Friday, March 22, 2013

Notes on Gait Function with Thomas Michaud

These are some of the highlights or things I found of importance in a recent webinar I took given by Thomas Michaud.

Walking, your center of mass (COM) is highest at midstance.  Running the COM is lowest at mid stance.

Inefficiency of the Gastroc is the point where speed goes from walking to running.

Some studies done with forefoot running as a means to prevent injury were flawed as they were done with college runners that had already become midfoot strikers.

Runners that are not elite that transfer to a forefoot or minimalist type shoe show arch inner calf problems if they have a flatter arch, higher arched individuals show with more metatarsal strain/stress fracture.

Most runners are more efficient with heel strike when energy expenditure is looked at.  Around the 6 minute clip is when forefoot running becomes more efficient.

Shape of the heel is perfectly suited to absorb impact.  100lb female has a larger heel bone then a 350lb Gorilla.

Heel expands and contracts like a rubber ball.  Thin outer layer of bone and and extensive blood supply to help repair.

The heel is protected by a well designed 3/4 inch fat pad.  The fat pad is spiral chamber of sealed fat.  Fat pad is several chambers.  Outer layer is a protective cup.  The inner layer is a major shock absorber.      It quickly deforms and reforms.  Retains all its shock absorption even in cold environments.   It is made of polyunsaturated fat.

Barefoot running shows 60% deformation of heel pad.  Shoes it is 35%.  Walking is 40%.  Thinning of the heel pad is a major predictor of foot pain.

With a heel strike the Tibialis Anterior is used to handle the absorption of impact which it is well designed to do.  Midfoot strike the Tibialis Posterior is responsible for slowly lowering the heel.  Forefoot strike the Gastroc is used.  It is not well designed for this as it crosses 2 joints.  2 joint muscles are easier hurt.

Flexor Digitorum muscles are important for dampening the oscillation from bony vibrations.

Lateral Gastroc and Biceps Femoris were important for pre muscle contraction right before impact.  This is why running surface matters very little.

While glute med/min are important for hip stability, the faster you run, the more important the Glute Max becomes.

One myth is that disc act as shock absorbers.  McGill has proved that the endplates of the vertebral bodies are what absorb impact.

IT Band is an energy storer.  Hips are force producers, lower legs act like rubber bands storing and returning energy.  Prosthetic makers have started to take advantage of this key understanding.

Seems counterintuitive, but the calf muscles don't go through big lengthening, more of an isometric with the tendons going through large changes in length.  As we age, tendons get more brittle, hence we have a harder time moving fast.

Flexor Digitorum Brevis is an important muscle for maintaining arch height.  Weakness may be a important cause of plantar fasciitis.

Slow running possibly less stress on the joints then walking.

Flexor Hallucis Longus pulls the fibula head down.  This deepens the ankle mortise and helps to prevent ankle sprains.  So if dealing with an ankle sprain, mobilize fibula and strengthen FHL.

Achilles is unique as it rotates 90 degrees before attachment.  Gastroc/Soleus (GS) primary role is not one of concentric (shortening) but more isometric impulse as and anchor for the Achilles tendon and allow the Achilles to go through large ROM.

Plantaris is located between the GS.  To thin to be used for force production, now known to be loaded with mechanoreceptors.  It provides detailed information to CNS to allow the GS complex to create precise isometric impulse for proper Achilles function.

When Achilles is storing and returning energy efficiently, it reduces the load on the hip flexors.

Looking forward to reading through Thomas Michaud's latest book.  "Human Locomotion."

Tuesday, March 19, 2013

A Few Product Reviews

Here are a few of the products I've been using that I think are worth mentioning.

First up,  the Squatty Potty.  It's kind of a funny concept growing up in the United States, but many cultures still go to the bathroom using the "Third World Squat."  I first read an article about the proper way to eliminate and started looking further into it.  This is a pretty well made video.

Now I'm starting to see these recommend in a few places.  I like it and think there pretty cool.  I'm keeping mine.

Next up is the Slingshot from Marc Bell.  It essentially unloads some of your weight and supports your elbows as you bench or do push ups.  While it did do what it said it would do, allow you to complete more push ups.  I didn't really see much benefit from doing them that way.  It was strange in that I didn't get a pump in my triceps or chest from doing more push ups and after playing around with it a few days, haven't really used it to much since.

I've been doing some reading about how computer screens late at night can trick your body into not falling asleep.  Since I read a ton on my iPad at night, I looked into some options.  I forget who recommend the blue light filter from LowBlueLights, but it seems to work.  The blue rays are what causes suppression of the sleep hormone Melatonin.  My first night using it, I fell asleep while reading.  I had never done that before, but did all the time while reading hardcover books.  It's easy to remove in the daytime as well.

I had heard of the Perfect Health Diet for awhile now and finally bought the book and read through most of it.  I agree with most of it and think it's a solid way of eating.

So those are a few things I've been playing around with.  Enjoy!

Friday, March 15, 2013

Wednesday, March 13, 2013

Beauty and Health in Symmetry

If you look around the world, you will be instinctively drawn to symmetry.  We are hard wired for it it seems.  Babies will stare longer at symmetrical faces then non.  We unconsciously are drawn to more symmetrical people of the opposite sex.  Symmetry to us is beautiful.  It's embed in nature.  There may be even some deeper underlying health issues with symmetry as men and women with asymmetrical faces are more prone to depression and stomach issues.

In general we know that asymmetry in the body also predispose one to injury.  Not necessarily cause injury, but perhaps is a contributing factor, more so then general "inflexibility" or strength.

For instance, if one is on their back and raise one leg up, then the other,  compare.  The standard is 90 degrees to the floor.  If both are about equal, even if they are much less then the standard, the new way of thinking is that it is probably less of a deal then if one leg is more limited.  The limited leg may be a problem.  I stress MAY be.

There are a few instances where asymmetry may be appropriate such as a baseball pitchers elbow.  The lay back position has increased as thousands of repetitions have brought about appropriate bone and soft tissue changes to allow that 90 mile per hour fastball.

Most of us are not in the asymmetry will help category though.  Everyone now realizes that mobility is important, but many don't really know where to begin.  Movement screens have become very popular as of late for that simple reason.  It's easy to understand this is different then this.   Asymmetry is not just range of motion though, it can also be a firing pattern.  Sure your thoracic rotation was equal, but you were strong on the right and weak on the left.  This too is asymmetry.

Instead of blindly doing a half ass warm up at the gym or before a run, do a few symmetry checks, improve them and then go about the workout.  Not only will the workout most likely go better, but you may have increased your chances of staying injury free.

Everyone has a trademarked (number with cool sounding name) so I'm calling these the T.O.P. 6.  (get it?)

1.  On the floor, legs straight.  Press one heel into the floor, keep the other leg straight and raise it up.  Check the angle and feel.  Test the other leg.  Posterior Chain

2.  Same position.  Raise the leg up and slowly abduct the leg away from the body.  Keep your pelvis on the floor.  Return and test other leg.  Medial Chain

3.  Same position.  Bend one leg, heel on the floor.  Other leg is straight.  Keep you ankle in dorsiflexion on the straight leg.  Rotate the leg internally and externally.  Compare to the other leg.  Hip Rotation.

4.  Same position, bend one leg and keep the other leg straight.  Press through the heel of the bent leg and raise hips off the floor.  Keep your pelvis level, don't let the pelvis rotate.  Feel the glute or did you feel the hamstring?  Did your pelvis rotate?  Compare to the other side.  You want to be able to feel the glute and control the pelvis.  Glute Activity and Oblique Strength.

5.  Both legs bent.  Heels on the floor.  Keep your ribcage down, or parallel to the floor.  Keep the arm straight and raise it above you to try to get it the hand to the floor.  Again keep the ribs down, you will try to hyper extend the low back to cheat.  Keep it flat.  Test other side.  Thoracic Extension

6.  Same position.  Arms abducted ninety degrees to the body.  Bend 90 degrees at the elbow.  Rotate the shoulders internally, back to vertical and then externally rotate.  Shoulder Rotation

Run through these as part of your warm up.  It's feel as much as function.  Gain some symmetry.  Work for symmetry.

Tuesday, March 5, 2013

Regaining Intrinsic Foot Function

I would have said a few weeks ago that I value the intrinsic foot muscles as an important part of the global integration of health and performance.  But, I've never truly given "foot exercises."  So how important did I really value it?

It's not belief it's practice.  Without practice do you really truly believe it's that important.   Apparently I was fooling myself or hadn't quite realized how to implement.  I check on most of the muscles that contribute to big toe function and have patients roll with a golf ball to improve the tissue quality, but just kinda assumed just walking would be enough to strengthen.  The foot intrinsic muscles and especially the big toe,  triggers reflex's not only in the quads, but also in the hip.  They are important.

Things like plantar fasciitis have now been shown to be more of a degeneration then inflammation.  Degeneration is things mechanically not working well so they are abused.  If we have tendon degeneration we would work on tissue quality and perhaps go into some eccentric strengthening.

So I'm still an advocate for golf balling the muscles of the foot.  Part of the process helps reintegrate the proprioception in your foot.  Proprioception is just information from your body to the brain.  It also helps to free up perhaps one layer of the foot from a deeper layer.  Improving the glide function.  This part is somewhat controversial, but still improves movement.

After rolling, start with learning to control the big toe in dorsiflexion.  The video below is me working on just that for a few days.  I was pretty astounded when I first worked this drill and couldn't move the big toe at all.  I had zero brain connection to my hallucis muscles.  Humbling.  The drill is press your toes into the floor and without letting them lose contact with the floor, lift the big toe up.  Trust me, you should be able on conscious control to move any part of your anatomy.  It took several, several sessions of rolling and just trying to get that toe to move.  Now it seems easy.  Does this translate into anything amazing?  I don't know, but I do know I have more control.  We'll see what this produces down the line.  Get to work.