Just when you thought it was safe to watch a Neuromechanics Weekly episode, Dr Ivo throws a curveball. Check out the interesting clinical asides about myelopathy (pressure on the spinal cord causing ataxic gait) and the importance of which modality to check 1st, when doing an exam. Keep these things in mind the next time you are evaluating someone's gait. ... https://www.youtube.com/watch?v=tP-PvzB-fYM

Here is a great little video case. This is simple stuff if you know your functional anatomy, if you know your normal and abnormal gait patterns and understand what you are seeing. You have heard it from us too many times to count now, "what you see is not the problem, it is their compensation around the problem". This is another perfect video case demonstrating this very fact. Watch this gait pattern, the issues is most easily seen as they client walks towards you. Compare the right foot and the left foot. Look at the foot progression angle DURING SWING (when the foot is off the ground). Look at the left and look at the right each during swing. Can you see the difference ? If you have trained your "gait eyes" you should quickly be able to pick this one up on any client within a few steps, seriously folks, once you have seen 10's of thousands of gaits you will pick up on these things that fast. And in this case this is a classic gait pathology pattern. What you should see is the flipping out of the right foot into the frontal plane, this is a modified "circumduction gait". Typically the circumduction gait comes from the hip, but some folks can be sneaky in their subsconscious compensatory pattern around things. This person has a clearance problem on the right, meaning they cannot create enough hip flexion or ankle dorsiflexion to clear the foot as the limb swings forward to prep for the next foot strike on that same side. When ankle dorsiflexion is insufficient only, you tend to see this peroneal strategy. Meaining, engage the peronei and extensors of the toes to raise the foot laterally (everted) to create more clearance. Specific testing in these cases often shows that the supinator division of the tibialis anterior is more weak. And this is where your homework of rebuilding skill, endurance and strength must start.......IF that is in fact what your examination shows. You must NOT ASSUME from what you see, because remember, what you see is the compensation. So just be sure you test for the limitations. Limitations are not always muscular for all you muscle activation gurus out there. For example, what if this person had "Footballers ankle"? (look it up, sometimes functional limitations are osseous and joint). You cannot strengthen yourself or your clients out of every problem, so do a competent clinical examination of all the parts ! Make sure you check the core and hip in this case. These clients will often drop the foot into stance phase already progressing into pronation instead of creating that brief delay into pronation that is normal and critical for the timing of the stance phase events (remember, midfoot pronation via subtalar joint motion brought on by adduction, medial rotation and plantarflexion of the talus is not to occur until the ... https://www.youtube.com/watch?v=J0z8lpK7X1E