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Sports Medicine > 2) Running Gait Cycle and Athletic Shoe Evaluation > Flashcards

2) Running Gait Cycle and Athletic Shoe Evaluation Flashcards

1
Q

Running

A
  • Most popular recreational sport
  • Biomechanics differ from walking
  • Responsible for many lower extremity injuries
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2
Q

Stride

A
  • Foot strike to ipsilateral foot strike
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3
Q

Step

A
  • Foot strike to contralateral foot strike
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4
Q

Speed

A
  • Stride length + stride cadence
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5
Q

Forces

A
  • 3 – 4x body weight at contact
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6
Q

Kinetics vs. kinematics

A
  • Kinetics = causes

- Kinematics = effects

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7
Q

Pelvis and running

A
  • Function: maintain balance and keep center of gravity over support leg
  • Pelvic motion is the key to postural control
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8
Q

Support phase

A
  • Contact phase, 20 – 35 %
  • Foot strike
  • Midsupport
  • Propulsion
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9
Q

Non-support phase

A
  • Forward recovery phase, 65 – 80 %
  • Follow through
  • Forward swing
  • Foot descent
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10
Q

Foot strike (0-25%)

A
  • Ankle dorsiflexed, knee flexed, lower extremity inverted
  • Toe strike: (sprinters) Midtarsal joint provides control
  • Midfoot strike: most runners
  • Heel strike: “normal”; long distance runners
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11
Q

Midsupport (35-40%)

A
  • Knee flexion and subtalar joint pronation are maximal (shock absorption)
  • Patellar cross: as one legs passes the other
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12
Q

Propulsion (70-90%)

A
  • Begins with foot lift and ends with toe lift

- Active subtalar and midtarsal joint supination

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13
Q

Non-support phase (forward recovery phase)

A
  • Majority of the running gait cycle

- Involves a change in direction twice (more energy expenditure than in support phase ?)

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14
Q

Follow through

A
  • From toe lift until leg velocity = 0

- Continued extension of the hip with rapid flexion of the knee and ankle

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15
Q

Forward swing

A
  • Transference of angular momentum: hip flexors allow the leg to move faster than the body
  • Forward movement of the leg
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16
Q

Foot descent

A
  • Begins with hip and knee extension and ends with foot contact
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17
Q

Double float phase

A
  • One foot in follow through and the other in foot descent

- Neither foot is in contact with the ground

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18
Q

Running compared with walking

A
  • Less time in the support phase
  • Double float phase
  • Decreased angle of gait
  • Decreased base of gait
  • Increased limb varus
  • Increased velocity of stj / mtj pronation
  • Increased ankle joint dorsiflexion at foot contact
19
Q

Running vs. walking

A
  • Greater ROM and force generated at the first MTPJ in walking vs. running
  • Slower running associated with a greater overuse injury rate vs. faster running
20
Q

Running shoe construction

A
  • Last: board, slip or combination
  • Outersole: carbon rubber, tire rubber, blown rubber, gum rubber
  • Midsole: Ethyl vinyl acetate (EVA) or polyurethane foam
  • Upper: leather, canvas or Gortex
21
Q

Running specific shoes

A
  • Extra heel cushioning
  • Low – cut to allow for ankle motion
  • Minimal lateral stability
22
Q

Basketball specific shoe

A
  • ¾ - top construction for lateral stability
  • Firm upper for torsional stability
  • No additional heel cushioning
23
Q

Cross-trainers

A
  • Ok if doing a little of everything and < 10 miles / week running
24
Q

Running specific shoe exception

A
  • Ok for walking

- A walking shoe has a more rocker sole configuration which better approximates walking, though

25
Q

Shoe flexibility

A
  • Forefoot (toe box) should be flexible
  • Midfoot (shank) should be stable (not flexible)
  • Rearfoot should be firm
26
Q

Problems / solutions

A
  • Hallux limitus: a more rigid toe box would be desirable
  • Rigid toe box: may contribute to anterior tibial shin splints
  • Flexible shank: notorious for causing plantar fasciitis
27
Q

Last construction

A
  • Slip (sock – type, one piece construction)
  • Board (fiber board skeleton, most anti-pronation shoes)
  • Combination (most shoes)
28
Q

Last shape

A
  • Straight (rectus foot; anti-pronation)
  • Curved (cavus foot)
  • Semi-curved (most shoes)
29
Q

Running shoe categories

A
  • Neutral cushioning
  • Neutral cushioning with midtarsal joint control (pronation)
  • Stability cushioning: Subtalar and Midtarsal joint control
  • Motion (pronation) control: subtalar and midtarsal joint
  • Motion control: global
30
Q

Motion (pronation) control (midsole modifications)

A
  • Higher durometer EVA or polyurethane

- External plastic bars or cups

31
Q

Cushioning (midsole modifications)

A
  • Specialized EVA
  • Gel components
  • Compressed freon gas (Nike)
32
Q

Running shoe styles

A
  • Standard training shoes
  • Lyte training
  • Racing flats
  • Trail shoes
33
Q

Minimalist/other shoes

A
  • Nike “Free”
  • Vibram “five-finger”
  • Newton shoe
  • The best advice: they are not for everyone !
34
Q

Rocker shoes

A
  • Stable (hard / firm heel)
  • Unstable (soft heel)
  • Unstable rockers require a stable knee
  • Useful for a variety of problems
35
Q

Barefoot running

A
  • Recent popularity
  • Experienced runner
  • Gradual introduction
  • Compact sand / turf surfaces initially
36
Q

Shoe weight

A
  • NOT a good way to select an appropriate athletic shoe

- A light shoe is not necessarily desirable

37
Q

Fit (feel)

A
  • Subjective

- “If it feels right, it probably is” (assuming that the other criteria have been met)

38
Q

Running shoe replacement time frame

A
  • Running shoes should be replaced every 200 – 400 miles

- For those who run every day: buy two pairs and rotate them

39
Q

Patient Rx: shoe selection

A
  • Sport specific
  • Trainer / trail / racing flat
  • Motion / cushioning needs : biomechanically correct shoe
  • Check flexibility: toe box
  • Price: > $ 85.00
  • Fit (feel): Their call !
  • Weight: Forget about it
  • Proper size: Thumb width
40
Q

Excessive pronator shoe prescription

A
  • Some degree of motion control shoe (usually 3 levels available)
41
Q

Excessive supinator shoe presecription

A
  • Cushion with stability

- Currently no reverse-density midsole available ( other than custom, Bart Hersey shoes)

42
Q

Sock influences

A
  • Blister formation (friction)
  • Perspiration
  • Comfort (hot / cold)
  • Tinea pedis / onychomycosis
  • Acrylic / CoolMax fibers reduce blister formation and “breath” better than cotton socks !!
43
Q

Eliminating perspiration: the wicking effect (from best to worst)

A
  • CoolMax
  • Acrylic
  • Polypropylene
  • Wool
  • Cotton
44
Q

Sock fiber type –> Sport

A
  • Acrylic –> Golf, tennis, hiking
  • Acrylic / wool –> Outdoor – cold
  • Acrylic / Thermax –> Outdoor – cold
  • Acrylic / CoolMax –> Outdoor – warm
  • CoolMax –> Running, cycling

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