Gait Re-Education, restoring normal walking gait (ankle, knee, hip injury) — Transcript

Full transcript

1. 0:00okay oh you guys join with your neighbor
2. 0:03Paulina and Valentina's behind the
3. 0:05camera and we're doing a video on how to
4. 0:08and get back to normal walking pattern
5. 0:12following an injury so and what's very
6. 0:15frequent is that somebody has a limp or
7. 0:17an interrogation
8. 0:20following an injury and their their
9. 0:23walking speed decreases they put a lot
10. 0:26more weight and load through the the
11. 0:29uninjured or the onin both side and they
12. 0:32start talking about well you know what
13. 0:33I'm feeling a bit on my knee on this
14. 0:34side because I'm taking so much more but
15. 0:36I've almost forgotten how to walk so
16. 0:38it's a skill that we've got to relearn
17. 0:40we've gotta you know take very you know
18. 0:43because we gotta treat very importantly
19. 0:45at the start of rehab so this is what we
20. 0:47call gave me education walking we
21. 0:49education so I'm gonna do this with
22. 0:51Paolina so we'll go through some of the
23. 0:53phases and dinner phases that you can
24. 0:55practice at home yourself so firstly
25. 0:57what we do is I'll just get Pauline to
26. 0:59send her to the camera here and so she's
27. 1:02just going to just do some lateral
28. 1:04weight shifts so all she's doing is
29. 1:06learning to accept the Lord on the or
30. 1:11involves ID as well as the involve side
31. 1:13so she's just rocking from side to side
32. 1:16now what's happening here is that it
33. 1:19whittles an ankle injury or an injury or
34. 1:21a hip injury or a hamstring injury or
35. 1:23calf injury the leg is beginning to
36. 1:25accept the Lord now from there so it so
37. 1:30we've got this frontal plane so when
38. 1:33we're moving across and now we've got a
39. 1:34walk in a sagittal plane so what we're
40. 1:37gonna do we're gonna look at the three
41. 1:38phases of the gait cycle so we've got
42. 1:40your initial contact which is your heel
43. 1:43strike then you've got a foot flat and
44. 1:46then you've got a toe off so what we're
45. 1:50gonna do and usually what happens with
46. 1:52people when they've got a when they've
47. 1:54got a limp is that they're missing heel
48. 1:57strike so you can see I'm going down on
49. 1:59my mid foot first so I haven't got my
50. 2:04heel strike so a normal gauge would be
51. 2:06when my heel strikes first initial
52. 2:09contact you can strike foot flat toe off
53. 2:11but in
54. 2:13engaged and walking it when I'm injured
55. 2:15most of the time I spend longer on my
56. 2:18good side in my stance phase I've got a
57. 2:21short and swing phase here and I've got
58. 2:23a short and strike this so I'm nuts to
59. 2:26our sensory so I'm not taking off a lot
60. 2:28of thought
61. 2:29so one of the things that we can do is
62. 2:30go side onto a wall like this okay and
63. 2:34then we can just practice putting the
64. 2:36foot out and then just getting that heel
65. 2:39to touch first and then moving it foot
66. 2:42flat bring it back so Pauline if I get
67. 2:46you to do it on the other side for video
68. 2:48purposes good so he'll foot flat and
69. 2:52then bring it back heel foot flat and
70. 2:56bring it back
71. 2:57and here we're encouraging the first
72. 2:59part of the gait cycle now when you're
73. 3:02confident enough with that what Paulina
74. 3:04can do is then is she can go to toe off
75. 3:06so to go to toe off what she's gonna
76. 3:08have to do is she's gonna have to lift
77. 3:09the other leg so again using water for a
78. 3:11bit of support heel foot flat and then
79. 3:15just to there so now she's taking it all
80. 3:18into it well so we haven't actually gone
81. 3:20to toe off there so it's heel foot flat
82. 3:22and then see can she take the weight
83. 3:26right for like so the next one would be
84. 3:28heel foot flat can I do it without
85. 3:31support so now I'm working on my single
86. 3:34leg balance so as you can see she's
87. 3:36doing really well there and then the
88. 3:38next part of that would be heel foot
89. 3:39flat toe off so she can she go up on her
90. 3:43toes good and again heel foot flat toe
91. 3:48off and then the next part of that there
92. 3:51will be healed foot flat
93. 3:53- off and then seek and we get onto here
94. 3:56heel foot flat and two off so try and
95. 4:02keep it as simple as I possibly can or
96. 4:04everybody should because that's what the
97. 4:05walking it is and if you can see the
98. 4:07Paolina now is just showing you slowing
99. 4:10the gate pattern right down trying to
100. 4:12get destroyed link reciprocal so the
101. 4:14same length on each side working through
102. 4:16that initial contact an - foot flat and
103. 4:20then into toe off so really working on
104. 4:22the earth through kinematics and osteo
105. 4:24kinematics arthro kinematics is when we
106. 4:26were talking about the joint so your
107. 4:29tailor crore joint your mid foot joint
108. 4:31your proximal toes and then osteo
109. 4:35kinematics is talking about the bones so
110. 4:37how they're getting influenced with
111. 4:39regards to the muscles so you've got
112. 4:42your your at the back of the leg there
113. 4:44you can see her gastroc sand or you know
114. 4:47call your triceps surae
115. 4:49so really important guys if you're
116. 4:51looking at recovering well from an
117. 4:55injury that you get back to normal
118. 4:57walking pattern because it's gonna have
119. 4:59consequences with regards to the knee so
120. 5:02the knees need to fully extend so what
121. 5:04I'm going to he'll strike I need to be
122. 5:06able to fully extend any so is that a
123. 5:08limiting factor I have I got reduced
124. 5:10dorsiflexion am I only able to take the
125. 5:14note so there are many reasons why you
126. 5:15may have an entire case it may be due to
127. 5:19pain and may be due to stiffness it may
128. 5:20be due to previous injury it may be you
129. 5:22take an easy phobia which is a fear of
130. 5:24movement or fear injury so important to
131. 5:28work that true with whoever you're
132. 5:29working with regards to whether it's
133. 5:31your sports therapist or physiotherapist
134. 5:33your S&C coach or whoever it is Ammar if
135. 5:35you're working trailer on your own and
136. 5:36working through YouTube it's great a
137. 5:38great resource then and it's a I think
138. 5:41this is a pretty simple way to work
139. 5:43through it but it really important to
140. 5:45get that walking gait right guys so I
141. 5:47hope you enjoyed that video on and
142. 5:49learning to walk again after injury so
143. 5:52it's baby steps