From Gait to Feet to Legs
Now that you understand the basic phases of gait, you can learn to recognize the motions of the legs and feet and the interrelationship of these structures. The period of double support, during which both feet are on the ground, occurs twice during the stance phase, during the initial portion and in the final 20 percent.
The terminal double support phase has implications for the final portion of stance phase, which is the propulsion subphase. The propulsion subphase can be divided into active and passive periods. The active portion occurs after heel off yet before the opposite foot touches down and terminal double support begins. The passive portion of terminal double support begins with the touchdown of the opposite foot and the ending of the work that the propelling calf muscle was doing. Some people call this subphase the pre-swing phase.
At heel contact, the pelvis is slightly in external rotation. Slightly after heel contact, as the foot is adapting to the ground, the pelvis rotates internally. Just before toe off, it rotates externally, where it remains during the swing phase.
Force Flow
Force flow through the foot can today be measured by a variety of means. The Electrodynogram, the first system available for doctor's office use, consisted of seven sensors applied to standard positions on the foot. Other technology exists today that accomplishes this and lets you observe forces beneath the foot that normally cannot be seen.
Devices also measure the timing of the phases and subphases of gait, greatly increasing knowledge of what is occurring during the gait cycle. Normal pressure flow through the foot starts slightly lateral in the heel, flows forward between the first and second metatarsi, and exits through the big toe.
During running, if a runner swings his arms across his body, there is a compensatory increase in pelvic rotation. It is more efficient for the pelvis and better for the pelvic musculature if the runner moves his arms parallel to the motion in which he is running.
Selecting a Sports Physician
It is important to choose a doctor with experience in treating athletes. You cannot rely on finding such a doctor simply by referencing a telephone book. The best sources of information are other runners. Ask around; chances are high that several members of an area running club have needed treatment from a specialist sports doctor.
A specialty running store is another source since the employees there are typically runners. Even if they're not, they should be able to put you in touch with individuals or groups that can help you. Why go to all this trouble? Because it is vital that you choose a medical specialist with both experience and a good reputation among runners.
Board Certification
Despite suggestions in the popular press that your sports physician be board-certified in sports medicine, there are no organizations that currently award such certification to any physician, including podiatric physicians. Fellowship status can be achieved, however, through qualification and testing by the American College of Sports Medicine and the American Academy of Podiatric Sports Medicine.
Should the sports physician be a runner, too?
Whether the doctor is also a runner doesn't matter. Although a doctor-athlete can add to your understanding of the psychical and physical conditions that lead to injury, this is not a prerequisite for appropriate diagnosis and treatment. The recommendations of knowledgeable people are the most valuable resource for finding a capable sports medicine physician.
A Certificate of Added Qualifications in Sports Medicine is granted physicians who meet multiple criteria and successfully pass a certifying examination given through a joint venture of the American Board of Family Practice, American Board of Podiatrics, American Board of Internal Medicine, and American Board of Emergency Medicine.
Other sports medicine organizations include the American Orthopedic Society of Sports Medicine and the American Medical Society of Sports Medicine. Organizations that can help you find a capable sports medicine practitioner are the American Running and Fitness Association, the American Academy of Podiatric Sports Medicine, and the American College of Sports Medicine.
