Podcast 166: Senile Degeneration of afferent mechanoreceptors.

Podcast 166: Senile Degeneration of afferent mechanoreceptors.

This podcast is way more interesting than the title !

join us each month on the Masterclass in Gait

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Join at the $40 monthly level and get the masterclass each month, bonus material and the detailed monthly content we only share on Patreon.

The Masterclass is a formal LIVE presentation of 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 ! The 40$ Patreon level will give you the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money (why would you do that?) and just buy our Monthly $40 Masterclass at our VIMEO on demand page: https://vimeo.com/ondemand/thegaitmasterclass


Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

https://traffic.libsyn.com/secure/thegaitguys/pod_166final_Dec11_launch_-_121120_2.34_PM.mp3

https://thegaitguys.libsyn.com/podcast-166-senile-degeneration-of-afferent-mechanoreceptors

https://directory.libsyn.com/episode/index/id/17160167


Eight-Week Inspiratory Muscle Training Alters Electromyography Activity of the Ankle Muscles During Overhead and Single-Leg Squats: A Randomized Controlled Trial

J Appl Biomech. 2020 Oct 12;1-8. doi: 10.1123/jab.2019-0315. Online ahead of print.
Behnam Gholami-Borujeni 1 , Ali Yalfani 1 , Leila Ahmadnezhad 1

Why Don't Runners' Knees Fail More Often?

Biology suggests that decades of running should invariably blow out your knees. Scientists are trying to understand why that doesn’t happen.

-suggests that 98% of knees should fail after three decades of running. But they don't, and the big question is why not. One possibility: contrary to the usual view, cartilage adapts to repeated loading.
https://www.outsideonline.com/2417356/runners-knee-cartilage-study-2020?utm_medium=social&utm_source=twitter&utm_campaign=onsiteshare

Lengthening of the gastrocnemius-soleus complex: an anatomical and biomechanical study in human cadavers
Gregory B Firth 1 , Michael McMullan, Terence Chin, Francis Ma, Paulo Selber, Norman Eizenberg, Rory Wolfe, H Kerr Graham. JBJS Am.: 2013 Aug 21;95(16):1489-96

The loads are going to go somewhere.

You cannot change one thing, and not expect the other parts to change, to have to adapt, and possibly those parts to complain at some point.

The loads are going to go somewhere.

Too much pronation means the arch may be reduced in height, but it also means that the first ray complex (the 1-2 metatarsals essentially) is dorsiflexing more than normal. This means they will not likely get to their adequate plantarflexion by the time the foot is ready to heel rise and toe off at supination. In other words, if you have pronated and dorsiflexed too long and too much, you will eat up the time you needed to plantarflex and supinate.

This means that "Increased foot pronation may compromise ankle plantarflexion moment during the stance phase of gait, which may overload knee and hip."-Resende et al

If you cannot plantarflex the foot-ankle complex sufficiently, or in a timely manner, you should understand that you are carrying this fault forward while moving into heel rise during the forefoot rocker stance phase of gait, and you are doing it over a less stable, less rigid foot-ankle complex because it is still in relative pronation. This means you are placing higher propulsive loads over an unprepared ankle-foot complex. This means different/altered posterior compartment function, which can mean altered knee and hip function. Sagittal plane function, to name the most obvious, will have to create and endure compensatory loads. Sure, they may be fine for a time, but perhaps there will be a cost over time. Now, many might say, "if it is not a problem now, it is not a problem", let them build robustness on their chosen pattern; that can be very hopeful and shortsighted thinking in our opinion. Why not change things that are obviously aberrant and build robustness on a pattern and correction that is suspected to be more sound? This can be a cyclical argument that no one wins, EVER, we all see it all the time. After all, the arguments become silly after time, and we resist our own silly comments like "well, why change the oil in your car right now, nothing bad is happening at this time. Or, well that front right tire, though bald and nearly flat, is still rolling along so why bother changing it out?" But that stuff gets no one anywhere, other than pissed off, so we hold back. The debate never gets furthered along, because no one can see the future.

So, we will leave this rant with this thought, we cannot change one thing, and not expect the other parts to change, have to adapt. And adaptation can be both good OR bad. Or maybe we should say, good AND bad.

The loads are going to go somewhere. Lets leave it at that.

photo: credit pixabay.com

Gait Posture. 2018 Oct 23;68:130-135. doi: 10.1016/j.gaitpost.2018.10.025. [Epub ahead of print]

Effects of foot pronation on the lower limb sagittal plane biomechanics during gait.

Resende RA1, Pinheiro LSP2, Ocarino JM3.

Fatigue matters. Why a quick treadmill analysis of someone's gait will lie to you.

This is why i think gait analysis, on a treadmill with all the sensors, the visual captures , there are so many lies and fake outs.

Driving to work today and I saw this 40 something lady running. It just might have been the most tortured running i have seen in ages. It made me wonder, when we see our clients at the office and we ask them to run, they are typically in a fresh state, they're going to give us their best running, they are naturally going to put out their best for us, even if we ask them to "just run".

The truth is, they haven't been out there for 10-15 miles slogging it out in the heat and the pain and in the dysfunction. They haven't been out in the elements slowly fatiguing stabilizers, slowly layering neuro-protective tightness and strategies to offset the fatiguing structures. Even if that lady came in to see me tomorrow, i am not going to see what i saw in here on the side of the road. The clues i might see will be the muscular inhibition, the neuro-protective tightness, the compensations, the things on the hands on examination. This is why gait analysis has to have a hands on examination. And if i put her through a screening method, i am going to see her strategies in the screen to get around all that i mentioned above.

This is why i think gait analysis, on a treadmill with all the sensors, the visual captures , there are so many lies and fake outs. That process has significant limitations. Do not get me wrong, everything has value, but do we know what that value is, and what the lies are?

I think my question for my clients needs to be, be honest with me how ugly does your run get in the later miles when you're in pain? But then again, that is an impossible question isn't it !? Self awareness has its limitations. After all, we are human.

When asked to run at my doctors office, i am still gonna put on my best run for them. I will hide my flaws, my weaknesses, my tightness, my soreness, and give them the best run i have. The game is on them. Lets see how good they are.

Good luck today comrades, see what you can find and solve in all those who come begging for help, yet doing their best to hide their worst.

Why are you putting your internal hip rotation into your low back (pain)?

On October 12th, 2018 I wrote about utilizing the gluteals in internal hip rotation. You will have to go back and search FB for that article and video.
Assessing Internal hip rotation (in various ranges of hip flexion, extension, abduction and adduction) is a basic exam principle I examine on nearly every patient and athlete that comes to see me, regardless of their complaint. Other than breathing, walking is the next most under appreciated movement we undertake, and take for granted.

Lack of adequate internal hip rotation, in my clinical experience (20+ years), is all too often a fundamental parameter in hip, knee and low back pain. It is necessary to have unrestricted internal hip rotation during gait. Adequate internal hip rotation in the mid to late stance phases of gait is critical and is also paired with hip extension, in fact, one has to pass through adequate internal hip internal rotation to get to proper hip extension. Without one, we do not get the other. And, if the internal rotation is not imparted in the hip when the hip is supposed to be the one internally rotating, that demand is going to move up or down, caudally or rostrally, low back or knee.

Of interesting note, taking things deeper, the opposite arm is also going to go through internal rotation and extension at the same time. Impair one limb, and we can make a case, often enough, that the contralateral upper or lower limb is also challenged. This fundamental fact is one of the fascinating reasons Dr Ivo and I get so geeked out by gait and human movement. Because, it is very complicated. And if one is not looking close enough, paying enough attention with enough fundamental knowledge, things are going to get overlooked and missed when solving for "X" in a client's pain/problems/movement. Compensation will ensue, all too easily. Build strength on said compensations and we are off to the races in driving neuronal pasticity into potential asymmetries. If one is strength training a client without examining them and making specific corrections along the way, well, we reap what we sew. Ok, enough soap-boxing. -Dr. Allen

Here, don't take our word for it, . . . . .

"Correlation between Hip Rotation Range-of-Motion Impairment and Low Back Pain. A Literature Review."
Ortop Traumatol Rehabil. 2015 Oct;17(5):455-62. doi: 10.5604/15093492.1186813.
Sadeghisani M1, Manshadi FD1, Kalantari KK1, Rahimi A1, Namnik N2, Karimi MT3, Oskouei AE4.
"There is a hypothesis which suggests that a limited range of hip rotation results in compensatory lumbar spine rotation. Hence, LBP may develop as the result. This article reviews studies assessing hip rotation ROM impairment in the LBP population.
"Asymmetrical (right versus left, lead versus non-lead) and limited hip internal rotation ROM were common findings in patients with LBP. Reduced and asymmetrical total hip rotation was also observed in patients with LBP. However, none of the studies explicitly reported limited hip external rotation ROM."
CONCLUSION: "The precise assessment of hip rotation ROM, especially hip internal rotation ROM, must be included in the examination of patients with LBP symptoms."

Sacroiliac joint dysfunction and asymmetrical gait.

"Walking is often compromised in individuals with low back and hip disorders, such as sacroiliac joint dysfunction (SIJD). The disorder involves reduced coactivation of the gluteus maximus and contralateral latissimus dorsi, which together provide joint stability during walking."- Feeney et al. 2018

This study, 2018, seems to reconfirm some ideas of old, and these are muscular patterns of weakness and dysfunction we see all the time. Read on . . .

There are many ways to approach pain and dysfunction at the SI joint interval. This joint has many pain patterns, both locally and peripherally, and everybody's pain pattern is a little different.
Some lean on mobilization, some manipulation, some needling, other distraction, repeated active patient mobilizations, injections, NSAIDS, ice, and the list goes on.
However, do any of these methods truly hit at the heart of the source of the problem? Maybe.
We like to look notably at the muscular component, often first, as we fell that without balance, strength, still, endurance of the active joint stabilizers of this joint, problems can easily arise and perpetuate. This article supports this.
"Walking is often compromised in individuals with low back and hip disorders, such as sacroiliac joint dysfunction (SIJD). The disorder involves reduced coactivation of the gluteus maximus and contralateral latissimus dorsi, which together provide joint stability during walking."- Feeney et al. 2018
"EMG. Non-negative matrix factorization was used to identify patterns of EMG activity (muscle synergies). Individuals with SIJD exhibited less hip extension and lower peak vertical ground reaction forces on the affected side than the unaffected side. In contrast to controls, the SIJD group also displayed a depressed muscle synergy between gluteus maximus on the affected side and the contralateral latissimus dorsi. The results indicate that individuals with SIJD exhibited both reduced activation of gluteus maximus during a loading synergy present in walking and greater asymmetry between legs when walking compared with age-matched controls."-Feeney et al 2018
J Electromyogr Kinesiol. 2018 Sep 22;43:95-103. doi: 10.1016/j.jelekin.2018.09.009. [Epub ahead of print]
Individuals with sacroiliac joint dysfunction display asymmetrical gait and a depressed synergy between muscles providing sacroiliac joint force closure when walking.
Feeney DF1, Capobianco RA2, Montgomery JR3, Morreale J4, Grabowski AM5, Enoka RM6

Is there a linkage between the toes and ankle range of motion ? Yes.

Toe stiffness affects gait.
Awhile back we proposed a thought experiment on toe flexion and MTP joint extension and how the 2 might conflict during toe off in gait, thus producing some flexion plastic changes in the soft tissues.

We all read about ankle rocker and, when it is impaired, how it can wreak havoc on sagittal foot-ankle and gait mechanics. When ankle rocker/dorsiflexion is limited, moving our body mass forward over the foot-ankle complex can be a challenge because we have to compensate elsewhere to move forward (putting loads in places we do not want them, or working harder in areas we don't wish to be working so hard).
This study below suggests a linkage between the toes and ankle range of motion.
The study "characterized the effects of varying toe joint stiffness across a range of different ankle joint stiffness conditions, and the effects of varying toe shape on walking biomechanics. "
As we eluded to above, the study suggests "To our surprise, we found that varying toe joint stiffness affected COM Push-off dynamics during walking as much as, or in some cases even more than, varying ankle joint stiffness. Increasing toe joint stiffness increased COM Push-off work by up to 48% (6 J), and prosthetic ankle-foot Push-off work by up to 181% (12 J)."
Follow this thought experiment:
1. So, yesterday. (Oct. 15, 2018) we proposed a thought that increased toe flexion loads during stance phase loading can impact normal metatarsophalangeal (MTP) dorsiflexion. One will find it a biomechanical challenge to extend the toe when the flexors are trying to flex (yes, eccentric contractions thus come into play in this thought experiment but here today we are referring to those who over grip/clench into toe flexion for one of a myriad of mechanical reasons we will not discuss here today).
2. Note, MTP dorsiflexion (ie, extension) is what happens at the end of ankle rocker and progression thus into heel rise.
3. Heel rise encompasses posterior compartment engagement, in which studies suggest that up to 50% of propulsion comes from the calf-posterior compartment.
4. This study today said that "varying toe joint stiffness affected COM Push-off dynamics during walking as much as, or in some cases even more than, varying ankle joint stiffness. Increasing toe joint stiffness increased COM Push-off work by up to 48% (6 J), and prosthetic anklefoot Push-off work by up to 181% (12 J)."
5. So, is it possible to suggest that plastic changes in flexor tissues, capsule, and ligaments impair MTP function, thus impairing ankle rocker, thus demanding more, and premature calf complex loading work up to 48%?
Do you have a client with toe gripping and to flexion overdrive? Do they also have a loss of ankle rocker/dorsiflexion? Loss of hip extension and gluteal activity? Low back pain? After. all, we are just moving up the posterior chain, . . . we like to say,
. . . . the load has to go somewhere and the work will have to be done somewhere.
http://iopscience.iop.org/article/10.1088/1748-3190/aadf46

Leg exercise is critical to brain and nervous system health: Clues into why motorneuron diseases decline so quickly.

Leg exercise is critical to brain and nervous system health
"New research shows that using the legs, particularly in weight-bearing exercise, sends signals to the brain that are vital for the production of healthy neural cells."
This research supports what we already know, but in a new spin, that sensory input is just as important as motor output. This study gives new clues into why people with motorneuron diseases (spinalmuscular atrophy etc) decline so quickly as their movement impairment deepens.
This research might suggest that those who do not continue to weight bear load, such as bedridden or chronically ill patients and even the aging population, are at risk for faster decline. "Not only (do they) lose muscle mass, but their body chemistry is altered at the cellular level and even their nervous system is adversely impacted," says Dr. Raffaella Adami from the Università degli Studi di Milano, Italy.
"Limiting physical activity decreased the number of neural stem cells by 70 percent compared to a control group of mice, which were allowed to roam. Furthermore, both neurons and oligodendrocytes -- specialized cells that support and insulate nerve cells -- didn't fully mature when exercise was severely reduced."
"Reducing exercise also seems to impact two genes, one of which, CDK5Rap1, is very important for the health of mitochondria -- the cellular powerhouse that releases energy the body can then use. This represents another feedback loop."
Bottom line here folks, you have to move, you have to load, especially if you have a neurologic disorder and especially if you are declining in age. At the very least, throw some lunges or body weight squats into your day. Walk the stairs, don't ride the elevator. Move. Lift. Strain.
https://www.sciencedaily.com/rel.../2018/05/180523080214.htm
the gait guys, shawn & Ivo
#gait, #gaitproblems, #exercise, #legstrength, #squats, #lunges, #neuronhealth, #SMA, #neurologicdisease

Podcast 164: Foot placement challenges, vestibular issues & spatial orientation.

Podcast 164:  Foot placement challenges, vestibular issues & spatial orientation.

This podcast is way more interesting than the title !

join us each month on the Masterclass in Gait

https://www.patreon.com/thegaitguys

Join at the $40 monthly level and get the masterclass each month, bonus material and the detailed monthly content we only share on Patreon.

The Masterclass is a formal LIVE presentation of 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 ! The 40$ Patreon level will give you the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money (why would you do that?) and just buy our Monthly $40 Masterclass at our VIMEO on demand page: https://vimeo.com/ondemand/thegaitmasterclass


Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

https://traffic.libsyn.com/secure/thegaitguys/Pod_164_was_pod_162_May_25_-_81520_6.20_PM.mp3

https://thegaitguys.libsyn.com/foot-placement-challenges-vestibular-issues-spatial-orientation

https://directory.libsyn.com/episode/index/id/15625700

Podcast 163: The hip and foot talk to each other. A research paper.

You cannot miss this mini-podcast. It is an excerpt from our Masterclass program. Come join us monthly on the Masterclass at for the monthly Masterclass installment hour.

https://www.patreon.com/thegaitguys

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 ! The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money (why would you do that?) and just buy our Monthly Masterclass at our VIMEO page: https://vimeo.com/ondemand/thegaitmasterclass


Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

Other locations:

https://traffic.libsyn.com/secure/thegaitguys/163_mini_pod_peronei_-_8120_12.01_PM.mp3

https://thegaitguys.libsyn.com/the-hip-and-foot-talk-to-eachother-really-a-research-paper

https://directory.libsyn.com/episode/index/id/15439292

Today's article link: https://pubmed.ncbi.nlm.nih.gov/32717719/

Podcast 161: Central pattern generators: Why and how movement goes bad

Hello, World!

*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 ! The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !

Or, you can get less for your money and just buy our Monthly Masterclass at our VIMEO page: https://vimeo.com/ondemand/thegaitmasterclass

Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

Links to find today's show:
https://traffic.libsyn.com/secure/thegaitguys/pod._163_June_21_-_62120_9.41_AM.mp3
https://thegaitguys.libsyn.com/central-pattern-generators-why-and-how-movement-goes-bad-0
https://directory.libsyn.com/episode/index/id/14905823

Podcast 160. Masterclass in Gait #2: VIMEO Q & A Podcast

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join us at the 40$ level,

VIMEO on demand (pssst, the 40$ patreon level is a better deal  !)

https://vimeo.com/ondemand/thegaitmasterclass

*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 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 !

The 40$ Patreon level will give you the best deal on the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now ! Note, the 40$ Patreon level gets you more Masterclass content than the $40 VIMEO purchases.
Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

Links to today's show:

http://traffic.libsyn.com/thegaitguys/pod_160_april._14_-_42620.mp3

http://thegaitguys.libsyn.com/masterclass-in-gait-vimeo-q-a-podcast

http://directory.libsyn.com/episode/index/id/14157119

Podcast 159: Accelerating body mass, foot intrinsic thickness, ADHD gait and more !

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join us at the 40$ level,

VIMEO on demand (pssst, the 40$ patreon level is a better deal  !)

https://vimeo.com/ondemand/thegaitmasterclass

*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 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 !

The 40$ Patreon level will give you the best deal on the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now ! Note, the 40$ Patreon level gets you more Masterclass content than the $40 VIMEO purchases.
Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

Links to today's show:

http://traffic.libsyn.com/thegaitguys/pod_159_april_5_-_42620.mp3

http://thegaitguys.libsyn.com/accelerating-body-mass-foot-intrinsic-thickness-adhd-gait-and-more

http://directory.libsyn.com/episode/index/id/14155346

Show notes:

Gait Posture. 2020 Feb 20;78:54-59. doi: 10.1016/j.gaitpost.2020.02.014. [Epub ahead of print]

Muscle capacity to accelerate the body during gait varies with foot position in cerebral palsy.
Hegarty AK1, Kurz MJ2, Stuberg W2, Silverman AK3.

J Sport Rehabil. 2020 Mar 31:1-9. doi: 10.1123/jsr.2019-0211. [Epub ahead of print]
Effects of a 4-Week Short-Foot Exercise Program on Gait Characteristics in Patients With Stage II Posterior Tibial Tendon Dysfunction.
Kim J, Lee SC, Chun Y, Jun HP, Seegmiller JG, Kim KM, Lee SY.

Hum Mov Sci. 2020 Apr;70:102584. doi: 10.1016/j.humov.2020.102584. Epub 2020 Feb 8.
Gait control in children with attention-deficit/hyperactivity disorder.
Simmons RW1, Taggart TC2, Thomas JD3, Mattson SN3, Riley EP3.

Gait Posture. 2020 Mar 17;78:30-34. doi: 10.1016/j.gaitpost.2020.03.009. [Epub ahead of print]
Navicular drop is negatively associated with flexor hallucis brevis thickness in community-dwelling older adults.
Fukumoto Y1, Asai T2, Ichikawa M3, Kusumi H3, Kubo H4, Oka T5, Kasuya A6.

Front Pediatr. 2020 Feb 28;8:75. doi: 10.3389/fped.2020.00075. eCollection 2020.
Effects of Selective Dorsal Rhizotomy on Ankle Joint Function in Patients With Cerebral Palsy.
Ates F1, Brandenburg JE2,3,4, Kaufman KR1.

Gait Posture. 2020 Mar 4;78:26-29. doi: 10.1016/j.gaitpost.2020.03.003. [Epub ahead of print]
Higher visual reliance during single-leg balance bilaterally occurring following acute lateral ankle sprain: A potential central mechanism of bilateral sensorimotor deficits.
Kim KM1.

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

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 !

The 40$ Patreon level will give you 50% off the Masterclass and also get you the $20, $10, and 5$ Patreon level content. What a deal ! It will not be here forever so lock in now !
Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".
_______________________________________________________________________________
Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

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 154. A "Farewell to the King", Knee Fences, and Durability

A "Farewell to the King", Knee Fences, and Durability
This is a nice follow up to pod 153, the reboot

#RUSHisking, #theprofessor, #neilpeart, #greatestdrummerofalltime

Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

Other links for today's show:
http://traffic.libsyn.com/thegaitguys/pod_jan17_-_12620.mp3

http://thegaitguys.libsyn.com/a-farewell-to-the-king-knee-fences-and-durability

http://directory.libsyn.com/episode/index/id/12889889

#RUSHisking, #theprofessor, #neilpeart, #greatestdrummerofalltime

#153, The Podcast Reboot: A Deep dive on knee mechanics, loading and running.

Its 2020 and we are back ! The Gait Guys Podcast Reboot !

Links to find the podcast:
Look for us on Apple Podcasts, Google Play, Podbean, PlayerFM, RADIO and more.
Just Google "the gait guys podcast".

Our Websites:
www.thegaitguys.com
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

other links for today's show:

http://traffic.libsyn.com/thegaitguys/pod_jan10_-_11220.mp3

http://directory.libsyn.com/episode/index/id/12705212

https://oembed.libsyn.com/embed?item_id=12705212

http://thegaitguys.libsyn.com/podcast-reboot-deep-dive-on-knee-mechanics-loading-and-running

Podcast 150: Subtalar joint control? Plus Heel raise effects on low back pain

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
Find Exclusive content at: https://www.patreon.com/thegaitguys
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:
Apple podcasts:
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

Other links:
http://traffic.libsyn.com/thegaitguys/pod_1500final_-_81819_9.45_AM.mp3
http://thegaitguys.libsyn.com/subtalar-joint-control-plus-heel-raise-effects-on-low-back-pain

http://directory.libsyn.com/episode/index/id/10909609

Show notes

The HyProCure proceedure

https://images.search.yahoo.com/yhs/search;_ylt=AwrEeBmEH0RdlDUAiAUPxQt.;_ylu=X3oDMTByMjB0aG5zBGNvbG8DYmYxBHBvcwMxBHZ0aWQDBHNlYwNzYw--?p=hyprocure+sinus+tarsi+implant&fr=yhs-sz-001&hspart=sz&hsimp=yhs-001

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621198/
https://www.ncbi.nlm.nih.gov/pubmed/21106413
https://www.ncbi.nlm.nih.gov/pubmed/29786228

High-heeled walking decreases lumbar lordosis.EdenyBaaklini et al.
https://www.sciencedirect.com/science/article/pii/S096663621730108X

The effect of high-heeled shoes on lumbar lordosis: a narrative review and discussion of the disconnect between Internet content and peer-reviewed literature. Brent S. Russell
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206568/

Prolong Wearing of High Heeled Shoes Can Cause Low Back PainFarjad Afzal1* and Sidra Manzoor
https://pdfs.semanticscholar.org/afb4/641b8ed6450fcbdfa8ff99029d935c2bdc88.pdf

Relation between Wearing High-Heeled Shoes and Gastrocnemius and Erector Spine Muscle Action and Lumbar Lordosis. Cezar Augusto Souza Casarin
https://www.medscitechnol.com/download/index/idArt/892352

A flatter foot approach?
https://twitter.com/IzzyMoorePhD/status/1157034538192855041

Thoughts: titrate into speed work just like doing the same for longer and longer runs
Creating a "speed base"
https://www.fastrunning.com/?p=26410&preview=true

"monster walks"
Hip-Muscle Activity in Men and Women During Resisted Side Stepping With Different Band Positions. Lewis CL, et al. J Athl Train. 2018.
https://www.ncbi.nlm.nih.gov/m/pubmed/30615490/

Physical findings differ between individuals with greater trochanteric pain syndrome and healthy controls: A systematic review with meta-analysis.
Plinsinga ML1, Ross MH1, Coombes BK2, Vicenzino B3.
Musculoskelet Sci Pract. 2019 Jul 25;43:83-90. doi: 10.1016/j.msksp.2019.07.009. [Epub ahead of print]
https://www.ncbi.nlm.nih.gov/pubmed/31369906

The top 6 reasons we like hills for training ankle rocker and hip extension

image source: https://commons.wikimedia.org/wiki/File:Caer_Caradoc_hill.jpg

1. Hills do not cost money and are almost always readily available : )

2. Being outside is good for your health

3. Hills do not pull the hip into extension and place a stretch (pull) on the anterior hip musculature including the rectus femoris, iliopsoas and iliacus. This causes a slow stretch of the muscle, activating the muscle spindles (Ia afferents) and causing a muscle contraction via the stretch reflex. This will inhibit the posterior compartment of hip extensors (especially the glute max) through reciprocal inhibition, making it difficult to fire them.

4. A hill does not force your knee into extension, eliciting a stretch reflex in the hamstrings like a treadmill does

5. A hill naturally puts the ankle into dorsiflexion, and, along with active pulling up of the toes, helps you to get more into your anterior compartment and eliminates the tendency of the ankle being pulled into dorsiflexion (like with a treadmill) which would initiate a stretch reflex in the gastroc/soleus and long flexors.

6. The increased hip flexor requirement of going uphill gives you more opportunity to engage the abs before the psoas and rectus femoris/TFL and on the stance phase leg, you can get an increased stretch of those muscles

Tips for picking the right hill and using it to your advantage

• When just starting out, try and pick an incline that does not exceed the ankle dorsiflexion available to the patient/client

• It’s OK if it’s uncomfortable, but not if its painful

• Concentrate on pulling up the toes and dorsiflexing the ankle

• Squeeze your glute at heel strike and toe off

• leave your stance phase heel on the ground as long as possible

• Place your hands on your abs and concentrate on activating them PRIOR to flexing your hip

Dr Ivo Waerlop, one of The Gait Guys

#walkinghills #traininganklerocker #thegaitguys # increasinghipextension

The glutes medius is playing target practice.

We think about the gluteus medius often, mostly, during stance phases of locomotion. But, do not forget about the absolutely necessary function of the gluteus medius on the swing limb. Foot placement of that swing leg is in part dictated by how well the pendulum leg receives gluteus medius control to abduct the leg. When it fails to abduct adequately, a more adducted/medial foot placement occurs (think deeply about our long posts and podcast rants on the cross over gait, the narrow based walking and running gait style).
An agreeable balance between the abductors and adductors affords a more pure forward saggital pendulum of the hinging leg. When imbalanced, from insufficient gmedius and the rest of the abductory team, the foot and leg can target a more medial pendulum swing and thus a more medial foot target placement. Thus, the gluteus medius is important in both the stance and swing phases of gait. Failure to develop the skill, endurance and strength of the gluteus medius and related complex of muscles during stance AND swing phases will often result in frontal plane pelvis drift on the stance limb, and adduction targeting of the foot (narrow step width). What is this called ? We call it the Cross Over gait and we have written oodles of articles about this gait phenomenon, more than anyone else. It is real, it has economical advantages and similar liabilities. Want to learn more, type it into the SEARCH box on our website-blog. Many people thinkn this is a normal gait, how we should all walk and run. And they are wrong, in part. Like most things, it has a place, but not a permanent place. We think like most things in this world, there is a benefit and a drawback to things, and it is how you use it, as long as you read the instructions. Sadly, we were never given a "users manual" when we were born, so we all did what felt natural and safe. It doesn't mean it was right.

-Dr. Shawn Allen

For our Patreon patrons:
read and digest this post again before i film a video of a critical exercise we use to train the gluteus medius in BOTH PHASES ! All to often people just train the glute medius in the stance phase, and that is critical, but the swing phase is just as critical ! And this exercise i will film and post up on Patreon in the next 24 hours or so will help with this swing phase, but stance phase too. Be sure, when you study the video, that you do not get bogged down in what the exercise looks like. That is the easy part. For you to train yourself and your client, there MUST be a deep understanding of the specifics of the exercise. You have likely seen versions of this exercise other places, but it is the how and the why, and not getting sloppy with it, that is the key factor.

Photo: this came in an old box of Altra shoes, a brochure. We love Altras, they aren't for everyone, but if you are looking for a lower heel drop shoes with a wide toe box, try out a pair !

Tricks of the trade: Backward walking

image credit: https://pixabay.com/vectors/slide-sliding-falling-stickman-151861/

A single event can generate asynchronous sensory cues due to variable encoding, transmission, and processing delays. Robert Peterka talks about this, along with posture compensation and system apportionment when it comes to balance and coordination of the visual, vestibular and proprioceptive systems. We have talked about that here on the blog in the past.

We are often looking for ways to “highlight” pathology and make it more visible in the clinical exam. Having your patient/client walk backwards is one of those tools.

Walking and remaining upright in the gravitational plane requires 3 integrated systems to work in concert with one another: the visual, vestibular and proprioceptive systems. Backwards walking requires a more coordinated effort AND IF there is a “hiccup” or extra demand on the system (the proprioceptive in this case), neurological processing can take a little longer, efforts can be delayed and the end result is a greater compensation is needed; this often makes pathology more evident.

Try having your client walk backwards when you are doing your exam and see what we mean. We think you will be surprised with the results : )

Dr Ivo Waerlop, one of The Gait Guys

Peterka RJ, Statler KD, Wrisley DM, Horak FB. Postural compensation for unilateral vestibular loss. Front Neurol. 2011 Sep 6;2:57. doi: 10.3389/fneur.2011.00057. eCollection 2011.

temporal Shayman CS, Seo JH, Oh Y, Lewis RF, Peterka RJ, Hullar TE.Relationship between vestibular sensitivity and multisensory temporal integration. J Neurophysiol. 2018 Oct 1;120(4):1572-1577. doi: 10.1152/jn.00379.2018. Epub 2018 Jul 18.

Hawkins KA, Balasubramanian CK, Vistamehr A, Conroy C, Rose DK, Clark DJ, Fox EJ. Assessment of backward walking unmasks mobility impairments in post-stroke community ambulators. Top Stroke Rehabil. 2019 May 12:1-7. doi: 10.1080/10749357.2019.1609182. [Epub ahead of print]

#backwardwalking #clinicalexam #thegaitguys #gaitpathology #clinicaltricksofthetrade

Pronation anyone? Coupling? Walking Speed? How do they relate?

We have talked many times here on TGG about pronation, supination, overpronation, asymmetrical pronation, and more.

When most people think of pronation, they think of midfoot pronation, or pronation about the subtalar or transverse tarsal joints. Pronation can actually occur about any articulation or bone, but with respect to the foot, we like to think of rearfoot (ie. talo-calcaneal), midfoot (talo-navicular) and forefoot (transverse tarsal). The question is why does this matter?

Pronation, with respect to the foot, is defined as a combination of eversion, abduction and dorsiflexion (see picture attached) which results in flattening of the planter vault encompassing the medial and lateral longitudinal arches. In a normal gait cycle, this begins at initial contact (heel strike) and terminates at midstance, lasting no more than 25% of the gait cycle.

In a perfect biomechanical world, shortly following initial contact with the ground, the calcaneus should evert 4-8 degrees, largely because the body of the calcaneus is lateral to the longitudinal axis of the tibia. This results in plantar flexion, adduction and eversion of the talus on the calcaneus, as it slides anteriorly. At this point, there should be dorsiflexion of the transverse tarsal (calcaneo-cuboid and talo-navicular joints). Due to the tight fit of the ankle mortise and its unique shape, the tibial rotates internally (medially). This translates up the kinetic chain and causes internal rotation of the femur, which causes subsequent nutation of the pelvis and extension of the lumbar spine. This should occur in the lower kinetic chain through the 1st half of stance phase. The sequence should reverse after the midpoint of midstance, causing supination and creating a rigid lever for forward propulsion.

Pronation, along with knee and hip flexion, allow for shock absorption during throughout the 1st half of stance phase. Pronation allows for the calcaneo-cuboid and talo-navicular joint axes to be parallel making the foot into a mobile adaptor so it can contour to irregular surfaces, like our hunter gatherer forefathers used to walk on before we paved the planet. Problems arise when the foot either under pronates (7 degrees valgus results in internal tibial rotation), resulting in poor shock absorption or over pronates (> 8 degrees or remains in pronation for greater than 50% of stance phase).

This paper talks about how foot and ankle pathologies have effects on other articulations in the foot. They looked at stance phase of gait in 14 people without pathology at 3 different walking speeds. they found:

coupling relationships between rear foot inversion and hallux plantar flexion and rear foot eversion with hallux dorsiflexion.... When the rear foot everts (as it does as discussed above) during pronation from initial contact to mid stance , the hallux should be extending AND when the rear foot everts, as it should from mid stance to terminal stance/pre swing, the hallux should be plantar flexing to get the 1st ray down to the ground

medial (internal) rotation of there leg was accompanied by mid foot collapse (read pronation) and lateral (external) rotation with mid foot elevation (read supination).... Because of the shape of the talar dome and shape of the talo calcaneal facet joints, the talus plantar flexes, everts and adducts from initial contact to mid stance, and dorsiflexes, inverts and adducts from mid stance to terminal stance/ pre swing

walking speed significantly influenced these coupling relationships....meaning that the faster we go, the faster these things must happen and the greater degree that the surrounding musculature and associated cortical control mechanisms must act

So, when these relationships are compromised, problems (or more often, compensations) ensue. Think about these relationships and the kinetics and kinematics the next time you are studying someones gait.

Dr Ivo Waerlop, one of The Gait Guys

Dubbeldam R1, Nester C, Nene AV, Hermens HJ, Buurke JH. Kinematic coupling relationships exist between non-adjacent segments of the foot and ankle of healthy subjects.Kinematic coupling relationships exist between non-adjacent segments of the foot and ankle of healthy subjects.Gait Posture. 2013 Feb;37(2):159-64. doi: 10.1016/j.gaitpost.2012.06.033. Epub 2012 Aug 27

cool video on our blog to go with this post:

https://www.thegaitguys.com/thedailyblog/2018/8/7/what-do-you-know-about-pronation-and-supination

#gaitanalysis #thegaitguys #pronation #couplingrelationshipsandgait #pronation