The opposite upper and lower limbs model each other. Today we discuss adduction. See the photo.

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The opposite upper and lower limbs model each other. Today we discuss adduction. See the photo.

This is a discussion we had last March 11 and 12, 2019 on this photo. Today, lets look closer at the photo.

Runners, athletes . . . Even in your drills, do it correctly !
Last week we discussed this and its relation to the Bird Dog exercise. This is no where near the same pattern as Bird Dog, as we discussed, the Bird Dog is neurologically incorrect. Today, Adduction is the topic at hand.

This runner is performing a skill, a proper neurologic skill when it comes to patterning limbs the way we repeatedly move in walking, running, and often (but not always) sports. If you want to know why Bird Dog is an outlier neurologically, go back and find our post last week on the topic.

Today, look at the right knee, he has allowed it to adduct. We discussed why this is a lazy pattern, unless he has a purpose for not abducting the hip (possibly addressing something we are unaware of). Now look at the left arm, it too is adducted towards the midline. When left to its patterned and balanced based ways, the brain will use balance and patterning to model the limbs with their counterpart. This is the neurologic "shaping" we have discussed previously. The upper limb can help to shape the movement of the lower, but we know there is the opposite effect as well. We also know that the lower limb has a higher "leading" affect, it runs the show more. This is why we feel coaching arm swing is not the best way to go about changing someone's gait issues/form.

Try what he is doing, stand up and try it. You will see that the upper limb and lower limb better follow the modeling and shaping when they are both doing the same things (in this case, hip and shoulder flexion, and adduction). Now, keep the right thigh flexed and adducted, and ABduct the arm, you will find a subtle balance challenge and it will feel like there is a slight disassociation, because you have taken one limb away from the midline. Now, instead, adduct the left shoulder, but abduct the right thigh/hip. It is harder to do, again. Not leaps and bounds harder, but you had to think about it, because one limb is moving toward the midline and the other is not , all the while in a static balance position. Now yes, some will argue that this was not hard at all, and this kind of thing happens in sport all the time, agreed. Sometimes balance and proprioception (i.e. the vestibular system) trumps neurological patterning because of the hierarchy in the CNS. BUT don't miss our point, that there are underlying neurologic patterns and principles that dictate limb function when we are not paying attention to it. This is our point, and you will see it in your clients when they walk and run. And you see it in this guys case, because we would bet that he was not doing this left shoulder left hip adduction on purpose. He was doing it because it felt right, felt normal, felt balanced, and it is neurologically sound. But, he could do better, if he abducted the left arm and right hip, he be earning a more pattern as a runner. And, he would reduce the tendency of the cross over gait pattern, because, as you can see here, if that right foot heads to the ground, he is going to be very narrow step width in his gait, and that COULD mean potential problems and power leaks.
One more thing, do not be surprised that the right arm is abducting while it is extending, this is spin off of the adduction of the other limbs we discussed today. If he likely remedies them, the right arm will no longer abduction, likely.
And, these same concepts play out if you are adducting your arms across your body when walking or running, if the arm is pulling hard across the midline, do not be surprised if your step width is narrow. Hence, if you wish to run with more glutes and a wider more powerful gait, reduce the arm adduction and the legs will have to follow from the "shaping" influence of the arms.

Crawling and Bird Dog, a subtle but important difference.Can you see it ?

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Crawling and Bird Dog, a subtle but important difference.
Can you see it ?
When we crawl, as in the photo, we use the following pattern:
- the right shoulder is in extension (but it is fixed on the ground, it is the body that is moving forward/extending over this fixated point, it is approximating the flexing right hip as the knee moves up towards the hand)
- the left hip is in extension, pairing appropriately with the right shoulder extension.
- similarly, the left shoulder is in flexion (it is over head in this photo, just like in the other photo of the runner similarly doing the same patterning but standing up, meanwhile the right hip is in flexion.
* take the photo of the runner in the green shirt, and put him in a quadruped crawling pattern as you will see that it is the same pattern as the one of me in the crawling posture.
* This is not bird dog, as seen in the photo, do not confuse them.

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The Bird Dog exercise is not neurologically correct for the reason of training the proper crossed patterning from a neuro perspective. Note that in the 2nd photo, the bird dog, the same left arm is in flexion, but his left leg is in EXTENSION ! If you want to use the bird dog to teach core engagement, that is one thing, but do not think you are coordinating normal gait patterns or the proper crossed response. This is why we do not use the Bird Dog with our patients, it goes against training fundamental gait patterns.

This first photo of me in the black shirt is normal, natural, neurologically correct, cross crawling. Don't believe us ? Get on the floor and crawl like an infant, it is no where near the bird dog exercise, in crawling the coupled crossed extension and flexion responses are NOT conflicting. So, just because the Bird Dog "sort of looks like crawling" do not get it confused with crawling, because it is not. It is a mere balance exercise, some use it for the core stability, but it is one based on UN-fundamental neurologic patterning we use every day.......something called gait, and running, things we do in our sports. So understand what message you are sending to the CNS.
We are not saying the Bird Dog does not have value, not at all, but if you are not thinking about what it actually is doing, you might be driving patterns you do not want.

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A new twist on an old exercise

Do you know the the “Bird Dog” exercise? It looks like the picture above. The upper and contralateral lower extremities are extended, the the opposite ones are flexed. Seems to make make sense, unless you think about gait and neurology (yes, as you can see, those things seem to always be intertwined).

Think about gait. Your right leg and left arm flex until about midstance, when they start to extend; the left leg and right arm are doing the opposite. At no point are the arm and opposite leg opposing one another. Hmmm.

If you look at it neurologically, it is a crossed extensor reflex (see above); again, flexion of the lower extremity is paired with flexion of the opposite upper extremity. It is very similar to a protective reflex called the “flexor reflex” or “flexor reflex afferent”.

Wouldn’t it make more sense to do a cross crawl pattern? Or maybe like the babies shown above? Seems like if that’s the way the system was programmed, maybe we should try and emulate that. Don’t we want to send the appropriate messages to our nervous system for neurological re patterning? If you are doing the classic “opposite” pattern, what is your reasoning? Can you provide a sound neurological or physiological reason?

Think before you act. Know what you are doing.

The Gait Guys. Bridging the gap between neurology and gait, so you can do a better job.

A theory for bipedal gait ? Ipsilateral interference between the foot and hand in quadrupedal gait.

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Human quadrupedalism is not an epiphenomenon caused by neurodevelopmental malformation and ataxia: Uner Tan Syndrome, Part 3

* Alert: Before you read this blog post you will do yourself a great degree of mental service by reading our 2 prior blog posts on this video.  There is an important learning progression here. Here are the links:

http://thegaitguys.tumblr.com/post/28332726553/the-hand-walkers-the-family-that-walks-on-all

http://thegaitguys.tumblr.com/post/78470419988/the-hand-walkers-part-2-uner-tan-syndrome-the

Note that in this video there is ipsilateral interference between the foot and hand in this quadrupedal gait. In this diagonal quadrupedal locomotion (QL) the forward moving lower limb is impaired from further forward progression by the posting up (contact) hand of the same side. This would not occur if the QL gait was non-diagonal (ie. unilateral), the forward progression of the lower limb would be met with same time forward progression of the upper limb, allowing a larger striding out of both limbs.  This would enable faster locomotion without increasing cadence (which would be the only way of speeding up in the diagonal QL), at the possible limitation of necessitating greater unilateral truncal postural control (which is a typical problem in some of these Uner Tan Syndrome individuals who typically have profound truncal ataxia).  

As the video progresses one can see that bipedal locomotion IS IN FACT POSSIBLE in Uner Tan syndrome individuals. 

This is the excerpt from the embedded video:

“Two adult siblings from a consanguineous famiy in Kars, Turkey, exhibited Uner Tan syndrome with severe mental retardation, and no speech, but with some developmental differences.. 
There was no homozygocity in the genetic analysis, but the extremely low socio-economic status suggested epigenetic changes occurred during pre- and post-natal
development. 
Quadrupedal locomotion in cases with Uner Tan syndrome exhibit interference between the ipsilateral extremities, and this also occurred in all tetrapods with diagonal sequence QL since this form of locomotion appeared around 400 MYA. 
The ipsilateral limb interference might have been the triggering factor for bipedal locomotion in our ancestors, and walking upright would enhance their chances of survival, because of the benefits in the visual and manual domains. The ipsilateral interference theory is a novel theory for the evolution of bipedalism in human beings, and was first proposed by Uner Tan in 2014.”

As Karaca, Tan & Tan (1) discussed in their article:

“In discussions of the origins of the habitual QL observed in Uner Tan syndrome, it was argued that this quadrupedalism might be an epiphenomenon caused by neurodevelopmental malformation and severe truncal ataxia (Herz et al., 2008). The present work will show that this argument may be untenable, presenting two individuals with QL who do not exhibit ataxia, and who have entirely normal brain images and cognitive functions.”

As we mentioned in our last blog post,

“Tan and Ozcelik mentioned in their recent research, in UTS the obligate diagonal QL was associated with some genetic mutations and cerebellovermial hypoplasia, and was seen as an adaptive self-organizing response to limited balance. On the other  hand, the present work showed that human QL may spontaneously occur in humans with an unimpaired brain, probably using the ancestral locomotor networks for the diagonal sequence preserved for about the last 400 million years. (Shapiro and Raichien, 2005; Reilly et al., 2006)." (1)

Kind of brings some new "slap in the face” thoughts to the rehab “bird dog” exercise doesn’t it !  Driving a 400 million year old quadruped motor pattern (ya, ya, we know it is a early-window primitive cross crawl infant neurodevelopmental pattern, we have been to Pavel Kolar seminars. Don’t try to argue, just think past all this. Go get a beer or walk in the park and cogitate on this a bit, it is important.)

If you want to dive deeper into this kind of work,  you may want to go and look at some of our recent work on Arm Swing here. But don’t forget to watch this video above again and pay close attention to what we mentioned here.

We received this video on Monday (March 3, 2014) directly from Dr. Uner Tan himself in Turkey. We are very grateful for all that he has been sharing with us behind the scenes and we are grateful for his research and for this budding relationship.  Thank you Dr. Tan !  

Dr. Shawn Allen, one of The Gait Guys

Reference: 

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480821/