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Hip Drive vs Gravity Drive

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Brian A. Rothbart, Jan 28, 2013.

  1. Brian A. Rothbart

    Brian A. Rothbart Active Member


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    What is abnormal pronation? I have presented a methodology to answer this question. I suggest that whether the foot motion is normal or abnormal, is based on whether the foot is being driven by the transverse plane oscillations of the hip, or by gravity.

    Hip Drive. Internal hip rotation pronates the ipsilateral foot. External hip rotation supinates the ipsilateral foot.

    Normal or Abnormal Foot Motion (e.g., pronation and supination) is defined in terms of Hip Drive:

    Normal foot motion (pronation and supination) - when the foot motion is driven by hip drive.

    Abnormal foot motion (pronation and supination) - when the foot motion escapes hip drive (e.g., Gravity Drive)

    Prof B
     
  2. efuller

    efuller MVP

    Hip motion is independent of STJ motion. It is possible to internally rotate your hip when the STJ is supinating and when it is pronating.

    Brian, I'm not going to click on your link. If you want to present your theory, paste it into a post. Can you define abnormal pronation without defining what normal is? What criteria would one use to define normal pronation. Of course, you would have to describe the conditions for your definition because, normal pronation for one condition would not be normal for another condition. (e.g. Walking across a slope.)

    Eric
     
  3. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Eric,

    In my opinion, when the foot is placed in a closed kinetic chain, clockwise rotation of the hips will pronate the left foot and supinate the right foot.

    One can easily test this by standing up and rotating your hips. Then observe the action in the STJ. If what you say is correct, then rotation of the hips will not change the position of the STJ. This is contrary to my experience.

    Prof B
     
  4. efuller

    efuller MVP

    When I rotate my hips, I can choose to move my STJ in any direction by using the extrinsic muscles of my feet. I will admit that I don't have the same range of motion when I go in the direction with the opposite twist, but it is possible because the motions are independent. The motion at each joint will be caused by the net moment at each joint. Musces can contribute to it. Yes, if you take a cadaver and rotate the lower leg and get a coupled motion. This does not extrapolate to the the hip because the knee is not designed to transmit this torsional force.

    Have you ever asked anyone to perform that hip twist maneuver while looking at their ankles. You can see the increase in tendon tension when the subject contracts their muscles. The motion that you see is more from the muscle contraction than from the twist of the hips.

    Eric
     
  5. Brian A. Rothbart

    Brian A. Rothbart Active Member

    My view is in line with Close and Inman. Inman was the first (I believe) to describe this link between the pelvis and foot. I have seen this link consistently and use it to determine if (during gait) the foot motion is normal (directed by the hip) or abnormal (directed by gravity).

    For example, if the right hip is rotating clockwise (on the transverse plane), the right foot should be supinating (I would consider that normal foot motion). However, if the right foot is pronating while the right hip is rotating clockwide, I would consider that as abnormal foot motion. In my opinion, it is not the degree of foot motion that makes it normal or abnormal, it is the timing of that foot motion which is directly linked to the pelvis. (Hence my discussion on Hip Drive vs Gravity Drive)

    Obviously you can impact this link by engaging muscles in a way that normally are not recruited during ambulation. But this does not invalidate the natural link between the foot and pelvis. And you are correct, increased tension is noted in the ligaments around the ankle when the hips oscillate in the transverse plane (in a closed kinetic chain). But Thomas Myers and others have described this as a natural outcome of the 'anatomy trains of fascial links', that run foot to cranium.

    To wonder slightly off this discussion, I have observed this same type of linking throughout the body. For example I have described the link between the motion in the foot and the position of the pelvis and the link between the position of the pelvis and temporal bones (both pure ascending models). For example, when the pelvis rotates externally (anteriorly), the ipsilateral temporal bone rotates externally (posteriorly). Jonathan Howat (in his book) describes this same link between the temporal bone and ipsilateral innominate, but from a descending pattern.

    The body is truly connected, foot to head. That is why I continuously stress the importance of evaluating the entire skeletal framework when putting anything underneath the foot.

    Prof B

    Myers T: Anatomy Trains. Mysofascial Meridians for Manual and Movement Therapists. 2nd ed. Churchill & Livingstone

    Howat JM. Chiropractic Anatomy and Physiology of Sacro Occipital Technique.
     
  6. efuller

    efuller MVP

    The hip is a joint with bones on either side of it: The pelvis and the femur. The pelvis can rotate over the femur without the femur moving or with the femur moving. The momentum of the body will twist the femuronly if the external rotatory muscles are active. I question whether the femur can externally rotate the tibia. The knee is not a good torque transmitter.


    I didn't say ligaments, I said tendons. The distinction is important in that the muscles and tendons are controlled by the CNS. The movement seen is not passive but caused by the muscles. The terms hip drive and gravity drive give the sense that this not muscle caused motion.

    I will admit that it is easier to take a longer stride if the stance leg STJ is supinating at the same time the pelvis is externally rotating over the stance leg femur. This not a natural link. The body goes through other motions than straight ahead walking. There will be maneuvers that will require the STJ to pronate when the hip externally rotates. If the idea of fascial links can't take this into account those ideas should be discarded.

    Eric
     
  7. Brian A. Rothbart

    Brian A. Rothbart Active Member

    When I refer to the hip, I am referring to the innominate bone (not the femur).

    When I said ligaments, that was not a mistake. I am not taking about active muscular control (which would involve tendons, as you stated). I am taking about a passive link, activated by what I believe are anatomical fascial links. You are correct in that Hip and Gravity Drive are not driven by muscular contractions.

    Do not confuse the transverse plane oscillations of the femur with what I am describing (e.g., the foot to innominate link). One has nothing to do with the other.

    Prof B
     
  8. efuller

    efuller MVP

    Brian, again you are putting words in my mouth. I said that "hip drive" is muscular. I will grant you that a small portion of the time, when the hip is at its end of range of motion, it is possible to get a moment from the forward momentum of the body applied to the femur. But when the hip is in the middle of its range of motion the hip ligaments are not tight and will not apply a torque to the femur. If this not the mechanism that you are talking about, then I'd like to know which fascial links are talking about? Where are these pieces of fascia attached?

    As for gravity driving pronation... If gravity drove pronation then people would never get inversion sprains of the ankle. Ground reaction force acting at the location of the center of pressure will determine the moment from ground reaction force. When the center of pressure is medial to the STJ axis the ground will create a supination moment and when the center of pressure of ground reaction force is lateral to the axis then the ground will create a pronation moment. When the moment from the ground is added to moments from other sources (e.g. muscles) then a net moment is created and the motion will be in the direction of the net moment.

    Brian the hip bone is connected to the thigh bone, the thigh bone is connected to the leg bone and the leg bone is connected to the foot bone. What fascia are you talking about. What fascia, that runs from the pelvis to the foot, can create a transverse plane moment at the foot?

    Eric
     
  9. Brian A. Rothbart

    Brian A. Rothbart Active Member

    If you wish to discuss the fascial links described by Myers and others, open up a thread on that topic. This thread is specifically on Hip and Gravity Drive.

    Regarding Gravity Drive, you first need to isolate the cause that places the body in Gravity Drive. Certain structural aberrations do increase the risk of inversion injuries to the ankle (e.g, PMS), others may not.

    Apparently, you are trying to link forces that are occurring on the transverse plane to Hip and Gravity Drive. This can not be done when discussing Gravity Drive, which is linked to compensations occurring on the sagittal plane.

    Also again, Hip Drive is initiated by the transverse plane oscillations of the pelvis (two innominates and sacrum), not the femur. My research has lead me to conclude that this transverse plane oscillation is passed downward to the foot without muscular activity in the lower limb.


    Prof B
     
  10. efuller

    efuller MVP

    I just wanted you to tell me what parts of the fascia you are using to claim that the hip drives STJ motion. The thread title has hip drive in it. If you believe that fascial links aren't related to hip drive, then I'll accept that. Just because somebody describes something means that it's true.


    Gravity causes gravity drive?

    PMS causes ankle sprains?



    I'm trying to figure out how you are linking them. You are the one who said transverse plane hip rotation causes STJ motion. How is that linked?



    What causes the pelvis to oscillate in the transverse plane?

    Wait, What research?
     
  11. Brian A. Rothbart

    Brian A. Rothbart Active Member

    The link between transverse plane oscillations of the pelvis driving foot motion was first described (I believe) by Inman. He goes into great detail describing this interaction. If you would like to read more about it, see the citation below.

    Regarding the cause of the transverse plane oscillations of the hip, I suggest you review your notes on human gaiting. This is a fundamental concept, easily demonstrated.

    Professor Rothbart

    Inman VT Joints of the Ankle Baltimore MD Williams and Wilkins 1976:42
     
  12. efuller

    efuller MVP


    Read it. He describes the connections of the bones and does not use "fascial links".

    Brian, I suggest you read David Winter. He used inverse dynamics to learn what causes the motion of the hips. He expanded upon Inman's work. When I asked the question what causes the hip to oscillate I wanted to see if you knew. The Winter articles answer that question. In your "research" have you read anything later that 1976?
     
  13. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Yes, I am very familiar with David Winters work on variablility in joint moments and powers.

    However, I am more in agreement with Erik Simonsen's findings. He found that the most critical part of obtaining joint moments by inverse dynamics is in the placement of the center of pressure. It must be correctly aligned to the foot. Small errors in this synchronization between force and movement data can produce very different joint moments.

    I am not impressed with Winter's precision in his placement of the foots COP.

    I believe Inman model is more accurate and it is what I see clinically and in my research. Inman's model has served me well in the past, and continues to do so.


    Professor Rothbart


    Simonsen E. B., Dyhre-Poulsen P., Voigt M., Aagaard P., Sjøgaard G. &
    Bojsen-Møller F. 1995. Bone-on-Bone Forces during Loaded and Unloaded
    Walking. Acta Anatomica. 152, pp 133-142.
     
  14. efuller

    efuller MVP

    Brian, the abstract of that article does not mention anything about center of pressure accuracy. I would agree that errors in Center of pressure location relative to the foot will cause joint moment errors. But that paper was not about assessing errors in Winter's work. Why do you think that Winter's work was inaccurate? Did you just see that one line in the paper and like it because it allowed you to ignore new information that was counter to what you already believed?

    It is also interesting to note that a large number of Simonsen's later papers use inverse dynamics. So you shouldn't use one of his earliest papers to say that he thinks that inverse dynamics and the information from it is inaccurate.

    Inman's model is just descriptive. It just describes the motion that takes place some of the time. Not everyone walks the way Inman described and it appears that you are now using Inman's description as an ideal. Why was Inman correct to chose that as an ideal?

    Using inverse dynamics you can get a better idea of what is causing the motion. Inman's model is just a stepping stone on the way to inverse dynamics.

    Eric
     
  15. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Eric,

    We are really diverting from the topic of this thread. If you want to continue this discussion on reverse engineering, it should be done by email.

    In a nut shell, the reason I started this thread is summarized below:

    I believe the distinction between hip and gravity drive will allow us to reach a definition of what is normal foot motion vs what is abnormal foot motion.

    Abnormal foot motion is not a matter of degree, it is a matter of timing. Looking at hip and gravity drive, one can see this change in timing (e.g., when the foot is pronating, when it is supinating).

    Once we agree on what is normal foot motion, we can then look at how abnormal foot motion distorts the entire skeletal framework, foot to jaw. It is the global postural distortional patterns that I believe result in chronic musculoskeletal pain.

    This has been the thrust of my research.

    Professor Rothbart
     
  16. HansMassage

    HansMassage Active Member

    You both have good points but I think the neurological response to the whole kinematic chain is the determining factor. I have direct experience of using Rothbart inspired orthotics and Tom Myers anatomy trains in my practice. My observation is that the choice of repetitive foot motions is determined by the sum of postural distortions that are being compensated.

    Hans Albert Quistorff, LMP
    Antalgic Posture Pain Specialist
     
  17. Yep.....me too....great doorstops!
     
  18. HansMassage

    HansMassage Active Member

    Must have been the ones with the wedge under the hallux.
     
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