Week 6: Front and back hip in gait

Week 6 has completed and it was great to learn more about  the hip joints and muscles. This region has some of the biggest muscles in the body and is the powerhouse for movement. The way the body moves from the feet to head, or the head to the feet, loads the hip joints (eccentric) in preparation for an explosive (concentric) unload. The triplane motion of this joint and, in particular the transverse plane internal rotation in gait, enables the buttock muscles to perform ecocentrically. This means the muscle uses its eccentric lengthening to perform concentric shortening, both at the same time.

 

The primary movement assessed this week was gait. We looked at the front hip and back hip in gait. We took our knowledge of what happens at the foot in gait and learnt the chain reaction up to the pelvis. It was clear that the movements through the chain reaction prepare the buttock muscles to load and then unload powerfully. We also looked at golf and how both hips are loaded in the back swing, in preparation for an unloading powerful stroke.

 

The webcasts on 3D squat looked at the various combinations of bilateral squat movements using combinations of saggital, frontal and transverse plane positions. (There are 27 possible combinations).

We also added in arm motions and also did triplane motion using single leg balance positions.

 

We grew our understanding of nomenclature using the SaFTey syntax. The key to assessment is to make the tweaks small at the start and see the clients response and then make the tweaks bigger later. We know the most powerful tweaks can be those planes of motion which are not the primary plane of motion of the joint.

We increased out understanding of nomenclature by learning how to describe exercise movements and how movements are done in reference to a common point called a Tripost.

 

In AFS Strategies we learnt about the desire of the body for success, to have fun, to be avoid pain. If we can have all these elements in our approach the body will unconsciously want to do the movement.

 

We finished the Sign language alphabet. It was not that difficult to learn and I look forward to learning some great new phrases.

 

Overall this week took the concepts of AFS and put it into the function of gait. Great week to consolidate some key principles in tweaking for success

 

 

 

 

 

 

 

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Get your Biomechanics assessed early to avoid injuries

There is a difference between osteopaths, chiropractors and physiotherapists. Physiotherapists’ background is often based upon rehabilitation and, in this sense, physiotherapists learn to assess the biomechanics of the joints of the body and then how that movement is coordinated in function. For this reason you see physiotherapists associated with professional sports teams.

Understanding the biomechanics of the body helps to identify the cause of an injury or, if an injury has already occurred, how to rehabilitate a person back to sport. A trainer’s role is to strengthen the body and, in this sense, they will look at how to control movements with specific strengthening exercises. The physiotherapist can complement the trainer by looking at the finer points of joint movement and by integrating other systems of the body, such as neurophysiology, pathology, and the cardiovascular system.

When training for the first time in the gym, or looking to achieve a goal, it helps to have your biomechanics assessed to aid in avoiding injury. An experienced physiotherapist and trainer can work together to protect from potential injuries which can occur if the body already has poor biomechanics. No two people are built the same, and therefore an assessment should be very bespoke. An example of poor biomechanics would be: a person who has a restriction in the ankle joint such that when they do squats, lunges or step-ups this causes a secondary movement in the knee, hip or back – and somewhere pain will start to occur. This is a very simplistic example of how to assess biomechanics, but it illustrates the importance of identifying these problem areas.

Biomechanical issues may not be a problem in the initial stages of training, where the number of repetitions or length of training is low. However, when training distances and intensities increase, these biomechanical issues will start to cause injuries. It is advised that you do not try to work through these injuries, but rather have them assessed, to allow your training to progress smoothly and with minimal chance of injury. The synergy of a physiotherapist and trainer working together is a formidable team in helping to prevent injury –and exists in many professional sporting environments.

Personal Training series: Running shoes and running biomechanics

There are many shoes on the market at the moment for running. Running biomechanics have taken a big shift in the last 5 years.  Running brands such as Asics, Brooks and  Saucony have created shoes which are designed to prevent collapsing of the foot, or increased cushioning for those people with high arches. The general understanding of biomechanics and these types of shoes, is one which involves a heel strike pattern. In this pattern the heel will hit the ground first, the heel of the shoe absorbs the shock; the heel then controls the foot as it passes through mid stance and toe off.

Conventional shoes have worked over time for some people; however for others they have not made any difference, and some people who wear these shoes are still prone to knee, hip and lower back pain. When running with a heel strike pattern it is thought that as the heel strikes in front of the body there is a vertical force passed back up through the leg, the hip, the groin, the knee, and the lower back and that this results in injury.

Over the last 5 years there has been a wealth of research and contentious debate over the benefits of forefoot running. Forefoot running is where a person runs landing more towards the mid and front of their foot, instead of the heel being the first point of contact when the foot hits the ground during running. The foot also lands underneath the body and the stress imposed on joints are reduced.

Support for forefoot running comes from practical demonstrations on treadmills. When someone walks on a treadmill they have a characteristic heel strike pattern; however as the speed of the treadmill is increased they naturally start to run more towards the mid and forefoot. It has been theorised that the body is not designed to run with a heel strike pattern. When videoed at a faster speed on the treadmill the foot can be seen to strike more towards the mid foot and spring off. When seen at its best – like in Olympic marathon runners – the foot will actually hit the ground under the body; it is then kicked up behind their back using the hamstring muscles, before quickly returning to land again directly under the body.

The theory that running on the forefoot reduces joint pressure has been researched. With forefoot running the force of the body passes directly up through the body vertically –thereby relying upon the natural cushioning effect of the quads and the hip muscles. If the body is stiff enough – and the biomechanics are correct – the knee and hip joints can absorb the repetitive loading of running and hence reduce injury to the joints.

There are now shoes which have been adapted for forefoot running. Vivo barefoot is one of these companies and has created a range of shoes designed for walking right through to cross country running. Forefoot running shoes are designed to have minimalistic cushioning in the foot. These shoes are designed for the foot to feel the ground and reaction forces of the ground as the foot hits the floor. When the foot can feel the landing onto the floor, it can stimulate muscles to fire and get immediate push off onto the opposite leg. The soles of these shoes are very thin and Vivo Barefoot have described the sole to being as close to skin depth as possible.

Clients have reported they enjoy using these shoes. They feel completely different to thick soled shoes. They also give a refreshing feel to the foot at contact with the ground. The key is that this ‘feel’ will stimulate better muscular activity, shock absorption and reduction injuries. There are many successful runners in Olympics and World Championships who do not have a forefoot running pattern. It is not advised that everyone run on their forefoot – and a physiotherapist and trainer will be able to tell whether your body is capable of withstanding the pressure required to learn how to forefoot run.

Recently a trainer started forefoot running; it has taken 4 months for him to be able to run on his forefoot for 10km continuous running. To change to a forefoot running pattern requires significant adaptation and change within the body. The runner must allow time for this adaptation to occur because if they push themselves too hard and too fast in training injuries will occur.

I believe forefoot running biomechanics seems to make sense; however I have also seen that not everyone is prepared to take the time to learn how to forefoot run and people who run heel strike can still become world champions.

If you want to learn how to forefoot run it is important that you see a forefoot running coach – such as a physiotherapist who has experience, or an independent specialised coach.

Personal Training series: Foot and Ankle injuries

The foot is often overlooked by medical professionals and trainers. The foot can be a common cause of problems in other areas of the body. Biomechanics of the foot can be complex; however if assessed with video analysis, looking at joint play within the foot and how the muscles are coordinated to control the foot, then often the problem can be identified.

I have treated a runner who developed groin pain because he developed a stiff first toe (big toe). He was a 100m sprinter which involved rapid bursts out of the blocks and ten seconds of very intense running. Over time the big toe created abnormal ankle movement which led to knee, hip, pelvic and lower back pain. The weakest link among all these joints was his groin. The groin pain affected him so badly he could no longer compete for that season.

Another illustration is someone who has had a previous ankle injury and the ankle joint is stiff. When comparing the right and left sides they can see that one side of their body has less ankle movement when they squat. The restriction in the ankle will create abnormal knee and hip motion and have consequences on the pelvis and lumbar spine. The ankle joint can be a difficult joint to increase mobility. To keep the improved range of motion often requires regular home stretching. Sometimes a Physiotherapist is required to help return normal joint play to the smaller joints within the foot.

The foot and ankle are made up of an array of small and long bones; these bones all have to work in a coordinated fashion to enable the ankle joint to move correctly. It is the job of the physiotherapist and trainer to identify where these smaller restrictions may be – where they affect or present as generalised pain in other parts of the body.

Clinically, if the ankle has been fractured or sprained there can be restrictions due to a poor healing process.  If the restriction has come on with no trauma then maybe the ankle has been restricted over time due to myofascial restrictions throughout the foot and ankle. The latter can be corrected much more quickly. When a client has on-going assessment by their personal trainer and Physiotherapist myofascial restrictions like this can be easily identified, especially in the foot but also throughout the rest of the body.

The foot and ankle are the first parts of the body to connect with the ground when walking, standing, running. Before training, it is important that the foot and ankle have normal range of motion to prevent injury.

Learning to run on the Forefoot at Vivobarefoot running clinic

 Physical Edge attends Barefoot (Forefoot)  running Lab with Rollo from Vivobarefoot. This was a 6 hour Lab looking at the current biomechanics supporting Forefoot running and then how to run on the Forefoot itself.  The Laboratory is based in Farringdon, London and it contains the latest technology for gait analysis, including video analysis and force plate measurements. 
 
The training demonstrated the importance of correcting restrictions in the foot before starting Forefoot running. These restrictions can alter the flexibility of the first toe, Metatarsal and ankle. When running it was a key concept to feel pressure exerted through the knuckle of the first toe. This was called the Line of Leverage and shifted the Centre of Mass forward onto the Forefoot. The body is designed to take pressure through this Line of Leverage to help propel the body forward in running.
 
The way we walk, run and sprint require different biomechanics. If the body adopts the old paradigm of running, heel- to toe, it is constantly exposed to decelerating forces and subsequent injuries. Common areas for injury can be the ankle, knee, hip and low back. Primary areas to keep flexible to enable efficient Forefoot running are the Thoracic spine, hip and ankle. 
 
The day was an insight into the development of shoes designed to assist in Forefoot running. These shoes have very thin soles to replicate skin and assist in creating the sensation of running Barefoot. Forefoot running in the shoes is comfortable. In winter they can get cold but you can buy socks to keep your feet warm.
 
Physical Edge noticed when running Forefoot for the first time the calf muscles and soles of the feet can get very stiff and sore the next day. This is an adaption process and a reason why training is done gradually. If you have an injury you can learn to run Forefoot but it will require a period of rest from training. You can do alternative cardiovascular exercises like swimming, water running and possible cycling. 
 
Physical Edge can you help you prepare your body for Forefoot running and direct you to trained Forefoot running coaches. If you have any questions do call or email us and we look forward talking to you soon.