PreSchool children and barefoot policies

Preschool children and the possible effects of a barefoot policy while in kindergarden. 
You will see it if you pay enough attention to enough barefoot young children, some kids have not yet dropped the toes to the ground.
-study compared the effects of barefoot policy on children where their toes do not rest on the ground while standing normally
-In conclusion, the ground contact of the toes becomes better for boys in kindergarten with a barefoot policy. The results were inconclusive with regard to girls

The effect of the kindergarten barefoot policy on preschool children’s toes

Shigeki Matsuda, Kosho Kasuga, Tadayuki Hanai, Tomohiro Demura, and Keisuke Komura

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937549/

Dual tasking, Pokemon, and Cross walks.

Someone has to save the Pokemon Go users. The Gait Guys to the rescue !
With the help of these pavement tiles by design firm Büro North, they created a street tile that alerts phone users when they’re approaching danger. Smart Tactile Paving, a concept that would alert walkers — much like a street light — when they’re nearing traffic with the standard red, yellow, green system (see the article link below for this product and idea).
Someone has figured out how to stop you from texting into the street at a cross walk while you and your kids scoop up Squirtles and other nonsense. Oy Vey. 
You are looking down while on your smart phone and some inventor knew they had to do something to save the world from the Pokemon Go death mark population control device. 
Dual tasking is difficult especially when one task is cognitive and the other is spacial and motor. At some point something has to give, especially if you are on the edge of tapping out the executive function centers in the brain.
Recently in the Journal of Applied Biomechanics, Parr and associated took 30 young able bodied healthy individuals with experience texting on cellular phones. The study used an 11-camera optical motion capture system on a 8m obstacle-free floor.

The study showed a reduction in gait velocity in addition to significant changes in spatial and temporal parameters, notably, step width, while the double support phase of the gait cycle increased. Furthermore, and equally disturbing, toe clearance decreased but luckily step length and cadence decreased.

There is much more to say about this today on the blog. It is Rewind Friday, come get reacquainted with the problems your kids will have playing pokemon go.
-Shawn

https://thegaitguys.tumblr.com/post/104851280879/texting-and-walking-your-gait-will-change-when

http://thenextweb.com/insider/2016/07/28/these-pavement-tiles-could-stop-phone-addicts-from-walking-into-traffic/

Short gastrocnemius ?

What is our mantra when it comes to ankle dorsiflexion/ankle rocker ? "Build anterior strength to achieve posterior length." We have been saying it for years. You MUST have the skill, endurance and strength of the anterior compartment muscles (tib.anterior, peroneus tertius, toe extensors) to even remotely get the posterior compartment (gastrosoleus achilles complex)to offer you reasonable length to get the dorsiflexion. You cannot get the joint range just by mobilizing and stretching the posterior compartment. Sure, you can borrow some range after stretching for a very brief period of time, but we choose to get our clients to earn and own the length. if there is contracture, yes, that is another matter. But, those are very rare cases for the most part. This is why so many have troubles transitioning into a more neutral heel drop (ie. lower) heeled shoe. They have not first achieved the requisite anterior SES (skill, endurance and strength) anteriorly to offer the ankle dorsiflexion range. These folks will often gait forward tibial progression through subtler joint over pronation and rear foot over eversion. Obviously this creates internal limb spin and knee valgus loading risks.

Gastrocnemius Contracture in Patients With and Without Foot Pathology. James R. Jastifer, MD1,2⇑, Jessica Marston, MD2

http://fai.sagepub.com/content/early/2016/07/21/1071100716659749.abstract?platform=hootsuite

Running Economy and joint stiffness

Well, this is possible, but so is the existence of aliens we suppose. But this article MAY have more of a dialogue on the faulty strategies of the long and short flexors and extensors as a combined strategy for gait stability and purchase of the foot on the ground. Postural sway may necessitate a toe clench strategy, for example, which could force a toe hammer strategy and thus more long flexor/short extensor tone of the digit muscles. This in itself could alter MPJ passive stiffness over time and may not correlate with any of the study findings below.

Findings by Hok Sum Man et al:
MPJ passive stiffness in sitting position is highly correlated to leg stiffness in running.
•MPJ passive stiffness in sitting position is moderately correlate to vertical stiffness in running.
•MPJ passive stiffness in either sitting and standing position is not correlated to running efficiency.

http://www.gaitposture.com/article/S0966-6362(16)30123-0/abstract?platform=hootsuite

Achilles tendon properties

All tissues need time to accommodate to loading stresses. Adaptation takes time, the achilles is no different than any other tissues that need adaptive time. But, people think that can drop to a low heel-toe drop shoe and pay no price. Time... some people need more adaptive time....gradually work into it. 
- here, increased achilles cross sectional area and other changes

Achilles tendon properties in minimalist and traditionally shod runners.

Exercise is the best medicine.

If you have an hour, this looks like a pretty good lecture by Harvard's Dr. Lieberman on movement, adaptation, how we made our way to a bipedal gait, and how we got into obesity, heart disease, and finally, using exercise as medicine. I've watched most of it, pretty good if you have an hour play it while you clean up your home office or while you do 100 Hindu squats, 60 pushups, and 10" of planks. :)

https://www.youtube.com/watch?v=8Cd0OB-xgoo

Gait Pathomechanics: Walking in a Pencil Skirt.

Gait Pathomechanics: Walking in a Pencil Skirt.

We wrote this piece 5 years ago. We are updating it with a new disasterous video. Speed ahead to the 30 second mark to get to the good stuff. The Gait stuff. Read the blog post and then come back to the video and see what we talk about. There are some severe gait compromises in a skirt like this, let alone with the high heel shoes accompanying the gait.

According to wikipedia:
The slim, narrow shape of a pencil skirt can restrict the movement of the wearer so pencil skirts often have a slit at the back, or less commonly at the sides. Sometimes a pleat, which exposes less skin, is used instead of a slit. The classic shoes for wearing with a pencil skirt are high heels,^[3] with sheer stockings or tights. The predecessor to the pencil skirt is the hobble skirt, a pre-WWI fad inspired by the Russian Ballet. This full-length skirt with a narrow hem seriously impeded walking. The French designer Christian Dior introduced the classic modern pencil skirt in the late 1940s. The pencil skirt feels different from looser skirts, and can take some adjustment by the wearer in terms of movement and posture in order to manage it successfully. Walking needs to be done in short strides; entering and leaving a car gracefully takes practice; and when sitting the legs are held close together which some find restrictive (though others like the feeling of their legs being “hugged” by the skirt). Activities such as climbing ladders and riding bicycles can be very difficult in a pencil skirt. The pencil skirt is warmer due to the reduced ventilation, and is less likely to be blown up by gusts of wind.

The Gait Guys dialogue on pencil skirts :
Tie a rope or theraband around your knees, you will suddenly experience the short cute steps that this gals does devoid of almost all hip flexion and hip extension, both serious gait cycle restrictions.
Without hip flexion-extension the entire timing of the swing phase is off. No longer can there be adequate use of the obliquity of the pelvis and thus abdominals or contralateral leg swing to initiate supination and toe off.
Step and stride lengths are dictated by the tightness of the roap, and in this case the diameter and give of the bottom of the skirt.  Not to mention the bloody complication added by the high heels !
- There is an unnatural oscillation of the pelvis due to the restrictions mentioned above.

The Pencil skirt:  Never again will you be able to wear one and not notice its gait impairments. Nor will men be able to just watch the ladies in the skirts for the appreciation of beauty and style. Men, you will have much more to study now, you just may hate us for your undying need to evaluate the biomechanics in skirt wearers forevermore ! Just be sure you do not abuse this new evaluation superpower as an excuse to your spouse to watch girls walk by.  We are not responsible for abuses of acquired superpowers.  And although we many have actually just become your new heros, just remember, with great powers come great responsibilities.

Shortly we will be selling a  new product, “pencil skirt training noose” on our online store.  $50 for the finest roap loops !

Shawn and Ivo, your new superheros of gait. Gait Fashonistas, perhaps we have a purpose and calling in the fashion industry !

Podcast 111: Gait, Movement, & the Messengers

Great open clinical discussions today on things we see in the clinic. Hope you will join us on this clinical journey today.

 

Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.tumblr.com) and you will come to our blog. In the left tab, 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).

 

Show notes:

Treadmill Biomechanics
http://thegaitguys.tumblr.com/post/146994093374/new-research-on-non-motorized-treadmills

http://thegaitguys.tumblr.com/post/9252105802/the-truth-about-treadmills-a-neurological

Shoes alter the spring-like function of the human foot during running
Luke A. Kelly, Glen A. Lichtwark, Dominic J. Farris, Andrew Cresswell
http://rsif.royalsocietypublishing.org/content/13/119/20160174

Lower limb alignment characteristics are not associated with running injuries in runners:…
http://www.tandfonline.com/…/17461391.2016.1195878…
http://www.tandfonline.com/doi/abs/10.1080/17461391.2016.1195878?journalCode=tejs20&

Gait modification strategies in trunk over right stance phase in patients with right anterior cruciate ligament deficiency.
Shi D   Gait Posture. 2016 May;46:63-8. doi: 10.1016/j.gaitpost.2016.02.016. Epub 2016 Mar 2.
http://www.ncbi.nlm.nih.gov/pubmed/27131179

Check out our latest Podcast episode!

Take a good look at this gals gait. In the 1st section, she is walking on relatively level ground and in the second part, the topography changes and the balance requirements become much greater. You may remember a post we did some time ago talking about proprioception and learning to walk here.

Besides the obvious gluteus medius weakness, genu valgum and pronation, R>L, can you see how when the task becomes more complex, that the system begins to break down? Did you see the increased base (wider) of gait? did you see the decreased speed of movement? Did you see the increased ancillary arm movements?

Keep your eyes open for clues like this in your clinical exam. When the going gets rough, the nervous system often reverts to what it knows best a slows down a bit.

Knee pain and hyperpigmentation.

Seen this?

Take a look at these legs. Have you seen anything similar in a client, patient or perhaps yourself? This gent came in with knee pain  and we were looking at his feet. It turns out that this was a reaction to an antibiotic he had taken 3 years ago!

Hyperpigmentation can be caused by bacterial infections, congenital problems, lime Cafe au Lait spots, endocrine disorders, like Addison’s disease and hyperthyroidism, hemochromatosis as well phototoxic reactions from the use of systemic or topical antibiotics (1, 2) or from contact with certain plants or foods in conjunction with sun exposure (3).  

Often initially, patients develop an reddened skin response caused by an allergic reaction. The inflammatory response often includes lymphocytes, eosinophils, and edema, which can result in a “blister like” reaction on sun-exposed skin. Over time, hyperkeratosis and melanocytic hyperplasia (increased numbers of the cells that give your skin pigmentation) develop, causing hyperpigmentation (1).  

Some medications result directly in hyperpigmentation, without sun exposure, in a diffuse pattern, like on the gent we see here (4-9). The tables included in reference 2 can provide additional clues

Keep your eyes open! Who knows what the medications may have done to thwart your efforts in the healing response!

1. Gould JW, Mercurio MG, Elmets CA. Cutaneous photosensitivity diseases induced by exogenous agents. J Am Acad Dermatol. 1995;33:551–73.
2. http://www.aafp.org/afp/2003/1115/p1955.html
3. Friedlander SF. Contact dermatitis. Pediatr Rev. 1998;19:166–71
4. Crowson AN, Magro CM. Recent advances in the pathology of cutaneous drug eruptions.Dermatol Clin. 1999;17:537–60.,viii
5. Pepine M, Flowers FP, Ramos-Caro FA. Extensive cutaneous hyperpigmentation caused by minocycline. J Am Acad Dermatol. 1993;28(2 pt 2):292–5.
6. Kelly AP. Aesthetic considerations in patients of color. Dermatol Clin. 1997;15:687–93.
7. Goroll AH, Mulley AG Jr, eds. Primary care medicine: office evaluation and management of the adult patient. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2000
8. Skin diseases of general importance—part II. In: Cecil RL, Goldman L, Bennett JC. Cecil Textbook of medicine. 21st ed. Philadelphia: Saunders, 2000: 2288–98
9. Friedlander SF. Contact dermatitis. Pediatr Rev. 1998;19:166–71.

Podcast 110b "Shorts": Evolution of Upright Bipedal Gait & Glute Development.

We take a brief but necessary discussion on food and cooking to get to a logical place on bipedalism, upright gait, glute development and vision. Thank you for spending some time with us in your ears.  :)

A. Podcast links:

http://traffic.libsyn.com/thegaitguys/pod_110b_Shortsfinal.mp3

http://thegaitguys.libsyn.com/podcst-110b-shorts-evolution-of-upright-bipedalism-gait

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:

The Scars of Evolution: Part 0

http://news.nationalgeographic.com/news/2012/10/121026-human-cooking-evolution-raw-food-health-science/

http://thegaitguys.tumblr.com/post/22193730427/the-upright-walking-and-the-stoned-chimpanzee

http://www.scientificamerican.com/article.cfm?id=raw-veggies-are-healthier

Gaining Anterior Length, Through Posterior Strength. A Lesson in Reciprocal Inhibition

Gaining Anterior Length, Through Posterior Strength and vice versa….A Lesson in Reciprocal Inhibition

I found a really cool article, quite by accident. I was leafing through an older copy of one of, if not my favorite Journals “Lower Extremity Review” and there it was. An article entitled “Athletes with hip flexor tightness have reduced gluteus maximus activation”. Wow, I thought! Now there is a great article on reciprocal inhibition! This reminded me of a piece we wrote some time ago

What is reciprocal inhibition, also called “reciprocal innervation” you ask? The concept, was 1st observed as early as 1626 by Rene Descartes though observed in the 19th century, was not fully understood and accepted until it earned a Nobel prize for its creditor, Sir Charles Sherrington, in 1932.

Simply put, when a muscle contracts, its antagonist is neurologically inhibited (see the diagram above) When your hip flexors contract, your hip extensors are inhibited. This holds true whether you actively contract the muscle or if the muscle is irritated in some manner, causing contraction. The reflex has to do with muscle spindles and Type I and Type II afferents which I have covered in an article I wrote some time ago.

We can (and often do) take advantage of this concept with treating the bellies of hip flexors (iliopsoas, tensor fascia lata, rectus femoris, iliacus, iliocapsularis) and extensors (gluteus maximus, posterior fibers of gluteus medius). This is especially important in folks with low back pain, as they often have increased psoas activity and cross sectional area, especially in the presence of degenerative changes.

There also appears to be a correlation between decreased hip extension and low back pain, with a difference of as little as 10 degrees being significant. Take the time to do a thorough history and exam and pay attention to hip extension and ankle dorsiflexion as they should be the same, with at least 10 degrees seeming to be the “clinical” minimum. Since the psoas should only fire at the end of terminal stance/preswing and into early swing, problems begin to arise when it fires for longer periods.

Can you see now how taking advantage of reciprocal inhibition can improve your outcomes? Even something as simple as taping the gluteus can have a positive effect! Try this today or this week in the clinic, not only with your patients hip flexors, but with all muscle groups, always thinking about agonist/antagonist relationships.

In the moment: Sports medicine  Jordana Bieze Foster: Athletes with hip flexor tightness have reduced gluteus maximus activation  Lower Extremity review Vol 6, Number 7 2014

https://tmblr.co/ZrRYjx1VG3KYy

Mills M, Frank B, Blackburn T, et al. Effect of limited hip flexor length on gluteal activation during an overhead squat in female soccer players. J Athl Train 2014;49(3 Suppl):S-83.

Ciuffreda KJ, Stark L.  Descartes’ law of reciprocal innervation. Am J Optom Physiol Opt. 1975 Oct;52(10):663-73.
Jacobson M Foundations of Neuroscience Springer Science and Business Media, Plenum Press, NY 1993 p 277

http://www.nobelprize.org/nobel_prizes/medicine/laureates/1932/sherrington-bio.html

https://thegaitguys.tumblr.com/post/9708399904/ah-yes-the-ia-and-type-ii-afferents-one-of-our

Arbanas J, Pavlovic I, Marijancic V, et al MRI features of the psoas major muscle in patients with low back pain. Eur Spine J. 2013 Sep;22(9):1965-71. doi: 10.1007/s00586-013-2749-x. Epub 2013 Mar 31.

Roach SM, San Juan JG, Suprak DN, Lyda M, Bies AJ, Boydston CR. Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls. Int J Sports Phys Ther. 2015 Feb;10(1):13-20. Erratum in: Int J Sports Phys Ther. 2015 Aug;10(4):572.

Paatelma M Karvonen E Heiskanen J Clinical perspective: how do clinical test results differentiate chronic and subacute low back pain patients from “non‐patients”? J Man Manip Ther. 2009;17(1):11‐19.[PMC free article] [PubMed]

Evans K Refshauge KM Adams R Aliprandi L Predictors of low back pain in young adult golfers: a preliminary study. Phys Ther Sports. 2005;6:122‐130.

Mellin G Correlations of hip mobility with degree of back pain and lumbar spinal mobility in chronic low‐back pain patients. Spine. June 1988;13(6):668‐670. [PubMed]

Lewis CL, Ferris DP. Walking with Increased Ankle Pushoff Decreases Hip Muscle Moments. Journal of biomechanics. 2008;41(10):2082-2089. doi:10.1016/j.jbiomech.2008.05.013.

Nodehi-Moghadam A, Taghipour M, Goghatin Alibazi R, Baharlouei H. The comparison of spinal curves and hip and ankle range of motions between old and young persons. Medical Journal of the Islamic Republic of Iran. 2014;28:74.

Daniel Moon , MD, MS; Alberto Esquenazi , MD Instrumented Gait Analysis: A Tool in the Treatment of Spastic Gait Dysfunction JBJS Reviews, 2016 Jun; 4 (6): e1. http://dx.doi.org/10.2106/JBJS.RVW.15.00076

Kilbreath SL, Perkins S, Crosbie J, McConnell J. Gluteal taping improves hip extension during stance phase of walking following stroke. Aust J Physiother. 2006;52(1):53-6.

The gait from hell.

* VIDEO: About 4-5 years ago some of you that have been with us for awhile will recall that i studied some latin and smooth ballroom dance for a few years. It was humbling to say the least. There are so many reasons why men suck at dancing. But, I have never been one to stray away from fearful and humbling experiences. I enjoy being curious and trying hard things and i am ok with looking like a fool to get an edge on wisdom seeking. This dance thing was the hardest thing i have ever done, the pros make it look easy, but it is hard. Movement, coordination, timing, rhythm, memorizing steps and principles, then learning to lead a partner through all that SILENTLY !  but one of the hardest things to learn was how to use the whole body to create movement. Dancing is whole body, latin dancing is a workout, and the core gets smashed when done right. There is a reason dancers have amazing bodies, because this stuff is hard !  One day one of the male coaches came over to me and said something resembling “you are not reacting into the floor with your feet, you have to feel the inside and outside edges of your rear, mid and forefoot at any one moment of time. If you cannot get that right, you cannot properly engage the leg muscles, hips and certainly not your core”. He was right. I had no idea how to move. He then said, “go home, but on some socks and polish your floors, reacting into, and then off of, the floor. When you begin to feel your leg muscles and learn that the feet can be used in so many ways other than walking, things most people never even come close to in sports, you will be ready to START.”  This was what happened after one week of reacting into the floor, I came to name it, “EDGEWORK”. I was learning to use the inside and outside edges of my rear, mid and forefoot, sometimes on the opposite sides of the body, pronating at times through the right rear foot while supinating through the left forefoot etc.  This is why I laugh to myself when i see people posting what they call holy grail “foot exercises” on the internet. Much of it is novice stuff, but admittedly that is where most people have to begin, and should begin. This was just one reason I appreciated learning 10 different dances, from cha cha and jive which had extremely fast and agile foot work, to rhumba and salsa and their complicated foot work into the floor, and then dances like foxtrot or waltz that required an entirely different kind of footwork, skimming and floating across the foot with grace. Oh, and did i mention leading a lady about the floor, silently with just body jestures and gentle hints of pressure. Oh, and to music, on time, in rhythm etc. This was a journey in which i gave zero f#@&ks about about what people thought when they knew i was taking dancing lessons, because I knew I was learning to move and use my body like few others even remotely had a clue about, and likely never will.  Enjoy my silly little FOOT EDGEWORK video i shot for this coach, so he could see what i had been able to do in just a week. You will see inside edges, outside edges, skimming, floating, pressuring into the floor, directional changes, pivots etc. From here, my journey into movement took a giant leap forward. I began to truly understand how the foot worked on the ground, truly “worked” and how that would translate into hip rotation, core engagement, upper body turning, spinning, posture, arm movements, glute and calf use, peroneal stability for the lateral ankle and many more things. There is a reason why some of the greatest athletes in sports took on dancing and ballet to improve their undertanding and grace of movement to their chosen field. Because it was an edge no one else willing to embrace. Go ahead laugh at the silly video, i sure did. I just found it while purging computer files and immediately put the wool socks back on and went to polish the floors.  Come on men, help keep the house floors sparkly clean like mine, give them a shine :) Oh, and thanks Bruce Lee, Hong Kong Cha cha champion for making it ok to follow you.  You can take that to the bank Connor McGregor.

Podcast 110: Step width, breasts, and diaphragm changes with movement.

We have a great show for you today. All of the above topics in the title, plus the immune system’s effect on fine tuning motor control as well as some long form dialogue on human base of support and stability during walking and running. All the links you need are below in the show notes. Thank you for spending some time with us in your ears.  :)

Show Sponsors:   Newbalancechicago.com   Altrarunning.com

A. Podcast links:

http://traffic.libsyn.com/thegaitguys/pod_110f.mp3

http://thegaitguys.libsyn.com/podcast-110-elite-runners-breasts-diaphragms-and-human-movement

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:

Flexible recording patch
http://www.cnet.com/news/flexible-patch-performs-like-a-wearable-tricorder/?ftag=COS-05-10aaa0b&linkId=24813511

How Neurons Lose Their Connections
http://neurosciencenews.com/genetics-neurons-cpg2-3441/

The immune system and fine tuning motor control and movement.
http://neurosciencenews.com/mghi-motor-control-genetics-4035/

Breast biomechanics
http://www.outsideonline.com/2065486/how-breasts-affect-your-performance

http://thegaitguys.tumblr.com/post/50570270440/human-gait-changes-following-mastectomy-taking

Elite runners
http://www.gaitposture.com/article/S0966-6362(16)00086-2/abstract?cc=y=

Diaphragm and Chronic Ankle Sprains
http://thegaitguys.tumblr.com/post/145209607699/the-diaphragm-and-chronic-ankle-instability

A cool paper on taping and reciprocal inhibition. 

“Hip extension increased significantly with gluteal taping (p < 0.05) for both walking speeds at late stance phase of walk compared to sham taping and control. The mean absolute difference between gluteal and control conditions for self-selected velocity was 14.2 degrees (95% CI 8.6 to 19.8) whereas the difference between sham and control conditions was 2.0 degrees (95% CI –2.0 to 6.0). Also, for both speeds, step length on the unaffected side increased significantly with gluteal taping compared with either the control or placebo” conditions. 

link to full text: http://www.sciencedirect.com/science/article/pii/S0004951406700629

Aust J Physiother. 2006;52(1):53-6.Gluteal taping improves hip extension during stance phase of walking following stroke.Kilbreath SL, Perkins S, Crosbie J, McConnell J.

Providing you more ways to listen to us. We are up on Soundcloud now, next pod should also launch to iHeartRadio, Youtube and a few other places. Just trying to share our love in more places :)

https://soundcloud.com/user-152640364

Podcast 109b “Shorts”: The gluteus medius during swing phase.

A 12 minute talk on what the swing leg does in gait, and what it has to do when we drift the pelvis in the frontal plane over the stance leg.
Ever find yourself kicking your opposite ankle ?  We have answers.
Join us for a rewind of an old 12 minute talk we had on what the glutes do in the swing phase.

Podcast links:

http://thegaitguys.libsyn.com/podcast-109b-shorts-the-swing-phase-use-of-the-gluteus-medius

http://traffic.libsyn.com/thegaitguys/pod_110shortfinal.mp3

Article link:

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

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

Difficult hip presentations. Coordination of deep hip muscle activity is often altered in symptomatic femoroacetabular impingement (FAI).

If your clinic is anything like ours, you are regularly seeing failed therapy cases of hip pain walk into your clinic. Many of these cases have been diagnosed clinically or with imaging as FAI (femoral acetabular impingement (syndrome)). FAI can give all kinds of hip pain presentations around the front, side or back of the hip, groin and pelvis, even with referral into the knee. Lets make no mistake, these are difficult cases.
The attached study suggests that these often difficult cases are fraught with undefined parameters. These cases can be difficult for us all, particularly if one do not have the clinical examination skills to tease out what muscles are not working, which ones are over working, what has happened to joint centration, how the client loads the hip, what the pelvis posturing attitude is and what motor stabilization strategies are being deployed. Lumbar, pelvis and hip posturing and stabilzation is key in understanding FAI and these often vague and frustrating cases. Determing how the client deploys stacking of the lower limb joints and how they then deploy these strategies in gait and running is paramount to your success in assisting these client cases. This is a deeply multifactorial problem and often why these issues do not get resolved. 

Recently I just closed yet another case with a 21 year old female who had FAI and labral tear surgery 2 years ago. She had been told she would always have some pain and never run again. As many of these cases often proceed, after defining all of the issues above, it was clear she had many unaddressed components postoperatively. It appeared many components had not been addressed preoperatively, and had they been addressed, I suspect she may have not needed surgery. These multitudes of dysfunctional components can lead to FAI and labral damage. Many torn labrums do not need surgery, as evidenced by how many clients come out of surgery still having the same pre-operative pain as well as how many improve or resolve by a non-surgical approach to addressing all of the components above.

This study, by Diamond et al compared coordination of deep hip muscles between people with and without symptomatic FAI using analysis of muscle synergies (i.e. patterns of activity of groups of muscles activated in synchrony) during gait. The study utilized intramuscular fine-wire and surface electrodes EMG activity of selected deep and superficial hip muscles.  
This study found a significant correlation with the quadratus femoris muscle, one we have repeatedly found problematic over the years. This study was nice to read, it confirmed many of the issues we have found rooted in these often difficult cases. The study surmised that 

“coordination of deep hip muscles in the synergy related to hip joint control during early swing differed between groups. This phase involves movement towards the impingement position, which has relevance for the interpretation of synergy differences and potential clinical importance. ”

We strongly refer you back to our podcast #99 to look into the gluteus medius during swing phase. This is a key component to one’s deeper understanding of how complex the hip works, during both stance and swing. We all tend to get too caught up in stance phase mechanics because that is the one we can see and assess most clearly, however, if one does not understand how vital the gluteus medius is in swing phase limb targeting through the sagittal plane, one is likely missing a big piece of a client’s clinical puzzle. One can do all the dynamic and functional movement and stabilization therapy they wish, but if one does not understand the swing phase mechanics, and perhaps most importantly, if one does not reteach a client how to make the necessary adaptive gait changes to employ the therapeutic work the changes remain on the therapy table and never cross over into functionally using them. The clinician must address the client’s previously deeply rooted gait motor program. A client may have in their bank account the new functional abilities they have been taught, but they likely have not been taught how to deploy them in a new more appropriate gait strategy. 

-Dr. Shawn Allen

1. Coordination of deep hip muscle activity is altered in symptomatic femoroacetabular impingement.
Laura E Diamond, Wolbert Van den Hoom, Kim L Bennell, Tim V Wrigley, Rana S Hinman, John O’ Donnell, Paul Hodges

2. 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

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

4. https://thegaitguys.tumblr.com/post/133206339519/podcast-99-how-foot-placement-the-glutes-and

“Too much tripping, soles worn thin. Too much Trippin and my soul’s worn thin.”

Scott Weiland

Take a look at these shoes which are basically a leather glove for the foot. Look at the wear pattern and how the lines of force travel from the heel, of the lateral aspect of the foot, across the metatarsal heads and out the great toe. To have you wear on the right is due to a left-sided leg length discrepancy.  She has a higher lateral longitudinal arch as evidenced from the absence of where just anterior to the heel.  Looks like she’s getting her first Ray to the ground, Eh?

Podcast 109: A clinical case of a total knee replacement and achilles tendonopathy.

Great open clinical discussions today on things we see in the clinic. We start with a great case that opens up the dialogue, a case of a total knee replacement and achilles tendonitis.  Hope you will join us on this clinical journey today.

Interested in our store ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.tumblr.com) and you will come to our blog. In the left tab, you will find tabs for STORE, SEMIANRS, 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). 

A. Podcast links:

http://traffic.libsyn.com/thegaitguys/pod_109f.mp3

http://thegaitguys.libsyn.com/podcast-109-a-clinical-case-of-a-total-knee-replacement-and-achilles-tendonopathy

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:

Loose dialogue  on Anterior pelvis tilt and training it out

https://www.t-nation.com/training/dont-be-like-donald-duck?utm_source=facebook&utm_medium=social&utm_campaign=article3173

Ivo put up 2 articles recently on “Why is your muscle tight” and “iliocapsularis” muscle.
Why training the upper body might help integrate arms into gait for sporthttp://thegaitguys.tumblr.com/post/141990433844/gait-and-climbing-and-dns-part-2-introducing

http://journals.lww.com/acsm-msse/Abstract/publishahead/Influence_of_Step_Rate_on_Shin_Injury_and_Anterior.97596.aspx
- cross over looked at ?- ankle rocker looked at ?  endurance of anteiror compt looked at ?