More thoughts on gait, and what to do about it

Gait, walking, or running , is the most fundamental of all human movement patterns. We evolved to have a bipedal reciprocal gait pattern that allows all of our body’s other complimentary systems to function – everything from our respiratory and digestive systems through to our spatial awareness and emotional state are directly affected by the primary movement pattern of walking.

 

Walking (or running) therefore – whereas in previous ages was essential for our survival as a species, – is now essential so have an optimally functioning and pain free body.

 

The notion of foot mechanics being something we should consider has been around for a while, popularized by Daniel Liebermans Born to Run, countless runners took to the streets in their minimalist five finger shoes, and then immediately reported back with bruised heels, stress fractures and Achilles tendonitis.    The reasoning behind this is quite simple – our feet have evolved over millennia to move, but to move over uneven an irregular surfaces – grass, sand, rocks.   Tarmacked and paved road surfaces are – in evolutionary terms – incredibly recent developments.  Accepting our feet are designed to move is correct, but they didn’t evolve to cope with the impact of running over concrete!

 

The human foot has 33 joints, which are also designed to move. However, none of them move in isolation.

 

 

What our feet actually need is protection from the impact of running over artificial surfaces, but also flexibility to go through their natural process of pronation and supination.

 

Quite a tricky balance to strike, but not impossible – to understand the importance of this I will expand a little on the importance of biomechanics in gait:

 

The calcaneus, or the heelbone, is one of the most important bones in the skeleton. Both for providing stability to the foot, but also for providing sensory input to the brain, and assisting with its determination of where it (and therefore you) are in space.

 

All motion in the foot and ankle occurs about six joint axes:

 

1 – Talocrural

 

2 – Subtalar

 

3 – Longitudinal Midtarsal

 

4 – Oblique Midtarsal

 

5 – First Ray

 

6 – Fifth Ray

 

Gait is a whole body movement, the foot is important but it doesn’t stop (or start!) there

The subtalar (talocalcaneal) joint is the most important of all of these, because when it pronates (turns towards the midline)the forefoot unlocks, and when it supinates (turns away from the midline) the forefoot is locked.   During gait, and particularly during accelerated gait the foot is required to move through tri-planar motion – in simple terms this means it should move in multiple directions at the same time.  If this doesn’t happen – then other joints further up the kinetic chain are required to provide compensatory movement.

Accelerated locomotion (running) requires sequenced flexion of the joints of one leg whilst simultaneously producing sequenced extension of the opposite leg.

The ankle is the initiator of sequenced flexion (dorsiflexion / lifting toes up) , which then continues up to the knee (heel towards bum) and then the hip (lifting the knee in front of the body). The hip is the initiator of extension, which then travels down the chain ending in the ‘toe off’.

When this sequencing is out of line we have a foot unable to pronate, and a forefoot locked against a pronated foot – which in turn creates a shear force at the ankle and subsequent wear and tear of the joint capsule.  If pronation is unable to occur, or occurs too late on the gait cycle for stable propulsion,  then we can also create instability of the lumbo pelvic joints and whats known as tibial varum (bow legs in lay persons terms),  this bow leggedness causes issues at the knee, hip and the lower back – all due to a locked up foot!

In short – if a foot can not pronate and supinate freely during gait – then we will quite literally run into trouble.

Footwear choice is one factor to consider when looking to optimise gait – all 33 joints of the human foot are designed to move, so they should be allowed to do so, however we do also need protection from hard pavements or treadmills!

However, the most effective thing you can do get your legs doing what they should is to specifically target the muscles that are responsible for driving the sequence:

Training hip extension is one of the most important considerations in improving gait

3 Exercises to assist with optimal Gait

 

1 Single leg glute bridges. 

  • The point of toe off – literally when the toe of the rear foot leaves the floor on a running stride – as mentioned above –  should be initiated through unilateral (single legged) hip extension, driven by the gluteus maximus on the rear leg.

How to?

Position yourself in a bridge position with your shoulders on a bench or a soft plyo box. The shoulder blades should be fully supported by the bench (box),  the feet firmly grounded and the pelvis neutral.

Take one foot fom the floor and grab the knee with two hands.  This puts the hip flexors on the non working leg on slack and minimizes the tendency to cheat the movement by using them to help.

Keeping the chin tucked in to prevent over extension of the neck lower the hips towards the floor, and then drive through the grounded foot pushing the pelvis high, you shold feel a string contraction in the buttock of the working leg.

Ensure you drive through the bal of the foot on the working leg, not the heel.  We are trying to train toe off with glute max recruitment, driving too much through the heel recruits more hamstrings which should not be the initiator of gait.

Perform 3 sets of 8-10 reops on each side

  • Pallof Press

 

  • Being able to manage the pelvis through three planes of motion will assist in optimizing the power of the stride, but also in ensuring that extension is initiated through the hip, and flexion is initiated through the ankle.This also allows for reciprocal counter rotation through the ribcage in turn allowing optimal respiration during gait.

How to?

            Position yourself at 90 degrees to a cable column, feet fully grounded and pelvis in neutral

            Select a light to moderate weight and grasp the handle in both hands up against your midsection..

            Sense your heels, unusual instruction, but allowing your weight to shift back over the heels rather than being forward in your toes will train the correct muscles in the right places!

            Press the handle directly out in front of you, as your arms extend, they create a longer lever arm for the cable, and it will try to rotate you towards the cable column.  You must attempt to resist this rotational pull by engaging the internal and external obliques.

            Ensure tension is coming through the obliques and not from the diaphragm by exhaling on the press away and inhaling as you draw the handle back towards you.

Perform 3 sets of 6-8 reps each side

 

  • Modified Single leg RDL

The hamstrings should act as the ‘pull’  on the front leg.  As the front foot strikes the ground, they immediately contract in opposition to the glute max on the rear leg.

How to?

            Stand tall with a neutral pelvis and the obliques engaged

            Giving the example of the left leg as the working leg,  reach the right hand down towards the right foot.  Exhale fully as you do so to allow the ribcage to reciprocally rotate. And the left lower ribs to move towards the left illium.

            Grasp the left ankle with the right hand and place the ball of the right foot on the ground comfortably behind you, the right foot should be flexed at the midfoot and you should be able to sense your left heel.

            Use the left hamstring to pull the torso back to upright and neutral, think of the left heel and mid foot as ‘clawing’ the floor backwards beneath you.

            The right foot should act as a brake – the ball of the foot giving traction into the floor.  This should allow you to feel a co-contraction in the right glute max and the left hamstrings

Perform 3 sets of 10-12 reps on each leg

2019-07-11T18:25:06+00:00July 11th, 2019|0 Comments

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