems. I have written many articles on the topics of arm swing, phasic and anti-phasic gait, central pattern generators. The are all archived here on the blog. I try to write a new original thought-process article each week for the blog amongst the other “aggregator” type stuff we share from other folks social media. My weekly article serves to go deeper into things, sometimes they are well referenced and in this case, I am basing today’s discussion on the referenced work in the other pieces I have written on arm swing, phasic and anti-phasic gait, central pattern generators etc. So please do your readings there before we begin debate or dialogue, which i always welcome !

Dr. Shawn Allen