Podcast 109b “Shorts”: The gluteus medius during swing phase.

A 12 minute talk on what the swing leg does in gait, and what it has to do when we drift the pelvis in the frontal plane over the stance leg.
Ever find yourself kicking your opposite ankle ?  We have answers.
Join us for a rewind of an old 12 minute talk we had on what the glutes do in the swing phase.

Podcast links:

http://thegaitguys.libsyn.com/podcast-109b-shorts-the-swing-phase-use-of-the-gluteus-medius

http://traffic.libsyn.com/thegaitguys/pod_110shortfinal.mp3

Article link:

J Neurophysiol. 2014 Jul 15;112(2):374-83. doi: 10.1152/jn.00138.2014. Epub 2014 Apr 30. A neuromechanical strategy for mediolateral foot placement in walking humans.  Rankin BL

Other Gait Guys stuff

B. iTunes link:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138
C. Gait Guys online /download store (National Shoe Fit Certification & more !)
http://store.payloadz.com/results/results.aspx?m=80204
D. other web based Gait Guys lectures:
Monthly lectures at : www.onlinece.com type in Dr. Waerlop or Dr. Allen, ”Biomechanics”

-Our Book: Pedographs and Gait Analysis and Clinical Case Studies
Electronic copies available here:

-Amazon/Kindle:
http://www.amazon.com/Pedographs-Gait-Analysis-Clinical-Studies-ebook/dp/B00AC18M3E

-Barnes and Noble / Nook Reader:
http://www.barnesandnoble.com/w/pedographs-and-gait-analysis-ivo-waerlop-and-shawn-allen/1112754833?ean=9781466953895

https://itunes.apple.com/us/book/pedographs-and-gait-analysis/id554516085?mt=11

-Hardcopy available from our publisher:
http://bookstore.trafford.com/Products/SKU-000155825/Pedographs-and-Gait-Analysis.aspx

If you do not undestand limb torsions, you are quite possibly screwing up your runners.

You must understand all 3 of these (see below) to understand funky gaits that you see, and to clean up your physical exams with clients. If you are making gait or running form recommendations on this stuff without understanding Torsions you are quite possibly making very bad form recommendations and could be putting forces and torque into foot, ankle, knee or hip that are detrimental. Trust us. We know what we are talking about.

In light of our teleseminar on Chirocredit.com last night we will re-run the 5 Part series on limb Torsions and Versions.

Remember, there are three areas this needs to be considered in:

1. torsion of the talus

2. tibial torsion

3. femoral torsion

here is the link to our old post on this topic, part 1a

http://thegaitguys.tumblr.com/post/30799942620/torsions-this-gentleman-has-2-excellent-examples

Shawn and Ivo

The “Top-End” Peroneal Walk Foot Skill: Another Restoration Foot Trick by The Gait Guys

Have stability problems in your ankles ? Lots of people do !
Here is a brief video of a simple, but difficult, functional exercise to strengthen the peroneal muscles in full plantar flexion (we will give more detailed tricks and techniques away on the Foot-Ankle DVD exercise series, once we get some time to get to it !). The key here is to not let the heel drop during single fore-foot loading and to keep the ankle pressing inwards as if to try and touch the ankles together medially …..if you feel the heel drop on the single foot loaded side (or you can feel the calf is weaker or if you feel strain to keep the inward press of the ankle) then it might be more than the peronei, it could be the combined peroneal-gastrocsoleus complex. The key to the assessment and home work is to make sure that the heel always stays in “top-end” heel rise plantarflexion. But you have to strongly consider the peronei just as seriously. Studies show that even single event sprains let alone chronic ankle sprains create serious incompetence of the peronei. Most people do not notice this because they never assess the ability to hold the foot in full heel rise (plantarflexion) while creating a valgus load (created by the peronei mostly, a less amount from the lateral calf) at the ankle. This is why repetitive sprains occur. The true key to recovery is to be able to walk on the foot in this heel-up “top-end” position while in ankle eversion (ankles squeezed together) as you see in this video. This is something we do with all of our basketball and jumping sports athletes and it is critical in our dancers of all kinds. And if they cannot do the walking skill or if they feel weakness then we keep it static and put a densely rolled towel or a small air filled ball between the ankles and have them do slow calf raises and descents while squeezing the towel-ball with all their ability. This will create a nice burn in the peroneal muscles after just a few repetitions. The user will also quickly become acutely aware of their old tendency to roll to the outside of the foot and ankle because of this lack of awareness and strength of those laterally placed ankle evertors - the peronei. It is critical to note that If you return to the ground from a jump and cannot FIRST load the forefoot squarely and then, and only then, control the rate of ankle inversion and neutral heel drop (ankle dorsiflexion) then you should not be shocked at chronic repetitive ankle sprains. Remember, the metatarsals and toes are shorter as we move away from the big toe, so there is already a huge risk and tendency to roll to the outside of the foot through ankle inversion. Hence why ankle sprains are so common. We call this “top end” peroneal strength but for it to be effectively implemented one must have sufficient top end calf strength as well, you cannot have sound loading mechanics without both.
It is not as easy as it appears in this video. We encourage you to give this a try and we bet that 1 out of every 2 people who try it will notice “top end” weakness felt either in the peronei and/or in the calf via inability to keep the heel in “top-end”. Oh, and do not think that you can simply correct this by more calf work, not if the peronei are involved, which they usually are.
One more trick by The Gait Guys………bet you cannot wait for the foot dvd huh !? Ya, it has only been on our list for 3 years now !
 We talk more about this kind of stuff on our National Shoe Fit Certification program.
Email us if you are interested thegaitguys@gmail.com

A Window into the Glutes: Anatomy lesson for the day.

A rather literal statement for a rather literal picture. Taken from the Human Body Exhibit at the Denver Museum of Science, this picture offers us a glimpse into, or in this case through, one of our favorite muscle groups. This group that we see here, is probably our second favorite group. They are often called the “deep six” and are the deep hip external rotators. If you count, you will notice there are only five….one remains unseen the obturator internus. More on that later.

See the linear white lines on the right of the window? That’ s the two portions of the sciatic nerve. Notice how it runs under the muscle at the top and over the others? The muscle it runs under is the famous piriformis. When this muscle gets tight, it can impinge the sciatic nerve, causing pain down the leg (known as sciatica). This represents one of many causes of pain radiating down the leg.

The next muscle south is the gemelli superior, then the obturator externus, gemelli inferior, and quadratus femoris. The sixth of the deep six is the obturator internus, which runs from the inside of the pelvis on the obtrobturator foramen (those huge “eyes” you see in an x ray when looking at a pelvis from the front) to a similar place on the femur.

A few observations you should make.

• when someone chews your butt off, or chews you a new one, this picture gives it a whole new meaning

• the sciatic nerve runs under the piriformis

• The top (superior) five muscles have a tendonous insertion to the femur that you can see as a whitish area on the left

• the last (or most inferior muscle) has a muscular insertion to the femur (which is a reddish area on the left)

• the positioning of these muscles allows them to be external rotators of the femur when the foot is in the air

• when the foot is planted, they become external rotators of the pelvis or can act to slow internal rotation of the femur during stance phase

• as you proceed caudally, the muscles become stronger adductors of the thigh

We will see this post as a reference for some future posts on this most fascinating muscle groups. Until then, study up!

The Gait Guys. Uber Foot Geeks. Join us in our mission to educate the world on the importance of understanding human motion and its impact on translating us forward in the gravitational plane.

all material copyright 2013 The Gait Guys/ The Homunculus Group. All rights reserved

So, what kind of shoes do I put this guy in?

The answer is, well…it depends.

This gentleman has a large Q angle (need to know more about Q angles? click here). The second photo is taken from above looking down at his knee.

If he has medial (inside) knee pain (possibly from shear forces), you would want to unload the medial knee, so a more flexible shoe that would allow more pronation of the foot and INCREASE the amount of valgus would open the medial joint space and probably be more appropriate.

If he had lateral (outside) knee pain (possibly from compressive forces), then a shoe with more support (like a motion control shoe) would help to unload the lateral knee and create more space may be appropriate. And that just covers the local knee issue. What if he has a pes planus and needs more than a “more stable” shoe ? And, what if that pes planus is rigid and won’t accept a more rigid arch supporting device ? What are you gonna do then ?

The caveat?

There are no hard and fast rules AND there is no substitute for examining the person and asking LOTS of questions BEFORE putting them in a shoe. You must approach each case on a case-by-case basis with all factors brought into the fold to make the best clinical decision.  Simply watching them walk, as you have heard it over and over again here on The Gait Guys, will lead you into wrong assumptions much of the time. Sometimes the obvious fix is not possible or won’t be tolerated by the person’s foot, knee, hip or body.  So, sometimes you have to settle with something in-between. 

Need to, or dying to, know more? Take our 3 part National Shoe Fit Program and be a shoe guru!

Email us at thegaitguys@gmail.com for details.