Digital video gait analysis reveals what is causing your foot and lower extremity pain

Pedigait 4 camera system and treadmill

My colleague and good friend Brian Cragg from Markham Footcare has produced a very informative YouTube video (shown below) outlining the benefits of using the PediGait synchronous 4 camera gait analysis system.  We both introduced this technology into our offices in April 2012. 

Gait analysis is used on a daily basis by chiropodists/podiatrists  as a  component of the physical evaluation of the presenting patient.  Typically, gait analysis consists of watching a patient walk back and forth in a hallway.  The information observed in the gait analysis helps to reveal the the cause the patient's presenting symptoms.  

Hallway gait analysis provides valuable information to the practitioner but provides no visual feedback for you "the patient" relating to the way you walk or run. 

Gait analysis in hallway

Since the introduction of PediGait into our Whitby office,  we have elevated clinical gait analysis to the next level by providing more informed patient education as well as direct visual feedback to help you to understand why you have foot, ankle, shin, knee, hip and back pain.

The benefits of the Pedigait system include:

1. Films and records you walking or running on a treadmill simultaneously from the front view, back view, left side view and right side view.  

2. Archives a permanent visual record of your gait that can be played back immediately or at a future date.

3. 

   PediGait Screen
   

   Immediate playback to allow  observation of  your gait from four views at the same time or from one single view on a large high definition TV

4. The video can be slowed down, viewed frame by frame or paused to allow you to see your gait in complete detail from four different views or one single view.

5. Provides comparisons between multiple video captures such as walking or running barefoot, with shoes and with shoes plus orthotics. 

6. Can provide a video file either  for insurance purposes, or for another health professional such as your family doctor or simply to view on your home computer.

Comparison Screen

Finally, one of the benefits for the chiropodist/podiatrist is the ability to view your gait analysis video in more detail after you have left the office.  If your treatment plan requires a prescription foot orthotic,  the archived visual record  from 4 views is extremely useful  when writing a prescription for custom foot orthotics.

 

 

 

   

www.footcarewhitby.ca

www.painfreefeet.ca

Flip Flops: Why they are bad for flat feet

The summer is coming to a close and flip flop weather will come to a close as the weather gets cooler. Wearing flip flops can be difficult on your feet. The design of flip flops do not allow the foot to be properly secured to the foot. If you have flat feet (pronated foot) your heel will shift off of the flip flop (watch the video).  Furthermore, your toes will have to grip the flip flops to keep them from falling off while you walk. Over time( successive summers) this can result in clawed or hammered toes leading to pain in the ball of your foot. This can lead to metatarsalgia or pain in the ball of the foot.
The American Podiatric Medical Association has a seal of approval section which lists recommended  flip flops. These APMA approved flip flop sandals have a molded foot bed and more secure straps that help to minimize foot problems.

www.footcarewhitby.ca
www.painfreefeet.ca

The Olympic marathon run

This is the final day of the Olympics and one of the last events is the marathon run of 26 miles.  This event brings together the 100 best marathon runners from all over the world.  The trio of runners from Kenya: Wilson Kipsang Kiprotich, Abel Kirui and Emmanuel Mutai could sweep the marathon medals. The eventual marathon winner will be the runner most able to keep a constant speed throughout the race over the varied terrain.  The best marathon runners have a body type best suited for marathon running but more importantly, they can minimize their injury rate by proper training and recovery. Many recreational marathon runners develop many foot and lower leg injuries because of poor training methods, improper footwear and poor lower extremity biomechanics.  Structural problems occurring in the foot and lower leg can cause plantar fasciitis, shin splints, Achilles tendinitis, and ilio-tibial band syndrome.  If these problems occur should be addressed as soon as possible before the injury becomes chronic. Good luck to all the Olympic marathon runners.

The Mexican upset win over Brazil and congratulations to the Canadian women's soccer team.

This morning I have been watching the 2012 Olympic men’s soccer/football finals. It has been an excellent game between Mexico and Brazil. You can hear the Samba beat in the stands at Wembly Stadium. I have been impressed with the speed of the players. I know from treating soccer player in my practice that some of these players are participating with some type of foot injury. Plantar fasciitis, hallux limitus, bunions and ankle sprains are some of the most common foot injuries that occur while playing. Women soccer players’ tend to develop patellofemoral syndrome if their feet are flat or if the Q angle is large. I am sure the therapists and trainers involved in the Olympic soccer tournament have minimized these foot injuries. If you have any of these foot injuries as a result of playing recreational sports or due the repetitive nature of your job you should not delay getting treatment for these injuries. Congratulations to the Canadian Olympic Women’s soccer team for their bronze medal and to the Mexican Olympic Men’s soccer team for their gold medal.

The Dream 100 metre Final

Tonight in the main stadium at the London games in front of 80,000 spectators the men’s 100 metre final will held, The final 8 runners are Richard THOMPSON, Asafa POWELL, Tyson GAY, Yohan BLAKE,  Justin GATLIN, Usain BOLT, Ryan BAILEY and Churandy MARTINA.  This is considered to be a dream final and a much anticipated event at the games.  In watching the semi-finals and preliminary rounds it was amazing to see the fluid mechanics of running demonstrated by the top runners.  Usain Bolt is the favorite to repeat as champion.  As a chiropodist/podiatrist I am amazed at the power that he unleashes using his long legs and arms. His feet act like well-oiled springs that transmit the power from his upper and lower leg muscles for push off from the track.  Unfortunately, recreational runners can damage their muscles, tendons, ligaments and bones if their feet cannot properly act like springs to transmit power. Plantar fasciitis is one such problem that prevents the foot to act like a spring.  The plantar fascia is one of many supportive structures on the bottom of the foot.  If the plantar fascia is damaged the foot cannot properly act like spring.  Plantar fasciitis is something that should be treated right away by a chiropodist/podiatrist before it becomes chronic.  And the winner is Usain Bolt. Congratulations!

Good luck to the Canadian Olympic Team

Over the next 3 weeks the London Summer Olympics will be showcasing thousands of athletes from all over the world. These athletes have been training for years to hone their performance to meet summer game standards and strive for a podium finish.  There is no doubt these athletes have injured themselves during their training while running, walking, jumping, lifting, aiming, throwing, diving, vaulting, rowing and swimming. Some athletes may even be competing at the London games with some type of injury.  The good news is that Olympic athletes have access to many different health professionals to treat their ailments to help them get ready for competition. 

Some of the lower leg extremity problems that can hamper an athlete included:

Hip pain

·         Bursitis

·         Leg length difference

Knee pain

·         Jumper’s knee (patellar tendinopathy)

·         Patellofemoral syndrome,

·         Ilio tibial band syndrome,

·         Runner’s knee (Chondromalacia patella)

Leg pain

·         Shin splints (tibial stress syndrome)

Ankle pain

·         Achilles tendonitis (Achilles tendinopathy)

·         Recurrent ankle sprain (lateral ankle instability)

Foot pain

·         Plantar fasciitis

·         Heel spur syndrome

·         Collapsed arch (adult acquired flat foot)

·         High Arch (pes cavus)

·         Callus and Corns

·         Bunions and metatarsalagia

·         Morton’s neuroma

Many of athletic injuries listed above can occur due to an work related injury caused by repetitive stress, unstable foot posture and improper footwear.  Many occupational injuries get worse because people will try to work through the injury and not seek help in a timely fashion. Chiropodists and podiatrists are part of your health team to get you back to work pain free.  Chiropodists and podiatrists can identify the mechanical instability in your foot or lower leg that may be causing your injury.  We will examine your feet, lower legs, walking pattern, footwear and any systemic medical problems that may contributing your injury such as diabetes. Custom foot orthotics may be part of the solution to get you pain free and back to work

I wish the Canadian Olympic team members the best of luck in London in their pursuit of a podium finish. 

Flip Flop Fungus

Yesterday on the on the drive home from the office I was listening to “Here and Now” hosted by Laura Di Battista on CBC radio. She was talking with Michael Bhardwaj (@radiobhardwaj) the national science columnist for CBC Radio. He was discussing  a flip flop fungus experiment that was reported by Jason Feifer in the New York Magazine. Michael outlined the variety of fungus and bacteria found on the upper surface of flip flops to Laura’s horror. Michael stated even though there are many bacteria and fungus on the surface of your feet and flip flops, our healthy immune systems can deal with the bacteria and fungus. He suggested washing the upper surface of your flip flops touching your feet with soap and water. This gets rid of 99.9% of the bacteria and fungus.
Foot fungus is a common complaint that I treat on a daily basis in my office.  A fungi is a microscopic plant like organism that thrives in moist, humid and dark environments. A mushroom that grows on a lawn or in a forest is a fungus that feeds on wood. In contrast, the fungus that infects the foot feeds off a protein called keratin found in the skin and nails.

Foot fungus appears in a number of presentations on the skin and nails of the foot. A fungal skin infection is called tinea pedis. One of the most common areas for a fungal skin infection is in between the toes. A fungal infection in between the toes results in red, hot, split, itchy and wet skin. A fungal nail infection is called onychomycosis. A fungal infection of the nail results in a thick, yellow and sometimes painful nail.

How can you get a fungal infection of the skin and nails? First, the fungal organism requires entry via some type of damage to the skin or nails. Second, the body’s immune system needs to be compromised. If the body’s immune system is compromised by stress, poor nutrition or disease such as diabetes a fungal foot infection can easily occur. I have many patients who have diabetes and fungal nails. Foot fungus is naturally found on human skin and is prevented from becoming a problem by virtue a complex interaction between “good” and “bad” bacteria on your skin. The good bacteria on the skin are like a “neighborhood watch program” repelling the bad bacteria. As long as there is good bacteria on your skin the likely hood of any type on skin or nail infection is low.
Unfortunately, the fungus that causes skin and nail infections has the ability to survive and infect another day. The fungus can produce a seed or spore that can survive for years. Once the conditions for growth are present the spore will germinate and cause another fungal skin or nail infection. This fact makes preventing a reinfection of skin and nails difficult because the spores can be found in an old pair of shoes or on top of your flip flops from the previous summer. Make sure you disinfect your shoe and socks of spores. Our office dispenses a couple of products that help to disinfect your shoes.

Enjoy the rest of the summer.

Euro Cup 2012

The Euro Cup is an exciting time for soccer/football fans. Soccer is a very good sport for keeping young people active.  Unfortunately, with all the running that occurs during a game, injuries can occur to the foot and lower leg. The list of injuries include: knee cap pain; ankle sprains; shin splints; heel pain; arch pain and forefoot pain.  Some of these injuries are caused due to an underlying structural problem that puts stress on the supporting soft tissue structures such as muscle, tendons, ligaments and joint capsules.

If your child is suffering from any foot or lower leg problem we can evaluate your child's running style.  We can record your child running on a treadmill which allows us to observe if there are any structural problems causing the foot or lower leg complaint via Pedigait slow motion analysis.   Enjoy the Euro cup during the month of June and we hope your favourite Euro cup team is victorious.