Podcast #140: Running, hallux amputation, building deeper gait concepts.

/

Topics:

hallux amputation, achilles tendon, achilles tendinopathy, rehab achilles, bursae, marathons, vapourfly, shoes, shoe fit, gait, gait problems, gait correction, gait retraining, running, foot strike, heel strike, midfoot strike, rearfoot strike, heel strike, loading responses, gait rehab, muscle strength, isotonics

Links to find the podcast:

Look for us on iTunes, Google Play, Podbean, PlayerFM and more.

Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com

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:

iTunes page:

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

Direct download URL: http://traffic.libsyn.com/thegaitguys/pod_140real_-_10618_9.18_AM.mp3


Permalink URL: http://thegaitguys.libsyn.com/podcast-140-running-hallux-amputation-building-running-concepts


Libsyn Directory URL:http://directory.libsyn.com/episode/index/id/7135745


Topics and links:


The tendinopathic Achilles tendon does not remain iso-volumetric upon repeated loading: insights from 3D ultrasound. Nuri L, et al. J Exp Biol. 2017.

https://www.ncbi.nlm.nih.gov/m/pubmed/28620014/

Good tip to decrease loading and help decrease injury risk in runners: See study by Chan et al.:
http://journals.sagepub.com/doi/abs/10.1177/0363546517736277?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&

Vapourfly shoe
https://www.nytimes.com/interactive/2018/07/18/upshot/nike-vaporfly-shoe-strava.html

Men’s marathon:
https://twitter.com/chrisbramah/status/1019481750039343104/photo/1


fun facts:

Foot strike patterns of the World Championships Marathon:
Women’s race:
73% rearfoot, 24% midfoot, 3% forefoot
Men’s race:
67% rearfoot, 30% midfoot, 3% forefoot
pic.twitter.com/iWRzjImQBZ
https://www.iaaf.org/about-iaaf/documents/research#biomechanical-research-projects

Foot structure and stiffness is critical
https://www.nature.com/articles/srep29870

Tendons can change
Progressive calf strength training led to increased achilles stiffness @ 4 weeks & increased tendon cross sectional area @ 8 weeks
https://link.springer.com/article/10.1007/s00421-018-3904-1

Bursae can thicken painlessly as a normal adaption to activity... just like skin calluses!
https://www.ncbi.nlm.nih.gov/pubmed/24907190

Between 63-72% of participants were wearing incorrectly sized footwear. review of the literature here from @LTPodiatry team:
https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-018-0284-z

How Neuroscientists Explain the Mind-Clearing Magic of Running -- from the Science of Us
https://www.huffingtonpost.com/science-of-us/how-neuroscientists-expla_b_9787466.html

/
Custom orthotic or Sham for mid tendon achilles tendonopathy? It doesn’t seem to matter.This study prescribed eccentric calf exercises along with either a custom or “sham” foot orthosis for 140 people who were randomized as to whic…

Custom orthotic or Sham for mid tendon achilles tendonopathy? It doesn’t seem to matter.

This study prescribed eccentric calf exercises along with either a custom or “sham” foot orthosis for 140 people who were randomized as to which group got the real goods and which one did not.  A Victorian Institute Sports Assessment-Achilles questionairre was given at baseline, 1, 3, 6 and 12 months. No statistically significant difference between the groups.

Hmmm..

We wonder just what were the custom and sham like? When we use orthoses, we use full arch contact devices. Perhaps the type of orthosis makes a difference? What has been your experience?

Munteanu SE, Scott LA, Bonanno DR, Landorf KB, Pizzari T, Cook JL, Menz HB.  Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial.
Br J Sports Med. 2015 Aug;49(15):989-94. doi: 10.1136/bjsports-2014-093845. Epub 2014 Sep 22.

Podcast 55: Cold Joints, Gluten Brain & Toilets

/

-The Neurophysiology of your Joint Pain and Problems

A. Link to our server:

Direct Download: http://traffic.libsyn.com/thegaitguys/pod_55final.mp3

Permalink: http://thegaitguys.libsyn.com/podcast-55-cold-joints-gluten-brain-toilets

B. iTunes link:

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

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

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

D. other web based Gait Guys lectures:

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

________________________________________

* Today’s show notes:

3 neuroscience pieces this week:
___________

‘Gluten Brain’: Wheat Cuts Off Blood Flow To Frontal Cortex 

http://www.greenmedinfo.com/blog/research-wheat-cuts-blood-flow-brains-frontal-cortex

Influence of midsole hardness of standard cushioned shoes on running-related injury risk

__________
blishahead/Running_Shoes_Increase_Achilles_Tendon_Load_in.98153.aspx
_____________
Case From a blog reader
Hello, 
I’m a swedish elite cross-country skier and newly graduated physio and I find your podcasts very interesting and informative! I have a question about something I’ve never heard you talk about, and which has been a problem for me for the last year.
It’s about the IP-joint of the big toe. I’ve had discomfort/pain in the joint for the last year, mostly after my workouts. It’s a bit swollen and there is crepitus to some degree(especially when I manually flex the toe while compressing it and at the same time have a pressure downwards/ventrally of the distal phalanx. I think it may be coming from a trauma I had 4-5 years ago when I stubbed my big toe really hard in a rock in an orienteering competition, which caused me to rest from running for a week or two.
So, my question to you is if you have any suggestion for me or others in my situation? Treatment? Which types of shoes to use? How would a future joint-fusion affect my running?
I’m only 23 years old and I’m really worried that this ache/discomfort will just get worse and worse.. I’ve asked a lot of great physios here in Sweden, but most of them don’t know much about what to do.
I’d be really grateful if you could take the time to give this a thought and share it.
Thanks!
_______________
Another reader case:
 

Good morning. I am a former collegiate runner, I competed at Eastern Michigan University and Grand Valley State University, my father is a Chiropractor in northern Michigan. While in school I was recalled to active duty in the reserves after 9/11 and was unable to finish my eligibility. I am now 32, living in North Carolina, and trying to make a comeback to running and competing in Triathlons. At 6’2” and 170lbs. during college  I was competitive at the collegiate level  but always a step behind the true elites in the distance races in college, probably just because of my size, etc. competing against guys carrying 30 less lbs.

I train with a team called Without Limits  (iamwithoutlimits.com ) in Wilmington NC. My coach had mentioned that I had a really long loping stride which felt normal to me, but I cannot remember if I ran this way in college or not. When I finally counted, I had a cadence of 140 steps per minute rather then the optimal 180…

Long story short, I got really out of shape, now getting into pretty good form again, but I am having problems with the IT band and pain in the knee on the right leg. I never ever had this in college training at very high levels (90-100 mile weeks in the off and early parts of each season) …so now I have the bike component that I am working on, but being a larger distance runner I am trying to fine tune my gait/stride and see if I can improve my running that way and also figure out what is going on with this IT band issue as I am only running 30-40 miles/week now but on the bike and in the pool a lot. I am back down to 175 and pretty lean but carrying a little extra muscle from biking and swimming.

Would you be interested, if I could send you several high quality videos from different angles, in taking a look at my gait (or even riding the bike on the trainer) and see if you notice anything ? I have been working on improving my cadence since the IT band issues began, and found your videos online while doing research.  I understand this would be better done on a treadmill or in the parking lot at your office where you could watch up close, but if you are interested, please let me know. I look forward to hearing from you.

 Sincerely,

 Tim

__________

The sedentary life affects your neurons !

http://www.outsideonline.com/news-from-the-field/Sitting-Still-Is-Bad-For-Your-Neurons.html

_________

A 3rd case this week, on Dystonia

Do you guys have any recommendations for analysis and treatment of acquired focal and gait dystonia?
It started as a splinting mechanism with a very loose right si and some L5 radiculopathy over 5 years ago.  The dystonia would come and go then eventually stuck all the time.
All the dystonia is on the right side and I don’t have any systemic neurological disease.
Forward walking, stair climbing, running (although barefoot running in grass and in particular undulating surfaces is ok in small amounts, asphalt or treadmill
brings on dystonia within seconds) are all a problem. Can cycle, run in water for 40 minutes or so no problem, so I think Si may still be hypermobile.  Walking backwards no problem.
Dystonia presents as stiff right leg with knee hyperextension, right eccentric weak, right glute medius weak, sticky posterior weight shift, but full and
painless movement through complete range of hip and knee.  I do have some focal dystonia as well mostly knee extension with hip flexion and foot supination and eversion with hip and knee flexed.

There must be someone who deals with this somewhat locally to me, Virginia Beach, VA.  Hoping you all may have some contacts on the east coast.
Thanks,
Sally

Get This: A Smart Toilet That Aims to Correct Poor Posture, and Even Detect Pregnancy and Disease | Entrepreneur.com
http://www.entrepreneur.com/article/231344