Appropriate Placement of Metatarsal Pads

In a follow-up to our last IGTV video, here we look at appropriate place in metatarsal pads. Metatarsal pads can do a great job to lift and separate the individual metatarsal heads and create space for things like neuromas and alter the forefoot mechanics. They are not a substitute for appropriate exercise and strengthening.

This individual had right “sixth toe“ disease and the metatarsal pad was being used by a podiatrist to alter for foot mechanics. It was clearly too far back on the right side. 

“If you like this kind of stuff come join us on our website www.thegaitguys.com

And get even more exclusive content over on Patreon (www.patreon.com/thegaitguys)

But, if you really want to deepen your education come join us as we take this kind of material and  deeply dissect it in our MasterClass in a monthly basis over on Vimeo. 

(Vimeo.com/ondemand/thegaitmasterclass)

*join the Patreon $40 level and get the monthly masterclass and top level Patreon videos all included (it’s a far better deal than buying on Vimeo) 

6th Toe Disease

It’s probably fair to say that a good number of us see people with “sixth toe” problems or a Taylor’s bunion more often than not. This problem is often accompanied by internal tibial torsion and sometimes femoral retro torsion. This video reviews a case that came in yesterday.

If you like this kind of stuff come join us on our website www.thegaitguys.com

And get even more exclusive content over on Patreon (www.patreon.com/thegaitguys)

But, if you really want to deepen your education come join us as we take this kind of material and  deeply dissect it in our MasterClass in a monthly basis over on Vimeo. 

(Vimeo.com/ondemand/thegaitmasterclass)

*join the Patreon $40 level and get the monthly masterclass and top level Patreon videos all included (it’s a far better deal than buying on Vimeo) 

#6thtoe #6thtoedisease #tailorsbunion #lateralfootpain #footpain #footproblem #gait

The gluteus medius and low back pain


We see this one ALL the time. We are sure you do as well. “Gluteus medius weakness and gluteal muscle tenderness are common symptoms in people with chronic non-specific LBP.” It is often more on the side of pelvic frontal plane drift. The abdominals and spinal stabilizers also often test weak on this same side.

Screenshot (9).png

We often see compromise of hip rotation stability as well because , since the hip is relatively adducting (because the pelvis is undergoing repeated frontal plane drift, hence no hip abduction) there is often a component of cross over gait phenomenon which can threaten rotation stability of the lower limb (type “cross over gait” into the search box of our tumblr blog for an sample of work we have written on that phenomenon). 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.
http://www.ncbi.nlm.nih.gov/pubmed/26006705

#

Part 2 Isometric Force


Finding the right load for a given tendon and a right frequency of loading and duraction of loading is also case by case specific. Part of finding the right loading position is a discovery process as well, as noted in the photos above. Finding the fascicles you want to load, and the ones you do not want to load (painful) can be a challenging discovery process for you and your client. Finding the right slice of the pie to load, and the ones not to load takes experimentation. When it is the achilles complex, finding the safe However, if one is looking for a rough template to build from, brief, often, heavy painfree loads is a good template recipe to start with.

Screenshot (7).png


Here, in this Geremia et al article, "ultrasound was used to determine Achilles tendon cross-sectional area (CSA), length and elongation as a function of plantar flexion torque during voluntary plantar flexion." They discovered that, "At the end of the training program, maximum isometric force had increased by 49% and tendon CSA by 17%, but tendon length, maximal tendon elongation and maximal strain were unchanged. Hence, tendon stiffness had increased by 82%, and so had Young’s modulus, by 86%. Effects of high loading by eccentric triceps surae training on Achilles tendon properties in humans.
European Journal of Applied Physiology
August 2018, Volume 118, Issue 8, pp 1725–1736

Part 1 Isomentric Force

Maximum isometric force had increased by 49% and tendon CSA by 17% !
Tendons can change their cross sectional area, if you load them.

Here I show lateral forefoot loading in a heel raise, and a medial forefoot loading in heel raise. This has to be part of the discovery process outlined below.

Isometrics are useful, they have their place. In a recent podcast to load up here in the future, we discuss the place and time to use isometrics, isotonics, eccentrics and concentrics.
One of the goals in a tendonopathy is to restore the tendon stiffness. Isometrics are a safe way to load the muscle tendon complex without engaging a movement that might have to go through a painful arc of movement. With isometrics here is neurologic overspill into the painful arc without having to actually go there.

Screenshot (5).png


The key seems to be load. More load seems to get most people further along. Remember, the tendon is often problematic because it is inflammed and cannot provide a stiffness across its expanse. Heavy isometric loading seems to be a huge key for most cases. But, we have to say it here, not everyone fits this mold. Some tendons, in some people, will respond better to eccentrics, and strangely enough, some cases like stretching (perhaps because this is a subset of an eccentric it seems or because there is a range of motion issue in the joint that is a subset of the problem). Now the literature suggests that stretching is foolish, but each case is unique all in its own way, and finding what works for a client is their medicine, regardless of what the literature and research says.

Awareness is key

Awareness is key. Does this person know they are doing this ? Do they have pain? If they do not have pain or awareness is it a problem and does it need addressed ? These shoes did not make this person load like this, the person broke the shoes into this pattern. There is something going on, the question is what drove this ? Most likely, this is not a footwear problem, this is a person problem in the footwear.

Screenshot (3).png


What we see is not the problem most of the time. We are seeing their strategies , coping mechanics and their ultimate failure to load more cleanly most of the time.


There are people out in the fields that are saying posture doesn't matter, that your next posture is your best posture. This is a bit curious to us. Sure, if you are not in pain then is a given posture a problem? One could argue that, but not with a strong argument, we believe. Take this foot-shoe posturing for example, is this a problem if it is not painful ? Do we leave it alone if it is not painful? Or do we "head this one off at the pass" before possible pathology or pain presents itself? There are certainly no guarantees, however, one can use some educated and calculated logic and make some reasonable decisions that things are going to go off the rails at some point (or in this case, the heel is going to actually go off the shoe!). So, are you going to change this person's footwear ? Bring it to their awareness ? Look for problems in there body mechanics locally and globally? Or are you just going to say, "foot posturing doesn't matter". Saying it is not a problem, until it is a problem, seems awfully negligent, doesn't it?

One cause of hammertoes

IMG_8055.jpg

One cause of hammertoes

Take a look at this gals left foot. Notice the high, cavus arch as well as increased tone in the long flexors of the toes. Is it any wonder she has weakness of the long extensors on that side?

Look at the other picture and note that she has a shorter leg on the left. Yes, it is anatomical and tibial on clinical exam. She also has limited ankle dorsiflexion and hip extension bilaterally, left greater than right.

When the foot is cavus it puts an increased stretch on the long flexor muscles of the foot because the metatarsalphalangeal joint is in relative extension. More than likely this will activate the Ia afferents from the muscle spindles causing more tone in the flexors. Yes, that will decrease over time but you will also increase the relative length of the long flexor tendons and decrease the length of the long and short extensor tendons.

IMG_8054.jpg


 More tone in the flexors equals less tone in the extensors. Combine this with a lack of ankle dorsiflexion and hip extension and it’s prescription for more hammertoes. In addition, she has an anatomical short leg on the left putting that foot in relative supination with respect to the right. She will need to claw her toes in an attempt to create stability on that side.

The fix will be getting better control and strength in the long extensors and improving ankle dorsiflexion and hip extension.

What's wrong with the big toe on the right?

IMG_8039.jpg

So this is what happens when you don’t wear the right shoes as a kid…

This woman came into the office with lower back pain. Do you notice anything peculiar about her feet?

She said that when she was young she was told by the doctor she was “dink toed” and given special shoes (on a sidenote, she has bilateral external tibial torsion and no evidence of forefoot adductus) . The shoes evidently (according to the doctor) were too tight and caused the deformity that you see here. She stated that the shoes were extremely painful while wearing them and then for quite a while when she stopped. This is always been her “problem foot“ with limited toe dorsiflexion and ankle dorsiflexion on that side.

Notice how the distal phalanx of the Halex is stunted and it’s with is increased. Dorsiflexion at the MTP is limited with respect to the other side and dorsiflexion flexion at the IP is limited as well. It appears that the growth plate was damaged resulting in a hypo plastic digit which, due to insufficient length, transfers a lot of weight during terminal stance and preceding ( at the end of her gait cycle, preparing for propulsion) to the second metatarsal head where she gets moderate discomfort.

IMG_8040.jpg



We can increase the motion of the first ray with mobilization and exercise but unfortunately we are not able to lengthen her digit.

Growth plates are fragile things and what we do to children early on can have a profound impact upon their adult life.
footproblem #toeproblem #hallux #halluxdeformity #bigtoe #gait #gaitanalysis #footexam

Podcast 160. Masterclass in Gait #2: VIMEO Q & A Podcast

Patreon and Masterclass:  https://www.patreon.com/thegaitguys

join us at the 40$ level,

VIMEO on demand (pssst, the 40$ patreon level is a better deal  !)

https://vimeo.com/ondemand/thegaitmasterclass

*The Masterclass in Gait, with the Gait Guys join us monthly at: https://www.patreon.com/thegaitguys for the monthly Masterclass installment hour. Formal presentations, slides, videos, demos, deep dives on topics you will not hear anywhere but here ! We hit gait, biomechanics, neurology and orthopedics of all of the gait topics we present. This is not for the weak and timid, this is the deep dive you have been waiting for. Join us while we turn our normal 50 minute presentations into 3.5 hours on a regular basis !

The 40$ Patreon level will give you the best deal on the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now ! Note, the 40$ Patreon level gets you more Masterclass content than the $40 VIMEO purchases.
Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2
Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Links to today's show:

http://traffic.libsyn.com/thegaitguys/pod_160_april._14_-_42620.mp3

http://thegaitguys.libsyn.com/masterclass-in-gait-vimeo-q-a-podcast

http://directory.libsyn.com/episode/index/id/14157119

Podcast 159: Accelerating body mass, foot intrinsic thickness, ADHD gait and more !

Patreon and Masterclass:  https://www.patreon.com/thegaitguys

join us at the 40$ level,

VIMEO on demand (pssst, the 40$ patreon level is a better deal  !)

https://vimeo.com/ondemand/thegaitmasterclass

*The Masterclass in Gait, with the Gait Guys join us monthly at: https://www.patreon.com/thegaitguys for the monthly Masterclass installment hour. Formal presentations, slides, videos, demos, deep dives on topics you will not hear anywhere but here ! We hit gait, biomechanics, neurology and orthopedics of all of the gait topics we present. This is not for the weak and timid, this is the deep dive you have been waiting for. Join us while we turn our normal 50 minute presentations into 3.5 hours on a regular basis !

The 40$ Patreon level will give you the best deal on the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now ! Note, the 40$ Patreon level gets you more Masterclass content than the $40 VIMEO purchases.
Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2
Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Links to today's show:

http://traffic.libsyn.com/thegaitguys/pod_159_april_5_-_42620.mp3

http://thegaitguys.libsyn.com/accelerating-body-mass-foot-intrinsic-thickness-adhd-gait-and-more

http://directory.libsyn.com/episode/index/id/14155346

Show notes:

Gait Posture. 2020 Feb 20;78:54-59. doi: 10.1016/j.gaitpost.2020.02.014. [Epub ahead of print]

Muscle capacity to accelerate the body during gait varies with foot position in cerebral palsy.
Hegarty AK1, Kurz MJ2, Stuberg W2, Silverman AK3.

J Sport Rehabil. 2020 Mar 31:1-9. doi: 10.1123/jsr.2019-0211. [Epub ahead of print]
Effects of a 4-Week Short-Foot Exercise Program on Gait Characteristics in Patients With Stage II Posterior Tibial Tendon Dysfunction.
Kim J, Lee SC, Chun Y, Jun HP, Seegmiller JG, Kim KM, Lee SY.

Hum Mov Sci. 2020 Apr;70:102584. doi: 10.1016/j.humov.2020.102584. Epub 2020 Feb 8.
Gait control in children with attention-deficit/hyperactivity disorder.
Simmons RW1, Taggart TC2, Thomas JD3, Mattson SN3, Riley EP3.

Gait Posture. 2020 Mar 17;78:30-34. doi: 10.1016/j.gaitpost.2020.03.009. [Epub ahead of print]
Navicular drop is negatively associated with flexor hallucis brevis thickness in community-dwelling older adults.
Fukumoto Y1, Asai T2, Ichikawa M3, Kusumi H3, Kubo H4, Oka T5, Kasuya A6.

Front Pediatr. 2020 Feb 28;8:75. doi: 10.3389/fped.2020.00075. eCollection 2020.
Effects of Selective Dorsal Rhizotomy on Ankle Joint Function in Patients With Cerebral Palsy.
Ates F1, Brandenburg JE2,3,4, Kaufman KR1.

Gait Posture. 2020 Mar 4;78:26-29. doi: 10.1016/j.gaitpost.2020.03.003. [Epub ahead of print]
Higher visual reliance during single-leg balance bilaterally occurring following acute lateral ankle sprain: A potential central mechanism of bilateral sensorimotor deficits.
Kim KM1.

Pod #158: Gait and COVID-19, Motor Learning, Shoes and Injuries

People Suddenly falling down who have COVID-19? We got to thinking, that more neurologic, isn't it?

*The Masterclass in Gait, with the Gait Guys join us monthly at: https://www.patreon.com/thegaitguys for the monthly Masterclass installment hour. Formal presentations, slides, videos, demos, deep dives on topics you will not hear anywhere but here ! We hit the gait, biomechanics, neurology and orthopedics of all of the gait topics we present. This is not for the weak and timid, this is the deep dive you have been waiting for. Join us while we turn our normal 50 minute presentations into 3.5 hours on a regular basis !

The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !
Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2


Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Links to today's show:

http://traffic.libsyn.com/thegaitguys/pod_158__32420.mp3

http://thegaitguys.libsyn.com/gait-and-covid-19-motor-learning-shoes-and-injuries

http://directory.libsyn.com/episode/index/id/13682240

1.Current frameworks on running-related injury (RRI) aetiology emphasize the relation between exposure to training load, internal tissue loads, and tissue capacity; with tissue load exceeding its capacity being the key biological mechanism in the development of RRI. Despite this, . . .

https://www.tandfonline.com/doi/abs/10.1080/19424280.2020.1734869?journalCode=tfws20#.Xl5ejXBuHqI.twitter



2.Systematic Review of the Role of Footwear Constructions in Running Biomechanics: Implications for Running-Related Injury and Performance. Xiaole Sun et al.
https://www.jssm.org/volume19/iss1/cap/jssm-19-20.pdf

3.The neuroinvasive potential of SARS‐CoV2 may play a rolein the respiratory failure of COVID‐19 patientshttps://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728
"The entry ofSARS‐CoV into human host cells is mediated mainly by a cellularreceptor angiotensin‐converting enzyme 2 (ACE2), which is ex-pressed in human airway epithelia, lung parenchyma, vascular endothelia, kidney cells, and small intestine cells."
"Additionally, some patients withCOVID‐19 also showed neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also invade the central nervous system inducing neurological diseases. The infection of SARS‐CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. (Experimental studies using transgenic mice revealed that either SARS‐CoV34or MERS‐COV,13when given in-tranasally, could enter the brain,possibly via the olfactory nerves,and thereafter rapidly spread to some specific brain areas including thalamus and brainstem)
Furthermore, some coronaviruses have been demonstrated able to spread via a synapse‐connected route to the medullary cardiorespiratory center from the mechanoreceptors and chemoreceptors in the lung and lower respiratory airways.
*increasing evidenceshows that CoVs may first invade peripheral nerve terminals, and then gain access to the CNS via a synapse‐connected route"

4.Motor Learning
https://journals.lww.com/acsm-essr/Fulltext/2013/01000/Changing_Up_the_Routine___Intervention_Induced.10.aspx

5.Ahead of the curve in the evolution of human feet

https://www.nature.com/articles/d41586-020-00472-z

Gait Ataxia, Foot Strength & Glute medius tears


Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Links to today's show:
http://traffic.libsyn.com/thegaitguys/pod_Feb_7_2020_-_22920_8.26_AM.mp3

http://thegaitguys.libsyn.com/gat-ataxia-foot-strength-glute-medius-tears

http://directory.libsyn.com/episode/index/id/13350479

SPG7 mutations are a common cause of undiagnosed ataxia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371411/

Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Ulisses T.Taddei,  Alessandra B.Matias,  Fernanda I.A.Ribeiro, Sicco A.Bus, Isabel C.N.Sacco. Physical Therapy in Sport
Volume 42, March 2020, Pages 107-115
https://www.sciencedirect.com/science/article/abs/pii/S1466853X19304687
Effect of an 8 week foot intrinsics muscle strength program:

Jill Cook (@ProfJillCook)
11/10/19, 12:14 AM
⁦‪@BRoe28‬⁩ ⁦‪@Bill_Vicenzino‬⁩ ⁦‪@MuscleScience‬⁩ ⁦‪@jongumucio‬⁩ New study by Docking et al shows both US and MR cannot pick a partial tear from tendon pathology (glut med tendon)
Partial tears over-diagnosed and over-treated
Treat as tendinopathy and LOAD them


Paul Hough (@the_hough)
10/29/19, 12:45 PM
⬆️ in muscle force after 4 weeks of strength training is mediated by neural adaptations (motor unit recruitment & rate coding)
https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/JP277250
The increase in muscle forceafter 4 weeks of strength training is mediated by adaptations in motor unit recruitment and rate coding.Journal of physiology,  Feb 2019
Alessandro Del Vecchio, Andrea Casolo, Francesco Negro, Matteo Scorcelletti et al


The role of the width of the forefoot in the development of Morton's neuroma
Park Y,  Jeong S,  Choi G  , Kim H
Bone and Joint Journal-3-99B (2017)

Podcast 156: Round 2, Coach Mike Lucchesi: Olympic Trials 2020 Atlanta.

We talk all things training again, a deeper dive follow up to podcast 152 with Coach. Listen to that one as well. Your training will thank you.

Links:

https://www.secondcitytc.com/
www.thegaitguys.com
www.shawnallen.net
www.doctorallen.co

Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

other links for today's show:

http://traffic.libsyn.com/thegaitguys/pod_mikeL2_feb21220Final.mp3
http://thegaitguys.libsyn.com/round-2-coach-mike-lucchesi-olympic-trials-2020-atlanta
http://directory.libsyn.com/episode/index/id/13123520

https://www.secondcitytc.com/
thegaitguys.com
shawnallen.net
doctorallen.co

Mini Podcast, 155: Biomechanics & Shoe foam with Coach Mike Lucchesi

Mini Pod: Biomechanics, Shoe foam with Coach Mike Lucchesi of Second City Track Club

155. Mini  Pod: Biomechanics, Shoe foam with Coach Mike Lucchesi from SCTC, Second City  Track  Club.  This is a conversation we had as we get read to send Coach and 9 of his runners  down  to  Atlanta for  the Olympic trials in a few weeks.

http://traffic.libsyn.com/thegaitguys/minipod_mikeL_biomechanics_-_21120.mp3

http://thegaitguys.libsyn.com/mini-pod-biomechanics-shoe-foam-with-coach-mike

MasterClass in Gait: Part Zero: The Gait Guys Way

Screen Shot 2020-02-04 at 7.57.30 AM.png

Video Link

The Masterclass: The Gait Guys Way

As promised, a live hour with us, some  structured, some loose and conceptual, but it is our way.  This is part zero, free to everyone.  Part 1 will be recorded in the next 2 weeks. Those classes will be pay per view.  This will be at the least a dozen classed, probably 2 or 3 dozen, we have a lot to teach you.

We  are, as of yet, undecided as to the cost, what Patreon levels get this for free  (likely the 50$ per month). We may  (likely will) parse out big pieces and portions to the 20$ folks for free, included in their monthly donation.   But, do not hold us to this, we are undecided, but we did not want to hold back part ZERO, the rough intro so you can get a feel for us, and the material we are going to teach.   Remember, there will only be 100 live seats when we go live (likely Wednesday nights, or Friday late afternoons Central time), and Patreon folks will get first dibs to fill seats, so check in regularly, we will post a TEXT notification here and give a weeks notice.  For those who cannot get into the LIVE class where we will take LIVE real time questions, just like in a classroom, we will record the classes and harbour them on a service like youtube or vimeo behind a pay wall. You can always take our classes for CEU/CE over on onlineCE.com but these Masterclasses will be far far deeper in content, discussion, case demos, deep dives and open ended discussions.

Until then, enjoy.

Stay tuned !

*video link is above

shawn and ivo

Podcast 154. A "Farewell to the King", Knee Fences, and Durability

A "Farewell to the King", Knee Fences, and Durability
This is a nice follow up to pod 153, the reboot

#RUSHisking, #theprofessor, #neilpeart, #greatestdrummerofalltime

Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Other links for today's show:
http://traffic.libsyn.com/thegaitguys/pod_jan17_-_12620.mp3

http://thegaitguys.libsyn.com/a-farewell-to-the-king-knee-fences-and-durability

http://directory.libsyn.com/episode/index/id/12889889


#RUSHisking, #theprofessor, #neilpeart, #greatestdrummerofalltime

The funny problem with the stairs at Brooklyn’s 36th Street subway. Why we trip..

The funny problem with the stairs at Brooklyn’s 36th Street subway. Why we trip..

At Brooklyn’s 36th Street subway stop, one of the steps is slightly higher than the others. Stairs have a standardized Rise and Run and when this is altered, specifically the Rise, funny things happen. Filmmaker Dean Peterson set up his camera to capture the stumbles and the video can be seen here http://vimeo.com/44807536 and above on our blog.

The dangerous step, it turns out (which has since this video been repaired), is apparently a half-inch higher than the others. Stairway design guidelines vary within a small range. Guidelines call for risers to be a minimum of 6 inches and a maximum of 7 ¾ inches. The allowable variance between steps is 3/8 of an inch depending on the source you seek.

(The general rule (in the US) is 7-11 (a 7 inch rise and 11 inch run). More exactly, 7 ¾ rise and an 11 ½ inch run, although some people will use a run of as little as 9 inches.)

This is a perfect example of how sensitive and predictive the human body is with all of its amazing joint position sense receptors. But there is more to it than a simple step height differential. Read on.

There are multiple demands that stairs place on the neuro-musculoskeletal system. There are needs for input from the somatosensory, visual, and vestibular systems at various stages in the task. Some of these collaborating systems deteriorate with the aging process making the failure of stair negotiation a legitimate risk for the elderly or those that are handicapped in one of the 3 primary systems noted above. Studies (see references below) strongly link impairments in the visual system to safe stair negotiations. The Buckley study found that the mediolateral balance during stepping up and down stairs (single limb support stability) was significantly reduced (especially stepping down) by blurred vision highlighting the critical necessity of vision in stepping dynamics. Hence, one must be aware of people traffic on steps, if a stairway is dense with traffic the ability to gain the visual cues of the successive stairs is paramount. The next time you are in a school or subway stairwell notice the undercurrent of your discomfort may be from the inability to see enough steps in front of you. Letting the person ahead of you clear some distance is a must, especially if you are vision impaired, elderly, wearing dark tinted glasses or are without the ability to use other cues such as railings (ie. adding a tactile feedback system to satisfy the impairment of visual cues).

There are other user created impairments that we may be unaware of consciously. In the Miyasike-daSilva study it was determined that as participants approached and walked stairs, gaze was within 4 steps ahead of their location indicating that individuals often rely on spatial cues from prior experience or from other visual cues to obtain the necessary information from the environment. Thus, one must be careful carrying something such as a baby, groceries or laundry basket in front of you thus impairing the lower visual field. We have all carried something up or especially downstairs and either thought we were on the last step or found we had one more to go and found ourselves either stumbling forward or hyperextending our knee as we lurch down onto the unexpected step. In the video you will see a great example of this forward catch as one of the ladies is carrying a baby in front of her, luckily she makes the correct saving motor choice. Being able to plan/control landing mechanics are significantly different when the visual system is locked out or impaired from stepping tasks. Timmis found that the contribution of information from the lower visual field of gaze in controlling the landing strategy occurs predominantly prior to or during movement initiation of the foot and limb and that ‘online’ or immediate vision is used only in the latter portion of the descent phase to fine tune the step landing. Buckley found that under visual impairments subjects used the cautious strategy of keeping their weight back on the trail limb longer making weight transfer noncommittal affording the time necessary for the lead limb to fish around for the next step.

There is so much involved in negotiating stairs and steps, even level ground walking. There are many cues we have learned to subconsciously glean information from. Sadly, when we begin to age and lose proprioceptive or visual information things begin to fall apart. The system is so sensitive and intuitive. This is why when someone changes the ground level, or the height of a step as in this video, the system fails even the best of us who have all of our faculties about us. And, we learn more about gravity at that moment than we wish to learn.

Shawn and Ivo, The Gait Guys

References:

1. J Am Geriatr Soc. 2000 May;48(5):567-80. Startzell JK,Owens DA , Mulfinger LM, Cavanagh PR .Stair negotiation in older people: a review.

2. Gait Posture. 2005 Oct;22(2):146-53.Buckley JG,Heasley K,Scally A,Elliott DB.The effects of blurring vision on medio-lateral balance during stepping up or down to a new level in the elderly.

3. Exp Brain Res. 2009 May;195(2):219-27. Epub 2009 Mar 31.Timmis MA,Bennett SJ,Buckley JG .Visuomotor control of step descent: evidence of specialised role of the lower visual field.

4. Exp Brain Res. 2008 Jan;184(2):223-32. Epub 2007 Aug 29.Buckley JG,MacLellan MJ,Tucker MW,Scally AJ,Bennett SJ.Visual guidance of landing behaviour when stepping down to a new level.

5. Exp Brain Res.2012 Sep 22. [Epub ahead of print]Shinya M,Popescu A,Marchak C,Maraj B,Pearson K.Enhancing memory of stair height by the motor experience of stepping.

6. Exp Brain Res. 2011 Mar;209(1):73-83. Epub 2010 Dec 25.Miyasike-daSilva V,Allard F,McIlroy WE .Where do we look when we walk on stairs? Gaze behaviour on stairs, transitions, and handrails.

7. PLoS One.2012;7(9):e44722. Epub 2012 Sep 6.Does it really matter where you look when walking on stairs? Insights from a dual-task study. http://www.ncbi.nlm.nih.gov/pubmed/22970297Miyasike-Dasilva V,McIlroy WE.PMID:22970297[PubMed - in process] PMCID:PMC3435292 Free PMC Article

#153, The Podcast Reboot: A Deep dive on knee mechanics, loading and running.

Its 2020 and we are back ! The Gait Guys Podcast Reboot !

Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

other links for today's show:

http://traffic.libsyn.com/thegaitguys/pod_jan10_-_11220.mp3

http://directory.libsyn.com/episode/index/id/12705212

https://oembed.libsyn.com/embed?item_id=12705212

http://thegaitguys.libsyn.com/podcast-reboot-deep-dive-on-knee-mechanics-loading-and-running




The Future of AI and gait.

Regarding the future study of gait and human movement in 10 years.

. . . . he has now developed "Talk to Books", which is a program where by you ask a question, and within a half a second (0.5 seconds) it will read 120,000 books (yes, 120 thousand books) on the verbiage you asked it to look into, and give you the most in-depth answer based on that 120,000 book wisdom. This is search based on meaning, context, not on key words and hashtags. This is the future of information acquisition. . . . .

"Semantic Search" is quite possibly going to take over things. Forget key words and hashtags, perhaps. But what does this have to do with gait and us at The Gait Guys.

I recently re-listened to a Ray Kurzweil interview where he discussed the predicted technological breakthroughs in artificial intelligence in 10 years (2030). Kurzweil is an odd visionary in this regard, he is often very close to spot on which is the reason for his ground breaking inventions. If you do not know about Ray Kurzweil, you should see his ahead-of-the-rest inventions on his Wikipedia page, the man has been ahead of the curve most of the time. There is a good reason Google hired him several years ago.
Kurzweil was hired to deepen several projects, one namely, "semantic research", to deepen the meaning behind the data and the facts, which is largely what the internet now provides. So in essence, he was hired to take the internet's data and place meaning behind it and within it, semantics. Semantics are the branch of linguistics and logic concerned with meaning, they are the meaning behind words. This is sort of what we are referring to as AI, Artificial Intelligence.

According to Kurzweil, this is where "the web" is headed, some would argue it is already upon us, it is inevitable in his opinion and it is hard to argue. "Semantic search" will lead us, meaning no longer will we be searching the web, "googling" key words, rather we will be searching by meaning and conversing with the web. He has been successful in this endeavor according to this latest TED talk interview; he has created "Smart Reply". This is already tapping into Google Smart Home, Google Assistant etc. What this means for a computer is that it models the intent and various nuanced elements of language and data. Kurzweil projects this to be full on board by 2029, 10 years from now, which is why he believes AI will be fully on board by that date. It is not hard to see that this is an accurate and a foregone conclusion. For example, he has now developed "Talk to Books", which is a program where by you ask a question, and within a half a second (0.5 seconds) it will read 120,000 books (yes, 120 thousand books) on the verbiage you asked it to look into, and give you the most in-depth answer based on the contents of the 120,000 books. This is search based on meaning and context, not on key words and hashtags. This is the future of information acquisition. And if you are lazy, and have the time for 6 seconds, it will read 1 million books and offer you and even more in-depth answer. No longer will memorizing data, facts or anything of the sort, be necessary, our questions will be answered, and answered deeply. This is what Kirzweil refers to as "the singularity" once it is integrated into our human physiology. And as Ray suggests, we are basically already there, we just merely hold this AI (our smart phones) in our hand right now, soon it will be fully integrated. Rather than in our hand or pocket, we will be "Bluetoothed", or "Wifi'd" in to the system. We already have seen this technology implemented in circumventing spinal cord injuries. Ivo and I discussed this in a podcast long ago.
(https://www.nytimes.com/…/wireless-brain-spine-connection-p…)

So where does this leave Ivo and myself, The Gait Guys?
Well, in 2009 we bought into the deeper web design, launching our initial voyage into the AI to come. We knew that if we were one of the initial teams of people and/or researchers putting volumes of integrated thoughts on the web based on research, clinical trials and our own integrated clinical insights that we "could" be one of the main platforms that others would follow, and build further upon. We could not have seen or known the depths that companies like Google could go to dive into a "semantic search" on "gait problems" or "gait analysis" or "gait and hallux rigidus" or anything of the sort that we #hashtagged or Key Worded. But we did know that a data base of all things gait and human movement needed to be developed and we decided to see what we could build on that front. At the time things like #hashtags were not even present, but that eventually sped up the basis of "key word" search, which has lead us to the now developing "sematic search". Back then we hoped that if we could consistently, over the next 10 years, amass a data source large enough, that we could ensure that our work and the known and validated research we based most of our writings, podcasts, videos, and even web-based teaching courses upon (onlineCE.com) could provide part of the template for other things to come, things that Kurzweil has now termed this "semantic search" and "talk to books". Certainly, obviously, we didn't see any of this Kurzeil-ian stuff coming, but we saw that the web provided more up to date and faster moving sources than our libraries of books, and as we no longer were able to acquire the answers we needed from our dated libraries, we found the internet was our go to source, and we realized that it was going to be the way for everyone very quickly.

Ivo and I have been filling the Internet with our research and thoughts on gait and related systems for 10 years now (145 podcasts, 1600+ posts and articles, research reviews and deep dive discussions and tangents taken off of the current research). Companies like Google and their "deep mind" project, and other related projects as discussed here, integrate all pieces of data.
So, it is our greatest hope that we are in fact helping to provide a great network of information for the development of gait and human movement knowledge.
In 2019 we will continue to do as we have, taking small piece research ideas and broadening them into the bigger terms and correlations and relationships with gait and human movement so that things like "Semantic Search" can help others find the information they are seeking. We hope that what people will read in 10 or 20 years is going to be partly based off of the honest framework that we have tried to provide. We hope that this heavy lifting is valuable to you. In turn, we have learned a lot from our own writings and assimilation of what is out there in the web-o-sphere and from our discussions amongst ourselves, and wit you all.

In 2019 you will be seeing some new additions to our mission here to source out good information and deep discussions. Things like live WebEx seminars, new OnlineCE.com seminar offers, AMA (Ask Me Anything) discussions with you, and we are starting up a vlog as well, hopefully bimonthly. Patreon patrons at, and above, the 10-20$ subscription levels will get many of these for free we anticipate, plus we will add on a new subscriber platform as well since Patreon seems to be challenging some "Free speech", or so it seems. So another platform with different terms of service will give you all choices in how you donate to our mission to bring you the best of what we know, and are learning.
Happy New Year to all !

Shawn & Ivo
The Gait Guys

free photo courtesy of Pixabay.com

Listen to Ray Kurzweil on what the future holds next from The TED Interview in Podcasts.

https://itunes.apple.com/us/podcast/the-ted-interview/id1437306870?mt=2&i=1000425101600&fbclid=IwAR2wdHQiaaUBOoFtz02Nu9BRLnvQnkfkDck3_iHnAd7moponZT3HcBsw-Mc