Pod #124: Gluteal gripping, Runner's dystonia. Are leg length differences real ?

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Key tag words:
running, gait, injuries, kidney, kidneydamage, marathoners, foot, feet, dehydration, heatstroke, elon musk, neural lace, hip pain, crossfit, squats, deadlifts,  LLD, short leg, dystonia, runner's dystonia, posture, 

Summary:  Today we hit some very important topics on how to examine a client and how asymmetries play into gait, running, posture and pathomechanics. We hope you enjoy today's show, it is our first one back in 6 weeks. We are back strong after a brief early summer sabbatical. Back to the "podcast every 2 weeks" again. Thanks for being patient while Ivo recharged for the second half of the year.   Plus, on today's show, we also dive into Runner's kidney, dehydration, gluteal gripping, runner's dystonia, functional leg length differences due to asymmetries, and more !

Show links:

http://traffic.libsyn.com/thegaitguys/pod_124final.mp3

http://thegaitguys.libsyn.com/pod-124

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www.thegaitguys.com

summitchiroandrehab.com   doctorallen.co     shawnallen.net
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Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, 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).
 
Our podcast is on iTunes, Soundcloud, and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.
 
Show Notes:

Kidney Damage in Runners. 82%  !?
http://www.newsweek.com/running-bad-you-marathons-damage-kidneys-runners-bodies-575829
 
Kidney nephropathy in mesoamericans.
http://www.ajkd.org/article/S0272-6386(15)01257-3/fulltext  
 
Elon Musk's Neural Lace.
https://www.scoopwhoop.com/elon-musk-launches-neuralink-which-hopes-to-combine-your-brain-with-artificial-intelligence/
 
Leg length discrepancies,do they really even exist ?
Dystonia ?
The Gluteal gripping phenomenon.

Acute tendon changes in intense CrossFit workouts

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Study: Acute tendon changes in intense CrossFit workout

Habitually overloaded tendons often thicken and increase the tendonopathy risks -- nothing new here.
However as this study points out "it remains unknown whether acute overload caused by strenuous, high-intensity exercise will exert changes in tendons and if these changes can be detected and described by ultrasonography."

This study (note: Achilles, and plantaris tendon ultrasounds were performed before and after a specific workout in 34 healthy subjects)
. . . .noted "a significant increase in the thickness of the patellar and Achilles tendons" in response to strenuous, highly intense CrossFit exercises. Cross fit is not the culprit here, it is the load and load rate. None the less, it is good to know that an aggressive workout can leave us more vulnerable. This is why adequate rest and recovery must be part of your regular weekly workouts. One cannot keep fully stomping on the gas pedal over and over, workout after workout, and not expect problems to creep in if adequate recovery time has not been afforded to the working parts. This study showed changes after just one workout. No rocket science here today, we should see changes, load was applied. This is just good old fashioned "well duh, that makes sense". Here is the problem, we don't always listen to logic, nor do our clients who have goals and timeframes. We live in the "more is better" world now, so stay vigilant on logic gang. Dial your foolish clients in a little, save them some grief.  Yes, this goes for runners and all other venues of activity, there is a reason why we see problems in people with speed workouts more frequently than base miles.

Acute tendon changes in intense CrossFit workout: an observational cohort study. F. Y. Fisker et al
http://onlinelibrary.wiley.com/doi/10.1111/sms.12781/full

Podcast 74: Cross Fit: More on Squatting and Hip Torsions, Part 2

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Lots of great hip, squatting and biomechanics in this weeks show !

*Show sponsor: www.newbalancechicago.com

A. Link to our server: 

http://traffic.libsyn.com/thegaitguys/pod_75.f_74.mp3

Direct Download: 

http://thegaitguys.libsyn.com/podcast-74

B. iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

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Today’s Show notes:

Diving deeper into crossfit’s squatting, lunges, leg press.

 Walking in sync makes enemies seem less scary

 
 

The Next Big Thing In Sports Data: Predicting (And Avoiding) Injuries

http://m.fastcompany.com/3034655/healthware/the-next-big-thing-in-sports-data-predicting-and-avoiding-injuries

“LER editor’s pick: Hip internal and external rotation are associated with shoulder mechanics in collegiate baseball pitchers. http://ow.ly/zULpO”

Michael August 27 at 7:49pm I’m curious to hear some thoughts on this, too. I listened to the podcast and read the blog post by the Gait Guys. I’ve coached CrossFit since 2009 and have owned my own affiliate for the last three years and follow Starrett closely. The cue “knees out” originated in powerlifting and the purpose is to keep people from ending up compensating with a valgus knee position during a squat, which is the most common compensation. Also, CrossFit did a special “Offline Episode” with Starrett, Kilgore, Russel Berger (he represented CrossFit) and two other coaches in which the sole topic was the “knees out” cue. It’s very illuminating for this topic. One interesting thing is that CrossFit does not tell people who go through the level 1 to tell others as a law, knees out. It’s merely a cue to fix a common compensation.

Podcast 73: Cross Fit and Squatting. Knees out ?

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Podcast 73: Femoral and Tibial Torsions and Squatting: Know your Squatting Truths and Myths

*Show sponsor: www.newbalancechicago.com

Lems Shoes.  www.lemsshoes.comMention GAIT15 at check out for a 15% discount through August 31st, 2014.

A. Link to our server: http://traffic.libsyn.com/thegaitguys/pod_74f.mp3

Direct Download: 

http://thegaitguys.libsyn.com/podcast-73-cross-fit-squatting-knees-b. out

iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

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Today’s Show notes:

1. Bioengineers create functional 3D brain-like tissue   http://www.nih.gov/news/health/aug2014/nibib-11.htm

2.  A Novel Shear Reduction Insole Effect on the Thermal Response to Walking Stress, Balance, and Gait
 
3.  Hi Shawn and Ivo, There is a lively debate in the Crossfit community about “knees out” during squatting. I have attached a blog post. It might be a good blog post or podcast segment. 
 
4. Shoe Finder ?
 
5.  Michael wrote: “I know this is too broad a topic for facebook, but I was wondering what your general recommendation would be for someone with flat feet and exaggerated, constant over-pronation. I’ve tried strengthening my calves and ankles, but have seen no noticeable reduction in the automatic "rolling in” of my feet whenever walking or standing. I can consciously correct the over-pronation, of course, but as soon as I stop tensing my arch muscle, everything flops back down.“
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How do you measure tibial torsion anyway?

With all the talk on the Crossfit blog about the knees out debate, we though we would shed some light on measuring torsions, beginning with tibial torsion, since this does not seem to have been taken account of in the discussion and we feel it is germane. 

Yo may have seen some of our other posts in tibial torsion here or here; this post will serve to help you measure it. 

Looking at the top left picture: we can see that the axis of the tibial plateau and the transmalleolar axis (an imaginary line drawn through the medial and lateral malleolus) are parallel at birth (net angle zero) and progress to 22 degrees at skeletal maturity, resulting from the outward rotation of the tibia of about 1-1.5 degrees per year. This results in a normal external tibial version of about 17-18 degrees (you subtract 5 degrees for the talar neck angle, talked about in the link above). Note that this is the normal or ideal angle we would expect (hope?) to see. Go 2 standard deviations in either direction and we have external and internal tibial torsions.

You can go about taking this measurement in may ways; we will outline 2 of them. 

  1. In the upper left picture, we see an individual who has their knee flexed to 90 degrees over the side of a table while seated. This represents the tibial plateau angle. You the use a protractor to measure the angle between the tibial plateau and an imaginary line drawn through the medial and lateral malleoli. This is the transmalleolar angle. You then subtract 5 degrees from this number (remember the talar neck angle?) to get the angle of tibial version (or torsion).
  2. In the lower left and right pictures, we have the patient supine with the knees pointed upward and tibial plateau flat on the table. Then, working from inferiorly, use a goniometer to measure the angle of the transmalleolar axis. Again, we subtract 5 degrees for the talar neck.

We would encourage you to read up on torsions. This post, which we wrote over a year ago, is probably one of the most important ones on tibial torsions. 

Torsions. Important stuff, especially when you are talking about the axis of the knees in activities like a squat. Remember, the knee is a hinge between 2 multiaxial joints (hip and ankle) and will often take the brunt of the (patho)mechanics, as it has fewer degrees of freedom of movement. If you have external tibial torsion and you push your knees (angle your feet) out further, you are moving the knees outside the saggital plane. You have better have a very competent medial tripod! If you have internal tibial torsion, angling the feet out may be a good idea. Know your (or your patients/clients/athletes) anatomy!

The Gait Guys. Bald, Good Looking and Twisted. Here to help you navigate your way through better biomechanics.