Brace2Play ankle brace. Caveat emptor.

Lets be clear ! This brace is for above the ankle mortise sprains, ie. low and high ankle sprains, sprains to the syndesmosis. It is NOT for ankle mortise and below sprains (ie. lateral and medial stabilzing ankle ligament sprains, ATF, PTF, deltoid ligs etc). If you use this brace on those injuries, good luck......you will not have any protection to those torn ligaments. 
Also, i am hesitant to buy into the "treats shin splints". Braces are supportive, nothing more. So, "supports" shin splints is more accurate IMHO. 
I would also make a case that a syndesmosis sprain (low-high ankle sprain) is not an injury you should be looking for a brace to enable you to continue to play on. Rather, rest and heal and do your initial phase low load rehab. 
Like most things, devices like this have a place and a purpose, but you have to know what you have injury wise, and know what you are dealing with. For example, if you have both a syndesmosis (low-high ankle sprain) AND a deltoid or lateral ligamentous complex sprain, this brace is not what you should chose in our opinion.

https://www.edgemobilitysystem.com/products/brace2play-above-the-joint-ankle-brace?variant=21314299587

Toe grip strength and hallux valgus

#craigpayne over at Podiatry Arena said, "chicken or the egg", which came first ?
Weak Toe Grip Strength (TGS) correlates with hallux valgus . . . 
Do not yet take this study as "do more toe grip strength work", that is NOT what it is saying !!!!!!

We have taken note in our clinics that it "appears" that more long hallux flexor use often "seems" to accentuate a hallux valgus (HV). We continue to study this observation, but not hanging our hat on any conclusions as of yet. But, when someone with HV grips with the long toe flexor hammering down the distal toe, the valgus appears to accentuate. We shall see, its an observation. None the less, we try to get these folks into a pressing, then add the long flexor, and this seems to give adequate purchase on the ground without as much valgus posturing. Keep looking into more active toe extension, separation and hallux abduction as a means to an end. This will likely be a discussion on podcast 113, coming soon. Have you listened to podcasts 108 or 109 yet ? 109 launched Saturday. Keep up !

Weak TGS Correlates with Hallux Valgus in 10 12 Year Old Girls: A Cross- Sectional Study

https://www.researchgate.net/publication/304271421_Weak_TGS_Correlates_with_Hallux_Valgus_in_10_12_Year_Old_Girls_A_Cross-_Sectional_Study

Arm swing and hip ranges.

Most folks think they know a sufficient amount about arm swing, but the truth speaks otherwise for many. Many know heaps about upper quarter biomechanics and how to assess and evaluate the joints of the upper quarter but they have no clue what to look for when it comes to the client using the limb in locomotion. What really happens during the complex arm motions during gait and various forms of locomotion in runners and throwing sports ?
"For the first time, we provide evidence that the spinal interneuronal networks linking the forelimbs and hind limbs are amenable to a rehabilitation training paradigm. Identification of this phenomenon provides a strong rationale for proceeding toward preclinical studies for determining whether training paradigms involving upper arm training in concert with lower extremity training can enhance locomotor recovery after neurological damage.” -Shah et at, Brain 2013 Nov

"Our results demonstrate that altered hip rotational range of motion, measured clinically, has a direct effect on the amount of external rotation torque and horizontal adduction range of motion of the shoulder during the throwing motion." -Laundner et al, (article below)

Want to dive deeply into arm swing ? Want to really know what you are doing and missing ? Goto our blog (thegaitguys.tumblr.com) and in the search box type "arm swing". You will find nothing short of dozens of articles we have written on the topic.

The relationship between clinically measured hip rotational motion and shoulder biomechanics during the pitching motion

Kevin Laudner, Regan Wong, Takashi Onuki, Robert Lynall, Keith Meister

http://www.jsams.org/article/S1440-2440(14)00137-6/abstract

The Skill of walking

The Skill of Walking:
We enjoy most of what goes up on #BreakingMuscle. This one brings up a point we use in the clinic all the time, Mimicry.
We use to to help our patients "see" what we see them doing in their gait or movements. We mimic what we see in their gait while we explain the "what" and "why" of their dysfunctional gait. 
Sometimes we are so wrong when it comes to understanding exactly what we are doing. Think your posture is good ? Check it next time you walk pasta mirror, it is possible it is not as pristine as you think it is. We have mirrors up all over our clinic so people can see what they look like and what they are doing. We encourage them to check on their posture in the mirrors when they walk down to the treatment rooms (and, it is not just for the patients! !). Mirrors can be a real asset when it comes to feedback. 
Mimicry of our clients movements helps them to understand, in 3 dimensions, in many respects better than 2D video what they are actually doing (we discuss this more in podcast 112 launching in a few weeks). Virtual reality is going to clean up many problems we have teaching in the clinic.

http://breakingmuscle.com/natural-move…/the-skill-of-walking

Short foot exercise death.

Here is an article we wrote 5 months ago. It is worth reviewing in light of the other short foot articles we have shared this week.
" . . . this Short Foot exereise is a pretty prehistoric exercise if you ask me, it needs to be dusted off and updated and retaught correctly"- Dr. Allen

" . . . as we are bearing weight down on the foot the arch should be in a controlled pronatory deformation to shock absorb. There is no time to be reacting off the floor into a short foot, that opportunity moment is lost at contact, actually it really never occurs once the ground is met whether one is in initial rearfoot, midfoot or forefoot strike. The foot has to be prepared at the time of contact with its’ most competent arch, not busy reacting after the fact trying to achieve the competent structure. The value in the short foot is earning competence in its loading ability and learning to control its adaptive eccentric lengthening, this must be possible in both toe extension and toe flexion (ground contact)."

We have much more to say in the blog post...... link provided below.

https://thegaitguys.tumblr.com/post/139486938004/is-the-short-foot-exercise-dead-dr-allen

Slower walking in the elderly and calf strength.

"Conclusions: In older men, walking at preferred speed allows triceps surae muscles to generate force with more favorable shortening velocity and to enhance use of tendinous tissue elasticity compared to walking at young men's preferred speed. The results suggest that older men may prefer slower walking speeds to compensate for decreased plantarflexor strength."

Slower Walking Speed in Older Men Improves Triceps Surae Force Generation Ability.
Stenroth, Lauri; Sipilä, Sarianna; Finni, Taija; Cronin, Neil J.

http://journals.lww.com/acsm-msse/Abstract/publishahead/Slower_Walking_Speed_in_Older_Men_Improves_Triceps.97437.aspx

Obese Feet

Doesn't it just make sense ? It needs to be part of the dialogue with your clients.
"Obese feet differ significantly from those of healthy adults, particularly in width."
And a change in width may mean a change in function, changes in mobility and stability, which may lead to pain and at the very least, accommodation and compensation.

Foot dimensions and morphology in healthy weight, overweight and obese males

Carina Price [correspondence] Press enter key for correspondence information [email] Press enter key to Email the author
, 
Christopher Nester
http://www.clinbiomech.com/article/S0268-0033(16)30101-2/abstract?platform=hootsuite

The Types of Jaywalkers

The jaywalker
The Veerer
The Plodder
The retroactive
The runner
The butters
The swaggerers

We walk amongst them all and it is never more ever-present than when moving amongst the masses in a big city. Especially, when we are in a hurry, do we notice the annoying nature of these people the most. However, the problem is ours, because we are all one of these walking types at some point. Next time you are waking in the big city, amongst the masses take note, instead of annoyance.

" . . . the history of pedestrian nuisances is a long and colorful one. The very term “jaywalker” — after jay, a silly person — was coined on August 3, 1924, in a New York Times editorial about the proliferation of pedestrian menaces."
In “The Confusion of Our Sidewalkers: And the Traffic Problem of the Future in the Erratic Pedestrian,” the original 1924 article by M. B. Levick writes:
"There are the veerers who come up sharply in the wind and give no signal. The runners who dash to a goal and then dash back again without even tagging another “it.” The retroactive, moving crabwise. Those who flee and turn swiftly to victory, making a commonplace of the ruse that gave Joe Choynski his fame in the ring. Left-ends and butters, the people who never met the Marquis of Queensberry and to whom Greco-Roman is more foreign than jiu-jitsu.

As mad as the satellite particles of an atom and amid each group, like a nucleus, a static type. The plodder, trudging through Times Square as o’er the lee and knowing neither near side nor off side. The inferiority complexes whose only sense of power is to make the world walk around them. Children of the cigar store Indians standing stock still, so that a couple passing must say “Bread and butter!” Others who are to movement what the color blind are to light and the swaggerers who in an earlier age would take the wall, but in this present confusion must take wall and gutter and all between to assert their precedence."

Here is the full article on Brainpickings.

The Four types of Jaywalkers. Maria Popova

https://www.brainpickings.org/2013/09/26/jaywalkers-wendy-macnaughton-1924/

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.