Why I consider the gait cycle.
An attempt to explain my thought process as to why I might work on you foot when your experiencing some shoulder troubles.
I got to share some of my work with a trainer at the gym today. We got talking about the gait cycle and I mentioned how important I find it in my assessment and working to improve pain and performance. He has amazing full body strength and movement pattern awareness. A big issue for him was a decrease in single arm hanging strength on the L ,in comparison to the R. He could perform a single arm chin up on the right, but not on the left.
He mentioned that for years as a kid he wore orthotics but took them out (go him!). When I got him to do a single leg stance test (SLS), he shifted his left foot into supination holding his weight on the outside of the foot. On the right foot, he pronated hard pushing the inside of his foot into the ground to hold his weight.
The single leg balance or single leg stance test is a nice way to assess what the foot is doing in the mid stance of the gait cycle. In mid stance the foot should be able to rest in neutral on the full tripod of the foot (Heel, base of the great toe, base of the little toe). If it can’t rest in neutral in this phase, it is going to effect the respective phases of the gait cycle that follow.
If the foot rests in supination in the mid stance phase, the foot is going to have a hard time visiting pronation when the leg swings forward and the foot takes the bodies load like suspension.
If the foot rests in pronation in the mid stance phase, the foot is going to have a hard time visiting supination when the leg swings back to propel the body forward.
In a static posture assessments the effects of the left supination / right pronation of the feet were having an effect up the kinetic chain. The L supination was giving the illusion of a longer left leg making his pelvis hike up on that side. In combination with the R pronation his pelvis was rotated to the left, bringing his right hip forward. His left shoulder was jacked up and hiked up higher than his right.
In the gait cycle the pelvis needs to be able to visit right rotation, in concert with left thoracic rotation to connect the left latissimus dorsi to the right gluteus maximus via the dorsal sling (visa versa). This is why when I tested his left lat dorsi, and left thoracic rotation, his brain had an extremely hard time communicating with it, and it tested weak. Think you might need a functional lat dorsi in a single arm chin up? I do!
So if his left foot is stuck in supination, its going to have a hard time visiting its pronation potential. If his right foot is stuck in pronation, its going to have a hard time visiting its supination potential. If the left foot is stuck in supination, and the right stuck in pronation, the pelvis is likely to be stuck in left rotation. If the pelvis is is stuck in left rotation, its going to have a hard time visiting its right rotation potential. If the pelvis can’t visit its right rotation potential, the thoracic spine is going to have a hard time visiting its left thoracic rotation potential. Meaning…. the left lat is going to have a freakin’ hard time to do its job.
I treat the supinated L foot first because the supination creates a rigid stability structure that is probably coaxing his L foot into pronation. I use Neurokinetic Therapy to educate the motor control centre (cerebellum) of the brain, that stores movement patterns to let the muscles supinating the foot relax, and let the muscles above do their job, without needing to compensated for with supination of the foot.
I find his L tibialis posterior compensating for his L Psoas, L Adductors, and L medial fibres of rec fem. After my release BOOM the left psoas, adduction, and rec fem all fire up strong. Stand him up, and put him in a R SLS again. He is now resting on the full tripod of the foot again. Put him in a L SLS and he is on the tripod again. Check the height of his hips and they are now level. His pelvis no longer rotates forward on the right. HIs L shoulder has relaxed and is no longer jacked up towards the ear. I test his L lat dorsi and it fires strong. I test left thoracic rotation and it fires strong. LOVELY! He has some work to do releasing his L tib post, and connecting with his L psoas.
Now…could the problem be influenced from elsewhere in the body? Up above? Sure it could. Though Rome wasn’t built in a day. We’ll start with where we get some great results, and take it from there.
The question I leave you with… is do you think orthotics would let the foot pronate and supinate to full potential, so that the structures above can load and explode and do their job efficiently?