Quadrupedal gait and tree climbing

Earlier today we posted on quadrupedal perspectives in locomotion. Now we find this to drive home the point.
A University of North Florida study “focused on "proprioceptively dynamic activities,” that is, ones that involved proprioception and a second factor (like locomotion or navigation) at the same time" such as climbing trees.
“All participants had their working memory tested at the start and two hours later (after climbing trees, running barefoot, and walking on a balance beam) and the researchers found that while the control groups showed no change, those who completed the proprioceptively dynamic tasks had a 50% jump in their working memory capacity.”

http://www.newser.com/story/210569/study-climbing-a-tree-is-good-for-your-brain.html

Quadruped facts.

Do the intimate relationships of the upper limbs and lower limbs suggest that quadrupedal skill sets, if not true quadrupedal gait, were a piece of our past locomotion strategies ? Or is it just representative of the close linkages for gait efficiency? Or maybe both?
Join us on the blog today for a short rewind piece where we discuss beaucoup things … . such as:
“this study’s results provide strong evidence that actively engaging the forelimbs improves hindlimb function and that one likely mechanism underlying these effects is the reorganization and re-engagement of rostrocaudal spinal interneuronal networks. ”

Here is the blog link:

http://thegaitguys.tumblr.com/post/111383241429/spinal-interneuronal-networks-linking-the

Doc, how many reps and sets should I do ?

Last night I (Dr Shawn Allen) received an email from a patient asking how many reps to do for their prescribed homework. Here was my response:

“hi Jon Doe:
as i may have mentioned, i do not give or care about absolute numbers……..it is about finding clean patterns and ramping up a number count towards fatigue in the movement pattern. As you approach fatigue we want to stop at this early stage. This is NOT about strength at this point, skill and endurance are the first pieces of a neurologic motor pattern…….so, clean, precise movements on high volume slowwwww repetitions not exceeding fatigue. Go up to fatigue, but not past it.
Yes, you are paying attention to the right things that you mentioned when running……..but do not force them. Running is a complex motor skill ……and so you cannot truly cerebrally make the corrections happen right now and make them stick, all you can do and should do at this stage is PAY ATTENTION to the movements. Your brain needs to know what is right and what is wrong. That is were learning begins. There will be much frustration and failure at the start, but coaxing the stacking awareness we discussed is the starting point. The exercises will drive the skill and endurance you need to correct the physicalities of what you are doing wrong.”

perhaps not a perfect response, but not bad either. We thought we would share smile emoticon

Gait, walking.:Why movement matters.

Gait … . walking.
Movement is medicine, nothing new.
A recent study out of Stanford University found that walking for at least 10 minutes enhances a person’s creativity.
” Dr. John Ratey states, “when his patients stopped exercising, many not only became depressed, by some actually developed adult ADHD.”

Some famous scientists were known to walk to stimulate creativity.
“Ratey is especially a fan of walking with no purpose. He says that’s when the brain can pick up more information and walking can allow one’s thoughts to come and go in a way they don’t when a person is focusing on something specific.“When we’re walking,” says Ratey, “We are stimulating the brain in many, many ways.”“

http://hereandnow.wbur.org/2014/05/19/why-walking-matters

Ankle Dorsiflexion stretching ?

Are we the only ones that did a “face palm” after reading this study? I mean, “duh”. Or are we missing something ?
Pronation gets more dorsiflexion all on its own so how in the world can this be a translatable study ?
Besides, in the pronation posture, length if achieved was perhaps mostly medial gastrocoleus divisions.
And……was the knee bend or straight? Hint: This matters, both those posterior muscles do not cross the knee, only one does.

Conclusion: After a 3-wk gastrocnemius-stretching program, when measuring dorsiflexion with the STJ positioned in supination, the participants who completed a 3-wk gastrocnemius stretching program with the STJ positioned in pronation showed more increased dorsiflexion at the ankle/rear foot than participants who completed the stretching program with the STJ positioned in supination.

Gastrocnemius Stretching Program: More Effective in Increasing Ankle/Rear-Foot Dorsiflexion When Subtalar Joint Positioned in Pronation Than in Supination
2015, 24, 307 – 314

http://journals.humankinetics.com/jsr-current-issue/jsr-volume-24-issue-3-august/gastrocnemius-stretching-program-more-effective-in-increasing-anklerear-foot-dorsiflexion-when-subtalar-joint-positioned-in-pronation-than-in-supination

Walking, strokes, movement.

Fact:
Mini-strokes affect up to half of the population over forty, but usually go unnoticed until damage builds.
Physical and mental health. Just put on your shoes and get moving. It is often that simple. My parents are both 81. They speed walk 4 miles a day and they are on zero medications. They eat exceptionally clean, zero alcohol, lots of vitamins.
Get your parents, friends, patients walking. It is a start, a big start, and for many, most of all they need.

From the article: “Despite what we know about exercise, for whatever reason, people still have the thought that it can’t work. Maybe they think it’s too easy,” says Liu-Ambrose.
Rather than put on a pair of runners and head outside, they’re willing to pay for online cognitive training, for instance, even though there’s less evidence that it works, she adds.

http://www.vancouversun.com/touch/story.html?id=11237102

Optimal walking speed

How fast you should move in order to improve your health?
In many studies, the more intense runners are healthier than those who walk or run more moderately. However, this is not the entire picture, there are studies that say moderation is wiser. Confusingly, and perhaps unfortunately there is literature that will support whatever makes you happy.
From the linked blog:
“This risk of death is lower even with a very minimal energy expenditure. The lowest-energy-expenditure group in each study is walking at about 3 mph for 20 to 40 minutes per day. In other words, a mile or two of walking. In exchange, their risk of death goes down by 10 percent.
"Walking a bit farther — say, 2 to 3 miles at 3 mph — gets you an additional death reduction of about 30 percent. But walking more than that, or more than an hour a day at this speed, is no better.”
“If we take this research at face value, we learn a few things. First, some exercise reduces your risk of death. Second, the optimal walking/jogging exercise is light to moderate jogging. The optimal speed is between 5 and 7 mph, and if you do 25 minutes about three times a week, you’re all set. Nothing in the data suggests that running more — farther, or faster — will do more to lower your risk of death.”

What do you think ? Agree /Disagree?

http://fivethirtyeight.com/features/whats-the-optimal-speed-for-exercise/

Higher Level Gait Disorders

How deep are you willing to take your gait understanding ?

“In conclusion, these data suggest that the gait and balance deficits in higher level gait disorders (HLGD) mainly result from the lesion or dysfunction of the network linking the primary motor cortex and the mesencephalic locomotor region (MLR), brain regions known to be involved in the control of gait and balance, whereas cognitive and ‘appendicular’ hypokinetic-rigid signs mainly result from deep white matter lesions (DWML) that could be responsible for a dysfunction of the frontal cortico-basal ganglia loops.”

http://www.ncbi.nlm.nih.gov/pubmed/24202784
J Neurol. 2014 Jan;261(1):196-206. doi: 10.1007/s00415-013-7174-x. Epub 2013 Nov 8.
High-level gait and balance disorders in the elderly: a midbrain disease?
Demain A

The effect of lower extremity fatigue on shock attenuation during single-leg landing.

Thank goodness the body can compensate. Here is a perfect example of this discussed in this study.
“ … it has been shown that a fatigued muscle decreases the body’s ability to attenuate shock from running. The purpose of the study was to determine the effect of lower extremity fatigue on shock attenuation and joint mechanics during a single-leg drop landing.”
This study suggests that as one part fatigued, the joint and muscle strategies elsewhere in the limb made up for it.
“Hip and knee flexion increased and ankle plantarflexion decreased at touchdown with fatigue. Hip joint work increased and ankle work decreased.” The results suggested that the lower extremity is able to adapt to fatigue though altering kinematics at impact and redistributing work to larger proximal muscles.

The effect of lower extremity fatigue on shock attenuation during single-leg landing. Clin Biomech (Bristol, Avon). 2006 Dec;21(10):1090-7. Epub 2006 Sep 1.
Coventry E1, O'Connor KM, Hart BA, Earl JE, Ebersole KT.
http://www.ncbi.nlm.nih.gov/pubmed/16949185

The smell of napalm in the morning: Your gait and trouser coughs, a clinical entity no one talks about.

Written by Dr. Shawn Allen


This is our very last gait guys blog post. Yes, all good things come to an end, even this trusted blog.
But, keeping in good faith, we will finish on a strong note ……. One of gardenia and lavender.  Thanks for the last 5 years gait brethren, is has been a great ride.  Shawn and Ivo
_______________________________
The technical title of this blog post should have been, “The reactive influence of non-normopressure bowel distention and spontaneous high vapor dissipation on bipedal locomotion.”  but no one but true gait nerds would have read it had we stuck with this pubmed-type title. Yes, we are talking about farts and gait here today folks, buckle up.

One biomechanical principle we will link to this entity of “off-gassing“ is that excessive or sustained ankle plantarflexion could inhibit dorsiflexion and certainly, at the very least, works against it. We have talked about this often here on the blog and how the lack of ample ankle dorsiflexion can impair many of the biomechanical events higher up into the human frame. So, how can someone’s bowel gas translate into gait problems ?

Think about this …  to squeeze out a right “cheek sneak” (fart) with optimal crowd pleasing pitch and peak vibrato, some elevation and relaxation of the lower and middle gluteus maximus divisions (coccygeal and sacral) seems imperative to optimally control off-gassing . Seemingly, to do this, a significant degree of right ankle plantarflexion may be necessary to lift the right hemipelvis driving a subsequent intentional clockwise pelvic distortion assisting in the relaxation of these gluteal divisions.  This consciously driven right side of the body “lift” via the right ankle plantarflexion can also be met and assisted via ipsitlateral abdominal and contralateral gluteus medius contraction to further enable the optimal right hemipelvis elevation. Go ahead, stand up and mimic the posture and note these biomechanical pieces. Recall our mantra, 

“when the foot is on the ground, the glutes are in charge, when the foot is in the air, the abdominals are in charge”.  

These coordinated motor patterns might be considered dual/multi tasking. This honed series of biomechanical events is one often perfected in frat houses and basement gaming rooms. But make no mistake, there is a biomechanical danger lurking here if this becomes a habitual compensation pattern, one common in large volume legume consumers (beware vegans). Habituation of this motor task, or demonstrating poor technique over time can render right quadratus lumborum shortening and weak lower abdominals rendering an anterior pelvic tilt. This tilt may lead to gluteal inhibition/weakness (because it is difficult to contract the gluteals in an anterior pelvic tilt, go ahead stand up again and try it) which over time can impair stance phase gait mechanics. However, relating to the off-gassing, this physical posturing might optimize low frequency gluteal vibrations that can optimize vibrato during gas dissipation if pressurization is in fact optimal for an “audible”.  It is important to note that conscious variable control of the tonus of the muscular anal sphincter complex plays a big part in the pitch and vibrato. There is always a drawback it seems, it does truly come down to motor control it seems, doesn’t it always ?


This is not to say that avoiding “audibles” through holding “one” in doesn’t have consequences. The exotic gas (nitrogen, carbon dioxide, hydrogen, methane, oxygen) induced gut distention that could only make your collage roommate proud can inhibit the abdominal wall and thus the lower thoracic canister and disable normal breathing mechanics. This could be a serious complication to the coupled events of respiration and thoracic mobility. So, holding that big one in for your friends rather than engaging the compensatory Trendeleburg-type off-gassing posture as described above is also fraught with problems. We know that functional disconnection of the thoracic canister from the pelvic core can disrupt the normal anti-phasic mechanics of the contralateral upper and lower limbs as well as possibly impair the normal spinal cord mediated central pattern generators.

Farts…..Call them what you want, those ear pleasing, nose hair curling, trouser coughs that only a teenage boy can truly relish and recognize as a function of boyhood success.  All joking aside, they truly should be your biggest concern in your gait analysis evaluation, bar none. Ask your patients about their bowels and off-gassing, it should be part of your clinical history intake. Maybe even consider taking out the discomfort of open dialogue, and put it on your intake forms. We found that a stick figure diagram in a good biomechanical squat posture with a mushroom cloud formation hanging overhead eases dialogue tension about this sensitive topic. We even give the young children crayons to they can color the cloud. What fun !


Dare us to write a part two on this topic. “Blue Angels” (unfamilar with this clinical phenomenon? look it up). Go ahead, dare us for a part 2. 

By now, if you haven’t realized that The Gait Guys just punked you, then you likely haven’t had your cup of morning coffee. Yes, we have no clue what we were talking about on this blog post, well, ok maybe, after all we do have that y-chromosome. Yes, we are NOT ending the blog either :) 

Are you now considering us juvenile ? Ok maybe we are a little, but don’t deny it, you thought about some unique and honest body biomechanics for a moment here and it is these mental gymnastics that will take your creative thinking about gait to the next level. If you are upset, so be it. There will be no apologies here in this growing PC world. Off-gassing is a human thing, we all do it. We have been writing serious stuff daily for 5 years here on The Gait Guys. It was time for us to write something a little lighter.  We can only hope that you will think of us and the complexities of the gait cycle the next time you sneak one out while having dinner at the in-laws.  Try not to giggle when you do, but for certain, think about your body mechanics when you do, we can’t be responsible for off-gassing injuries. Think of us.

Shawn Allen, remaining here, for the duration.

disclaimer: we cannot be responsible for injuries that might be sustained by improper off-gassing events. We also do not recommend attempts at performing Blue Angels, this is a potentially dangerous activity and could cause great bodily harm (seriously). :)

Pod #93: Ankle Rocker, Sacroiliac Joint symmetry , Landing mechanics

Ankle Rocker, Sacroiliac Joint symmetry , Landing mechanics, Gait Tech, Gray Cook theories, movement and music and so much more !

A. Link to our server:
http://traffic.libsyn.com/thegaitguys/pod_93Final.mp3

Direct Download:  http://thegaitguys.libsyn.com/pod-93-ankle-rocker-sacroiliac-joint-symmetry-landing-mechanics

Sponsor: www.newbalancechicago.com

-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:

-Landing mechanics
http://www.ncbi.nlm.nih.gov/pubmed/26117159

-Shock absorbing landing loads
J Athl Train. 2015 Jun 11. [Epub ahead of print]
Weight-Bearing Dorsiflexion Range of Motion and Landing Biomechanics in Individuals With Chronic Ankle Instability. Hoch MC1, Farwell KE1, Gaven SL2, Weinhandl JT1.

-Neuroscience:
Trying to reteach your client’s CNS new sensory-motor patterns so they can move better ?
New connections and pathways are fragile and only through repetition and practice and focused attention can those connections be established enough to become habitual or default behaviors.
Neuroscience for Leadership: Harnessing the Brain Gain Advantage (The Neuroscience of Business). Tara Swart

-Does variability in muscle activity reflect a preferred way of moving or just reflect what they’ve always done?
http://esciencenews.com/articles/2014/03/14/motion.and.muscles.dont.always.work.lockstep.researchers.find.surprising.new.study

-Context-dependent changes in motor control and kinematics during locomotion: modulation and decoupling. Foster and Higham
http://www.ncbi.nlm.nih.gov/pubmed/24621949

-gait technology problems :?
http://www.buzzfeed.com/stephaniemlee/who-owns-your-steps#.twn1Bg28P

-Dance video discussed, Alvin Ailey Dance Company
https://vimeo.com/36286106

-SI joint anatomy/rehab piece: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512279/
more rehab strategies here: http://lermagazine.com/article/music-therapy-and-gait-rehab-to-a-different-beat

-a few minutes on Gray Cook quotes. pick a few we can talk about (pic attached)

movement patterns talk: http://www.anatomy-physiotherapy.com/28-systems/musculoskeletal/lower-extremity/knee/1191-altered-movement-patterns-in-individuals-with-acl-rupture

Just because it looks good, doesn’t mean that it is.We have all had patients with seemingly negative knee x rays and pain, only to develop arthritic changes at a later date. Find and treat the cause!“Our analysis found that incident radi…

Just because it looks good, doesn’t mean that it is.

We have all had patients with seemingly negative knee x rays and pain, only to develop arthritic changes at a later date. Find and treat the cause!

“Our analysis found that incident radiographic knee osteoarthritis is preceded by prodromal symptoms lasting at least 2-3 years. This has potential implications for understanding phasic development and progression of osteoarthritis and for early recognition and management.”

Case R, Thomas E, Clarke E, Peat G. Prodromal symptoms in knee osteoarthritis: a nested case-control study using data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2015 Apr 2. [Epub ahead of print]

picture from: http://whyfiles.org/…/chronic-pain-understanding-the-roots…/

“Due to the shape of the condyles and the menisci, and the location of ligaments of and muscles acting on the knee, the joint rotation axis is located medially in the knee joint. This also in part explains why the lateral condyle and meniscus …

“Due to the shape of the condyles and the menisci, and the location of ligaments of and muscles acting on the knee, the joint rotation axis is located medially in the knee joint. This also in part explains why the lateral condyle and meniscus are more mobile. Maximum extension of the knee is caused by these factors and the “screw home” mechanism of the cruciate ligaments. The popliteal muscle is connected with the lateral meniscus and the caput fibulae: it locks the knee joint in and unlocks the knee joint out of its maximum extension. Moreover, it plays an important role for proprioception in the knee joint and is known to cause posterolateral knee pain.

from: http://www.anatomy-physiotherapy.com/…/94-test-your-knowled…

Forefoot valgus: A fixed structural defect in which the plantar aspect of the forefoot is everted on the frontal plane relative to the plantar aspect of the rearfoot; the calcaneum is vertical, the mid tarsal joints are locked and fully pronatedWant…

Forefoot valgus: A fixed structural defect in which the plantar aspect of the forefoot is everted on the frontal plane relative to the plantar aspect of the rearfoot; the calcaneum is vertical, the mid tarsal joints are locked and fully pronated

Want to know more? Join us Wednesday evening: 5 PST, 6 MST, 7 CST, 8 EST for Biomechanics 309: Focus on the forefoot on onlinece.com.

McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

Fore foot types: Differences between forefoot varus and forefoot supinatus.Certainly this can be a contraversial topic. Perhaps this will help clear up some questions.Supination of the forefoot that develops with adult acquired flatfoot is defined a…

Fore foot types: Differences between forefoot varus and forefoot supinatus.

Certainly this can be a contraversial topic. Perhaps this will help clear up some questions.

Supination of the forefoot that develops with adult acquired flatfoot is defined as forefoot supinatus. This deformity is an acquired soft tissue adaptation in which the forefoot is inverted on the rearfoot. Forefoot supinatus is a reducible deformity. Forefoot supinatus can mimic, and often be mistaken for, a forefoot varus. A forefoot varus differs from forefoot supinatus in that a forefoot varus is a congenital osseous deformity that induces subtalar joint pronation, whereas forefoot supinatus is acquired and develops because of subtalar joint pronation (1).

A Forefoot Varus induces STJ pronation whereas a Forefoot Supinatus is created because of STJ pronation (2).

As the foot experiences increased subtalar joint (STJ) pronation moments during weightbearing activities (as in forefoot supinatus) , the medial metatarsal rays will be subjected to increased dorsiflexion moments and the lateral metatarsal rays will be subjected to decreased dorsiflexion moments. Over time, this increase in STJ pronation moments will tend to cause a lengthening of the plantar ligaments and medial fibers of the central component of the plantar aponeurosis and a shortening of the dorsal ligaments in the medial longitudinal arch. As a result, the influence of increased STJ pronation moments occurring over time during weightbearing activities will tend to cause the following (3):

1. An increase in inverted forefoot deformity.
2. A decrease in everted forefoot deformity.
3. A change in everted forefoot deformity to either a perpendicular forefoot to rearfoot relationship or to an inverted forefoot deformity.

More on the forefoot tomorrow evening on onlinece.com: Biomechanics 309. Join us!

1. Clin Podiatr Med Surg. 2014 Jul;31(3):405-13. doi: 10.1016/j.cpm.2014.03.009. Forefoot supinatus. Evans EL1, Catanzariti AR2.

2. https://kenva.wordpress.com/…/…/forefoot-varus-or-supinatus/

3. http://www.podiatry-arena.com/podiatry-forum/showthread.php…

Does gait (re)training alter peoples biomechanics? You bet it does! Should we be retraining peoples gait? We like to think, yes. What do you think?“Overall, this systematic review shows that many biomechanical parameters can be altered by runn…

Does gait (re)training alter peoples biomechanics? You bet it does! Should we be retraining peoples gait? We like to think, yes. What do you think?

“Overall, this systematic review shows that many biomechanical parameters can be altered by running modification training programmes. These interventions result in short term small to large effects on kinetic, kinematic and spatiotemporal outcomes during running. In general, runners tend to employ a distal strategy of gait modification unless given specific cues. The most effective strategy for reducing high-risk factors for running-related injury-such as impact loading-was through real-time feedback of kinetics and/or kinematics.’

Br J Sports Med. 2015 Jun 23. pii: bjsports-2014-094393. doi: 10.1136/bjsports-2014-094393. [Epub ahead of print]
Gait modifications to change lower extremity gait biomechanics in runners: a systematic review.
Napier C1, Cochrane CK1, Taunton JE2, Hunt MA1.

How much “dip” in the coronal plane is in your single leg squat?“In conclusion, the Single-Leg Squat is a reliable tool to identify patients that would need to improve their hip and trunk muscle weakness and dysfunction (by strengt…

How much “dip” in the coronal plane is in your single leg squat?

“In conclusion, the Single-Leg Squat is a reliable tool to identify patients that would need to improve their hip and trunk muscle weakness and dysfunction (by strengthening and neuromuscular coordination retraining). ”

Crossley et al., Am J Sports Med 39 (2011) 866 - 873.

Performance on the single-leg squat task indicates hip abductor muscle function. - Anatomy &…

Clinical assessment of performance on the single-leg squat task is a reliable tool that may be used to identify people with hip muscle dysfunction.ANATOMY-PHYSIOTHERAPY.COM

How many times have you seen us post and talk about the shoulder complex and lower extremity relation? Here is another“Kids grow up thinking that throwing a baseball hard is all about strength in the arm and shoulder, but new evidence suggests…

How many times have you seen us post and talk about the shoulder complex and lower extremity relation? Here is another

“Kids grow up thinking that throwing a baseball hard is all about strength in the arm and shoulder, but new evidence suggests that muscle strength and range of motion in the hip affect shoulder function during throwing in youth baseball players.”

Lower-body focus could help youth baseball player arms | Lower Extremity Review Magazine