Marching, a rudimentary motion, is a great screening for people with motor programming difficulties. This gal has left lower extremity dystonia and we were looking to see if it was more peripheral or central in origin.
You can see how her movement breaks down after a few simple steps of attempted coordinated movement. Use this simple marching screen next time you suspect a central programming issue in your patients :-)
While working with a patient with runners dystonia the other day, I had one of those epiphanies. I thought I would share it with you here. Here is some food for thought.
We remember that we have 3 systems that keep us upright in the gravitational plane: The visual system, the vestibular system and the proprioceptive system. As we age, we seem to become more dependent on the visual system, but that is a story we have told before here, and could certainly been expanded on in another post or three...
The long story today involves the vestibular system. It is a part of the nervous system that lives between your ears (literally) and monitors position, velocity and angular acceleration of the head. There are three hula hoop type structures called “semicircular canals” (see picture above) that monitor rotational, tilt position and angular acceleration, as well as two other structures, the utricle and saccule, which monitor tilt and linear acceleration.
The vestibular apparatus (the canals and the utricle and saccule) feed into a part of the brain called the floccular nodular lobe of the cerebellum, which as we are sure you can imagine, have something to do with balance and coordination. This area of the cerebellum feeds back to the vestibular system (actually the vestibular nucleii, all 4 of them! superior, inferior, medial and lateral); which then feed back up to the brain (medial, inferior and superior nuclear pathway) as well as down the spinal cord (the lateral pathway) to predominantly fire the extensor muscles.
So, what do you think happens if we facilitate (or defaciltate) a neuronal pool? We alter outcomes and don’t see a clear picture. Most actions in the nervous system are a system of checks and balances, or positives and negatives, and the one the one that predominates, is the one that wins : )
Look at the picture above. Notice the lateral semicicular canals are 30 degrees to the horizontal? If you are standing up and extending your head , that lateral canal becomes vertical and the fluid inside (emdolymph) cannot flow, making it much less useful to the nervous system. Thats why it is hard to stand with your head extended and eyes closed and maintain balance (go ahead and try it, feeling is believing). Conversely, when we flex our head forward(like looking down to see what our footing looks like), we move this lateral canal onto a more physiologically advantageous position, enhancingour balance. If you are on uneven ground, have an injury or are having issues with proprioception (like many folks do), this actually helps the vestibular system (as well as the proprioceptive and visual systems) to work more efficiently.
OK, have that? Now one more concept..
So if we look down, we put a slow stretch into our neck extensor muscles, which just happen to have some great postural receptors in them, called muscle spindles, along with mechanoreceptors in the capsules of the joints. So, facilitating (ie. exciting) these receptors, fires more information into our cerebellum, the queen of balance in the nervous system. What do you think happens? Even better balance and coordination! The 2 systems work together, summate to improve movement and balance!
Wow. All this from head position…The key here is to realize what and why you are doing what you are doing....
Key tag words:
running, gait, injuries, kidney, kidneydamage, marathoners, foot, feet, dehydration, heatstroke, elon musk, neural lace, hip pain, crossfit, squats, deadlifts, LLD, short leg, dystonia, runner's dystonia, posture,
Summary: Today we hit some very important topics on how to examine a client and how asymmetries play into gait, running, posture and pathomechanics. We hope you enjoy today's show, it is our first one back in 6 weeks. We are back strong after a brief early summer sabbatical. Back to the "podcast every 2 weeks" again. Thanks for being patient while Ivo recharged for the second half of the year. Plus, on today's show, we also dive into Runner's kidney, dehydration, gluteal gripping, runner's dystonia, functional leg length differences due to asymmetries, and more !
Show links:
http://traffic.libsyn.com/thegaitguys/pod_124final.mp3
http://thegaitguys.libsyn.com/pod-124
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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.
-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
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https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138
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http://store.payloadz.com/results/results.aspx?m=80204
D. other web based Gait Guys lectures:
www.onlinece.com type in Dr. Waerlop or Dr. Allen, ”Biomechanics”
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* Today’s show notes:
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
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
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The sedentary life affects your neurons !
http://www.outsideonline.com/news-from-the-field/Sitting-Still-Is-Bad-For-Your-Neurons.html
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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
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