The Short Foot Exercise

Here it is, in all its glory...Our version of the short foot exercise. Love it or hate it, say it “doesn’t translate”, we find it a useful training tool for both the patient/client as well as the clinician. It awakens and creates awareness of the sometimes dormant muscles in the user and offers a window to monitor progression for them, as well as the observer.

Remember that the foot intrinsics are supposed to be active from midstance through terminal stance/pre swing. Having the person “walk with their toes up” to avoid overusing the long flexors is a cue that works well for us. This can be a useful adjunct to your other exercises on the road to better foot intrinsic function.


Dr Ivo Waerlop, one of The Gait Guys

Sulowska I, Mika A, Oleksy Ł, Stolarczyk A. The Influence of Plantar Short Foot Muscle Exercises on the Lower Extremity Muscle Strength and Power in Proximal Segments of the Kinematic Chain in Long-Distance Runners Biomed Res Int. 2019 Jan 2;2019:6947273. doi: 10.1155/2019/6947273. eCollection 2019

Okamura K, Kanai S, Hasegawa M, Otsuka A, Oki S. Effect of electromyographic biofeedback on learning the short foot exercise. J Back Musculoskelet Rehabil. 2019 Jan 4. doi: 10.3233/BMR-181155. [Epub ahead of print]

McKeon PO, Hertel J, Bramble D, et al. the foot core system: a new paradigm for understanding intrinsic foot muscle function Br J Sports Med March 2014 doi:10.1136/bjsports-2013- 092690

Dugan S, Bhat K: Biomechanics and Analysis of Running Gait Phys Med Rehabil Clin N Am 16 (2005) 603–621

Bahram J: Evaluation and Retraining of the Intrinsic Foot Muscles for Pain Syndromes Related to Abnormal Control of Pronation http://www.aptei.ca/wp-content/uploads/Intrinsic-Muscles-of-the-Foot-Retraining-Jan-29-05.pdf


#shortfootexercise #footexercises #footrehab #thegaitguys #gaitanalysis #gaitrehab #toesupwalking



https://vimeo.com/342800960

What are we listening to  this week ?    Therapy Insiders interview with Stu McGill entitled “the mechanics of a treatment approach with Dr. Stuart McGill"This was an interesting interview with some nice clinical pearls. Anyone who has had the opportunity to see Dr. McGill speak will certainly appreciate his humor and candor.  After a lengthy discussion on mustaches, they began to talk about competency of therapists. Dr. McGill then explains some salient points in his three hour evaluation of patients. His goals are to "precisely define The pain triggers to that patient” and then to “remove them”. Pretty simple but effective. We think the keyword here is “precisely”.He then talks about utilizing your clinical knowledge based in the powers of observation.   His assessment begins with a patient interview to determine The character of the patients pain. He’s very careful to listen to “exactly” what the triggers and really are for a patient’s pain. He then goes on to offer some nice clinical diagnostics pearls that we will leave for you to listen to the podcast to glean.  He then again emphasizes observing the patients movement and movement habits to establish their stability/mobility continuum. His examination consists of three parts: provocative motions, neural tests, and tissue specific tests. He looks for provocative motions postures and loads.  Once the pain should use identified, he then seeks to find positions postures or movements which will alleviate it. He then does neural tests, looking for things like neural or root tension. Finally he discusses some tissue specific diagnoses.  There’s an interesting discussion on pain and pain science. Dr. McGill emphasizes that people need to avoid the movement which causes pain not moving in general. He then goes on to talk about Central sensitization and how, if you can teach people to not invoke their “pain trigger” motion, that they will actually improve and central sensitization will decrease. in other words, don’t move “through” pain but find ways to work around the trigger.  There’s been a series of “Twitter” questions that are answered with an interesting discussion on Core stability and superimposed axial movement. All in all a informative interview with some clinical pearls.   you can give it  listen here:    http://updocmedia.com/mediacast/the-mechanics-of-a-treatment-approach-w-dr-stuart-mcgill/

What are we listening to this week

Therapy Insiders interview with Stu McGill entitled “the mechanics of a treatment approach with Dr. Stuart McGill"This was an interesting interview with some nice clinical pearls. Anyone who has had the opportunity to see Dr. McGill speak will certainly appreciate his humor and candor.

After a lengthy discussion on mustaches, they began to talk about competency of therapists. Dr. McGill then explains some salient points in his three hour evaluation of patients. His goals are to "precisely define The pain triggers to that patient” and then to “remove them”. Pretty simple but effective. We think the keyword here is “precisely”.He then talks about utilizing your clinical knowledge based in the powers of observation. 

His assessment begins with a patient interview to determine The character of the patients pain. He’s very careful to listen to “exactly” what the triggers and really are for a patient’s pain. He then goes on to offer some nice clinical diagnostics pearls that we will leave for you to listen to the podcast to glean.

He then again emphasizes observing the patients movement and movement habits to establish their stability/mobility continuum. His examination consists of three parts: provocative motions, neural tests, and tissue specific tests. He looks for provocative motions postures and loads.  Once the pain should use identified, he then seeks to find positions postures or movements which will alleviate it. He then does neural tests, looking for things like neural or root tension. Finally he discusses some tissue specific diagnoses.

There’s an interesting discussion on pain and pain science. Dr. McGill emphasizes that people need to avoid the movement which causes pain not moving in general. He then goes on to talk about Central sensitization and how, if you can teach people to not invoke their “pain trigger” motion, that they will actually improve and central sensitization will decrease. in other words, don’t move “through” pain but find ways to work around the trigger.

There’s been a series of “Twitter” questions that are answered with an interesting discussion on Core stability and superimposed axial movement. All in all a informative interview with some clinical pearls. 

you can give it  listen here: 

http://updocmedia.com/mediacast/the-mechanics-of-a-treatment-approach-w-dr-stuart-mcgill/

tumblr_nmfyt908iR1qhko2so1_400.jpg
tumblr_nmfyt908iR1qhko2so2_400.jpg

The Serratus and Gait..

Think about the role of the serratus anterior in gait. Now think about it in martial arts. There are profound neuromuscular and fascial connections and implications here. Just like the thoracolumbar fascia which also attaches to the ribs, these muscles seem to be necessary for core stability.

“Conclusions: Simultaneous recruitment of the lower extremity and trunk muscles increases the activation of the SA
muscle during the FPP exercise.
Clinical Relevance: Rehabilitation clinicians should have understanding of the kinetic chain relationships between
the LE, the trunk, and the upper extremity while prescribing exercises. The results of this study may improve clinicians’
ability to integrate the kinetic chain model in a shoulder rehabilitation program. ”

The authors also suggest a hierarchy of exercise to follow. An interesting read for a Sunday.

great full .pdf here: http://www.ncbi.nlm.nih.gov/…/PMC42751…/pdf/ijspt-12-924.pdf

Subtle clues often provide the answers.  
 We like yoga as much as anyone else. We saw this picture on the latest cover and couldn’t resist making a few comments on this pose. 
 Yoga has many benefits. Our understanding is that in addition to the cognitive and spiritual effects of yoga, is that it helps to build your core. 
  At first look you may say that this woman has a few issues: 
  she has a right pelvic shift and a left body lean 
 She has slight head rotation to the right and a slight left head tilt 
 you may have noticed that she appears to have more tone in the musculature on the right side of her face than on the left.   Just look at the nasolabial fold as well as the corner of her mouth any area of wrinkling underneath her left orbit. 
  You may have also noticed the subtle flexion and lack of external rotation of the right hip. 
   You may go on and think that she has a week right gluteus medius as well as an overactive quadratus lumborum on the left-hand side which may be causing the pelvic shift. The head tilt may be in compensation for the right side gluteus medius weakness and the subtle rotation may be an attempt to engage a tonic neck response. ( a tonic neck response is  ipsilateral extension of the upper and lower extremity to the side of head rotation with contralateral flexion of the same counterparts. 
   You may have also noticed  that the toes of the right foot are not dorsiflexed and that her hair appears to be flowing on the right side, and this is not the case at all, but rather she is either standing on a sloped surface or on the downward phase of a jump. According to the magazine it is the latter.  If you caught this at first then  congratulations:   you are sharper than most . If not remember to always look for subtle clues. 
  Like Sir Topham Hat says in Thomas the Train: “  You didn’t get the whole story. What really happened is what really matters. 
  So why the mild facial ptosis on the left side? She could have had an old Bells palsy, or other form of facial paresis. Note that mostly the lower portions of the (left) face are affected (ie, below the eye). We remember that the upper portions of the face receive bilateral innervation but lower portions of the face unilateral innervation, from the contra lateral facial motor nucleus; this is why it could be a mild upper motor neuron lesion (micro infact, lack of cortical afferent input) and not an lower motor neuron lesion (like Bells Palsy). Why is this germane? Or is it not?  
 Stand in front of a mirror. Jump up in the air trying to assume the same pose as this woman does and what do you see.  Make sure that you jump up from both legs and then bring one leg over and your hands in front of you in the "praying position”. You may want to have a friend take a snapshot of you performing this. You will notice that you have contralateral head rotation,  a pelvic hike on the side opposite the leg that’s extended and a head tilt to the side that is flexed.  You are attempting to stabilize your core as you’re going up and coming down. 
 What we are witnessing is a normal neurological phenomena.  This gal merely seems to have some limited external rotation of her left hip. Now perform the same maneuver again but this time don’t externally rotate your leg as far as this woman does and what do you see. You should’ve seen an increase in the aforementioned body postures. 
 Subtle clues are often the key. Keep your eyes and ears open.  
  The Gait Guys. Helping the subtle to become everyday for you, with each and every post.

Subtle clues often provide the answers.

We like yoga as much as anyone else. We saw this picture on the latest cover and couldn’t resist making a few comments on this pose.

Yoga has many benefits. Our understanding is that in addition to the cognitive and spiritual effects of yoga, is that it helps to build your core.

 At first look you may say that this woman has a few issues:

  • she has a right pelvic shift and a left body lean
  • She has slight head rotation to the right and a slight left head tilt
  • you may have noticed that she appears to have more tone in the musculature on the right side of her face than on the left.   Just look at the nasolabial fold as well as the corner of her mouth any area of wrinkling underneath her left orbit.
  •  You may have also noticed the subtle flexion and lack of external rotation of the right hip.

 You may go on and think that she has a week right gluteus medius as well as an overactive quadratus lumborum on the left-hand side which may be causing the pelvic shift. The head tilt may be in compensation for the right side gluteus medius weakness and the subtle rotation may be an attempt to engage a tonic neck response. ( a tonic neck response is  ipsilateral extension of the upper and lower extremity to the side of head rotation with contralateral flexion of the same counterparts.

 You may have also noticed that the toes of the right foot are not dorsiflexed and that her hair appears to be flowing on the right side, and this is not the case at all, but rather she is either standing on a sloped surface or on the downward phase of a jump. According to the magazine it is the latter.  If you caught this at first then congratulations: you are sharper than most. If not remember to always look for subtle clues.

 Like Sir Topham Hat says in Thomas the Train: “  You didn’t get the whole story. What really happened is what really matters.

So why the mild facial ptosis on the left side? She could have had an old Bells palsy, or other form of facial paresis. Note that mostly the lower portions of the (left) face are affected (ie, below the eye). We remember that the upper portions of the face receive bilateral innervation but lower portions of the face unilateral innervation, from the contra lateral facial motor nucleus; this is why it could be a mild upper motor neuron lesion (micro infact, lack of cortical afferent input) and not an lower motor neuron lesion (like Bells Palsy). Why is this germane? Or is it not?

Stand in front of a mirror. Jump up in the air trying to assume the same pose as this woman does and what do you see.  Make sure that you jump up from both legs and then bring one leg over and your hands in front of you in the "praying position”. You may want to have a friend take a snapshot of you performing this. You will notice that you have contralateral head rotation,  a pelvic hike on the side opposite the leg that’s extended and a head tilt to the side that is flexed.  You are attempting to stabilize your core as you’re going up and coming down.

What we are witnessing is a normal neurological phenomena.  This gal merely seems to have some limited external rotation of her left hip. Now perform the same maneuver again but this time don’t externally rotate your leg as far as this woman does and what do you see. You should’ve seen an increase in the aforementioned body postures.

Subtle clues are often the key. Keep your eyes and ears open. 

The Gait Guys. Helping the subtle to become everyday for you, with each and every post.

Concepts in Pelvic Stabilization. Do you know what you know?

We made this video several years ago. It is excerpted from our DVD series on core stabilization available here.

It reviews some concepts of the abdominal core and reviews problems with typical sit up and crunch exercises.

The take home message is one of technique and application. The details and little things are often the most important things. Especially when it comes to exercise and rehabilitation.

The Gait Guys

“Georges St-Pierre, MMA Limb Power & Spinal Stiffness” … Gait Guys style.

Here at ‘The Gait Guys’ we have been going at this teaching, writing and filming process for many years now. On our blog we have written over 1100 articles, our YouTube Channel and Facebook page continue to grow  and our podcasts continue to be heard presently in 85 countries.  We have a long way to go to get our message heard but we trust that our message is clean and clear and based on science and fact. Today we share with you a video of one of our personal professors from our undergraduate studies in human kinetics back in Canada in the late 1980’s, the world renowned Dr. Stuart McGill. In this video he speaks some of these clear honest facts about the spine, movement, joint loading and the sport of MMA (Mixed Martial Arts).  Watch the video, but be sure to read on here, where we bring things full circle for our readers.

We have been on a long academic quest when it comes to learning about different types of movement and we are willing to go to great lengths to humble ourselves to further this mission. Many of our long time readers are aware by now that at the end of 2012 Dr. Allen completed 3 years of private study of smooth and Latin dance to better understand the intricacies of core strength, foot work and complex limb coordination amongst other things. If it was good enough for Bruce Lee (1958 Hong Kong Cha Cha Champion) it is good enough for us ! Just like Tim Ferris, one of the modern day bio and brain hackers, who also took up the Tango to put to the test some facts about brain learning, we too are in it to learn and take things to the highest level possible. 

   Many of you by now know that I have moved my learning from dance into a different kind of study in human movement. I have now committed my brain and body to learning Brazilian Jiu-Jitsu under the instruction of World renowned World Champion Professor Carlos Lemos Jr. You can read about them here, Gracie Barra Downers Grove

There are many similarities between dance and jiu-jitsu (believe it, it is true) and we have completed a comparative article which we will post on The Gait Guys blog in the coming days to validate these thoughts on the human frame in both sports.  However, this is not the point of this brief blog article today, our point was to share the teachings of one of our mentors Dr. McGill.  In this video, showing the research of human movements of Georges St-Pierre and David Loiseau, Dr. McGill discusses the basic tenet that the hips and shoulders are used for power production and that the spine and core are used for creating stiffness and stability for the ultimate power transmission through the limb.  He makes it clear that if power is generated from the spine, it will suffer.  As gait experts, you should never forget this principle, if the spine and lumbopelvic interval is not strong/stiff and stable enough, the limbs can over power them and thus your gait, your running, your sport, could be causing you pain as the forces are poorly managed as they attempt to traverse the spine. 
McGill implies that martial artists find themselves near the top of the heap when it comes to power, strength and speed with an ability to contract muscles with great velocity but also the ability to relax the muscles with a terrific rate of speed. It is this ability to effectively and timely contract and relax that gives a martial artist the advantage.
However, these advantages can only be realized with a special ability to create spinal stiffness effectively, efficiently and with speed and coordination. These are huge advantages when in combat. We all hear about the importance of the core but these are the tenants that are key when referring to the core. And as McGill states, in martial artists who kick and punch, there must be an ability to create an initial pulse of energy, premised off of a stiff and stable spine. This is then followed by a relaxation of some of the limb muscles to ensure maximal velocity (a kinetic chain whip effect, like snapping/flicking a towel) and then followed by a sudden and timely re-stiffening of the spine, core and limb muscles to ensure that maximal force is transmitted to the opponent.
The spine and core must present sufficient amounts of recruited stiffness, yet mobility where necessary, to enable the power and velocity of the movements of the shoulders (punching) and hips (kicking) which are the two main portals of limb movement off of the spine/core.  These principles holds true in gait as well. For example, in human gait the psoas is not a hip flexor initiator when it comes to leg swing, it is a hip flexor perpetuator. The initial hip flexion in human gait comes from derotating the obliqued pelvis, via abdominal contraction, on a stiff and stable spine.  Once the pelvis rotation is initiated, the femur can further pendulum forward (via contraction of the psoas and other muscles) on the accelerated pelvis in the hip joint proper creating an energy efficient movement (again, the towel flick/whip effect). So, this premise holds true in gait, in an effective martial arts kick or even in a soccer kick. This is a solid principle of effective and efficient human locomotion. This principle also holds true for a punch or throwing an object, the stable torso/spine provides a stable anchor upon which to accelerate the arm in order to create a high velocity limb movement with power.

Watch the attached video of Georges St-Pierre, David Loiseau and Dr. Stuart McGill. These are foundational principles of movement in many sports and the martial artists seem to have it down pretty darn well.  These are the things we study and write about here at The Gait Guys. We are more than just gait.
Dr. Shawn Allen 
Dr. Ivo Waerlop 
visit our daily blog:   www.thegaitguys.tumblr.com or our other social media sites, YouTube Channel, Facebook, Twitter etc
copyright 2013 The Gait Guys/The Homunculus Group. All rights reserved. Video remains property of said owner.
Previously unreleased Video Available for download  
       
   “Performance Theories: Dialogues on Training Concepts”   
 How about some one on one with Shawn and Ivo? Hear our thoughts on: 


 • What is the definition of the core and what does it entail ? 

 • Physiologic overflow of muscles with respect to joint motion 

 • Isotonic Exercise concepts 

 • Physiologic characteristics of muscle types 

 • Strength Training: Neural Adaptation 

 • Motor Pattern Muscle Compensation Concepts 

 • Exercise Prescription Concepts 

 • Hip Extension Motor Pattern: A discussion on compensations 

 • Neurologic Reciprocal Inhibition: Principles of joint movement and stability 

 • The Concept of Tight and Short Muscles: They are different 

 • Stretching: Good or Bad? 

 We tackle the tough questions and provide real world answers.  An hour packed with hours worth of information! Download your copy  here  from Payloadz. 



  all material copyright 2009 The Homunculus Group/ The Gait Guys. All rights reserved.

Previously unreleased Video Available for download


“Performance Theories: Dialogues on Training Concepts”

How about some one on one with Shawn and Ivo? Hear our thoughts on:

• What is the definition of the core and what does it entail ?

• Physiologic overflow of muscles with respect to joint motion

• Isotonic Exercise concepts

• Physiologic characteristics of muscle types

• Strength Training: Neural Adaptation

• Motor Pattern Muscle Compensation Concepts

• Exercise Prescription Concepts

• Hip Extension Motor Pattern: A discussion on compensations

• Neurologic Reciprocal Inhibition: Principles of joint movement and stability

• The Concept of Tight and Short Muscles: They are different

• Stretching: Good or Bad?

We tackle the tough questions and provide real world answers.  An hour packed with hours worth of information! Download your copy here from Payloadz.

all material copyright 2009 The Homunculus Group/ The Gait Guys. All rights reserved.