Cortical Repatterning
We have been talking this week about what we all cortical repatterning or “motor programming”. Here I run through simple marching exercise for a patient with dystopia, giving some salient points and cues along the way.
Marching, a rudimentary motion, is a great screening for people with motor programming difficulties. This gal has left lower extremity dystonia and we were looking to see if it was more peripheral or central in origin.
You can see how her movement breaks down after a few simple steps of attempted coordinated movement. Use this simple marching screen next time you suspect a central programming issue in your patients :-)
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 !
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_______________________________________________________________________________
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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:
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https://directory.libsyn.com/episode/index/id/14905823
Calf size matters. Truly, and here is why.
The Achilles tendon (AT) moment arm transforms triceps surae muscle forces into a moment about the ankle which is critical for functional activities like walking and running. The achilles tendon moment arm changes continuously during walking. It changes as movement occurs and as the triceps surae contracts. But, it also changes as the muscle grows in size, or shrinks. This has relevance to exercise, strengthening, and atrophy of the calf compartment. When the muscle contracts, its cross sectional area changes, and this can change the pull angle on the achilles. One might think of the achilles tendon as being "tented" away from the tibia slightly, and one can feel this on their own foot when palpating the soft tissue space between the tendon and the tibia on plantarflexion even when sitting. Better yet, sit down, your foot on the ground. Now, palpate the soft tissue space between the achilles and tibia. Now raise your heel, thus forefoot loading. You will feel the space gap open, the moment arm has increased because of this, thus changing its moment arm. On dorsiflexion the moment arm shortens, on plantarflexion it lengthens. Sure, this does not create a monstrous line of pull change, but by the time we get down to the pivot point at the ankle mortise, a small change in moment arm can translate to significant changes in torque and force production. This is why a foot that does not supinate in time for heel off, or supinate sufficiently, meaning the rear foot isn't inverted optimally, means that the ankle mortise (talus position) might change/shorten that moment arm. This is not efficient mechanics. Want to jump higher ? You have to get that excessive pronation in ankle dorsiflexion under control and convert it to supination, and rearfoot inversion. Jumping from a collapsed foot tripod is a power leak and you will not optimize the triceps surae-achilles complex and their lever arm. This also goes for toe off in walking and especially running, particularly sprinting where you are up on that forefoot. Said another way, when the arch is more collapsed and the talus is thus more plantarflexed the moment arm is sorter for the achilles. Strength, power, torque all suffer. One does not want to engage heel rise and calf contraction from this ineffective position of pronation taken too far, or heel rise while still pronated. This can also put undue load, and angle of pull, through the achilles. Meaning, the linear pull one desires through the achilles, can be through a calcaneal insertion that is not oriented optimally. One might postulate, rightly so we believe, that the lateral bundles/fascicles of the achilles tendon might see more loading than the medial. At the very least, we might postulate that the medial and lateral achilles tensile loads are offset and unequal. This could create problems over time, meaning changes in tendon morphology.
In the below Rasske & Franz article, they posit that aging negatively effects the architecturally complex AT moment arm during walking, which thereby contributes to well-documented reductions in ankle moment generation during push-off. They looked at the "AT moment arms of young (23.9 ± 4.3 years) and older (69.9 ± 2.6 years) adults during walking, their dependence on triceps surae muscle loading, and their association with ankle moment generation during push-off. Older adults walked with 11% smaller AT moment arms and 11% smaller peak ankle moments during push-off than young adults. Moreover, as hypothesized, these unfavourable changes were significantly and positively correlated (r2 = 0.38, p < 0.01). More surprisingly, aging attenuated load-dependent increases in the AT moment arm (i.e., those between heel-strike and push-off at the same ankle angle); only young adults exhibited a significant increase in their AT moment arm due to triceps surae muscle-loading. Age-associated reductions in triceps surae volume or activation, and thus muscle bulging during force generation, may compromise the mechanical advantage of the AT during the critical push-off phase of walking in older adults. Thus, strategies to restore and/or improve locomotor performance in our aging population should consider these functionally important changes in musculoskeletal behavior."
Great article spawning deeper thoughts, here at The Gait Guys blog.
More to come on this most likely.
Aging effects on the Achilles tendon moment arm during walking. Kristen Rasske, Jason R.Franz
Journal of Biomechanics
Volume 77, 22 August 2018, Pages 34-39
Photo credit: Image by Huei-Ming Chai, National Taiwan University School of Physical Therapy as found on www.runsmartproject.com
Do you know what this is? You should if you walk or run!
It is the mechanism by which the tendon of the peroneus longus travels behind the lateral malleolus of the ankle, travels underfoot, around the cuboid to insert into the lateral aspect of the base of the 1st metatarsal and adjacent 1st cunieform.
When the peroneus longus contracts, in addition to plantar flexing the 1st ray, it everts the cuboid and locks the lateral column of the foot, minimizing muscular strain required to maintain the foot in supination (the locked position for propulsion). Normally, muscle strength alone is insufficient to perform this job and it requires some help from the adjacent articulations.
In addition, the soleus maintains spuination during propulsion by plantar flexing and inverting rear foot via the subtalar joint. This is assisted by the peroneus brevis and tertius which also dorsflex and evert the lateral column, helping keep it locked. Can you see why the peroneii are so important?
Signs of a faulty calcaneo cuboid locking mechanism:
-weak peroneus longus, brevis and or tertius
-excessive rear or midfoot pronation
-low arch during ambulation-poor or low gear “push off”
-subluxated cuboid
The calcaneo cuboid locking mechanism. Essential for appropriate supination and ambulation. Insufficiency, coming to a foot you will soon examine.
Would you like to know more? Join us for our “third Wednesdays“ online webinar: Biomechanics 313. Wednesday, June 18 at 6 MST. Onlinece.com
In a follow-up to our last IGTV video, here we look at appropriate place in metatarsal pads. Metatarsal pads can do a great job to lift and separate the individual metatarsal heads and create space for things like neuromas and alter the forefoot mechanics. They are not a substitute for appropriate exercise and strengthening.
This individual had right “sixth toe“ disease and the metatarsal pad was being used by a podiatrist to alter for foot mechanics. It was clearly too far back on the right side.
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It’s probably fair to say that a good number of us see people with “sixth toe” problems or a Taylor’s bunion more often than not. This problem is often accompanied by internal tibial torsion and sometimes femoral retro torsion. This video reviews a case that came in yesterday.
If you like this kind of stuff come join us on our website www.thegaitguys.com
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#6thtoe #6thtoedisease #tailorsbunion #lateralfootpain #footpain #footproblem #gait
We see this one ALL the time. We are sure you do as well. “Gluteus medius weakness and gluteal muscle tenderness are common symptoms in people with chronic non-specific LBP.” It is often more on the side of pelvic frontal plane drift. The abdominals and spinal stabilizers also often test weak on this same side.
We often see compromise of hip rotation stability as well because , since the hip is relatively adducting (because the pelvis is undergoing repeated frontal plane drift, hence no hip abduction) there is often a component of cross over gait phenomenon which can threaten rotation stability of the lower limb (type “cross over gait” into the search box of our tumblr blog for an sample of work we have written on that phenomenon). Eur Spine J. 2015 May 26. [Epub ahead of print]
Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls.
Cooper NA1, Scavo KM, Strickland KJ, Tipayamongkol N, Nicholson JD, Bewyer DC, Sluka KA.
http://www.ncbi.nlm.nih.gov/pubmed/26006705
#
Finding the right load for a given tendon and a right frequency of loading and duraction of loading is also case by case specific. Part of finding the right loading position is a discovery process as well, as noted in the photos above. Finding the fascicles you want to load, and the ones you do not want to load (painful) can be a challenging discovery process for you and your client. Finding the right slice of the pie to load, and the ones not to load takes experimentation. When it is the achilles complex, finding the safe However, if one is looking for a rough template to build from, brief, often, heavy painfree loads is a good template recipe to start with.
Here, in this Geremia et al article, "ultrasound was used to determine Achilles tendon cross-sectional area (CSA), length and elongation as a function of plantar flexion torque during voluntary plantar flexion." They discovered that, "At the end of the training program, maximum isometric force had increased by 49% and tendon CSA by 17%, but tendon length, maximal tendon elongation and maximal strain were unchanged. Hence, tendon stiffness had increased by 82%, and so had Young’s modulus, by 86%. Effects of high loading by eccentric triceps surae training on Achilles tendon properties in humans.
European Journal of Applied Physiology
August 2018, Volume 118, Issue 8, pp 1725–1736
Maximum isometric force had increased by 49% and tendon CSA by 17% !
Tendons can change their cross sectional area, if you load them.
Here I show lateral forefoot loading in a heel raise, and a medial forefoot loading in heel raise. This has to be part of the discovery process outlined below.
Isometrics are useful, they have their place. In a recent podcast to load up here in the future, we discuss the place and time to use isometrics, isotonics, eccentrics and concentrics.
One of the goals in a tendonopathy is to restore the tendon stiffness. Isometrics are a safe way to load the muscle tendon complex without engaging a movement that might have to go through a painful arc of movement. With isometrics here is neurologic overspill into the painful arc without having to actually go there.
The key seems to be load. More load seems to get most people further along. Remember, the tendon is often problematic because it is inflammed and cannot provide a stiffness across its expanse. Heavy isometric loading seems to be a huge key for most cases. But, we have to say it here, not everyone fits this mold. Some tendons, in some people, will respond better to eccentrics, and strangely enough, some cases like stretching (perhaps because this is a subset of an eccentric it seems or because there is a range of motion issue in the joint that is a subset of the problem). Now the literature suggests that stretching is foolish, but each case is unique all in its own way, and finding what works for a client is their medicine, regardless of what the literature and research says.
Awareness is key. Does this person know they are doing this ? Do they have pain? If they do not have pain or awareness is it a problem and does it need addressed ? These shoes did not make this person load like this, the person broke the shoes into this pattern. There is something going on, the question is what drove this ? Most likely, this is not a footwear problem, this is a person problem in the footwear.
What we see is not the problem most of the time. We are seeing their strategies , coping mechanics and their ultimate failure to load more cleanly most of the time.
There are people out in the fields that are saying posture doesn't matter, that your next posture is your best posture. This is a bit curious to us. Sure, if you are not in pain then is a given posture a problem? One could argue that, but not with a strong argument, we believe. Take this foot-shoe posturing for example, is this a problem if it is not painful ? Do we leave it alone if it is not painful? Or do we "head this one off at the pass" before possible pathology or pain presents itself? There are certainly no guarantees, however, one can use some educated and calculated logic and make some reasonable decisions that things are going to go off the rails at some point (or in this case, the heel is going to actually go off the shoe!). So, are you going to change this person's footwear ? Bring it to their awareness ? Look for problems in there body mechanics locally and globally? Or are you just going to say, "foot posturing doesn't matter". Saying it is not a problem, until it is a problem, seems awfully negligent, doesn't it?
One cause of hammertoes
Take a look at this gals left foot. Notice the high, cavus arch as well as increased tone in the long flexors of the toes. Is it any wonder she has weakness of the long extensors on that side?
Look at the other picture and note that she has a shorter leg on the left. Yes, it is anatomical and tibial on clinical exam. She also has limited ankle dorsiflexion and hip extension bilaterally, left greater than right.
When the foot is cavus it puts an increased stretch on the long flexor muscles of the foot because the metatarsalphalangeal joint is in relative extension. More than likely this will activate the Ia afferents from the muscle spindles causing more tone in the flexors. Yes, that will decrease over time but you will also increase the relative length of the long flexor tendons and decrease the length of the long and short extensor tendons.
More tone in the flexors equals less tone in the extensors. Combine this with a lack of ankle dorsiflexion and hip extension and it’s prescription for more hammertoes. In addition, she has an anatomical short leg on the left putting that foot in relative supination with respect to the right. She will need to claw her toes in an attempt to create stability on that side.
The fix will be getting better control and strength in the long extensors and improving ankle dorsiflexion and hip extension.
So this is what happens when you don’t wear the right shoes as a kid…
This woman came into the office with lower back pain. Do you notice anything peculiar about her feet?
She said that when she was young she was told by the doctor she was “dink toed” and given special shoes (on a sidenote, she has bilateral external tibial torsion and no evidence of forefoot adductus) . The shoes evidently (according to the doctor) were too tight and caused the deformity that you see here. She stated that the shoes were extremely painful while wearing them and then for quite a while when she stopped. This is always been her “problem foot“ with limited toe dorsiflexion and ankle dorsiflexion on that side.
Notice how the distal phalanx of the Halex is stunted and it’s with is increased. Dorsiflexion at the MTP is limited with respect to the other side and dorsiflexion flexion at the IP is limited as well. It appears that the growth plate was damaged resulting in a hypo plastic digit which, due to insufficient length, transfers a lot of weight during terminal stance and preceding ( at the end of her gait cycle, preparing for propulsion) to the second metatarsal head where she gets moderate discomfort.
We can increase the motion of the first ray with mobilization and exercise but unfortunately we are not able to lengthen her digit.
Growth plates are fragile things and what we do to children early on can have a profound impact upon their adult life.
footproblem #toeproblem #hallux #halluxdeformity #bigtoe #gait #gaitanalysis #footexam
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join us at the 40$ level,
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*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 (~$20).
Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.
Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2
Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast
Links to today's show:
http://traffic.libsyn.com/thegaitguys/pod_160_april._14_-_42620.mp3
http://thegaitguys.libsyn.com/masterclass-in-gait-vimeo-q-a-podcast
http://directory.libsyn.com/episode/index/id/14157119
Patreon and Masterclass: https://www.patreon.com/thegaitguys
join us at the 40$ 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.
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
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_Feb_7_2020_-_22920_8.26_AM.mp3
http://thegaitguys.libsyn.com/gat-ataxia-foot-strength-glute-medius-tears
http://directory.libsyn.com/episode/index/id/13350479
SPG7 mutations are a common cause of undiagnosed ataxia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371411/
Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Ulisses T.Taddei, Alessandra B.Matias, Fernanda I.A.Ribeiro, Sicco A.Bus, Isabel C.N.Sacco. Physical Therapy in Sport
Volume 42, March 2020, Pages 107-115
https://www.sciencedirect.com/science/article/abs/pii/S1466853X19304687
Effect of an 8 week foot intrinsics muscle strength program:
Jill Cook (@ProfJillCook)
11/10/19, 12:14 AM
@BRoe28 @Bill_Vicenzino @MuscleScience @jongumucio New study by Docking et al shows both US and MR cannot pick a partial tear from tendon pathology (glut med tendon)
Partial tears over-diagnosed and over-treated
Treat as tendinopathy and LOAD them
Paul Hough (@the_hough)
10/29/19, 12:45 PM
⬆️ in muscle force after 4 weeks of strength training is mediated by neural adaptations (motor unit recruitment & rate coding)
https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/JP277250
The increase in muscle forceafter 4 weeks of strength training is mediated by adaptations in motor unit recruitment and rate coding.Journal of physiology, Feb 2019
Alessandro Del Vecchio, Andrea Casolo, Francesco Negro, Matteo Scorcelletti et al
The role of the width of the forefoot in the development of Morton's neuroma
Park Y, Jeong S, Choi G , Kim H
Bone and Joint Journal-3-99B (2017)
We talk all things training again, a deeper dive follow up to podcast 152 with Coach. Listen to that one as well. Your training will thank you.
Links:
https://www.secondcitytc.com/
www.thegaitguys.com
www.shawnallen.net
www.doctorallen.co
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 (~$20).
Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.
Where to find us, the podcast Links:
Apple podcasts:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2
Google Play:
https://play.google.com/music/m/Icdfyphojzy3drj2tsxaxuadiue?t=The_Gait_Guys_Podcast
other links for today's show:
http://traffic.libsyn.com/thegaitguys/pod_mikeL2_feb21220Final.mp3
http://thegaitguys.libsyn.com/round-2-coach-mike-lucchesi-olympic-trials-2020-atlanta
http://directory.libsyn.com/episode/index/id/13123520
https://www.secondcitytc.com/
thegaitguys.com
shawnallen.net
doctorallen.co
Mini Pod: Biomechanics, Shoe foam with Coach Mike Lucchesi of Second City Track Club
155. Mini Pod: Biomechanics, Shoe foam with Coach Mike Lucchesi from SCTC, Second City Track Club. This is a conversation we had as we get read to send Coach and 9 of his runners down to Atlanta for the Olympic trials in a few weeks.
http://traffic.libsyn.com/thegaitguys/minipod_mikeL_biomechanics_-_21120.mp3
http://thegaitguys.libsyn.com/mini-pod-biomechanics-shoe-foam-with-coach-mike
The Masterclass: The Gait Guys Way
As promised, a live hour with us, some structured, some loose and conceptual, but it is our way. This is part zero, free to everyone. Part 1 will be recorded in the next 2 weeks. Those classes will be pay per view. This will be at the least a dozen classed, probably 2 or 3 dozen, we have a lot to teach you.
We are, as of yet, undecided as to the cost, what Patreon levels get this for free (likely the 50$ per month). We may (likely will) parse out big pieces and portions to the 20$ folks for free, included in their monthly donation. But, do not hold us to this, we are undecided, but we did not want to hold back part ZERO, the rough intro so you can get a feel for us, and the material we are going to teach. Remember, there will only be 100 live seats when we go live (likely Wednesday nights, or Friday late afternoons Central time), and Patreon folks will get first dibs to fill seats, so check in regularly, we will post a TEXT notification here and give a weeks notice. For those who cannot get into the LIVE class where we will take LIVE real time questions, just like in a classroom, we will record the classes and harbour them on a service like youtube or vimeo behind a pay wall. You can always take our classes for CEU/CE over on onlineCE.com but these Masterclasses will be far far deeper in content, discussion, case demos, deep dives and open ended discussions.
Until then, enjoy.
Stay tuned !
*video link is above
shawn and ivo
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