Human Locomotion
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Bowed Legs and Knee Arthritis: The Importance of Maintaining Hip Strength as You Age
Click Here to download a PDF of this article Tibial varum, or bowed legs, is a normal alignment pattern in toddlers that typically corrects itself by about age 2, when the knees gradually straighten and shift to a slight valgus alignment. A common cause for the...
How to Prevent and Even Reverse the Formation of Bunions Without Surgery
Click Here to download a PDF of this article Even though the word bunion is widely used to describe the condition in which the big toe angles out while the first metatarsal angles in, the technical name for this condition is either hallux abductus or hallux...
Understanding Peripheral Neuropathy: Why Alternative Therapies Are Finally Getting the Attention They Deserve
Click Here to download a PDF of this article Peripheral neuropathy (PN) is a complex and poorly understood condition in which the body’s peripheral nerves gradually deteriorate (Fig. 1). Symptoms associated with this condition range from mild tingling and numbness to...
The Twist Disk: The Easiest Way to Strengthen Muscles in the Transverse Plane
Click Here to download a PDF of this article While most people spend countless hours in the gym performing squats, lunges, deadlifts, and planks to strengthen their sagittal and frontal plane muscles (Fig. 1), relatively few focus on the small but extremely important...
Focal Muscle Vibration: A Powerful Clinical Tool to Improve Balance, Strength, and Agility
Click Here to download a PDF of this article Over the past 15 years, some amazing research has shown that when a contracted muscle is vibrated at a specific frequency and intensity, it can produce long-term changes in athletic performance and balance. In an...
I’ve Fallen and I CAN Get Up! The Ideal Way to Perform Floor-to-Stand Transitions.
Watch the Video Here If you were around in the eighties and nineties, you probably remember those medical alert commercials in which an older woman calls for help because she couldn’t stand up after a fall. We take it for granted when we’re young but the ability to...
The Human Locomotion Fall Prevention Protocol – How to Create a Customized Treatment Program to Maintain Strength and Agility as You Age
https://vimeo.com/884120090?share=copy Full Version https://vimeo.com/925505729?share=copy Abbreviated Version Click Here to download a PDF of this article Click Here to download a Powerpoint Presentation In his 1994 textbook, the gerontologist Bernard Isaacs states...
How a Subtle Evolutionary Adaptation to Bipedality has Increased the Likelihood we will Fracture our Hip as We Get Older, and What We Can do to Prevent it.
Click Here to download a PDF of this article Last year, 300,000 Americans fractured their hip after falling. The long-term consequences of hip fractures are devastating as nearly 25% of the people who fracture their hip will be dead in one year, and 50% of them will...
How to Get the Most Out Of the Latest Generation of Running Super Shoes
Click Here to download a PDF of this article Even though the latest generation of running super shoes can take more than a minute off your marathon time, they slightly increase your stride length, increase the degree of foot pronation and limit toe motions. All of...
The Ideal Exercises for Managing Insertional Achilles Injuries
Despite the fact that nearly 30% of all Achilles injuries happen at the insertion point (1) (Fig. 1), the overwhelming majority of research has focused on managing the more common non-insertional injuries. This is unfortunate because insertional injuries are...
New Concepts in Managing Non-Insertional Achilles Injuries: Why Improving Tendon Pressure Dynamics and Interfascicular Sliding Are Essential for Recovery.
Click Here to download a PDF of this article Achilles injuries are common, and the most frequently prescribed exercise interventions have relatively poor long-term outcomes. New research shows heavy-resistance long-duration isometric contractions accelerate tendon...
Good Balance and Strong Toes: The Most Under Appreciated Components of a Great Golf Stroke
Click Here to download a PDF of this article Whether you’re on the fairway or the green, the ability to hit a golf ball so it moves at the desired speed and trajectory is one of the most difficult, complex movements in all of sport (1). To be successful, the skilled...
Balance Buttons
How Stimulating Specific Locations on the Bottom of Your Feet Can Improve Balance and Prevent Falls
Click Here to download a PDF of this article Like it or not, as we age, most of our sensory systems begin to break down: our hearing worsens, our vision gets blurry, and our reflexes slow down. An under-appreciated sensory system that also worsens with age is the...
The Diaphragm: The Overlooked Core Muscle
Every chiropractor knows that a strong, well-coordinated core is essential for maintaining spinal health. The core muscles work as a unit to increase intra-abdominal pressure providing just the right stiffness to unload the spine during lifting and loading tasks....
The Strong Connection Between
Low Back Pain and Weak Multifidi
(and the Best Ways to Strengthen these Important Muscles)
In any given year, nearly 40% of the US population will develop a low back injury severe enough to limit activity (1). Once injured, there is a 22% chance of reinjury within three months, and a nearly 80% chance of reinjury within the next three years (2). The cost of...
The Surprising Connection Between Tight Hip Flexors and Painful Hip Arthritis
You would think that the connection between hip arthritis and pain would be pretty straightforward: people with the greatest degree of arthritis as measured on x-rays should have the greatest amount of pain. Surprisingly, this is not always the case as many people...
Does a Torn Rotator Cuff Really Require Surgery?
Click Here to download a PDF of this article Summary: Tears of the rotator cuff tendons are extremely common, and the vast majority of these tears involve the supraspinatus tendon. Because small to moderate thickness supraspinatus tears respond so well to conservative...
The Latest Stretches and Exercises to Make Sure Your Plantar Fascial Injury Never Returns
Summary: 44% of patients with plantar fasciitis will have pain 15 years after the original diagnosis. The most common treatment protocols, including orthotics, corticosteroids, and short-term stretches have not been proven to alter long-term outcomes. The majority of...
The Overlooked and Underappreciated Soleus Muscle
Summary: Soleus is the largest muscle of the leg, producing force of nearly 8 times body weight during pushoff. The world’s fastest marathon runners have the largest soleus muscles, and weakness of the soleus correlates with the development of Achilles tendinopathy....
Novel Exercises and Stretches for Managing High Blood Pressure
According to the World Health Organization, hypertension is a leading cause of stroke and cardiovascular disease, which cause more than 15 million deaths annually (1). Affecting more than 1.3 billion people worldwide, arterial hypertension is diagnosed when systolic...
Varus and Valgus Insole Posting: An Inexpensive and Effective Alternative to Orthotics
Summary People with low arches are 20 times more likely to be injured than people with neutral arches, while people with high arches are nearly 80 times more likely to be injured (1). Although effective at controlling motion and reducing injury rates, recent research...
Five Simple Exercises to Prevent Age-Related Muscle Loss
It’s a depressing fact but shortly after age 50, you begin to lose nearly 2 percent of your muscle fibers each year. Figure 1 is a graph of the average number of quadriceps muscle fibers present in adults aged 18 to 82 (1). Looking at the center of the graph, you can...
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How Isometric Exercises and Eating Tomatoes can Significantly Lower Your Blood Pressure
Click Here to download a PDF of this article High blood pressure is a public health crisis that causes more than 10 million deaths annually. Standard medical treatment for hypertension is pharmacological intervention (for people with systolic pressure greater...
Managing Tibialis Posterior Tendon Injuries
Published April 1, 2015 by Dynamic Chiropractic Magazine Tibialis posterior is the deepest, strongest, and most central muscle of the leg, with fibers originating from the tibia, fibula and the interosseous membrane. The tendon of tibialis posterior forms in the...
How To Beat Piriformis Syndrome
Published Jan. 16, 2016 by Competitor Magazine The piriformis is a small muscle in the back of the hip that is notorious for causing trouble in high mileage runners. The word piriformis is Latin for pear-shaped, since the muscle’s wide base and tapered attachment...
Differential Diagnoses of Heel Pain
Published January 13, 2015 by Dynamic Chiropractic Magazine Although heel pain occurs with a variety of injuries (e.g., calcaneal stress fractures and/or infracalcaneal bursitis), by far, the most common cause for heel pain is plantar fasciitis. The word fascia is...
Are We Really Born To Run? There is evidence that debunks the popular running theory.
Published Oct. 19, 2015 by Competitor Magazine According to a few well-respected paleoanthropologists, our ancient ancestors (specifically, Homo erectus) were so efficient at running they could chase prey for hours, eventually killing the exhausted animals by hand. In...
NSAIDS and Osteoarthritis: Are the Rewards Worth the Risks?
Click Here to download a PDF of this article Osteoarthritis (OA) is the most common of all joint diseases, affecting more than 30 million Americans. In the next few decades, the number of people suffering with osteoarthritis is expected to skyrocket, as people are...
Anteromedial Ankle Impingement Syndrome
Originally referred to as “athlete’s ankle” and later “footballer’s ankle” because of the high prevalence in soccer players, this condition occurs when osteophytes on the anteromedial tibia and dorsal talus collide during ankle dorsiflexion, pinching the soft tissues...
Focal Muscle Vibration: An Overlooked Tool for Diagnosing and Managing Low Back Pain
Initially discovered in the 1960s by Eklund and Hagbarth (1), a surprising body of research has shown that placing small vibrating motors over the belly of a muscle can produce presynaptic inhibition of the muscle’s spindles, which can reduce muscle tone by as much as...
The Treatment and Prevention of Anterior Cruciate Ligament Injuries
Click Here to download a PDF of this article The anterior cruciate ligament (ACL) is a powerful stabilizer of the knee, possessing 2 different bundles (Fig. 1) that help stabilize the knee against anterior shear force, valgus collapse, and excessive internal tibial...
Managing Sesamoid Injuries
Click Here to download a PDF of this article Published in Dynamic Chiropractic, Vol. 30, Issue 3 The word sesamoid is Latin for "sesame seed." These small bones are located inside specific tendons, where they improve mechanical efficiency by pulling the tendon farther...
Popliteus Tendinitis: Biomechanical Factors
and Conservative Treatment
Click Here to download a PDF of this article The popliteus muscle originates from the lateral aspect of the distal femur and inserts along the posterior aspect of the proximal tibia. It is comprised of three separate fiber bundles that are under different degrees of...
Gait Retraining for Knee Hyperextension
Unlike the hip joint, which possesses a deep ball and socket that provides inherent stability to reduce stress on the restraining ligaments, the knee is particularly prone to injury because the flatness of the tibial plateau provides little protection against...
Managing Limb Length Discrepancies
Excerpted from his book, Human Locomotion Limb length discrepancy (LLD), which is divided into functional and structural categories, is a common cause of injury. In a study of 3,026 subjects with radiographically confirmed LLD, Harvey et al. (152) determined that...
Three Reasons You Should Be Wearing Triple Stick Straps While Training
Fig. 1. The Triple Stick Strap Summary: The latest research confirms that blood flow restriction training using lighter cuff pressures can markedly increase the production of growth hormone, allowing you to substantially increase muscle mass while exercising with...
Blood Flow Restriction Training: An Interesting Method for Maximizing Muscle Remodeling
The process of applying thigh and arm tourniquets to impair blood flow while strength training was developed more than 50 years ago in Japan, where it is referred to as KAATSU training (1). Original advocates of this training technique wrapped straps around their...
The Positive Wink Sign: A New Diagnostic Test for Evaluating Toe Flexor Weakness
Weakness of the intrinsic toe flexors, specifically the flexor digitorum brevis muscle (FDB), is a common and underappreciated cause of a wide range of injuries. In 2015, Sullivan et al. (1) examined 202 people with chronic heel pain and compared them to 70...
How a Few Simple Changes in Your Running Form Can Improve Speed, Efficiency, and May Even Reduce Your Risk of Injury
Given the popularity of running, it’s surprising how much controversy exists over which style of running is best for improving performance. Some coaches advocate that all you need to do to achieve the ideal running form is to run with a cadence of 180 foot strikes per...
The Peel and Stick Interdigital Neuroma Balance
Summary Interdigital neuromas are common, poorly studied, and notoriously difficult to treat. By offloading the third and fourth metatarsal heads throughout propulsion, the new Peel and Stick interdigital neuroma balance allows you to effectively treat interdigital...
The Peel and Stick Sesamoid Balance
Summary Sesamoid injuries are extremely common, especially in high-arched individuals. The new Peel and Stick Sesamoid Balance is thicker than most sesamoid balances, and is made of a blend of urethane rubber, PPT, and synthetic suede designed to significantly reduce...
Covid-19: Lessons Learned From Prior Pandemics
Over the past 100 years, there have been 4 major pandemics that have collectively killed more than 60 mil- lion people. The most notorious of these pandemics is the 1918 Spanish flu, which infected 50% of the world’s population and killed over 50 million people....
In-Office Screening to Rule Out Vertebral Artery Dissection
In any given year, nearly one in 100,000 adults will develop a vertebral artery dissection (VAD) (1) (Fig. 1). Factors that increase the risk of dissection include elevated homocysteine levels, Marfan’s syndrome, family history of stroke, migraines, and even seasonal...
Forget Stretching and Foam-Rolling:
New Research Shows the Best Way to Warm Up May be to Lengthen and Strengthen Your Tendons
Twenty years ago, when a group of runners got together for a workout, a few would casually be stretching either their hamstrings or calves, but the stretches seemed pretty random and inconsistent. It was almost as if the runners knew they were supposed to stretch, but...
How to Rehab a Sprained Ankle
Ankle sprains are surprisingly common. In the United States alone, 23,000 people sprain their ankle each day (Fig. 1). The medical costs associated with treating ankle sprains exceeds $1.1 billion annually (1,2). To make matters worse, these numbers do not take into...
The Best Ways to Prevent Age-Related Muscle Loss
Shortly after age 50, the rate at which a person loses muscle mass begins to accelerate (1). Figure 1 is a graphical representation of the average number of quadriceps muscle fibers present in adults aged 18 to 82 (2). Looking at the center of the graph, it is clear...
Hip Strength as a Percentage of Body Weight: Using a Modified ToePro Dynamometer to Predict Knee Injuries
In any given year, nearly one in 25 athletes will tear their anterior cruciate ligament (1). More commonly, one in 10 recreational athletes develop patellofemoral pain annually, and once diagnosed, more than 90% will continue to suffer with chronic knee pain years...
The Importance of Toe Strength in Preventing Falls in the Elderly
In any given year, nearly 40% of senior citizens aged 70 and over will fall at least once (1). Each fall significantly increases the risk of not only sprains, strains, and contusions, but also fractures. The resultant injuries often begin a downward spiral of weakness...
Managing Heel Pain: The Overlooked Role of Peroneal and Toe Flexor Strength
Each year, nearly 2 million Americans seek medical attention for a painful heel. In the US alone, the annual economic cost for managing this common condition is in excess of $300 million (1). While the majority of patients with painful heels respond favorably within 3...
Managing Greater Trochanteric Pain Syndrome
Next to osteoarthritis, greater trochanter pain syndrome is the most frequently encountered hip injury, and it is estimated that it will eventually affect between 10% and 25% of the population (1). The typical patient complains of pain with single-leg stance and the...
Neuromotor Coordination and the Prevention of Running Injuries
For more than 30 years, researchers have been trying to identify specific risk factors that can predetermine whether or not a runner is likely to be injured. With an annual injury rate exceeding 50%, runners could save them selves a lot of time and frustration if they...
Is There An Ideal Running Form?
Making a few small changes in the way you run can make you faster, more efficient and possibly less injury-prone. But how do you know which changes to make?
The best running coaches in the world continually have their athletes work on their running form, either through daily drills or through significant biomechanical adjustments. Nike Oregon Project coach Alberto Salazar is famous for changing everything from the tilt of...
Strength and Stress Fractures
In any given year, more than one in five runners will sustain a stress fracture (1). In the U.S. alone, this trans- lates into nearly 2 million stress fractures annually (2). In a study of 320 patients presenting with stress fractures, Matheson, et al., (3) note that...
The Real Cause of Iliotibial Band Syndrome
Iliotibial band syndrome is a common injury, occurring in up to 12% of all runners (1). The pain associated with this syndrome is often described as “burning” and is reproduced clinically with Noble’s test, in which the examiner compresses the distal band against the...
The Conservative Management of Hamstring Strains
Of all the gait-related muscle injuries, hamstring strains have the highest rate of recurrence, with as many as one third of injured athletes suffering reinjury within the first few weeks following return to sport (1). Because their stride lengths may exceed 3.5...
Surprising Reasons for Orthotic Efficacy
Published September 15, 2015 by Dynamic Chiropractic Magazine Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome. In addition to...
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The Influence of Two Different Types of Foot Orthoses on First Metatarsophalangeal Joint Kinematics During Gait in a Single Subject