Movement is Key by APC's head podiatrist Colin Papworth
Movement. We take it for granted, until, that is, we can't do something. Then we are pulled up short. Like when we get a pain in our back or in our foot. All movement stops, we tense up, our bodies go rigid - this is our way of protecting ourselves. No movement equals no pain. This is what our bodies are designed to do. Our brains are fantastic, they protect us so much more than we think. Overriding our brains self protection mechanism is hard. How much effort does it take when we are trying for a sprint finish, we feel like we have given our all, we could give no more, we are totally spent. Then 5 minutes later we are up, walking about, chatting about our experience and queueing for a beer. Our brains have released their hold on us, our physiology has settled down and we are (nearly) ready to go again.
The main change we see, if this starts to happen, is that our stride length shortens as our hips do not move as much, this may then lead to us pulling our leg forward when we walk rather than pushing our leg out behind us. This will mean that we are not as strong in the push phase of our gait and we may feel that we have lost some of our 'spring' when walking, we overuse our hips to pull our leg forward. This new way of walking then becomes our normal way of walking. We may get some low back tightness and tension and you may be told your hips are tight and that you need to stretch them. But this is to no avail, because, unless you are able to lengthen your stride when walking the hip flexors will always remain short and tight and your back pain will remain. You have to change the way you are walking/using your hips to make the big changes you require to ease your back pain.
Bodies respond to the way they are used and they do this by adapting to their shortest functional length. So if you use muscles in a short range then this is all they will give you. Only doing static stretches for a short time is going to make very little difference, except maybe some short term relief. To make the big changes you need to know how you are moving and how to change this short movement pattern, so you can learn to use your hips through a longer range. Then you will use the muscles in a way that has the effect of stretching them whilst you walk or run.
Let's take a look at walking as an example. I see lots of people in the clinic and I spend a lot of time showing them how to walk again, how to use their bodies in a way that is more beneficial to them. This is key before we start moving onto looking at either making changes to running form or start to address specific rehab exercises. We all spend so much time walking and we can really help ourselves if we get this right. Walking is all about flowing movement and minimising the impact forces and maximising the push off force. We need to use our whole body in this process and this is often what I see that has been lost.
When we walk we should contact the ground with our heel and roll the foot onto the ground using the heel as a pivot. Our hip and knee bend to absorb the impact forces. This bending stretches out some muscles which store this impact as potential energy.
As our body continues to move over the foot on the ground we ideally want to keep the supporting leg straight and use this to push off from. This means leaving the heel down on the ground, and stretching out the muscles and soft tissues behind us as we continue to move forward. As we move further forward, just before the swinging foot is about to touch the ground, our heel will lift and we roll forward onto the ball of the foot and toes. This process is aided by the contraction of the calf muscles to drive us forward.
Further up the body, the opposite arm to the standing leg should move behind us, so creating a natural arm swing that is opposite to the leg function. Our legs will follow our arms. This creates a stretch and tension through all the soft tissues from our standing big toe up our leg, across our pelvis and back to our opposite shoulder and hand. This in effect winds up our body, a bit like a golf swing, and releases the stored tension to make the next step. The same for the upper body, tension is released across one side of the body and created on the other side. This stretch and release way of walking means we have to put less energy in as we can use the stored potential energy from the stretch of the muscles and other soft tissues.
Sunday 30th of August 2020