The Gait as a Global Functional Motion Pattern

The gait is perhaps the most impressive example for an activity that affects the entire body. We can see here how the entire locomotor system acts according to a certain pattern (motion pattern).10 '9-63107 All myofascial structures and all joints act as propelling organ as well as shock absorber.

The physiological processes of twisting together and twisting apart that occurs in the legs and trunk follow a special pattern. With the forward impulse during walking, this leads to the conversion of chemical energy, created by muscle activity, to kinetic energy that propels the body forward.155 We can compare this motion pattern to a spring that unwinds when the leg swings and winds back up when the weight once again lands on the heel. The impulse in the gait starts when the heel touches the floor, the weight is shifted forward, and the leg muscles conduct the movement through the pelvis towards the spinal column.

The fact that almost all joints permit three-dimen-sional movement, together with the alternating order of lordoses and kyphoses from the sole of the foot up to the root of the nose, and the arrangement of muscles into lemnisci permit harmonious and economical locomotion. This illustrates how function depends on structure.

Note: In an interesting article, Gracovetsky (in 15S) sets forth the hypothesis that the anteroposterior curves of the spinal column are not only an adaptation to gravity, but also serve the function of making locomotion more economical. Kypholordoses act like an anteroposterior leaf spring that is pressed together when the foot is set down and stretches out when the leg swings.

Howard J. Dananberg, posturologist and director of the Walking Clinic in New Hampshire, United States, describes impressively in an article titled "Lower Back Pain as a Gait-related Repetitive Motion Injury" (in l5S) how an extension deficit in the metatarsophalangeal (MTP) joint of the large toe can be the starting point for lumbar pain.

A stretch deficit of the large toe prevents the foot from rolling off completely during walking. The organism compensates for this by increasing the dorsal extension of the foot, flexing the knee, and flexing the hip. The result is an imbalance between hip benders and hip stretchers, which shortens the length of the stride. The iliopsoas and quadratus lumborum muscles in turn balance this out with an increased pelvis rotation. This example shows how a foot lesion is compensated with a certain muscle chain, which can lead to a predictable dysfunction.

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