In this weeks Neuromechanics weekly, Dr Waerlop takes us from the cortex to the muscle spindle. The journey through the neuraxis continues….
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So, the question you need to ask is why they cut the leg off and transplanted the foot/ankle 180 at the lower femur.
If you think about it, it is because he needed a joint to flex like his old knee. If they put the foot on forward there would be no knee bend (ie. his knee would have only bent as much as you can point your foot…….the motion of ankle plantarflexion. This would have been extremely insufficient in range to move as well as this fella is moving. )
By doing a rotation transplasty and putting the foot on backwards he could take advantage of the large range of ankle dorsiflexion. They talk about the toes alot in this video but this really has nothing to do with the success of this surgery, functionally anyways. The genius of this surgery was using the ankle as a knee hinge.
Pretty amazing stuff. Enjoy the brain-twister in understanding how he is using ankle dorsiflexion to replicate knee flexion. !!!!
taking Gait to another dimension……… Shawn and Ivo
Here Dr. Allen of The Gait Guys introduces some of the initial information necessary to understand proper shoe fit. Topics include body anatomy, shoe anatomy, physiology, biomechanics and compensation patterns. This was part of a private industry lecture where The Gait Guys were asked to help improve the understanding of the concepts critical to better shoe industry choices.
Ivo and Shawn …. what we do while you are sleeping.
our version of crop circles !
watch for signs of our presence at your local beach or wheat field near you !
you are not alone…….
photo from . http://nakedonsharppointystuff.blogspot.com/
So. How did you do?
As you can see, this individual lists to the R upon weight bearing on that side (midstance); did you pick up the increased progression angle of the foot on that side? How about the mild genu valgus?
Why would someone walk like this? There are a few plausible explanations.
1. he has a weak gluteus medius on the R side.
2. he has a R short leg and needs to lean to that side to get the long leg side (L) to clear.
3. impaired left ankle rocker (causing premature heel rise and left side early departure) could also cause him to accelerate onto the right as well.
His options to compensate are to either lean to the weak side ® or to shift his pelvis to the weak side ®. He could also circumduct the leg or flex the thigh to get that side to clear the ground. He has a mild BL circumdcution, probably to clear the knee from the opposite one.
His increased arm swing on the L is to help propel him forward, most likely due to weakness of the external obliques to assist in initiation of flexion of the thigh, and weakness of the gluteus medius, which also helps to propel the leg forward. He also does not push off adequately with the R leg; This is probably due to loss of hip extension and inadequate ankle rocker on that side.
The increased progression angle on the R helps to stabilize his body weight because he is leaning the torso to the R and his center of gravity moves right as well (he makes a wider base for himself)
Yup, you’re a geek! We remain The Geeks of Gait…Ivo and Shawn
oh look, it appears (but a little hard to tell) ……but it appears we have a casualty !
here is what her ankle is saying …..
“oh no, we do not have enough ankle dorsiflexion to be on this bad boy…….so, who wants to take it guys…….. how about you hyperpronate Mr. Arch, and to help we will drive Mr. Knee medially." ?
Part 3: The Problematic Cross-over gait motor pattern. The final piece.
Here Dr. Shawn Allen of The Gait Guys summarizes this gait problem in running form. The Cross-over gait is a product of gluteus medius and abdominal weakness and leaves the runner with much frontal plane hip movement, very little separation of the knees and a “cross over” of the feet, rendering a near “tight rope” running appearance where the feet seem to land on a straight line path. In Part 3, Dr. Allen will discuss a more detailed specific method to fix this. You will see this problem in well over 50% of runners. This problem leads to injury at the hip, knee and foot levels quite frequently. To date we have not met anyone who had a good grasp on this clinical issue or a remedy quite like ours. Help us make this video go viral so we can help more runners with this problem. Forward it to your coaches, your friends, everyone.
Thanks for watching our video
Here Dr. Shawn Allen of The Gait Guys further discusses this gait problem in running form. The Cross-over gait is a product of gluteus medius and abdominal weakness and leaves the runner with much frontal plane hip movement, very little separation of the knees and a “cross over” of the feet, rendering a near “tight rope” running appearance where the feet seem to land on a straight line path. In Part 2, Dr. Allen will discuss a more detailed specific method to fix this. You will see this problem in well over 50% of runners. This problem leads to injury at the hip, knee and foot levels quite frequently. To date we have not met anyone who had a good grasp on this clinical issue or a remedy quite like ours. Help us make this video go viral so we can help more runners with this problem. Forward it to your coaches, your friends, everyone.
Thanks for watching our video
-Shawn and Ivo……The Gait Guys
Funny Nancy Sinatra clip on Zero-drop.com→
/Thanks to our friend, Bill Katovsy on http://zero-drop.com for sharing a classic Nancy Sinatra clip from the The Ed Sullivan Show
Video presentation: The Problematic Cross-Over Gait pattern. Part 1
Here Dr. Shawn Allen of The Gait Guys works with elite athlete Jack Driggs to reduce a power leak in his running form. The Cross-over gait is a product of gluteus medius and abdominal weakness and leaves the runner with much frontal plane hip movement, very little separation of the knees and a “cross over” of the feet, rendering a near “tight rope” running appearance where the feet seem to land on a straight line path. In Part 2, Dr. Allen will discuss a more detailed specific method to fix this. You will see this problem in well over 50% of runners. This problem leads to injury at the hip, knee and foot levels quite frequently. To date we have not met anyone who had a good grasp on this clinical issue or a remedy quite like ours. Help us make this video go viral so we can help more runners with this problem. Forward it to your coaches, your friends, everyone.
Thanks for watching our video, thanks for your time.
-Dr. Shawn Allen, The Gait Guys
The Truth About Treadmills: A Neurological Perspective
Gender differences in walking and running on level and inclined surfaces.
Chumanov ES, Wall-Scheffler C, Heiderscheit BC. Clin Biomech (Bristol, Avon). 2008 Dec;23(10):1260-8. Epub 2008 Sep 6.
What the Gait Guys have to say about this article:
This article highlights some of the differences in gait between males and females on treadmills. Though treadmills don’t necessarily represent real life, they are an approximation. While reading this article, please keep the following in mind:
1. the treadmill pulls the hip into extension and places a pull on the anterior hip musculature, especially the hip flexors including the rectus femoris, iliopsoas and iliacus. This causes a slow stretch of the muscle, activating the muscle spindles (Ia afferents) and causing a mm contraction (ie the stretch reflex). This acts to inhibit the posterior compartment of hip extensors (especially the glute max) through reciprocal inhibition, making it difficult to fire them.
2. Because the deck is moving, the knee is brought into extension, with stretch of the hamstrings, the quads become reciprocally inhibited (same mechanism above).
3. The moving deck also has a tendency to put the ankle in dorsiflexion, initiating a stretch reflex in the tricep surae (gastroc/soleus) facilitating toe off through here and pushing you through the gait cycle, rather than pulling you through (with your hip extensors).
4. the moving deck forces you to flex the thigh forward for the next footstrike (ie footstance), firing the RF, IP and Iliacus, and reciprocally inhibit the g max
If your core isn’t engaged, the pull of the rectus femoris and iliopsoas/iliacus pulls the ilia and pelvis into extension (ie increases the lordosis) and you reciprocally inhibit the erectors and increase reliance on the multifidus and rotatores, which have short lever arms and are supposed to be more proprioceptive in function. Can you say back pain?
In summary, treadmills are not the scourge of humanity, but do have some pitfalls for training, and equal amounts of “backwards” running should be employed (with great caution, mind you)
With that being said, lets look at the results: increased hip internal rotation and adduction, as well as more glute activity for the ladies. Not surprising considering women generally have a larger Q angle (17 +/- 3 degrees for females, 14 +/-3 degrees for males) and greater amounts of hip anteversion (average 14 degrees in females vs 8 in males). The larger Q angle places more stress at the medial knee (compression of the medial femoral condyle and usually increased pronation as the center of gravity over the foot is moved medially) and thus more control needed to slow pronation (from the glutes to control/augment internal rotation). Greater hip anteversion means the angle of the femoral head is greater than 12 degrees to the shaft of the femur. This moves the lower extremity into a more internally rotated position, approximating the origin and insertion of the adductors, making them easier to access. With an increased Q angle and easier access, greater demands are placed on adductors in single leg stance (which is considerably greater in running), This increased adductory moment places more demand on the gluteus medius (and contralateral QL) as well, to stabilize the pelvis and this correlates with speed and incline, also found in the study.
The take home message? Don’t throw away your treadmill! The treadmill can be an excellent diagnostic tool! Gluteal and adductor insufficiencies will be more visible (and probably more prevalent) in females, especially those running or walking on treadmills. The hip extension and ankle dorsiflexion moment created by a treadmill works against some of the stabilizing mechanisms (glute inhibition, ankle dorsiflexor inhibition) and help to highlight some of the subtle gait abnormailities you may miss otherwise.
Abstract from Article
BACKGROUND: Gender differences in kinematics during running have been speculated to be a contributing factor to the lower extremity injury rate disparity between men and women. Specifically, increased non-sagittal motion of the pelvis and hip has been implicated; however it is not known if this difference exists under a variety of locomotion conditions. The purpose of this study was to characterize gender differences in gait kinematics and muscle activities as a function of speed and surface incline and to determine if lower extremity anthropometrics contribute to these differences.
METHODS: Whole body kinematics of 34 healthy volunteers were recorded along with electromyography of muscles on the right lower limb while each subject walked at 1.2, 1.5, and 1.8m/s and ran at 1.8, 2.7, and 3.6m/s with surface inclinations of 0%, 10%, and 15% grade. Joint angles and muscle activities were compared between genders across each speed-incline condition. Pelvis and lower extremity segment lengths were also measured and compared.
FINDINGS: Females displayed greater peak hip internal rotation and adduction, as well as gluteus maximus activity for all conditions. Significant interactions (speed-gender, incline-gender) were present for the gluteus medius and vastus lateralis. Hip adduction during walking was moderately correlated to the ratio of bi-trochanteric width to leg length.
INTERPRETATION: Our findings indicate females display greater non-sagittal motion. Future studies are needed to better define the relationship of these differences to injury risk.
PMID: 18774631 [PubMed - indexed for MEDLINE]
Yup, we’re gait nerds….Don’t laugh….You are too if you are reading this…..
The Gait Guys: finding other uses for treadmills, other than for hanging the laundry…..
DVD's we have made, for sale.
/Here is a list of what we currently have available on DVD:
Item Name:
The Performance Core
Item #:
Performance I
Price/ea:
$39.95
• The Neuro Core: Abdominal neurological connection and control
• Purpose of the DVD in Core Training
• The Problems with Crunches and Sit Ups
• Bracing and Hollowing:
• Breathing and the Core
• Exercise: Bicycles- Right and Wrong
• Problems with Leg Lifts
• Exercise: The Non-Tripod Core Exercise for Oblique Activation
• Core Progression Order: …. Pathologic motor pattern compensations
• Exercise: Tripod with a Ball
• Exercise: the Abdominal “Chairs”
• Exercise: “Chairs” progressions continued…….. getting harder !
• Exercise: The Glute and Core Combine
• Exercise: The Hip Extension Pattern- Assessment and Progression
• Exercise: Hip Extension progressions continued…….getting harder
• Exercise: Bridges and Planks. The Right and Wrong and progressions
• Exercise: Motor Pattern Setting……The Sit to Stand Core
Item Name:
The Performance Squat
Item #:
Performance III
Price/ea:
$39.95
The Performance Squat – First phase development exercises and concepts
DVD Running time: 46 minutes
• The Reason for the Squat: Problems
• Where the Squat Begins: The Foot Tripod Concept
• The 3 Rockers of Movement in Gait and the Squat
• How the Foot Works: The Basics of what you need to know right now
• Another Look at the Foot: Foot types and Shoe Types
• The Foot and Pelvis Position: Its Impact on Movements and Squats
• Video Case Study of a Sprinter: Issues of Foot and Limb Positions
• A Brief (Very Brief) Discussion on Shoes and their issues with the Squat
• Exercise: The Texas Walk- A skill for early squat preparation and performance
• Exercise: The Potty Squat- The proper motor sequence
• Exercise: The Ball Squat- With Breathing concepts intertwined (critical neuro training)
• Exercise: The Hip Hike
• Exercise: Iso (Isometric) Drops Done Right (“Box Drops and Depth Drops”)
• Video Case Study: Drop Assessment frame-by-frame stop motion analysis
Item Name:
The Performance Theories
Item #:
Performance II
Price/ea:
$39.95
The Performance concepts: Dialogues on Training Concepts
DVD running time: 65 mintues
• What is the definition of the core and what does it entail ?
• Physiologic overflow of muscles with respect to joint motion
• Isotonic Exercise concepts
• Physiologic characteristics of muscle types
• Strength Training: Neural Adaptation
• Motor Pattern Muscle Compensation Concepts
• Exercise Prescription Concepts
• Hip Extension Motor Pattern: A discussion on compensations
• Neurologic Reciprocal Inhibition: Principles of joint movement and stability
• The Concept of Tight and Short Muscles: They are different
• Stretching: Good or Bad
Item Name:
Performance Series: Advanced Core
Item #:
Performance Series: Advanced Core
Price/ea:
$39.95
This DVD will take viewers into the next step of the Core. Doctor Allen and Doctor Waerlop will cover the always favorite exercise the sit-up. They will show the many ways athletes misuse the exercise and show a perfect sit-up. They will also demonstrate and explain other exercise to take athletes to the next level with their core development, including proper technique for lat pulls
Item Name:
Performance Series. Advanced Squat
Item #:
Advanced squat
Price/ea:
$39.95
This DVD will take viewers into the next step of the squat: the traditional squat. Doctor Allen and Doctor Waerlop will cover the perfect technique needed to develop the glutes instead of the quads in “the king of all exercises”. They will also cover fixing some errors as well as the lunge. Every body part from the foot to head placement will be covered.
Item Name:
Power block- Glute development
Item #:
Power block- Glute development
Price/ea:
$29.95
This DVD was filmed in Chris Korfist’s garage on a nice Sunday afternoon. Dr. Allen and Chris were developing a better way to do the glute power block and they decided to film their discussion. They discuss proper technique on many exercises which serve the purpose of developing explosive glutes and making sure the foot and glute are connected. Now your glute power can be more than “all show and no go.
Performance Core Trio: $99
Advanced Series Trio: $99
All 6 DVD’s: $179.95
We also have the following download available on Payloadz:
Foot Function and the Effects on the Core and Body Dynamics http://store.payloadz.com/go/?id=914689
email us at …… thegaitguys@gmail.com
Oh Pippa ! For God’s sake (or at least the Queen’s) start using your gluteus medius for crying out loud ! That opposite hip drop isn’t winning Dr. Allen over. !
(internal tibial torsion, knees approximating (due to the lack of left g. medius use, high ramp angle shoe……..mon dieu !……. great dress, bad shoe though ! )
Gluteus medius avoidance and blood pudding, apparently it’s what’s for brunch these days !
The Gait Guys
