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

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

*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 !

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Where to find us, the podcast Links:
Apple podcasts:
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Google Play:
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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

Podcast 56: Motor Chunking, Gait Assessments & More

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A. Link to our server:

Direct Download: 

http://traffic.libsyn.com/thegaitguys/pod_59finall.mp3

Permalink: 

http://thegaitguys.libsyn.com/podcast-56-motor-chunking-gait-assessments-more

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”

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Today’s Show notes:

The Science of “Chunking,” Working Memory, and How Pattern Recognition Fuels Creativity
http://www.brainpickings.org/index.php/2012/09/04/the-ravenous-brain-daniel-bor/
Learning a locomotor task: with or without errors?
http://www.jneuroengrehab.com/content/11/1/25/abstract
How we go about a gait assessement:
 
toes:
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Neurocognitive Control in Movement Perception and Control

You have read our blog posts on how much we respect and admire those that engage in complex motor tasks like gymnastics, martial arts, parqour, dance and others.  The more complex the task the greater the rewards on several levels.
We found yet another article supporting multiple levels of sensory-motor advancement, in this article’s case, dance however it applies broadly across all complex motor tasks.  We have also included another video with dub dancer Marquese Scott with this blog post. You may recall our prior writing with him, link here where we talked briefly about “foot edge work”. The above video is another demo of Marquese doing what he does best, making complex motor tasks look simple.

Neurocognitive control in dance perception and performance.

Acta Psychol (Amst). 2012 Feb;139(2):300-8. Epub 2012 Jan 9.
Bläsing B, Calvo-Merino B, Cross ES, Jola C, Honisch J, Stevens CJ.

Department of Sport Science, Bielefeld University, Germany. bettina.blaesing@uni-bielefeld.de

Abstract: Dance is a rich source of material for researchers interested in the integration of movement and cognition. The multiple aspects of embodied cognition involved in performing and perceiving dance have inspired scientists to use dance as a means for studying motor control, expertise, and action-perception links. The aim of this review is to present basic research on cognitive and neural processes implicated in the execution, expression, and observation of dance, and to bring into relief contemporary issues and open research questions.

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What The Gait Guys have to say:

The abstract review above addresses six issues they discovered and investigated in dancers:

1) dancers’ exemplary motor control, in terms of postural control, equilibrium maintenance, and stabilization;

2) how dancers’ timing and on-line synchronization are influenced by attention demands and motor experience;

3) the critical roles played by sequence learning and memory;

4) how dancers make strategic use of visual and motor imagery;

5) the insights into the neural coupling between action and perception yielded through exploration of the brain architecture mediating dance observation; and

6) a neuroesthetics perspective that sheds new light on the way audiences perceive and evaluate dance expression.

As you have read from some of our previous blog articles, we have some experience in dance. We do this to make sure we are always pressing the edge of human sensorymotor development and learning.  Dance has been one of the most complex body movement endeavors we have undertaken, more difficult than many of the complex movements in various sports.  This is why we never have a problem recommending dance, gymnastics and pilates to our young patient’s parents who want their children to excel in any given sport.  Fast, precise, assured and efficient foot work will take one far in athletics.  It is why in basketball they talk so much about the importance of the first step off a dribble when confronting an opponent. The first step, when fast, precise, assured and efficient, will leave one’s opponent stunned and motionless as their savvy opponent effortlessly passes them by. Nothing teaches these foot skills better than dance in our experience. Just as Marquese displays above, mastering complex footwork leads to advanced body movement possibilities.  And possibilities in sport are what separate the great from the good.  The 6 points discussed above namely exemplary motor control, in terms of postural control, equilibrium maintenance, and stabilization, timing, on-line synchronization, sequencing of learning and memory, the advantages of strategic use of visual and motor imagery, the insights into the neural coupling between action and perception are all major advantages to the athlete who can put them into play at a higher level.  And the more complex cross training of tasks that occurs, the greater likelihood that these issues are what will allow the cream to rise to the top in sport.

The Gait Guys

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If you can understand this type of complex footwork gait then running foot strike is going to be child’s play. 

“It (music) allows you to think in a way that you used to not think, and it also trains a lot of other cognitive facilities that have nothing to do with music.”-Limb

Gait and Biomechanics and Love Potion #9 !

The topic today is the brain and human movement and music. We would like you to enjoy this video we chose today of Slavik and Anna a little differently that you would normally watch a video. We ask that you cover up the top half of the video with your hand or a thick piece of paper so that you can ONLY see their legs and feet. Trust us, the hands, arms and their youthful attractiveness will distract you from the amazing stuff going on down in the legs and feet. Go ahead now and watch the video and see the amazing skill and precision of complicated foot work. There will be times that the feet are a blur, you will think the video has been sped up. It has not. If you can understand this type of complex footwork gait then running foot strike is going to be child’s play. It is why we study this stuff, because everything after this is easy. These are two of the very best dancers of all time and they show it here. This video is a classic example of complex motor tasks combined to music. Music makes everything better. Weddings, parties, even elevators (usually) are better when there is music. Today we will discuss how the brain can use music to help us learn. If you know this next song, you may find yourself immediately humming it in your head …

A B C

Easy as 1 2 3

Or simple as Do Re Mi

ABC, 123, Do Re Mi, baby you and me

There you have it. The chorus to The Jackson 5’s song “ABC”.

Kids have always learned well and fast (such as the alphabet) when music is integrated into a concept. Music provides timing. Music taps into fundamental systems in our brains that are sensitive to melody and beat. And when you are learning a task, timing can access part of the brain to either make it easier, easier to remember, or engrain the learned behavior deeper. When you add music to anything you are exercising other parts of your brain with that task. It is nothing new in the world of music and brain research when it comes to proving that music expands areas of learning and development in the brain. As Dr. Charles Limb, associate professor of otolaryngology and head and neck surgery at Johns Hopkins University states “It (music) allows you to think in a way that you used to not think, and it also trains a lot of other cognitive facilities that have nothing to do with music.”

Several weeks ago we asked you as an athlete, and this pertains to runners and even those walking, to add music to your training. If you are walking, vary the songs in your ipod to express variations in tempo. Use those tempo changes to change your cadence. If you are a runner, once in awhile add ipod training to your workouts and do the same. Your next fartlek (a system of training for distance runners in which the terrain and pace are varied to enhance conditioning) might be a new experience. Perhaps an enjoyable one. Trust us, we have done it. Here at The Gait Guys, with our backgrounds in neurology and biomechanics amongst other things, we are always looking for new ways to learn and to incorporate other areas of brain challenge to our clients. To build a better athlete you have to use training ideas that are often outside the box.

Today’s video of Slavik and Anna is a classic example of complex motor tasks combined to music. It is much about timing. Dancers call it musicality. Asking anyone to learn these movements without music would not be impossible, it would take some time, but without a focus on perfect technique or music timing to the movements someone might be able to learn them crudely in a day or two. BUT, add the timing and musicality and accentuations to that music, such as Slavik and Anna show here, and this becomes a task of many many years study and practice. A task they make appear simple, elegant and fun to do or watch. Can you imagine the foot skill and core abilities of these two ? It is mind boggling the number of complex motor tasks that occur here every second.

So, go grab your iPod and go for a run or a walk. Mix up your songs. Hear the beat, feel the rhythm and change your next workout into “feeling” the change of the music’s embedded metronome. Use those advanced areas of your brain to integrate music and timing into your rehab, your run, your walk, your workout. Don’t just “listen” to the music. Rather, feel it, move your body to it, so your brain can integrate it and embed it and make your task more engrained. Remember what Dr. Charles Limb said,

“It (music) allows you to think in a way that you used to not think, and it also trains a lot of other cognitive facilities that have nothing to do with music.”

Shawn and Ivo……helping you push the edges of human performance, through science, music and medicine.

(And here is a thank you “shout out” to my dance instructors (Godiva, Brittni, Max, Jake, Vance, Ellie, Caleb and Michael) for helping me to understand, struggle, and learn about these complex foot, limb, core motions and how music changes the brain’s learning curve. It has taken my understanding of human movement, functional anatomy and biomechanics to a level that I never knew existed. Thank you !)

Attached here is an article from CNN and Dr. Limb that inspired today’s blog post.

http://www.cnn.com/2012/05/26/health/mental-health/music-brain-science/index.html

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Gait, Running, Dance, Martial Arts and the Mirror neurons of the brain. Today The Gait Guys put it all together.  (Why you need to get familiar with mirror neurons).


When was the last time you actually truly “listened” to music and “used it” while you worked out or ran?  Many of us do it, but many of us are not using the music to its optimal advantage. This is something we will talk about at the end as we summarize today’s very important article.

Beautiful human movement is something to behold.  Being able to watch and appreciate beautiful movement does several things within the brain.

According the the Scientific American Article (LINK) by Columbia University neurologist John Krakauer:

“some reward-related areas in the brain are connected with motor areas …  and mounting evidence suggests that we are sensitive and attuned to the movements of others’ bodies, because similar brain regions are activated when certain movements are both made and observed. For example, the motor regions of professional dancers’ brains show more activation when they watch other dancers compared with people who don’t dance.”

Many things stimulate our brains’ reward centers, among them, both the participation in and the observance of coordinated movements thanks to our mirror neurons. Today we show an example of the world famous Slavik Kryklyvyy once again. The combination of the physical capabilities and the artistic rendering of the fluid and complex movements stir something in your brain.  Thanks to the mirror neuron cells in the brain’s cortex, which link the sensory experience from when a person is performing a movement or when watching someone else do it generates a subsequent motor experience in the brain.  Watching someone execute a complex athletic task for example, your brain’s movement areas subconscously activate and mentally plan and predict how the athlete would move based on what you would do. We do this when watching sports all the time. How many times have you watched an athlete and either verbally or mentally said to yourself “Oh man ! That was a dumb move ! I would never have done that ! I would have done ______ !"  Krakauer mentioned, ” the motor regions of professional dancers’ brains show more activation when they watch other dancers compared with people who don’t dance.“  This will be the same for all athletes. This is the same neurologic phenomenon that also allows you to truly appreciate a movement when it is done with amazing skill and precision.  Think of Cirque du Soleil and you will instantly know what we mean.

Watching Slavik move in the video above is complex motor tasking at its best. Dancers are amazing athletes, they are not just dancers. They are much like martial artists. Take Capoeira for example. It is a Brazilian martial art that combines elements of dance and music. It was created in Brazil mainly by descendants of African slaves with Brazilian native influences. It is a complex and feared martial art known by quick and complex moves, using mainly power, speed, and leverage for leg sweeps. It is a beautiful art, and a deadly art.

So, why does music make it that much better ? It is the same reason why weddings are less touching without music.  It is why music is used in church. It is why dance is paired with music.  Music stimulates the pleasure and reward areas of the brain, such as the orbitofrontal cortex, the ventral striatum and the cerebellum where timing, coordination and movement planning is performed. The combination of music with the motor task amplifies the reward zone in the brain. It is the task of trying to add timing and rhythm to movement that makes these activities that much harder, but that much more rewarding to the brain.  Runners who run with music, those who truly hear the timing and rhythm of the music and then use it in their workouts get a little something extra out of it. But sadly so many people "just listen” to the music instead of incorporating it into the movement.  A smart runner will vary the music and combine it with a run to vary tempo, cadence, speed etc.  That way the brain will be on fire and dish out rewards at a  new level. Dancers have no choice but to force the issue. We will sometimes use a metronome snapping of our fingers or clapping in the rhythm of a clients gait to help them hear the rhythm of their gait, particularly when it is arrhythmic due to pain or faulty biomechanics. We will do this so that it cues a heightened awareness in them. Seeing, feeling and hearing are all additive when sensory-motor relearning is concerned.

Gait and running are complex movements which we take for granted.  They are so automatized that we really do not realize how complex and amazing they are until something goes wrong or until someone brings the subtle flaws to our attention.  Maybe it is a stroke that compromises it, or maybe a neurologic disease like Parkinsons, or maybe it is as simple as a sprained ankle, a torn knee mensicus, a strained hamstring or a degenerative hip.  But any compromise to this complex sensory-motor task of ambulation immediately brings about a recognition that something is wrong to the skilled and aware observer. As in life, we do not appreciate something until something goes wrong with it.  Getting good at recognizing beautiful clean fluid gait and running is our job, and it is now your job. Now that you know better you cannot ignore gait in your clients, your artists, your athletes. Now that you know better, you must hold yourself to a higher level of expertise. Knowing what beautiful looks like will help you better understand what loss of beauty looks like.  It is what will make you better at understanding gait and human movement and locomotion and better at your chosen craft. It is what will heighten your appreciation of the amazing beauty of the human form and motion, whatever form it might take.

Shawn and Ivo,  the gait guys