Awkward photos…Date smarter but necessarily walk that way…

Take a look at this photo from an airplane magazine I was leafing through on my way home from teaching a recent needling seminar.

I am not really interested in matchmaking (which this ad is for), but the “awkwardness” of the gait caught my eye (not much on the gait cam this time, sorry).

Yes, their feet and legs seem to be in synch (for the most part), but take a look at the arms and hands. First of all, he has his right hand in his pocket, which will restrict its motion during forward movement of his left leg. In the shot, his right leg is forward (as is hers), though they are slightly out of synch. His left arm and hand don’t move forward that much in that he adducts it across his body, so he seems to move his left shoulder up and forward to compensate. She appears to be resisting this motion somewhat with her right arm as her right leg comes forward and she needs to lean her body to the right. Also note the increased abduction of her left arm and forearm as it extends in tandem with her left leg and thigh.

Try walking with your right arm moving forward with your right leg. Notice how your right shoulder resists moving forward in tandem with the right hip? This is phasic, as Dr Allen likes to say, and because there is not an opposite force to counteract the forward movement of the hip in the saggital plane, you often lean to move the center of gravity to that side in the coronal plane.

Wouldn’t it make slightly more sense, when walking hand in hand to have the opposite legs in synch, rather the same ones? Hmm…Food for thought and fodder. All that from a  little picture : )

Podcast 103: Effects of Cold on Physiology/Athletes

Using Cold adaptation to your advantage, Walking Rehab “Carries”, Walking and Proprioception.

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Other Gait Guys stuff

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Monthly lectures at : type in Dr. Waerlop or Dr. Allen, ”Biomechanics”

-Our Book: Pedographs and Gait Analysis and Clinical Case Studies
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Show Notes:
Switching on a cold-shock protein may restore lost connections between brain cells & memory function in aging brain.

-“Connections between brain cells – called synapses – are lost early on in several neurodegenerative conditions, and this exciting study has shown for the first time that switching on a cold-shock protein called RBM3 can prevent these losses.

New study in mice in the inaugural issue of Brain Plasticity reports that new brain cell formation is enhanced by running.

Walking changes our mental state, and our mental state changes our walking.  60 sec audio clip.…/151119122246.htm

Walking. You don’t have to have the pedal to the metal.
"Those who walked an average of seven blocks per day or more had a 36%, 54% and 47% lower risk of CHD, stroke and total CVD, respectively, compared to those who walked up to five blocks per week.”…/151119122246.htm
New proprio study:
Piezo2 is the principal mechanotransduction channel for proprioception
Seung-Hyun Woo et al,
Nature Neuroscience 18, 1756–1762 (2015) doi:10.1038/nn.4162Received 14 July 2015 Accepted 13 October 2015 Published online 09 November 2015

Magnesium intake higher than 250 mg/day associated with a 24% increase in leg power & 2.7% increase in muscle mass.

Dietary Magnesium Is Positively Associated With Skeletal Muscle Power and Indices of Muscle Mass and May Attenuate the Association Between Circulating C-Reactive Protein and Muscle Mass in Women

Ailsa A Welch et al.

Gray Cook

Carries, lots of carries

And what have we been saying? parallel processing seems to be OK (balancing and reading), but dual or multitasking has its hazards…

  • decreased speed of movement. not surprising because of the dual tasking
  • increased ankle dorsiflexion (not necessarily a bad thing. This is probably to create a wider and more stable base through pronation
  • reduced cadence
  • decreased stride length

we were surprised there was not a increased “base of gait”, as balance requirements increase, gait usually decomposes (see here for a cool post and video we did on this a while ago)

“Numerous studies have analyzed the impact of dual tasks—specifically, tasks that cause cognitive distraction—on gait. With regard to texting as a dual task, many studies have consistently found that it does have an effect on gait, and that’s mostly to slow a person down.

For instance, Italian researchers in the Journal of NeuroEngineering and Rehabilitation assessed 18 healthy young adults who did not have problems with vision, or neurological or musculoskeletal disorders that could affect their gait.3 Barefoot participants walked a straight path of 15 meters (about 50 feet) for three minutes under two conditions: walking alone and walking while texting.

They found that texting while walking differed from walking alone in terms of muscle activation, kinematics, and spatiotemporal variables. Texting was associated with delayed activation of the gastrocnemius lateralis muscle and slightly increased ankle dorsiflexion followed by slightly reduced plantar flexion. It was also associated with a slower gait speed, reduced cadence and stride length, increased flat-foot contact, and decreased push-off. The researchers also found increased co-contraction of the ankle antagonist muscles during what they called the “critical” gait phase—from load response to midstance, corresponding to the transfer of body weight from one leg to the other.”

its a short one. Take the time to check it out…

link to article:

Yes, you are looking INSIDE this toe. That IS a screw and metal plate in that toe. 

What kind of stuff finds its way into your office ? I get all kinds of things it seems, at least once a day something comes in that makes me scratch my head. 

This client just wanted my opinion and thoughts on their toe and their gait once they are ambulating again. They have had multiple surgeries to this poor foot. You can see multiple scars over multiple digits and metatarsals.  This is the 3rd surgery to the big toe, the last 2 have been attempts at correcting failed prior surgeries. This is obviously the last straw surgery, total fusion of the metatarsophalangeal joint.  What is interesting in this case is that this plate was taken out about 4 weeks ago, and the skin was stretched back over and the wound closed up (forgot to take update photo for you). I saw it yesterday, and I was amazed at how healed up the area was. They are months post op now, and they can load the toe heavily now, that is always amazing to me. The body’s healing ability is a miracle. Of course, if you have been with us here long enough you will know that my “concern button” immediately got pushed but the client was proactive and asked the question before my oral diarrhea of concerns started.

So, they wanted to know about their gait and what to watch out for.  Off the top of your head, without thinking, you should be able to rattle off the following:

  • impaired toe off
  • premature heel rise
  • watchful eye on achilles issues
  • impaired hip extension and gluteal function
  • impaired terminal ankle plantar flexion (because they cannot access the synergists FHL and FHB)
  • impaired terminal ankle dorsi flexion (because they cannot access the synergists EHL and EHB)
  • lateral toe off which will promote ankle and foot inversion, which will challenge the peronei
  • frontal plane hip-pelvis drift because of the lateral toe off and lack of glute function
  • possible low back pain/tightness because of the  frontal plane pelvis drift and from altered hip extension motor patterning (and glute impairment)
  • possible knee pain from tracking challenges because they cannot complete medial tripod loading and thus sufficient pronation to internally spin the limb to get the knee to sagittal loading
  • impaired arm swing, more notable contralaterally

There is more, but that is enough for now. You need to know total body mechanics, movement patterns, normal gait cycle events (you have to know normal to know abnormal) and more. You have to know what normal is to understand when you are looking at abnormal.

* So, dial this back to something more simple, a “stubbed toe”, a painful sesamoid, painful pronation or a turf toe or hallux limitus.  They will all have the same list of complications that need to be evaluated, considered and addressed. This list should convey the importance that if your client has low back pain, examining the big toe motion is critical. Also, if you are just looking at the foot and toe in these cases, pack your bags … .  you don’t belong here. If you are just adjusting feet and toes and playing with orthotics while the list above does not constantly file back and forth through your brain, again, pack all your bags, grab your cat and leave town (just kidding, try reading more and get to some seminars).

If you know the complicated things, then the simple things become … … . . simple.

Your local treadmill gait analysis guru should know all of this if they are going to recommend shoes and exercises. Shame on them if there is no physical exam however. The data roadmap from the gait analysis software print out is not going to get you even out of the driveway let alone down the street. The data is going to tell you what you are doing to compensate, not tell you what is wrong. You must know anatomy, biomechanics, neurology, orthopedics and how to apply them to get the recipe right, not just which shoe in a store will unload the medial tripod of the foot or which exercise will lengthen your stride on the left. 

… .  sorry for the rant, too much coffee this morning, obviously.

Shawn Allen, one of the gait guys

Children: Postural control of balance

From the study:

“From these indexes it was established that the postural capacity needed just to control balance with the leg muscles was not attained before 4-5 years of independent walking, i.e., at about 5-6 years of age.” -Breniere

reference link:

Exp Brain Res. 1998 Aug;121(3):255-62.Development of postural control of gravity forces in children during the first 5 years of walking.Brenière Y1, Bril B.

Walking changes our mental state, and our mental state changes our walking.

60 second audio pod.  Our mental state changes our gait, and our gait changes our mental state.
We highly suspect that this is not the “bouncy” gait we typically refer to, the loss of ankle rocker gait.

A great, FREE, full text on forward and backward walking kinematics and a possible link to central pattern generators.

“Leg kinematics during backward walking (BW) are very similar to the time-reversed kinematics during forward walking (FW). This suggests that the underlying muscle activation pattern could originate from a simple time reversal, as well…

"We concluded that the changes in muscle contributions imply that a simple time reversal would be insufficient to produce BW from FW. We therefore propose that BW utilizes extra elements, presumably supraspinal, in addition to a common spinal drive. These additions are needed for propulsion and require a partial reconfiguration of lower level common networks.”

Similar muscles contribute to horizontal and vertical acceleration of center of mass in forward and backward walking: implications for neural controlKaren Jansen, Friedl De Groote, Firas Massaad, Pieter Meyns, Jacques Duysens, Ilse JonkersJournal of Neurophysiology Published 15 June 2012 Vol. 107 no. 12, 3385-3396 DOI: 10.1152/jn.01156.2011