Gait and Posture Analysis

Last week went went to the Embarcadero YMCA for our monthly visit. Every other month we offer and Ask the Doctor day and every other other month we offer video taped gait analysis and posture evaluations. This month was gait and posture, so we packed up our video camera and our spinal analysis machine and headed over there. We had a great time! Some months we don't see many people but this month was great. We had a lot of people interested in learning more about their health and in talking to us about their posture or their running or walking. It was a great chance to get out into the community and educate people about chiropractic and what we do. A lot of people think chiropractors only work on the spine and only perform adjustments. But we do so much more! As musculoskeletal specialists, there is a lot we can offer, especially to the average athlete.

Gait analysis, especially, is helpful for runners or those who want to become runners. We have the person walk and run on a treadmill while videotaping their ankles. Then we talk with the person about what healthy gait looks like (straight ankles, good heel strike, no toe-out, etc) and we show them their video. We often stop the tape at intervals to help them see any inconsistencies in their own gait. When we are done explain to them any problems we see in their gait, we talk with them about footwear choices that will be best for them. If it looks like they need further evaluation, they are of course welcome to come see us at the office. It's a great service for the people who participate because this kind of gait analysis usually costs about $100. We provide it free of charge, and only ask that they make a donation of $20 to the YMCA.

A lot of people are running with poor biomechanics or with the wrong shoes and they end up injured as a result. It's an easy thing for us to point out where they are going wrong and help prevent injury. If it's too late and they are already having pain with running, we can help them with chiropractic and physical therapy to get them back in shape and into the right shoes.

Case of the Week - Tension Headache

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Case: 26 year old female complaining of headaches several times per week, always in the afternoon or at the end of the day. The pain starts at the base of the neck and slowly moves up until it is at her forehead. The movement from neck to forehead takes about a hour. The patient has tried eating more regularly and drinking more water and decreasing or increasing caffeine intake, but none of these is effective. When she has a headache, the only thing that helps is to lie down and close her eyes. The headaches seem to be worse with increased time at the computer.

Examination:
The muscles of the neck, especially the sub-occipital muscle group, are very tight and tender. There are multiple trigger points in the sub-occipital muscles and in the sternocleidomastoid on the right. Pressure on the sub-occipital trigger points reproduces the headache. Range of motion is decreased in neck flexion and right rotation. Other orthopedic testing for nerve, muscle and joint involvement was negative. The temporomandibular joint (TMJ) was not contributory.

Discussion:
This is a classic tension headache case. As the patient works at her desk, poor posture and fatigue cause her to slump in her chair. This causes excess tension in the posterior neck muscles, especially those at the base or the skull (the sub-occipital muscle group). Treatment involves massage to release the muscle tension, adjusting of the thoracic and cervical spine (mid back and neck) to achieve good joint motion, and then training the patient on proper posture and ergonomics. The patient education is key in this case. Without good posture, her headaches will continue to develop. Our goal in the office is to ensure her spine is able to provide that posture.

Outcome:
The patient feels fully in control of her headaches. She continues to receive regular chiropractic check-ups to maintain her spinal health. She maintains healthly posture by exercising at her desk and taking regular breaks. Now, on the rare occassion that she does get a headache, she knows why and she knows what to do about it.


Exercise:
Posture pod – check out this link for a great 2 minute posture re-fresher. Once at the page, click on Posture Pod. These were designed to be done by anyone, regardless of their physical fitness. Have fun! http://www.straightenupamerica.org/Handouts/Handouts.html

Remember never to engage in an exercise without first consulting your chiropractic physician to see if it is safe for you and your unique conditions.

Suggestion:

Take a posture break! – Every hour you are at work, take 5 seconds to do the opposite of what you have been doing. If you are at a desk, stand up and walk around. If you are standing, sit down and relax. Roll your shoulders back. Stretch your neck. Get moving! Your muscles need to be reminded that they have a job to do: holding you up! Take a few seconds every hour to get refreshed.

Remember never to engage in an exercise without first consulting your chiropractic physician to see if it is safe for you and your unique conditions.