Podcast 163: The hip and foot talk to each other. A research paper.

You cannot miss this mini-podcast. It is an excerpt from our Masterclass program. Come join us monthly on the Masterclass at for the monthly Masterclass installment hour.

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Formal presentations, slides, videos, demos, deep dives on topics you will not hear anywhere but here ! We hit the gait, biomechanics, neurology and orthopedics of all of the gait topics we present. This is not for the weak and timid, this is the deep dive you have been waiting for. Join us while we turn our normal 50 minute presentations into 3.5 hours on a regular basis ! The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money (why would you do that?) and just buy our Monthly Masterclass at our VIMEO page: https://vimeo.com/ondemand/thegaitmasterclass


Links to find the podcast:
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Just Google "the gait guys podcast".
_______________________________________________________________________________
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Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
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 and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

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https://thegaitguys.libsyn.com/the-hip-and-foot-talk-to-eachother-really-a-research-paper

https://directory.libsyn.com/episode/index/id/15439292

Today's article link: https://pubmed.ncbi.nlm.nih.gov/32717719/

Podcast 162: Climbing and gait

Podcast Guest today: Dr. Nick Hedges from Summit Chiropractic and Rehab summitchiroandrehab.com

*The Masterclass in Gait, with the Gait Guys


join us monthly at: https://www.patreon.com/thegaitguys for the monthly Masterclass installment hour. Formal presentations, slides, videos, demos, deep dives on topics you will not hear anywhere but here ! We hit the gait, biomechanics, neurology and orthopedics of all of the gait topics we present. This is not for the weak and timid, this is the deep dive you have been waiting for. Join us while we turn our normal 50 minute presentations into 3.5 hours on a regular basis ! The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money and just buy our Monthly Masterclass at our VIMEO page: https://vimeo.com/ondemand/thegaitmasterclass


Links to find the podcast:

Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
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 and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Links to find today's show:

https://traffic.libsyn.com/secure/thegaitguys/pod_161_Climbing_final_-_72620_5.40_PM.mp3

https://thegaitguys.libsyn.com/gait-and-rock-climbing

https://directory.libsyn.com/episode/index/id/15367754

Podcast 161: Central pattern generators: Why and how movement goes bad

Hello, World!

*The Masterclass in Gait, with the Gait Guys

join us monthly at: https://www.patreon.com/thegaitguys for the monthly Masterclass installment hour. Formal presentations, slides, videos, demos, deep dives on topics you will not hear anywhere but here ! We hit the gait, biomechanics, neurology and orthopedics of all of the gait topics we present. This is not for the weak and timid, this is the deep dive you have been waiting for. Join us while we turn our normal 50 minute presentations into 3.5 hours on a regular basis ! The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money and just buy our Monthly Masterclass at our VIMEO page: https://vimeo.com/ondemand/thegaitmasterclass


Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
doctorallen.co
summitchiroandrehab.com
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 and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast

Links to find today's show:
https://traffic.libsyn.com/secure/thegaitguys/pod._163_June_21_-_62120_9.41_AM.mp3
https://thegaitguys.libsyn.com/central-pattern-generators-why-and-how-movement-goes-bad-0
https://directory.libsyn.com/episode/index/id/14905823

Early motor experiences.

The early locomotor experience , a free play spontaneous study
Once again, we learn from our mistakes, or we should at least.
This natural locomotion study suggests that better walkers spontaneously walk more and fall less.

"Twelve- to 19-month-olds averaged 2,368 steps and 17 falls per hour. Novice walkers traveled farther faster than expert crawlers, but had comparable fall rates, which suggests that increased efficiency without increased cost motivates expert crawlers to transition to walking. After walking onset, natural locomotion improved dramatically: Infants took more steps, traveled farther distances, and fell less. Walking was distributed in short bouts with variable paths--frequently too short or irregular to qualify as periodic gait. Nonetheless, measures of periodic gait and of natural locomotion were correlated, which indicates that better walkers spontaneously walk more and fall less. Immense amounts of time-distributed, variable practice constitute the natural practice regimen for learning to walk."

Psychol Sci. 2012;23(11):1387-94. doi: 10.1177/0956797612446346. Epub 2012 Oct 19.
How do you learn to walk? Thousands of steps and dozens of falls per day.
Adolph KE1, Cole WG, Komati M, Garciaguirre JS, Badaly D, Lingeman JM, Chan GL, Sotsky RB.

Childhood Long Bone Torsions: Neurodevelopmental Considerations

Key Tag words:  torsions, gait, long bone torsions, femoral torsion, tibial torsion, neuromotor, neuroscience, locomotion, DNS, ambulation, walking, running, gait analysis, infant gait, childhood gait, jiu jitsu, crossover gait, cross over, vestibular, Parkinson's disease

We hit some good topics today, from childhood torsional issues, fix or leave alone ? What to look for when first observing and examining your client's gait plus Balance and vestibular function in gait and bike riding, exercise and neurodegenerative disorders and diseases and even developing proper neuromotor patterns, and inhibiting improper ones.
Plus we hit a favorite topic, the cross over gait and Ivo hits some highlights on gating inhibitory pathways.


Links to find the podcast:

iTunes page: https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Direct Download: http://traffic.libsyn.com/thegaitguys/pod_134_Final.mp3

Permalink URL: http://thegaitguys.libsyn.com/childhood-long-bone-torsions-neurodevelopmental-considerations

Libsyn URL: http://directory.libsyn.com/episode/index/id/6247612


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 and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

Show Notes:

The glutes are in fact great internal hip rotators, too. Open your mind.

I recently got a message from a colleague questioning as to how in the world, that when the hip is in flexion, the glutes and piriformis become internal rotators.  This is again another example of lack of functional anatomy knowledge.  It took me awhile to find a picture to help explain this, but I finally found one reasonable to do so. Many readers who are stuck on this concept are just too stuck on the anatomy as presented in the image to the right, neutral stance-like.  This article today will be all about internal and external moment arms, here, this lecture will help a little, it is on glute medius internal moment arms in stance phase however, so there is little carry over but it will at least get you understanding moment arms more clearly. 

We tend to just think of the glute max as a hip stabilizer and extensor, for the most part. It also decelerates flexion in terminal swing.  The glute medius is mostly thought of as a lateral hip stabilizer and abductor, either of the femur (open chain) or of the pelvis in stance position (closed chain), meaning zero degrees or neutral plus or minus the trivial degrees of engaged hip flexion and extension used in normal gait.

No one I know consciously trains the glutes as an internal rotator, but there are many actions where we need this function, such as in crawling and many high functioning activities such as martial arts grappling and kicking for example. Gymnasts should also know that the glutes are powerful internal hip rotators.  If you are doing quadruped crawling work you also need to know this as your client approaches 90 degrees of hip flexion. No one ever seems to check this critical gluteal function, at least I see it missed all the time from my referring doctors and therapists for unresolving hip pain cases. Patients with hip pain, anterior, lateral or posterior, with lack of internal hip rotation need the glutes checked just as much as the other known internal hip rotators we all seem to know (though some still do not understand how powerful the vastus lateralis is as an internal rotator, but again, those are folks who just have not spend the time in a mental 3D space looking at functional anatomy. I live mentally in that 3D space all day long when working with patients, you should too.) Let me be more clear, the anterior bundle, the iliac bundle of the glute max, is an internal rotator in flexion, the sacral and coccyxgeal divisions are not, they are external hip rotators in flexion. The gluteus medius and minimus are internal hip rotators closing in on 90 degrees hip flexion.  Hence, you must be able to tease out these divisions in your muscle testing, one cannot just test the glutes as external rotators or extensors, you are doing a really sloppy job if that is all you are doing. Nor should someone just train the glutes as hip stabilizers, external hip rotators and extensors (which is probably 90% of the trainers and coaches out there I might assume?). IF one knows the origin and insertions (see the blue and green arrows) and moves those points towards each other in a fashion of concentric contraction (purple arrows) one should be able to easily see that this will orient the femur to spin into internal rotation in the acetabulum (follow the arc of the black arrows). The same goes for eccentric contractions, it is the same game.  If you are doing DNS and crawling work, you should know this stuff cold gang. When you close chain the hip in sitting, or are moving from tall kneeling into flexed kneeling chops, performing high knees in sprint training,  or especially in crawling and climbing type actions, you must understand the mechanisms of internal rotation creation and stabilization -- if the glutes are not present and trained and useful in flexion, you are missing a chunk of something big. Amongst many other things, your client must be capable, stable, strong and skilled in moving from supine to quadruped all in one turning-over motion to teach how to stabilize the hip in the quadruped action and then progress into crawling.  This is a reflexive action learned in the early motor developmental phase of locomotion.  So take your client back through this motor pattern if they have some of the hip problems with internal rotation, it is a small piece of the gluteal puzzle.

I am sure this will show up in someone's seminar at some point, hopefully it is in many already, it has always been in my lectures when going down the rabbit hole of all things glutes. And to be fair, I haven't been to seminars in years as I get too frustrated, so this concept may be everywhere for all I know (lets hope).  But that is something I have to get over, I am sure I still have much to learn.  

To give credit where credit is due, which we always insist upon here at The Gait Guys, this was refreshed in my mind by Greg Lehman in a Facebook post forwarded to me by the inquiring doctor.   Link here  and from the article that spurred him to discuss it, an old article I read long ago just after completing my residency, the article is by Delp et al.  It is worth your time.  Thanks Greg for bringing this back into the dialogue, it is critical base knowledge everyone should already know. 

Variation of rotation moment arms with hip flexion.  Scott L. Delp,*, William E. Hess, David S. Hungerford, Lynne C. Jones  J. of Biomechanics 32, (1999)

-Dr. Shawn Allen, the other Gait Guy

Gait and Climbing (and DNS): Part 2.  Introducing 14 year old Ashima Shiraishi.

14 year old “sends” V15 , a 30 move roof climb in Hiei, Japan, called “Horizon”.

“the present work showed that human QL (quadrupedal locomotion) may spontaneously occur in humans with an unimpaired brain, probably using the ancestral locomotor networks for the diagonal sequence preserved for about the last 400 million years.” - 2005 Shapiro and Raichien

I am flipping the script a little today for DNS’ers (Dynamic Neuromuscular Stabilization). Watch the video if you wish, but the point I will be drawing your attention to is the 2:15 mark when she goes inverted on the roof of this apparently “more simple” V9 route. Note, this is not a video of her historic ~30 move V15 route. Stay tuned for that, it is not available yet.

Look closely. In the video, a then 9 year old Ashima is climbing upside down, a roof climb, defying gravity’s push. Spin this picture 180 and she is crawling, finding points of “fixation” or “punctum fixum”. What is neat about climbing is that you can have one, two, three or four points of fixation, unlike walking (one or two points) and crawling (two, three or four points of fixation). The difference in climbing is that gravity is a bear, wearing you down, little by little. A deep similarity in climbing to any variety of crawling is that both involve pulling and pushing, compressing and extending over fixation points. Other common principles are those of fixation, stability, mobility and neurologic crawling patterns in order to progress.

Ashima just recently, in early 2016, was the first female to complete a V14d (it is said it may even be upgraded to a V15a, maybe even a V16). Not many pros of any gender can say they can complete a V15 so this is a real big deal for a 14 year old. Stay tuned for that video.

DNS, Kolar and Climbing

I took my first DNS course with Prof. Kolar 10 years ago. It was an interesting eye opener and I had just enough clinical experience (9 years at that point) to grasp just enough to take it back to my practice and integrate it. Since that time, it has been fun to see it grow and see young practitioners excited to get their first face palm epiphanies. I have been returning to it often, blending it into my rehab work much of the time. There are few hip, shoulder, spine, breathing or global stabilization exercises I prescribe that do not have a DNS component to them, with my own flare and alterations and amendments as necessary. If you have taken a DNS course you will know why I am bring the topic into climbing. If you have not taking a course, you will be a little lost on the conceptual spill over.

As you can see in the video above, start really paying attention at the 2:15 mark in the video when she goes inverted on the roof. Cross crawl patterns, concepts of fixation, compression, expansion, crossing over, and tremendous feats of shoulder and hip stability on spinal stiffness and rotation.  Now add breathing, oy !  Now add doing all of this by mere finger tip and toe tip fixation ! When you consider all of this, it becomes almost incomprehensible what she and other climbers are doing when they go inverted like this. Amazing stuff, finger pulling/compression and foot pushing to compressively attach the body to the wall and progress forward.

Lucid Dreaming, A climb in the Buttermilks

Last year I wrote a piece on Lucid Dreaming, the name of a rock (another V15 climb) in the Buttermilks of Bishop, California. Here is that blog post. Lucid Dreaming is no ordinary rock.  To summit this rock is basically only three moves off of three holds, from your fingertips, starting from a sitting position. The remainder of the climb is sliced bread. If you can do the three, you can get to the top. The problem is, only a handful of people in the world can accomplish the feat. In the piece I outlined many principles of crawling, quadruped and climbing from a neuro-biomechanical perspective. Here is a excerpt from what i wrote in Gait and Climbing, Part 1:

In climbing there is suspicion of a shift in the central pattern generators because of the extraordinary demand by pseudo-quadrupedal gait climbing due to the demand on the upper limbs and their motorneuron pools to mobilize the organism up the mountain.  We know these quadrupedal circuits exist. In 2005 Shapiro and Raichien wrote “the present work showed that human QL (quadrupedal locomotion) may spontaneously occur in humans with an unimpaired brain, probably using the ancestral locomotor networks for the diagonal sequence preserved for about the last 400 million years.”

Some research has determined that in quadrupeds the lower limbs displayed reduced orientation yet increased ranges of kinematic coordination in alternative patterns such as diagonal and lateral coordination.  This was clearly different to the typical kinematics that are employed in upright bipedal locomotion. Furthermore, in skilled mountain climbers, these lateral and diagonal patterns are clearly more developed than in study controls largely due to repeated challenges and subsequent adaptive changes to these lateral and diagonal patterns.  What this seems to suggest is that there is a different demand and tax on the CPG’s and cord mediated neuromechanics moving from bipedal to quadrupedal locomotion. There seemed to be both advantages and disadvantages to both locomotion styles. Moving towards a more upright bipedal style of locomotion shows an increase in the lower spine (sacral motor pool) activity because of the increased and different demands on the musculature however at the potential cost to losing some of the skills and advantages of the lateral and diagonal quadrupedal skills. Naturally, different CPG reorganization is necessary moving towards bipedalism because of these different weight bearing demands on the lower limbs but also due to the change from weight bearing upper limbs to more mobile upper limbs free to not only optimize the speed of bipedalism but also to enable the function of carrying objects during locomotion.

The take home seems to suggest the development of proper early crawling and progressive quadruped locomotor patterns. Both will tax different motor pools within the spine and thus different central pattern generators (CPG). A orchestration of both seems to possibly offer the highest rewards and thus not only should crawling be a part of rehab and training but so should forward, lateral and diagonal pattern quadrupedal movements, on varying inclines for optimal benefits. 

Dancing, Jiu Jitsu and Climbing. Bringing things together.

So, what am I doing with all this information? As some of you may know, I have been expanding my locomotion experiences over the years. First there was three years of ballroom and latin dance, some of the hardest stuff I have ever done, combining complex combined body movements to timing and music at different speeds, each time changing to different rhythms or genres of music. Some of my deepest insights into foot work and hip, pelvis and core stability and spinal mobility originated from my dance experiences, particularly Rumba, Cha Cha, Jive, Waltz and Foxtrot. On a side note, some of my greatest epiphanies about the true function of the peroneal-calf muscle complex came during a private session on a difficult Waltz step concept. It was such an epiphany I sat down and wrote scratch notes on the enlightenment for 20 minutes right there in the ballroom. Next I moved into the very complex martial art of Brazilian Jiu Jitsu, and after three years it is clear it is an art that you could do for a lifetime and never get to the end of the complex algorithms of defense and offense. This art will stay in my wheelhouse to the end if I am able to keep it there.

Rock climbing, this one is the next on the list. After years of sharing my hands on peoples physical problems I know I already have above average grip and finger strength, so this could either prove to be a blessing or a “career ender” in terms of finally finishing off my hands for good. But it is on the list, and it won’t leave my head, so for me that is the tipping point. Climbing is next. I need to understand and experience this, so I can understand human locomotion better.

I will have the video of Ashima “sending” V15+ when they put it up, stay tuned. I have a feeling it is going to be a jaw dropper, I hear the whole send is inverted which boggles my mind. We will dissect her roof crawling and I will try to have some new research for you.

If you want to come down my rabbit hole, come read some of my other related articles:

Part 1: Gait and Climbing. Lucid Dreaming

and my 3 part series on Uner Tan Syndrome. The people who walk on all fours.


Dr. Shawn Allen, one of the gait guys

___________

References:

Shapiro L. J., Raichien D. A. (2005). Lateral sequence walking in infant papio cynocephalus: implications for the evolution of diagonal sequence walking in primates. Am. J. Phys. Anthropol.126, 205–213 10.1002/ajpa.20049

Scand J Med Sci Sports. 2011 Oct;21(5):688-99. Idiosyncratic control of the center of mass in expert climbers. Zampagni ML , Brigadoi S, Schena F, Tosi P, Ivanenko YP

J Neurophysiol. 2012 Jan;107(1):114-25. Features of hand-foot crawling behavior in human adults. Maclellan MJ, Ivanenko YP, Cappellini G, Sylos Labini F, Lacquaniti F.

Children: Postural control of balance

From the study:

“From these indexes it was established that the postural capacity needed just to control balance with the leg muscles was not attained before 4-5 years of independent walking, i.e., at about 5-6 years of age.” -Breniere

reference link:

Exp Brain Res. 1998 Aug;121(3):255-62.Development of postural control of gravity forces in children during the first 5 years of walking.Brenière Y1, Bril B.

http://www.ncbi.nlm.nih.gov/pubmed/9746131/

Limitations: The powers of observation will help you.
Physical examination, FMS, DNS, gait analysis … . . these are all very important tools for the coach, trainer, therapist, clinician.  They will all offer information and lead the “th…

Limitations: The powers of observation will help you.

Physical examination, FMS, DNS, gait analysis … . . these are all very important tools for the coach, trainer, therapist, clinician.  They will all offer information and lead the “therapy giver” in a direction for intervention.  But when something doesn’t match up with the basic standard protocols, you have to go outside the standard box.  We have all been there and today is just a little reminder not to get caught up in the “proceedures” and merely running through protocol without an engaged brain putting the pieces together.  

Here we see 2 classic examples of deviations from the mean, the client on the left has drifted further outside the frontal plane because of tibial varum and a little genu varus.  The client on the right has imploded deep into the frontal plane via rigid pes planus foot collapse and genu valgum.  These will both affect your physical screenings for these clients. And keep in mind, and this is probably the most important point of today’s blog post, either client may have good or bad strategies around their anatomy.  In other words, some clients will have great compensations to limit further functional pathology, and some will have poor compensation strategies, and thus, both will have different physical exam findings, different screenings and different neuromotor patterns embedded deep into their CPGs (central pattern generators).   Put yet another way, all of the scenarios discussed may/will have varying screening assessment outcomes but for different reasons.  If you know the cause of these faults and the impaired neuro-recruitment patterns that are likely, your assessments will make more sense, and so will your exercise/therapy/rehab prescriptions.  If you do not understand the fundamental differences (ie long bone torsions or various femoral-neck shaft angles, foot types such as an uncompensated forefoot valgus etc) , one could prescribe therapies that will not address the underlying problems, rather they might address the compensations and strategies found with these client’s challenges.

It can get sloppy messy.  Wear a bib.

Dig for the roots, don’t mow the grass…… Shawn and Ivo, The Gait Guys