Kicking off this thread promised by Simon and Kevin.
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The papers by Novacheck and Alexander were excellent reads and I can totally recommend them to anyone who doesn’t understand that there are major differences between walking and running. I concede that this is all from Novacheck’s paper but the Alexander paper was very interesting in putting human locomotion into perspective.
Not to be lazy and to show my gratitude to those posters mentioned above, I thought I should point out some things that I have learned and ask some questions.
1. Potential Energy and Kinetic Energy
In walking, they are out of phase. When potential energy is high (midstance), kinetic energy is low. And when potential energy is low (heel strike), kinetic energy is high.
In running, they are in phase. When potential energy is high (when both feet are off the ground “double float”), kinetic energy is high. When potential energy is low (midstance, Novacheck refers to it as “stance phase reversal”), kinetic energy is low.
So at midstance in walking, potential energy is at its highest. Yet at midstance in running, potential energy is at its lowest.
2. Terminology
The terminology for the phases of the gait cycle for running are not the same as for walking – what is the accepted terminology? Also, does running and jogging mean the same thing and this refers to heel strike gait. As opposed to walking with a heel strike and sprinting with a forefoot strike.
3. Muscle groups responsible for power generation for forward propulsion of the body
I was surprised to see that as speed increased, the power provided by the ankle plantarflexors reduces. Walking 53%, running 41% and sprinting 34%.
4. Efficiency of walking vs running
Walking maintains efficiency by the interchange of potential energy and kinetic energy. This is not possible in running (as PE and KE are in phase). So running relies on two mechanisms to maintain efficiency:
a) the spring-like action of tendons
b) the presence of musculotendinous units that cross two joints which can transfer energy from one body segment to another eg: gastrocnemius and hamstring.
5. Economy of movement
The speed / economy curve for walking and running are very different. In effect, there is a very pinpoint speed that will prove most economical in walking. Anything above or below that speed is inefficient (the curve is U-shaped). But in running, the curve is not a curve, its straight. This indicates that energy cost is similar over a wide range of chosen running speeds.
6. Ankle joint motion
As speed increases, maximal dorsiflexion and plantarflexion occurs earlier. Aslo, the ankle joint range of motion is less in elite sprinters compared to running and sprinting at a non-elite level.
Rebecca
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A general relationship links gait mechanics and running ground reaction forces.
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Twelve steps per foot are recommended for valid and reliable in-shoe plantar pressure data
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netizens
There is a couple of articles recently published on evolution of bipedalism. If my reading is correct one revisits the theory that bipeds came from arboreal tree walkers who convert to knuckle walking then upright posture on terra firma. The authors are attempting to date upright stance and suggest arboreal tree walking would take place long before the current accepted theories. As far as I know the knuckle walking theory has long been debunked but seems not.
The other paper suggests our present physical appearance has more to do with running than walking and that our ancestors needed to develop longer legs, shorter arms and large gluteal muscles to survive a hostile environement. Again if my interpretation is accurate of the works, this might suggest walking was secondary to running.
As far as I understand Frued held the opinion our soft round wobbly bits were fashioned by bipedalism with the primary and secondary sexual characteristics fully visable to the naked eye. He concluded humans developed sight at the cost of smell. I always thought this related to walking but if the new theory holds water, then it seems to be more akin to running. Perhaps this may account for society's preoccupation with viewing athletes in tight attire and may go some way to explain viewing semi naked athletes is not and unhealthy pastime but a basic primal behaviour based upon survival of the species. If true then may help us understand why in 'sophisticated society' we artifically recreate walking impediments to appease the eye eg heels.
:morning:
toeslayer
with the -
Good Job Rebbecca - I'll attempt same idea with synopsis for gait efficiency topic
cheers
Martin
The St. James Foot Clinic
1749 Portage Ave.
Winnipeg
Manitoba
R3J 0E6
phone [204] 837 FOOT (3668)
fax [204] 774 9918
www.winnipegfootclinic.com -
You are awesome! I just wish we could clone you for the good of the podiatry profession!! Have a nice weekend. -
So what does all this mean in regard to a podiatrist providing orthoses for a runner (aka jogger) or a sprinter?
I remember you mentioning in a previous thread Kevin that the 1st MPJ dorsiflexes more in walking than in running. Why is that exactly? And does that go for running and sprinting? This might change your orthosis prescription versus an all purpose orthosis such that a dedicated 'running' orthosis is needed for serious runners / sportspeople.
The other thing you have mentioned Kevin is the varus ff wedge you use on orthoses for runners. As far as I know, that is for the runners varus ie narrower base of gait in running. Is that right? And this is presumably the same for sprinting (recently discussed pole vaulter).
What else?
Rebecca -
I don't know if there is any change in dorsiflexion requirements of the hallux in jogging versus running versus sprinting since all of these activities show a rise in the CoM after the middle of midstance phase of gait. In this regard, jogging is more similar to sprinting than jogging is to walking.
The foot orthosis prescription might change from walking to running if the patient has a symptomatic hallux limitus, but I don't believe, as the sagittal plane theorists propose, that functional hallux limitus drives the gait pattern or pathologies of the foot. Functional hallux limitus is generally a non-factor during running due to the decreased demands for hallux dorsiflexion during running versus walking. Therefore, I would tend to not put any reverse Morton's extension type extensions on running orthoses unless the patient had sesamoiditis or suffered from pathologies due to excessive external subtalar joint (STJ) supination moments.
My foot orthoses for runners are generally about 5 degrees more inverted than walking orthoses due to running limb varus. In addition, foot orthoses for runners are nearly always made with full length topcovers. I make more metatarsal neck length (i.e. 3/4 length) orthoses without topcovers for walking patients.
In sprinting activities, including long jumping, and pole vaulting, since the forefoot, and not the rearfoot, is receiving, by far, the most ground reaction force, instead of using a foot orthosis, I will sometimes only put a 2-5 degree forefoot varus wedge into their track spikes to reduce weight and reduce the STJ pronation moments in these athletes.
Hope this helps. -
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Thanks Kevin,
Rebecca -
I said a 2 to 5 degree varus forefoot extension, not a 2-5 varus forefoot extension. In these forefoot varus extensions, I generally make the extension plantar to only the 1st through 4th metatarsal heads, leaving the 5th metatarsal heads void of any extension material. The windlass effect of Hicks is less of a factor in running than in walking.
A varus forefoot wedge is simply a piece of adhesive felt, korex or EVA that is adhered on the dorsal surface of the insole of the track shoe. Track spikes come in many shapes and sizes and the length of the spikes may be varied for running on different surfaces, but the spike plate under the forefoot can not be made into a more varus position. By the way, I competed in track events (440, 880, mile, 2 mile, steeplechase, 5,000 m and 10,000 m) from the ages of 12-22. -
Kevin,
Would you include a 2-5 degree varus FF extension as you have described for a patient with a FF Supinatus?
Respectfully,
Ian -
I will use a varus forefoot extension on those runners that have pronation related symptoms caused by their inverted forefoot deformity. Generally, those injuries I will use it on include medial tibial stress syndrome, posterior tibial tendinitis and patellofemoral syndrome.
And how do you, Ian, differentiate between whether a patient has a "forefoot varus" or a "forefoot supinatus"? -
Kevin,
I generally consider a FF Supinatus deformity as an inverted FF due to soft tissue contraction (Davis' Law) and therefore if it is manually reducable on examination then I would class it as a Supinatus (as opposed to a 'true' bony FF varus)
It was my understanding that a varus FF post in this situation (FF Supinatus) would compound the inverted nature of the FF? -
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Kevin,
Generally with any frontal plane issue I would usually see if it is reducable so I suppose indirectly yes I do check for a supinatus deformity irrespective of the attitide of the FF.
Going back to my original question would you issue a varus FF post/extension in a patient with an inverted FF which you believed was due to a soft tissue contracture? -
Yes, I have no problems in adding a forefoot varus wedge to a shoe or orthosis in selected individuals with selected injuries that have a "forefoot supinatus" deformity. Unfortunately, I am not so sure that all feet don't have some form of "forefoot supinatus" deformity (i.e. a soft tissue contracture that prevents full plantarflexion of the medial forefoot during non-weightbearing examination).
I believe that forefoot to rearfoot relationship is a dynamic entity that can change over time in an individual as the forces acting externally and internally within the foot change over time. It is not as simple and easy as we were all taught in podiatry school and may be worthy of a separate thread. Are you up for it, Ian? -
Always up for it Kevin!
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Comparison of instantaneous knee kinematics during walking and running
WenjinWangab et al
Gait & Posture Volume 97, September 2022, Pages 8-12
<
A general relationship links gait mechanics and running ground reaction forces.
|
Twelve steps per foot are recommended for valid and reliable in-shoe plantar pressure data
>
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