Pod #158: Gait and COVID-19, Motor Learning, Shoes and Injuries

People Suddenly falling down who have COVID-19? We got to thinking, that more neurologic, isn't it?

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Links to today's show:

http://traffic.libsyn.com/thegaitguys/pod_158__32420.mp3

http://thegaitguys.libsyn.com/gait-and-covid-19-motor-learning-shoes-and-injuries

http://directory.libsyn.com/episode/index/id/13682240

1.Current frameworks on running-related injury (RRI) aetiology emphasize the relation between exposure to training load, internal tissue loads, and tissue capacity; with tissue load exceeding its capacity being the key biological mechanism in the development of RRI. Despite this, . . .

https://www.tandfonline.com/doi/abs/10.1080/19424280.2020.1734869?journalCode=tfws20#.Xl5ejXBuHqI.twitter



2.Systematic Review of the Role of Footwear Constructions in Running Biomechanics: Implications for Running-Related Injury and Performance. Xiaole Sun et al.
https://www.jssm.org/volume19/iss1/cap/jssm-19-20.pdf

3.The neuroinvasive potential of SARS‐CoV2 may play a rolein the respiratory failure of COVID‐19 patientshttps://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728
"The entry ofSARS‐CoV into human host cells is mediated mainly by a cellularreceptor angiotensin‐converting enzyme 2 (ACE2), which is ex-pressed in human airway epithelia, lung parenchyma, vascular endothelia, kidney cells, and small intestine cells."
"Additionally, some patients withCOVID‐19 also showed neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also invade the central nervous system inducing neurological diseases. The infection of SARS‐CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. (Experimental studies using transgenic mice revealed that either SARS‐CoV34or MERS‐COV,13when given in-tranasally, could enter the brain,possibly via the olfactory nerves,and thereafter rapidly spread to some specific brain areas including thalamus and brainstem)
Furthermore, some coronaviruses have been demonstrated able to spread via a synapse‐connected route to the medullary cardiorespiratory center from the mechanoreceptors and chemoreceptors in the lung and lower respiratory airways.
*increasing evidenceshows that CoVs may first invade peripheral nerve terminals, and then gain access to the CNS via a synapse‐connected route"

4.Motor Learning
https://journals.lww.com/acsm-essr/Fulltext/2013/01000/Changing_Up_the_Routine___Intervention_Induced.10.aspx

5.Ahead of the curve in the evolution of human feet

https://www.nature.com/articles/d41586-020-00472-z

Bone marrow lesions in runners.

"More than half of the lesions (bone marrow edema) (58%; 26/45) fluctuated during the season, with new lesions occurring (20%; 9/45) and old lesions disappearing (22%; 10/45)."

Stuff happens to your bones during a marathon, or on that long weekend training run. Make sure you give yourself time to recover adequately before you pound out that next run.
The incidental finding of bone marrow edema (BME) on MRI in professional runners is not well understood. Bone takes on load, as it should. In this study, it is suggested that many asymptomatic athletes show BME lesions, many of which will come and go with training. It is most like proper and ample recovery that allows athletes to heal and not let these lesions turn into greater stress responses, or stress fractures. It is when the load comes too often, to long, heavy and hard that things might mount.

Methods:
Sixteen athletes (13 men and 3 women; mean age, 22.9 ± 2.7 years) were recruited from the Dutch National Committee middle-distance and long-distance running selection. All athletes had been injury free for the year before the study. Magnetic resonance imaging scans were obtained before the start of the season and at the end of the season.

14 of the 16 athletes had BME lesions before the start of the season (45 BME lesions in total). Most BME lesions (69%; 31/45) were located in the ankle joint and foot. More than half of the lesions (58%; 26/45) fluctuated during the season, with new lesions occurring (20%; 9/45) and old lesions disappearing (22%; 10/45). The few clinical complaints that occurred throughout the season were not related to the presence of BME lesions.

Am J Sports Med. 2014 May;42(5):1242-6. doi: 10.1177/0363546514521990. Epub 2014 Feb 20.
Bone marrow edema lesions in the professional runner.
Kornaat PR1, Van de Velde SK.

Podcast 32: "Shorts"- Stress Fracture Buddies

Today we have a 4 minute short clinical story on a case we saw in the recent weeks. We have searched the medical literature and have not found a study on what we attempted, but we hope that one of our listeners will have found one or had similar experiences and be willing to share their story or a client’s story.

This is a story of a high school middle distance runner who cut her toe, and ended up developing a stress fracture in her metatarsal.  And … . what we attempted to offer immediate change, some theories as to how it worked and how we saved her season (we hope).

Enjoy our short story. 

Imagine, think, ponder, explore and experiment.  Sometimes, you might be surprised what you can come up with, even when it is as simple as something as reaching for a roll of tape.

The Gait Guys

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podcast link:

http://thegaitguys.libsyn.com/podcast-32-shorts-stress-fracture-buddies

iTunes link:

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

Gait Guys online /download store:

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

other web based Gait Guys lectures:

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