Langer Biomechanics Summer School 2013

Where are u sitting?
I writing about Beno's presentation now. Watch this pace - already made a couple of tweets!

 

Beno Nigg is first up:

Impact Forces, Soft Tissue and Muscle Tuning

Some snippets:

Wanted to show impact forces was bad when he started his career and how to reduce it – his career was full of surprises. We all believed that impact forces are bad and had to be reduced to prevent impact related injuries.

Run on hard or soft surfaces = get same frequency of injury
One study - lowest impact forces had more injury

--> back to the drawing board as impact force do not make sense

Goal should be to minimize vibrations --> less fatigue; more comfort etc

Nerves and muscles damaged by vibration some evidence - esp fast twitch fibers

Most comfortable shoes --> less energy needed to run

Not so well tuned musical instrument takes more energy to play

Different individuals react differently to different interventions - ie tune them to their properties; lots of evidence now for that concept.

Cirque du Soleil - injury rate was ~25% - thought to be due to variable compliances of surface; they did not know what landing on --> muscles could not be tuned --> high vibrations --> high possibility for injury
Solution: - create uniform surface --> reduced injury rate to a few %

Paradigm shift --> cushioning is important for muscle tuning and minimizing vibrations.

Impact forces are not critical for injury when surface is known



Anyone have anything to add.

 

Behind you.

Also resonance.

 

Chris Nester bringing the relevance of dermatology into biomechanics. As it should be. Bel will be loving this.

 

Really? Not sure this is accurate or indeed the best analogy!

 

Agreed

 

It was an anecdote that he related about a musician who sweated more from working harder when playing an instrument that was not tuned properly!

 

Chris Nester now up:
Soft Tissue Contributions to Foot and ankle biomechanics


Why important: motion sensitive to loads that arrive at the bone surface - huge number of soft tissues attached to calcaneus; bone do not exist in isolation

65-70% of foot is soft tissue

We underplay the important role that skin plays in transmitting load - esp if thickened with callus. Dryness, folds, fissures around heel --> affect force transmission.

Showed a cool finite element model of heel fissures!!


Large part of heel plantar fat pad is protecting muscles and not bone

Lot of previous work has tested tissues under non-physiological loading/rates/displacements.

Important role of intrinsic muscles

Smaller x-sectional area in pes planus:
-Abduc hallus
-FHbrevis
-Peroneals
-Plantar fascia (middle and met areas)
Greater in: FDlongus & FHLongus

Ultrasound scans while standing on orthotic; 3 different arch conditions and 4 different wedging conditions under heel (used Northplex as plastic to let US signal to pass) --> different changes in heel pad conditions.
Heel cup increases thickness of soft tissues under heel.
Arch compression: increase height of arch by 6mm above 'standard' --> only 1mm change in compression in arch soft tissue thickness

 

Would have liked to have seen this - shoulda paid my 500 squids!

 

It doesnt equate to using more energy though - probably sweating because he/she knew they were making an arse of the piece!

 

Yep, stealing that... with permission of course. Great demo of heel strike load propogating backwards and inducing fissures.

 

Craig speaking on adaption as an adjunct or alternative to orthoses. He is the king of "stuff I can take home and use on Monday".

 

Indeed great talk! Have to check that book on running technique... Which one was it again?

 

Running Technique

 

Robert Isaacs is giving the best practical demo EVER...
Sadly we are not allowed to film it

 

Robert now up

....he doing an entertaining participation demo that is hard to write about!

 

I don't have to write about it. He is still talking and Ken has tweeted a photo:
https://twitter.com/MrKenKVA/status/348068985461432321/photo/1

 

Day Two: ... few too many hangovers and DNA's for the first session
Dave Hancock up first
Director of Training & Conditioning for the NY Knicks

Extraordinary amount of objective data collected on players

Third of lateral ankle ligaments injuries recur
Balance not strength is key to prevention

 

Here is the video that Dave showed:

 

Contentious talk from Beno in terms of the effect of orthoses on muscles. Looking forward to the round table discussion on that.

 

Craig now also speaking on the effect of orthoses on muscles!

With evidence.

 

Even though I have great respect for Dr. Nigg, in the times I have lectured with him at conferences, Benno does tend to lump arch pads and other such in-shoe modifications into being "foot orthoses" in his lectures. Therefore, one must be aware of this factor when listening to Benno talk about "foot orthosis" biomechanics to make certain that one also understands that his "foot orthosis" may not be our "foot orthosis" but may, instead be our "medial arch pad".

 

That'd be it! More than a few were a tad confused at one point.

Great couple of days. Questioned stuff, learned stuff and of course, good to meet up with the usual riff-raff (including Ken and 'whatever') and meet many more like-minded colleagues:drinks

Just for the record; I was NOT one of the "hangovers", eh Craig?

 

Ditto.... On all counts

 

Nice body mass, Michael...


I overheard this (and similar expressions) during the following break; "It really helped me to understand that axis thing....",.

Well done, Robert. Knew you would do us proud :drinks

 

I am delighted to see that someone so capable as Robert is making the concepts of subtalar joint axis deviation much more understandable by his wonderful practical demonstrations. I am counting on the younger generation of podiatrists, such as Robert, to carry on the tradition of educating podiatrists on the intricacies of foot and lower extremity biomechanics when I am no longer able to do so.

Very much wish I could have been there to see your demonstration, Robert. You are to be commended for your excellent contributions to podiatric biomechanics education!:drinks

 

Kind words indeed. I have been most fortunate in my teachers, and with those who have supported me. .:drinks

Michael looks truly uncomfortable up there. If anyone has any larger pictures, I'd love to have a copy. He, and all of my volunteers, were thoroughly good sports.

I hatched a theory on biomechanics education over the weekend whilst discussing CPD with Chris Nester (who's video clips of cadaver feet brought back to life with pulleys and motors were absolutely jaw dropping by the way). When I get chance I shall start a thread.

 

Mug Shot:

 

It were indeed good days... it was nice to see you as well - and for the record you were there bright and early saturday mornin'!!

up to the next one :drinks

 

Nice line up Craig ... now do we have to point out who did it?