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:

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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

Varus anyone?

Varus anyone?

Does patello femoral pain have anything to do with rearfoot varus? Perhaps, according to this study:

" A small but significant increase in rearfoot varus was found in the patellofemoral pain group compared with the control group (8.9 vs. 6.8 degrees; p = .0002). These results suggest that increased rearfoot varus may be a contributing factor in patellofemoral pain and should be assessed when evaluating the events at the subtalar joint and the lower extremity. In addition, it has been demonstrated that consistent rearfoot measurements can be obtained by an individual clinician."

Powers CM, Maffucci R, Hampton S. Rearfoot posture in subjects with patellofemoral pain. J Orthop Sports Phys Ther. 1995 Oct;22(4):155-60.

Look at that forward lean and glute development !

There now, maybe we tricked you into finally reading one of our bigfoot / Gigantopithecus blog posts. These blog posts were highly informative yet sadly under viewed compared to our regular posts. We suspect only the true gait geeks found those worth of their time but maybe they were misleadingly superficial to the quick browsing viewer. And that is ok, to each his/her own. But if you want to learn about your own species and problems we have as humans it is always helpful to look at our distant species “relatives” to see where we came from.

In this video you will see this Silver Back walking on 2 limbs, this is quite a rare event to see. In this clip you can see a gorgeous forward lean and the subsequent midfoot strike that occurs when the foot fall occurs with the body mass directly over the foot.  If you look closely you will also see that this gorilla is carrying a log in his left hand, which is one of the theories postulated as to why we evolved to bipedal ambulation, to carry objects over a distance. You should note the increased arm swing in the contralateral hand which is always seen when one arm swing is impaired from carrying things or from injury. This same pendulum alteration occurs in the lower limb when there is an injury and thus a weight bearing alteration, such as ambulating on a sprained ankle.  If you still do not believe us, strap a 5 pound ankle weight to one ankle and note the immediate change in step and stride in both limbs.  In subtle injuries or merely in the presence of pain, the gait cycle is altered a subtle level, and this is where gait compensations often begin.

in the normal walking gait cycle, rear foot strike is normal. But we at The Gait Guys tend to have our clients focus more on heel “contact” as opposed to a true “strike”. The difference is one of how aggressively the foot’s heel interacts with the ground at initial contact. We all have a family member or neighbor that can be heard upstairs sounding like they are pounding nails into the floor when it is really just their normal heel strike.  The best way to help someone to reduce this pounding habit is to increase their forward torso lean and to educate them on heel contact on impact.  The lean must come from the ankles, not from the waist. It is like walking into a heavy wind, you must lean your whole body (we use a queue of “raise your chest a little and lead from the chest” and this often helps stop a collapse into the core and flexion from the waist). And when one does this, the foot cannot progress so far out in front of the body and generate that aggressive heel strike. One is close to midfoot strike at this point when the correction is made properly.  This is similar to Pose running technique but it is just simply good form running technique to hit a nice soft midfoot impact each time.  

We talked more about heel strike in Gigantopithecus last week in this blog post. And, we also mentioned the perpetual knee flexion to dampen the head oscillations.  

Shawn and Ivo, The Gait Guys, and aspiring primatologists apparently.