The LAST word....on Lasts

The last (look inside the shoe on top of the shank) is the surface that the insole of the shoe lays on, where the sole and upper are attached).

Shoes are generally board lasted, slip lasted or combination lasted.

A board lasted shoe is very stiff and has a piece of cardboard or fiber overlying the shank and sole (sometimes the shank is incorporated into the midsole or last) . It can be effective for motion control (pronation) but can be uncomfortable for somebody who does not have this problem.

A slip lasted shoe is made like a slipper and is sewn up the middle. It allows great amounts of flexibility, which is better for people with more rigid feet.

A combination lasted shoe has a board lasted heel and slip lasted front portion, giving you the best of both worlds.

When evaluating a shoe, you want to look at the shape of the last (or sole). Bisecting the heel and drawing an imaginary line along the sole of the shoe determines the last shape. This line should pass between the second and third metatarsal. Drawing this imaginary line, you are looking for equal amounts of shoe to be on either side of this line.

Shoes have a straight, curved or semi curved last. The original idea of a curved last (banana shaped shoe) was to help with pronation. A curved last puts more motion into the foot and may force the foot through mechanics that is not accustomed to. Most people should have a straighter lasted shoe.

The shape of a last will effect the biomechanics of the foot. It should match why shape of the foot as closely as possible. Generally speaking, we recommend straighter lasts for folks that have a tendency to overpronate through the midfoot and curvier lasts for folks that have a more rigid foot.

Because the fore foot abducts during mid stance, if the last is curved, the lateral aspect of the foot can rub against the side of the shoe and create blistering of the little toe and if present long enough, a tailors bunion. A general rule of thumb is: "when in doubt, opt for a straighter one"

Dr Ivo Waerlop, one of The Gait Guys

#last #gait #foot #thegaitguys #lastshape #curvedlast #straightlast #gaitanalysis #pronation

What did you notice? The Devil is in the details...

 Cavus foot? Loss of the transverse arch? Prominence of extensor tendons?

The question is: Why?

It’s about reciprocal inhibition. The concept, 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, So when your bicep contracts, your tricep is inhibited. This holds true whether you actively contract the muscle or if the muscle is irritated (causing contraction).

So how does this apply to this foot?

We see prominence of the extensor tendons (particularly the extensor digitorum brevis EDB; the longus would have caused extension at the distal interphalangeal joint). The belly of the muscle is visible, telling us that it is active. It is neurologically linked to the flexor digitorum brevis (FDB). This muscle, in turn, has slips which attach it to the abductor hallucis brevis (AHB) medially and the abductor digiti minimi (ADM) laterally. These muscles together form 2 triangles (to be discussed in another post) on the bottom of the foot, which lend to the stability of the foot and the arches, especially the transverse.

When the EDB fires, it inhibits the FDB, (which, in addition to flexing the MTP’s, assists in maintaining the arch). The EDB has an effect which drops the distal heads of the metatarsals as well (Hmm, think about all the people with met head pain) Now, look at the course of the tendons of the EDB. In a cavus foot, there is also a mild abductory moment, which flattens the arch. Conversely, the FDB in a cavus foot would serve to actually increase the arch, and would have a ,mild adductory moment. Net result? A flattened transverse arch.

Now look at the Flexor digitorum longus, overactive in tbis foot (as evidenced by the flexion of the distal interphalangeal joints, mild adduction of the toes (due to the change of direction of pull in a cavus foot) and lowering of the met heads due to hyperextesnion at the MTP joints ). This mm is reciprocally linked with the extensor digitorum longus. The prominence of the extensor tendons is do to increased activity of the EDB (go ahead, extend all your fingers and look at the tendons in your hand. Now flex the  DIP and IP joints and extend the MTP; see how they become more prominent?).

Reciprocal inhibition. It’s not just for dinner anymore…

We are and remain; The Gait Guys

How can feet relate to golf swing?

This 52 year old right handed gentleman presented with pain at the thoracolumbar junction after playing golf. He noticed he had a limited amount of “back swing” and pain at the end of his “follow through”.

Take a look a these pix and think about why.

Full internal rotation

Full internal rotation

full external rotation

full external rotation

full internal rotation

full internal rotation

full external rotation

full external rotation

neutral

neutral

neutral

neutral

Hopefully, in addition to he having hairy and scarred legs (he is a contractor by trade), you noted the following

  • Top: note the normal internal rotation of the right hip; You need 4 degrees to walk normally and most folks have close to 40 degrees. He also has internal tibial torsion.
  • second picture: loss of external rotation of the right hip. Again, you need 4 degrees (from neutral) of external rotation of the hip to supinate and walk normally.
  • third picture: normal internal rotation of the left hip; internal tibial torsion
  • 4th picture: limited external rotation of the left hip, especially with respect ti the amount of internal rotation present; this is to a greater degree than the right
  • last 2 pictures: note the amount of tibial varum and tibial torsion. Yes, with this much varum, he has a forefoot varus.

The brain is wired so that it will (generally) not allow you to walk with your toes pointing in (pigeon toed), so you rotate them out to somewhat of a normal progression angle. If you have internal tibial torsion, this places the knees outside the saggital plane. (For more on tibial torsion, click here.) If you rotate your extremity outward, and already have a limited amount of range of motion available, you will take up some of that range of motion, making less available for normal physiological function. If the motion cannot occur at the knee or hip, it will usually occur at the next available joint cephalad, in this case the spine.

The lumbar spine has a limited amount of rotation available, ranging from 1.2-1.7 degrees per segment in a normal spine (1). This is generally less in degenerative conditions (2).

Place your feet on the ground with your feet pointing straight ahead. Now simulate a right handed golf swing, bending slightly at the waist androtating your body backward to the right. Now slowly swing and follow through from right to left. Note what happens to your hips: as you wind back to the right, the left hip is externally rotating and the right hip is internally rotating. As you follow through to the left, your right, your hip must externally rotate and your left hip must externally rotate. Can you see how his left hip is inhibiting his back swing and his right hip is limitinghis follow through? Can you see that because of his internal tibial torsion, he has already “used up” some of his external rotation range of motion?

If he does not have enough range of motion in the hip, where will it come from?

he will “borrow it” from a joint more north of the hip, in this case, his spine. More motion will occur at the thoracolumbar junction, since most likely (because of degenerative change) the most is available there; but you can only “borrow” so much before you need to “Pay it back”. In this case, he over rotated and injured the joint.

What did we do?

  • we treated the injured joint locally, with manipulation of the pathomechanical segments
  • we reduced inflammation and muscle spasm with acupuncture
  • we gave him some lumbar and throacolumbar stabilization exercises: founders exercise, extension holds, non tripod, cross crawl, pull ups
  • we gave him foot exercises to reduce his forefoot varus: tripod standing, EHB, lift-spread-reach
  • we had him externally rotate both feet (duck) when playing golf

The Gait Guys. Helping you to store up lots “in your bank” of foot and gait literacy, so you can help people when they need to “pay it back”, one case at a time.

(1) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2223353/

(2) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705911/

Subtle clues. Helping someone around their anatomy

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This patient comes in with low back pain of years duration, helped temporarily with manipulation and activity. Her exam is relatively benign, save for increased lumbar discomfort with axial compression in extension and extension combined with lateral bending. Believe it or not, her abdominal and gluteal muscles (yes, all of them) test strong (no, we couldn’t believe it either; she is extremely regular with her exercises). She has bilateral internal tibial torsion (ITT) and bilateral femoral retro torsion (FRT). She has a decreased progression angle of the feet during walking and the knees do not progress past midlilne. There is a loss of active ankle rocker with gait, but not on the exam table; same with hip extension. 

We know she has a sweater on which obscures things a bit, but this is what you have to work with. Look carefully at her posture from the side. The gravitational line should pass from the earlobe, through the shoulder, greater trochanter and through or just anterior to the lateral malleolus.

In the top picture, can you see how her pelvis is anterior to this line? Do you see how it gets worse when she lifts her hands over her head (yes, they are directly over head)? This can signify many things, but often indicates a lack of flexibility in the lumbar lordosis; in this case, she cannot extend her lumbar spine further so she translates her pelvis forward. Most folks should have enough range of motion from a neutral pelvis and enough stability to allow the movement to occur without a significant change. Go ahead, we know you are curious, go watch yourself do this in a mirror and see if YOU change.

Looking at the this picture, can you pick out that she has a genu valgus? Look at the hips and look at the tibial angle.

Did you note the progression angle (or lack of) in her feet? This is a common finding (but NOT pathognomonic) in patients with internal tibial torsion. Notice the forefoot adductus on the right foot?

So what do we think is going on?

  • ITT and FRT both limit the amount of internal rotation of the thigh and lower leg. Remember you NEED 4 degrees of each to walk normally. Most folks have significantly more
  • if you don’t have enough internal rotation of the lower extremity, you will need to “create” it. You can do this by extending the lumbar spine (bottom picture, right) or externally rotating the lower extremity
  • Since her ITT and FRT are bilateral, she flexes the pelvis and nutates the pelvis anteriorly.
  • the lumbar facet joints should only carry 20% of load
  • she is increasing the load and causing facet imbercation resulting in LBP.

What did we do?

  • taught her about neutral pelvic positioning, creating more ROM in the lumbar spine
  • had her consciously alter her progression angle of her foot on strike, to create more available ROM in internal rotation
  • encouraged her to wear neutral shoes
  • worked on helping her to create more ankle rocker and hip extension with active drills and exercise (ie gait rehabilitation); shuffle walks, Texas walk, toes up walking, etc

why didn’t we put her in an orthotic to externally rotate her lower extremity? Because with internal tibial torsion, this would move her knee outside the saggital plane and create a biomechanical conflict at the knee and possibly compromising her meniscus.

Cool case, eh? We thought so. Keep on learning so your brain keeps expanding. If you are not growing your brain, you are shrinking it!

The Gait Guys

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

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

Our Websites:
www.thegaitguys.com

summitchiroandrehab.com   doctorallen.co     shawnallen.net
Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
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.

History shows...Keep it Simple... Even with those foot exercises

Being a foot nerd, certain things have a tendency to provide entertainment for me. One such thing was a recent article that was published in Foot and Ankle Surgery about the history of military flat foot care. Review of this appeared in one of my favorite journals: lower extremity review.

There was nothing earthshaking in the article other than the emphasis on function was made throughout the article. Exercises were emphasized (though I really don't like the toe flexion ones). And that was an interesting quote from the article

"Far more emphasis should be placed on the functioning of the foot, during the activities that need to be undertaken rather than the height of the arches alone".

They go on to describe a simple exercise where during a march is (is that were often required to do during WW1) people were instructed to keep their toes pointed straight ahead and shift the knees out words to offload the weight laterally. In that particular study, 75%of the people return to their groups and 54% were able to go back to full duty. All with some simple, straightforward instruction.

The lower extremity review article emphasizes intrinsic muscle strengthening for condition such as plantar fasciitis, Hallux valgus and lesser toe deformities. I would have to say that I couldn't agree more :-)

So goes the life of a foot nerd…

 

 

Nearly MT J Foot Ankle Surg. 2016 May-Jun;55(3):675-81. doi: 10.1053/j.jfas.2016.01.028. Epub 2016 Mar 12.

 

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

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 Every foot has a story. 

 This is not your typical “in this person has internal tibial torsion, yada yada yada” post.  This post poses a question and the question is “Why does this gentleman have a forefoot adductus?”

The first two pictures show me fully internally rotating the patients left leg. You will note that he does not go past zero degrees and he has femoral retroversion. He also has bilateral internal tibial torsion, which is visible in most of the pictures. The next two pictures show me fully internally rotating his right leg, with limited motion, as well and internal tibial torsion, which is worse on this ® side

 The large middle picture shows him rest. Note the bilateral external rotation of the legs. This is most likely to create some internal rotation, because thatis a position of comfort for him (ie he is creating some “relief” and internal rotation, by externally rotating the lower extremity)

 The next three pictures show his anatomically short left leg. Yes there is a large tibial and small femoral component. 

 The final picture (from above) shows his forefoot adductus. Note that how, if you were to bisect the calcaneus and draw a line coming forward, the toes fall medial to a line that would normally be between the second and third metatarsal’s. This is more evident on the right side.  Note the separation of the big toe from the others, right side greater than left. 

Metatarsus adductus deformity is a forefoot which is adducted in the transverse plane with the apex of the deformity at LisFranc’s (tarso-metatarsal) joint. The fifth metatarsal base will be prominent and the lateral border of the foot convex in shape . The medial foot border is concave with a deep vertical skin crease located at the first metatarso cuneiform joint level. The hallux (great toe) may be widely separated from the second digit and the lesser digits will usually be adducted at their bases. ln some cases the abductor hallucis tendon may be palpably taut just proximal to its insertion into the inferomedial aspect of the proximal phalanx (1)

Gait abnormalities seen with this deformity include a decreased progression angle, in toed gait, excessive supination of the feet with low gear push off from the lesser metatarsals. 

 It is interesting to note that along with forefoot adductus, hip dysplasia and internal tibial torsion are common (2) and this patient has some degree of both. 

 His forefoot adductus is developmental and due to the lack of range of motion and lack of internal rotation of the lower extremities, due to the femoral retrotorsion and internal tibial torsion.  If he didn’t adduct the foot he would have to change weight-bearing over his stance phase extremity to propel himself forward. Try internally rotating your foot and standing on one leg and then externally rotating. See what I mean? With the internal rotation it moves your center of gravity over your hip without nearly as much lateral displacement as would be necessary as with external rotation. Try it again with external rotation of the foot; do you see how you are more likely displace the hip further to that side OR lean to that side rather than shift your hip? So, his adductus is out of necessity.

Interesting case! When you have a person with internal torsion and limited hip internal rotation, with an adducted foot, think of forefoot adductus!


1.  Bleck E: Metatarsus adductus: classification and relationship to outcomes of treatment. J Pediatric Orthop 3:2-9,1983.

2. Jacobs J: Metatarsus varus and hip dysplasia. C/inO rth o p 16:203-212, 1960

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The case of the dropped (plantarflexed) metatarsal head. Or, “How metatarsalgia can happen”.

This gentleman came in with fore foot pain (3rd metatarsal head specifically), worse in the AM upon awakening, with first weight bearing that would improve somewhat during the day, but would again get worse at the end of the day and with increased activity. The began insidiously a few months ago (like so many problems do) and is getting progressively worse.

Rest and ice offer mild respite, as does ibuprofen. You can see his foot above. please note the “dropped” 3rd metatarsal head (or as we prefer to more accurately say, “plantarflexed 3rd metatarsal head”) and puffiness and prominence in that area on the plantar surface of the foot. 

To fully appreciate what is going on, we need to look at the anatomy of the short flexors of the foot. 

The flexor digitorum brevis (FDB) is innervated by the medial plantar nerve and arises from the medial aspect of the calcaneal tuberosity, the plantar aponeurosis (ie: plantar fascia) and the areas bewteen the plantar muscles. It travels distally, splitting at the metatarsal phalangeal articulation (this allows the long flexors to travel forward and insert on the distal phalanges); the ends come together to divide yet another time (see detail in picture above, yes, we are aware it is the hand, but the tendon structure in the foot is remarkably similar)) and each of the 2 portions of that tendon insert onto the middle of the middle phalanyx (1) 

As a result, in conjunction with the lumbricals, the FDB is a flexor of the metatarsal phalangeal joint, and proximal interphalangeal joint (although this second action is difficult to isolate. try it and you will see what we mean). In addition, it moves the axis of rotation of the metatasal phalangeal joint dorsally, to counter act the function of the long flexors, which, when tight or overactive, have a tendency to drive this articulation anteriorly (much like the function of the extensor hallucis brevis above in the drawing from Dr Michauds book, yes, we are aware this is a picture of the 1st MTP).

Can you see the subtle extension of the metatarsal phalangeal joint and flexion of the proximal interphalangeal joint in the picture?

We know that the FDB contracts faster than the other intrinsic muscles (2), playing a tole in postural stability (3) and that the flexors temporally should contract earlier than the extensors (4), assumedly to move this joint axis posteriorly and allow proper joint centration. When this DOES NOT occur, especially if there is a concomitant loss of ankle rocker, the metatarsal heads are driven into the ground (plantarflexion), causing irritation and pain. Metatarsalgia is born….

So what is the fix? Getting the FDB back on line for one. 

  • How about the toe waving exercise? 
  • How about the lift spread reach exercise? 
  • How about retraining ankle rocker and improving hip extension?
  • How about an orthotic with a metatarsal pad in the short term? 
  • How about some inflammation reducing modalities, like ice and pulsed ultrasound. Maybe some herbal or enzymatic anti inflammatories?

The Gait Guys. Increasing your gait and foot literacy with each and every post. 

1. http://en.wikipedia.org/wiki/Flexor_digitorum_brevis_muscle

2. Tosovic D1, Ghebremedhin E, Glen C, Gorelick M, Mark Brown J.The architecture and contraction time of intrinsic foot muscles.J Electromyogr Kinesiol. 2012 Dec;22(6):930-8. doi: 10.1016/j.jelekin.2012.05.002. Epub 2012 Jun 27.

3.Okai LA1, Kohn AF. Quantifying the Contributions of a Flexor Digitorum Brevis Muscle on Postural Stability.Motor Control. 2014 Jul 15. [Epub ahead of print]

4. Zelik KE1, La Scaleia V, Ivanenko YP, Lacquaniti F.Coordination of intrinsic and extrinsic foot muscles during walking.Eur J Appl Physiol. 2014 Nov 25. [Epub ahead of print]

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Flat Dogs

Take a look at these pedographs. Wow!

  • No rear foot heel teardrop.
  • No midfoot arch on left foot and minimal on right.
  • An elongated 2nd metatarsal bilaterally and forces NOT getting to the base of the 1st metatarsal and stalling on the 2nd: classic sign of an uncompensated forefoot varus.
  • increased printing of the lateral foot on the right

Knowing what you know about pronation (need a review? click here) Do you think this foot is a good lever? Do you think they will be able to push off well?

What can we do?

  • foot exercises to build the intrinsic and extrinsic muscles of the foot (click here, here, here, and here for a few to get you started)
  • perhaps an orthotic to assist in decreasing the pronation while they are strengthening their foot
  • motion control shoe? Especially in the beginning as they are strengthening their feet and they fatigue rather easily

The prints do not lie. They tell the true story of how the forces are being transmitted through the foot. For more pedograph cases, click here.

The Gait Guys. Teaching you more about the feet and gait. Spreading gait literacy throughout the net! Do your part by forwarding this post to someone who needs to read it.

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Some times there is not an easy answer.

A patient came in with intermittent pain in his feet, bilateral and symmetrical of approximately 1 months duration.  It is bothering him in the arches and the ends of the toes. He can akin it to no singular precipitaIng event. The discomfort is sharp at times, and he can sometimes get cramping. He has been taking good care of his feet, washing his feet as of late. There are no alleviating factors; lots of activity can sometimes cause more pain but not consistently.  It seems to happen in all different types of shoes, so shod or unshod makes no difference. He is unable to reproduce the pain or discomfort.

The feet were normal in appearance. Arches were normal to slightly cavus. He had a mild, uncompensated forefoot varus. No global redness. Mild redness noted at medial and lateral nail beds of the great toe. He had a loss of long axis extension of the metatarsophalangeal arIculaIons and talonavicular arIculaIons bi-­‐lat. No tenderness to palpation of the dorsal or plantar surfaces of the feet are noted. No difference in neurological integrity with respect to sensaIon, motor strength or deep tendon reflex on either side. Nail bed filling was normal. Feet were cool
and moist to touch.  He did have weakness of the short extensors of the great toes, somewhat of the long extensors of the remainder of the digits. Ankle dorsiflexion is 10 degrees on each side.

Gait was tandem with a slight crossover. 

Hmm. Pretty boring, eh?

This is what we thought the differential should include:

1.   Early Gouty arthropathy.  This would be rare in a bilateral situation but possible.
2.   Athlete’s foot. This usually presents with more redness or this could be a variant.
3.   Lack of arch support during the day and his feet are fatiguing.
4.   Lumbar spinal canal stenosis; note that he has no change with squatting or sitting, so this is unlikely.


This is what we recommended:

 He is going to try either TinacIn or Lotrimin on his feet for 2 weeks, twice per day applicaIons, changing his socks between, making his feet wet and moist before application. Will switch to a boot that breathes batter and is more supporIve for work (he is a mason), to see if this works well. Foot strengthening exercises for the muscular deficiencies were prescribed. If this does not alleviate the discomfort, we will consider running labs and imaging looking at the possibility of gouty arthropathy and/or stenosis.

The Gait Guys. Showing that we don’t always have all the answers, but have a pretty good idea of how to get them.

Welcome to rewind Friday Folks. 
 Think about all those folks in the Northeast who have been shoveling (OK, the folks in Colorado as well) and their feet being rubber boots! 
 Here’s an oldie, but a goodie. 
 Here’s one paper we though had merit (sure, go to Pub Med and search foot odor. There were 119 entries). We think we may try this in the office… 
  The Gait Guys: Yes, smelly feet are something we have to deal with at the office on a daily basis. One of the pitfalls of being a Foot Geek : )  
  
   Make sure to check back later for more on malodorous extremities…                            
  
     
   J Int Soc Sports Nutr.  2007 Jul 13;4:3.  
  A novel aromatic oil compound inhibits microbial overgrowth on feet: a case study.  
   Misner BD .  
 
  Source  
  West 1140 Glass Avenue Spokane, Washington, 99205, USA. drbill@omnicast.net.  
 
 
  Abstract  
  ABSTRACT:  
  BACKGROUND:  
  Athlete’s  Foot  (Tinea pedis) is a form of ringworm associated with highly contagious yeast-fungi colonies, although they look like bacteria.  Foot  bacteria overgrowth produces a harmless pungent  odor , however, uncontrolled proliferation of yeast-fungi produces small vesicles, fissures, scaling, and maceration with eroded areas between the toes and the plantar surface of the  foot , resulting in intense itching, blisters, and cracking. Painful microbial  foot  infection may prevent athletic participation. Keeping the feet clean and dry with the toenails trimmed reduces the incidence of skin disease of the feet. Wearing sandals in locker and shower rooms prevents intimate contact with the infecting organisms and alleviates most  foot -sensitive infections. Enclosing feet in socks and shoes generates a moisture-rich environment that stimulates overgrowth of pungent both aerobic bacteria and infectious yeast-fungi. Suppression of microbial growth may be accomplished by exposing the feet to air to enhance evaporation to reduce moistures’ growth-stimulating effect and is often neglected. There is an association between yeast-fungi overgrowths and disabling  foot  infections. Potent agents virtually exterminate some microbial growth, but the inevitable presence of infection under the nails predicts future infection. Topical antibiotics present a potent approach with the ideal agent being one that removes moisture producing antibacterial-antifungal activity. Severe infection may require costly prescription drugs, salves, and repeated treatment.  
  METHODS:  
  A 63-y female volunteered to enclose feet in shoes and socks for 48 hours. Aerobic bacteria and yeast-fungi counts were determined by swab sample incubation technique (1) after 48-hours feet enclosure, (2) after washing feet, and (3) after 8-hours socks-shoes exposure to an aromatic oil powder-compound consisting of arrowroot, baking soda, basil oil, tea tree oil, sage oil, and clove oil.  
  CONCLUSION:  
  Application of this novel compound to the external surfaces of feet completely inhibited both aerobic bacteria and yeast-fungi-mold proliferation for 8-hours in spite of being in an enclosed environment compatible to microbial proliferation. Whether topical application of this compound prevents microbial infections in larger populations is not known. This calls for more research collected from subjects exposed to elements that may increase the risk of microbial-induced  foot  diseases.  

  The Gait Guys. Bringing you the good, the bad and the smelly….

Welcome to rewind Friday Folks.

Think about all those folks in the Northeast who have been shoveling (OK, the folks in Colorado as well) and their feet being rubber boots!

Here’s an oldie, but a goodie.

Here’s one paper we though had merit (sure, go to Pub Med and search foot odor. There were 119 entries). We think we may try this in the office…

The Gait Guys: Yes, smelly feet are something we have to deal with at the office on a daily basis. One of the pitfalls of being a Foot Geek : )
Make sure to check back later for more on malodorous extremities…                        
 
J Int Soc Sports Nutr. 2007 Jul 13;4:3.

A novel aromatic oil compound inhibits microbial overgrowth on feet: a case study.

Source

West 1140 Glass Avenue Spokane, Washington, 99205, USA. drbill@omnicast.net.

Abstract

ABSTRACT:

BACKGROUND:

Athlete’s Foot (Tinea pedis) is a form of ringworm associated with highly contagious yeast-fungi colonies, although they look like bacteria. Foot bacteria overgrowth produces a harmless pungent odor, however, uncontrolled proliferation of yeast-fungi produces small vesicles, fissures, scaling, and maceration with eroded areas between the toes and the plantar surface of the foot, resulting in intense itching, blisters, and cracking. Painful microbial foot infection may prevent athletic participation. Keeping the feet clean and dry with the toenails trimmed reduces the incidence of skin disease of the feet. Wearing sandals in locker and shower rooms prevents intimate contact with the infecting organisms and alleviates most foot-sensitive infections. Enclosing feet in socks and shoes generates a moisture-rich environment that stimulates overgrowth of pungent both aerobic bacteria and infectious yeast-fungi. Suppression of microbial growth may be accomplished by exposing the feet to air to enhance evaporation to reduce moistures’ growth-stimulating effect and is often neglected. There is an association between yeast-fungi overgrowths and disabling foot infections. Potent agents virtually exterminate some microbial growth, but the inevitable presence of infection under the nails predicts future infection. Topical antibiotics present a potent approach with the ideal agent being one that removes moisture producing antibacterial-antifungal activity. Severe infection may require costly prescription drugs, salves, and repeated treatment.

METHODS:

A 63-y female volunteered to enclose feet in shoes and socks for 48 hours. Aerobic bacteria and yeast-fungi counts were determined by swab sample incubation technique (1) after 48-hours feet enclosure, (2) after washing feet, and (3) after 8-hours socks-shoes exposure to an aromatic oil powder-compound consisting of arrowroot, baking soda, basil oil, tea tree oil, sage oil, and clove oil.

CONCLUSION:

Application of this novel compound to the external surfaces of feet completely inhibited both aerobic bacteria and yeast-fungi-mold proliferation for 8-hours in spite of being in an enclosed environment compatible to microbial proliferation. Whether topical application of this compound prevents microbial infections in larger populations is not known. This calls for more research collected from subjects exposed to elements that may increase the risk of microbial-induced foot diseases.

The Gait Guys. Bringing you the good, the bad and the smelly….

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What do you do with these Dogs?

Take a good look at these feet. Hard to not cringe, we know. In this photo, the gentleman’s feet are relaxed! Imagine what it they will look like with some additional long flexor tone!

So, keeping in mind his tibial varum (bend in the tibia) and uncompensated forefoot varus (inability to get the head of his 1st ray down to the ground), what can we do?

  • how about we increase extensor strength? He could do the lift, spread, reach exercise while tripod standing. He could do the toe waving exercise.   He could do shuffle walks.
  • teach him to stretch his long toe flexors. Frequently. 20-30 mins minimum; daily
  • you could manipulate his feet to ensure better biomechnics
  • you could massage his feet to improve mobility and circulation
  • you could facilitate his long toe extensor muscles
  • you could inhibit his long toe flexor muscles
  • you could improve ankle dorsiflexion by showing him how to stretch the calves, 20-30 mins daily
  • you could improve ankle dorsiflexion by making sure he has adequate hip extension
  • he could wear correct toes, to improve the biomechanical advantage of the long toe extensors
  • he could wear shoes with a wider toe box
  • he could wear shoes with less ramp delta (or drop)
  • he could wear shoes with less torsional rigidity

and the list goes on. There are many simple things you teach a person with feet like this. many of them we have introduced you to here on the blog. Spend some time. Learn some cool stuff. Read the blog. Follow us on Facebook. Attend a Biomechanics class we teach the 3rd Wednesday of each month on onlinece.com . Check out our Youtube Channel. Consider furthering your education and taking the National Shoe Fit Program.

The resources are there. All you need to do is dig a little deeper.

We are The Gait Guys and we are all things gait.

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Holy Twisted Femurs, Batman. What is going on here?

So, this is what femoral antetorsion looks like!

Remember that ante torsion occurs during development and is when the neck of the femur makes greater than a 12 degree angle with the shaft. We did a great post on this a while ago, click here to read it.

If you remember that the femur heads point anteriorly in a standing position, this would accentuate that, so they stand with an increased progression angle (ie feet toed out; see 1st picture).

With the increased femoral neck angle, these folks have a greater range of internal rotation of the femur, and decreased external rotation. Can you see this in the pictures above? We have rotated her legs fully internally and externally.

A few questions for you:

if you look carefully at the 1st picture, you will note she has external tibial torsion. Why?

  • this condition can develop in utero, but more commonly occurs postnatally with"W" sitting (sitting with knees together and legs abducted, with buttocks between the legs or feet. Think about that constant internal force on the femurs and external rotatory force on the lower tibia! Have your kids sit differently!

What type of shoe should this person be in?

  • The condition itself does not dictate the type of shoe thay should be in. This individual has a rigid, cavus foot BUT has an uncompensated forefoot varus with a great deal of forefoot pronation. In addition to exercises to strengthen the external rotators of the thigh, and inverters of the foot, a shoe with some motion control features is indicated in this instance

The Gait Guys…..Twisted? Yes! And still bald, middle aged and geeky as well.

A bit confused? Dig into our blog more, or watch our youtube channel. Maybe it’s time to push your knowledge base to the next level and take the National Shoe Fit Program. email us at thegaitguys@gmail.com

The Naked Foot: Thoughts for the Shoe Minimalist

Authors: Dr. Shawn Allen, Dr. Ivo Waerlop, Coach Chris Korfist

This may be one of the very first articles we ever wrote for The Gait Guys. It must be 7-8 years old now, before the barefoot-minimalist craze ever started. It is a bit dated, but we think that it was time to revisit its contents. You will see that many of our early core principles have not changed and you can see the thought process of where the fads and trends were projected to go.  Wind your mind back a near decade, and read on !

_____________________

If you want to follow the fad craze these days, just look to companies like Vibram and Nike. Vibram is the company that has brought you the soles and treads of many of the shoes you have worn over the years and of course Nike are the people who first brought you the “running shoe” as we know it today. Nike first brought us the waffle bottom trainer, the cross trainer, air pockets, “shocks” and, the Air Jordan and now their barefoot minimalist series, the Nike Free. Now, we are sure not many of you have heard of the “Vibram Five Fingers” barefoot slip-on ‘shoe’ but virtually everyone who runs in some manner has seen and heard about the Nike Free. What initially stymied us when they first came out was the obvious question of “Why would the same people who sell us the shoes, and give us so many varieties and categories to choose from, now be advocating that we train barefoot, or close to it? ” Or are they ?

  • (Addendum:  this article was originally written long ago, at the start of this fad, the fad that has become a trend.  The article traveled fast around the internet and garnered us much attention including a gig with Vibram as consultants.  But that was then, this is now.  We, and the trend have come a long way, and so has the research.  Some supportive for the trend, some disagreements and plenty of controversy.  The remainder of this article has been unedited, hence its tense and outdated verbiage, shoe types and research.  But we thought it was time to review before moving ahead.)

The Nike version they are pushing, first the Nike Free 5 and now down to the Nike Free 3, has a light weight thin flexible sole and thin vamp top cover material whoís purpose is to merely hold the shoe onto the foot. The Vibram device, which is a fascinating yet simple slipper, is even more simplistic but has some brilliance built right into its heart. It is merely a rubber sock with compartments for each individual toe but that is part of its brilliance. So why would Nike and now Vibram go against their own creations and advocate that we begin walking and running barefoot, or at least become more “shoe-minimalists” after decades of building shoe and sole lines that previously were designed for various conditions, foot types and activities ? There appears to be sound moral reasoning if you delve into the research, but you have to look closely and you have to be careful you do not have one of those foot types that could lead to problems with this type of footwear (but that is a topic for another article to come soon, see Part II).

Barefoot theories are nothing new. In 1960 Abebe Bikila, perhaps the greatest barefoot runner of all time, won the first of his consecutive gold medals without shoes setting a world record of 2:15:17. Englandís Bruce Tulloh was setting overseas records into the 1960’s running unshod, skin to the ground. Today Ken Bob Saxton is one of the most visible barefoot marathoners, long beard and all, and is an advocate of the technique.

With the introduction of the Nike Free, the interest in barefoot running resurfaced at the turn of the century. An article by Michael Warburton, published as an internet paper on barefoot theories, seemed to spark some of the resurgence of the method of running. In his brilliant paper he had some interesting thoughts and pointed out some noteworthy facts. He indicated that research showed that an extra mass of 100 grams attached to the foot diminished the economy of running by one percent. Thus, two 10 ounce shoes (the weight of a lightweight training shoe) could compoundingly cripple you by more than five percent in efficiency. In tangible terms that could be more than six minutes tacked onto a world class marathoner, taking a world record time to a mere first group finishing time. So, it is a question of weight and time, or is there something more ?

To get started with some hard and simple research facts, current research has been conducted showing that plantar (bottom of the foot) sensory feedback plays a central role in safe and effective locomotion, that more shoe cushioning can lead to higher impact forces on the joints and higher risk of injury, that unshod (without shoes) lowers contact time versus shod running, that there are higher braking and pushing impulses in shod versus unshod running, that unshod running presents a reduction of impact peak force that would reduce the high mechanical stress that occurs during repetitive running and that the unshod foot induces a neural-mechanical adaptation which could enhance the storage and restitution of elastic energy at ankle extensor level. These are only some of the research findings but they are some of the more significant ones. These issues will not only support injury management benefits for the unshod runner but increase speed, force and power output.

Stepping backwards in time a little, in the caveman days things were different. The foot was unshod (without shoes) from the moment of the first step until one’s dying day, and thus the foot developed and looked different. The sole of the foot was thicker and callused due to the constant contact with rough and offending surfaces thus preventing skin penetration, the foot proper was more muscular and it may have been wider in the forefoot and the toes were likely slightly separated due to the demands of gripping which would obviously necessitate increase muscular strength and bulk to the foot intrinsic muscles. It was the constant input of uneven and offending surfaces such as rocks, twigs, mud, foliage and debris that stimulated the bottom of the foot, and thus the intrinsic muscles, sensing joint positions and relaying those variations to the brain for corresponding descending motor changes and adaptations to maintain protection and balance. The foot simply worked different, it worked better, it worked more like the engineering marvel that it truly is. The foot was uncovered and the surfaces we walked on were uneven and challenging. However, as time went on, man decided to mess with a good thing. He took a foot that was highly sensitive, a virtual sensory organ with a significant sensory and motor representation in the brain (only the hands and face have more brain representation as represented by the sensory and motor homunculus of the brain) and he not only covered it up with a slab of leather or rubber but he then flattened and then paved not only his world, but also his home, with black hard top, cement, wood or tile thus completing the total sensory information deprivation of the entire foot. Thus, not only did he take away critical adaptive skills from himself and generations to follow, but he began the deprivation of the brain of critical information from which the central nervous system would need to develop and continue to function effectively. It is not unlikely that the man of pre-shod time had a strong competent foot arch (perhaps somewhat flat to increase surface area contact for adaptation), but one that did not need orthotics, stability shoes or rigid shanks and inserts. In other words, the foot and its lower limb muscles were strong with exceptional skills and endurance. But in today’s day and time things are now different. We now affix a shoe to the child’s foot even before he can walk and then when he does, all propriosensory information necessary for the development of critical spinal and central nervous system reflexes is ensured to be virtually absent. Is it any wonder why there are so many people in chronic pain from postural disorders related to central core weakness and inhibition ? Is it any wonder why so many people seem to have flat incompetent feet and arches? Man has done it to himself, but thankfully man has proven that what he can do, he can undo. Thankfully we see modern medical research that has delved into this realm of thought and has uncovered the woes of our ways and to follow, companies like those mentioned earlier are imagining and developing devices that will allow us some protection from modern day offenses such as glass, plastics and metal and thus allow us the slow and gradual return to our healthier foot days, all fashion sense aside.

 Shawn and Ivo, The Gait Guys

Two fellas that were here at the beginning, and two fellas that will be here for the duration. 

Treat your children well.  
  We think Crosby, Stills, Nash and Young had it right…  
  look at this conclusion :  “Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern."                                                                       

  
 let’s break that down a bit:    
   "Shoes affect the gait of children.”   Shoes effect EVERYONE’S gait, not just kids. They alter the ground reactive forces, limit some ranges of motion and thus can promote a compensation or mechanics that you may not have seen previously. Take off one of your shoes. Lift your toes up slightly so you are centered on your tripod. Stand on your “barefoot” leg with your eyes closed. See how long you can stand without faltering. Now repeat that with your shod foot. Some difference, eh?  I thought shoes dampened proprioception…They do.  But they also give you more support and mechanics that you didn’t have previously, so the foot doesn’t have to work as hard.  
    “With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity.”  Remember we are talking about kids here. Longer steps because with a shoe we promote heel rocker and because of the added support, more stability (or at least more perceived stability). This means more confidence. Greater knee and ankle motion because of the increased stride length. Greater tibialis anterior activity because of greater dorsiflexion of the foot because of the increased weight (the shoe adds ounces and this muscle must work harder to attenuate the foot as it approached midstance)   and   increased heel and ankle rocker. 
  “ Shoes reduce foot motion and increase the support phases of the gait cycle.”   Shoes constrain the foot and reduce available ranges of motion (yes, even non motion control shoes). Less motion (and thus proprioception) means less feedback to the brain about muscles length and tension (via muscle spindles and golgi tendon organs). The brain will need to have the foot have more contact with the ground to know where it is in space.  
   “During running, shoes reduce swing phase leg speed,  probably due to the increased weight so it takes more to start the process of initial (early) swing 
  … attenuate   some shock   we know shoes attenuate at least initial ground reactive forces 
  …and  encourage a rearfoot strike pattern.”   most likely due to the cushioning (remember from the recent Kenyan study about barefoot heel strikers?  ( click here  if you need a reminder)  They were more likely to heel strike on softer surfaces)  AND  the increased stride length (which would require more ankle dorsiflexion).  

  
 Wow. Shoes really do make the, er….kid. 

  
  The Gait Guys. Making it real and increasing your shoe and gait IQ with each post.                                                                                   

   J Foot Ankle Res.  2011 Jan 18;4:3. doi: 10.1186/1757-1146-4-3.  
  Effect of children’s shoes on gait: a systematic review and meta-analysis.  
   Wegener C ,  Hunt AE ,  Vanwanseele B ,  Burns J ,  Smith RM .  
 
  Source  
  Discipline of Exercise and Sports Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, PO Box 170, Lidcombe, 1825, NSW, Australia. cweg6974@uni.sydney.edu.au.  
 
 
  Abstract  
  BACKGROUND:  
  The effect of footwear on the gait of children is poorly understood. This systematic review synthesises the evidence of the biomechanical effects of shoes on children during walking and running.  
  METHODS:  
  Study inclusion criteria were: barefoot and shod conditions; healthy children aged ≤ 16 years; sample size of n > 1. Novelty footwear was excluded. Studies were located by online database-searching, hand-searching and contact with experts. Two authors selected studies and assessed study methodology using the Quality Index. Meta-analysis of continuous variables for homogeneous studies was undertaken using the inverse variance approach. Significance level was set at P < 0.05. Heterogeneity was measured by I2. Where I2 > 25%, a random-effects model analysis was used and where I2 < 25%, a fixed-effects model was used.  
  RESULTS:  
  Eleven studies were included. Sample size ranged from 4-898. Median Quality Index was 20/32 (range 11-27). Five studies randomised shoe order, six studies standardised footwear. Shod walking increased: velocity, step length, step time, base of support, double-support time, stance time, time to toe-off, sagittal tibia-rearfoot range of motion (ROM), sagittal tibia-foot ROM, ankle max-plantarflexion, Ankle ROM, foot lift to max-plantarflexion, ‘subtalar’ rotation ROM, knee sagittal ROM and tibialis anterior activity. Shod walking decreased: cadence, single-support time, ankle max-dorsiflexion, ankle at foot-lift, hallux ROM, arch length change, foot torsion, forefoot supination, forefoot width and midfoot ROM in all planes. Shod running decreased: long axis maximum tibial-acceleration, shock-wave transmission as a ratio of maximum tibial-acceleration, ankle plantarflexion at foot strike, knee angular velocity and tibial swing velocity. No variables increased during shod running.  
  CONCLUSIONS:  
  Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern. The long-term effect of these changes on growth and development are currently unknown. The impact of footwear on gait should be considered when assessing the paediatric patient and evaluating the effect of shoe or in-shoe interventions.  
   http://www.ncbi.nlm.nih.gov/pubmed/21244647   

   all material copyright 2013 The Gait Guys/ The Homunculus Group. All rights reserved. Yea, that means ask before you touch!

Treat your children well.

We think Crosby, Stills, Nash and Young had it right…

look at this conclusion: “Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern."                                                                   

let’s break that down a bit:

"Shoes affect the gait of children.” Shoes effect EVERYONE’S gait, not just kids. They alter the ground reactive forces, limit some ranges of motion and thus can promote a compensation or mechanics that you may not have seen previously. Take off one of your shoes. Lift your toes up slightly so you are centered on your tripod. Stand on your “barefoot” leg with your eyes closed. See how long you can stand without faltering. Now repeat that with your shod foot. Some difference, eh? I thought shoes dampened proprioception…They do. But they also give you more support and mechanics that you didn’t have previously, so the foot doesn’t have to work as hard. 

“With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity.”Remember we are talking about kids here. Longer steps because with a shoe we promote heel rocker and because of the added support, more stability (or at least more perceived stability). This means more confidence. Greater knee and ankle motion because of the increased stride length. Greater tibialis anterior activity because of greater dorsiflexion of the foot because of the increased weight (the shoe adds ounces and this muscle must work harder to attenuate the foot as it approached midstance) and increased heel and ankle rocker.

Shoes reduce foot motion and increase the support phases of the gait cycle.” Shoes constrain the foot and reduce available ranges of motion (yes, even non motion control shoes). Less motion (and thus proprioception) means less feedback to the brain about muscles length and tension (via muscle spindles and golgi tendon organs). The brain will need to have the foot have more contact with the ground to know where it is in space. 

“During running, shoes reduce swing phase leg speed,probably due to the increased weight so it takes more to start the process of initial (early) swing

attenuate some shock we know shoes attenuate at least initial ground reactive forces

…and encourage a rearfoot strike pattern.” most likely due to the cushioning (remember from the recent Kenyan study about barefoot heel strikers? (click here if you need a reminder) They were more likely to heel strike on softer surfaces) AND the increased stride length (which would require more ankle dorsiflexion). 

Wow. Shoes really do make the, er….kid.

The Gait Guys. Making it real and increasing your shoe and gait IQ with each post.                                                                                 

J Foot Ankle Res. 2011 Jan 18;4:3. doi: 10.1186/1757-1146-4-3.

Effect of children’s shoes on gait: a systematic review and meta-analysis.

Source

Discipline of Exercise and Sports Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, PO Box 170, Lidcombe, 1825, NSW, Australia. cweg6974@uni.sydney.edu.au.

Abstract

BACKGROUND:

The effect of footwear on the gait of children is poorly understood. This systematic review synthesises the evidence of the biomechanical effects of shoes on children during walking and running.

METHODS:

Study inclusion criteria were: barefoot and shod conditions; healthy children aged ≤ 16 years; sample size of n > 1. Novelty footwear was excluded. Studies were located by online database-searching, hand-searching and contact with experts. Two authors selected studies and assessed study methodology using the Quality Index. Meta-analysis of continuous variables for homogeneous studies was undertaken using the inverse variance approach. Significance level was set at P < 0.05. Heterogeneity was measured by I2. Where I2 > 25%, a random-effects model analysis was used and where I2 < 25%, a fixed-effects model was used.

RESULTS:

Eleven studies were included. Sample size ranged from 4-898. Median Quality Index was 20/32 (range 11-27). Five studies randomised shoe order, six studies standardised footwear. Shod walking increased: velocity, step length, step time, base of support, double-support time, stance time, time to toe-off, sagittal tibia-rearfoot range of motion (ROM), sagittal tibia-foot ROM, ankle max-plantarflexion, Ankle ROM, foot lift to max-plantarflexion, ‘subtalar’ rotation ROM, knee sagittal ROM and tibialis anterior activity. Shod walking decreased: cadence, single-support time, ankle max-dorsiflexion, ankle at foot-lift, hallux ROM, arch length change, foot torsion, forefoot supination, forefoot width and midfoot ROM in all planes. Shod running decreased: long axis maximum tibial-acceleration, shock-wave transmission as a ratio of maximum tibial-acceleration, ankle plantarflexion at foot strike, knee angular velocity and tibial swing velocity. No variables increased during shod running.

CONCLUSIONS:

Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern. The long-term effect of these changes on growth and development are currently unknown. The impact of footwear on gait should be considered when assessing the paediatric patient and evaluating the effect of shoe or in-shoe interventions.

http://www.ncbi.nlm.nih.gov/pubmed/21244647

all material copyright 2013 The Gait Guys/ The Homunculus Group. All rights reserved. Yea, that means ask before you touch!

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READY

A little beach forensics, anyone?

As far as we know, there is only one shoe that makes a print like this one. You guessed it, a Newton (great going guys! You are all the way out here on the east coast!). We are pretty sure it is an MV2, because it has 5 actuator lugs. (Danny, Ian, Jordan, please feel free to chime in!)

Look at the top left and right images; left is running, right appears to be walking or a midfoot strike). What do you see? One foot imprint (the left) is accentuated and they are a forefoot striker. We are pretty sure this is how Newton encourages folks to run and if you have ever been in the shoe, you know it is pretty rockered and pushes you on to your toes.

Now look at the images that compare left to right. Notice how the outside of the forefoot makes a deeper impression on the left? Looks like that lateral column is sinking in the sand more. What type of forefoot type may cause this? You guessed it, a forefoot varus!. The forefoot is striking (and coming off the ground) in more supination on the left than the right.

Anything else? what about that right foot in the top right image? More printing on the medial aspect. Hmmm, maybe some increased forefoot pronation or possibly some forefoot valgus.

You could argue that due to the slop on the beach, we may be seeing this…and that would be a good argument, except that these are on the flats and repeat for many cycles.

Yup, we probably should be looking at all stuff north of the feet on the beach, but hey, we ARE geeks and “feet” are our thing.

The Gait Guys. Yes, we are always watching!…Even at the beach!


copyright 2012 The Gait Guys/The Homunculus Group. Al rights reserved. If you want to use our stuff, just ask nicely : )