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Biomechanics as a Medical Specialty Field or Department

 

Biomechanics: The Study of how a Living Organism Moves

 

I was recently delighted to participate in a podcast by the Glasgow Triathlon Club along with Jonny Kilpatrick from Physio Effect and Ciaran Canney from The Foot Medic. We were asked to talk about the subject of biomechanics: what it is, why it might be important, how we assess, what we commonly see in our clinics and footwear. It was such a great opportunity and I was quite nervous! The guys were great and I enjoyed learning from them too. We are clearly all very passionate about the subject, a subject which I think is very important. Biomechanics is the study of the structure and the movement of a living organism, which I find fascinating.

There was so much that I, in hindsight, wanted to say and on reflecting I thought I'd share some more views on the subject and some take home messages.

Female athlete runs on the athletic track. Running movement phases concept.

 

So, why are Biomechanics important and why should we be interested?

 

We are creatures of habit and this is no bad thing if that habit is efficient and functional. If our movement; our biomechanics, is not efficient then over a period of time you may develop symptoms or pain, overstrain and discomfort. You can imagine that if we move the same way in everything we do that eventually areas of the body may become more worn out. It makes sense then that if we move differently and add variety to our training and daily activites we will then share the load more evenly and possibly prevent one area taking the brunt. If we train our bodies to have balanced muscle tone, balanced and adequate joint range of motion and a spring in our step we become robust and importantly adaptable.

The body experiences pain for a reason, but the reason is not always obvious

Repetitive Strain

There are many scenarios that can occur and a common one is simply repetitive strain. If we do the same thing over and over the tissues that are not designed to manage the forces you are applying to it alone, fatigue and start to wear out. An example of this is 'tennis elbow' or lateral epicondylalgia as it's called. If you are typing and texting and gripping all day long the forearm extensor tendon where tennis elbow occurs becomes overstrained = pain.

Businesswomen's elbow pain, A young woman touching her painful elbow

Compensation

Sometimes a strain within the body come about for no apparent reason; the patient has not experienced any physical trauma and they have no idea why they are in pain. This is when taking a thorough case history is important to not only learn what that person has been through over the years but to also ensure there is no underlying pathology that could be causing their pain. When considering the biomechanics however, one knows that the body has been compensating for some thing(s) which has lead to pain.

A Common Pattern

 

Man with low back pain in gym. Sports exercising injury

 

A very common example which I discussed on the podcast is when someone explains they have pain for example, in their left lower back. I'm guessing as I've not crunched the stats, but I reckon 90% of those people have had a bad ankle sprain in the past, or a trauma to the knee. More often it's the ankle. Pain makes us move differently, and this alone can become a new habit; a new movement pattern. Sometimes this new movement becomes ingrained. The range of motion in the ankle can become imbalanced (very restriceted in one joint, and overly mobile in the joint that was sprained) leading to the rest of the body compensating. The foot and ankle send reflexes to the hip musculature (glutes), communicating up the kinetic chain for smooth activition of the muscles. Once there's been a sprain, the communication gets cut, fuzzy, lost. The glutes no longer activate when they should. The back compensates, then back pain ensues. This can be triggered by the most trivial, gentle movements when 'the reservoir of compensation' expires. Then this can lead to fear avoidance behaviour, the pain gets worse, movement variability becomes even more limited, and adaptability reduces. Back pain becomes a depressing, chronic problem that is always in the thoughts of the patients' mind. It has profound effects, but it can get better. The body is adaptable! We just need to use it differently, think about it differently and have the confidence to spend some time dedicated to make positive changes to not only our biomechanics but also to our emotions that contriubute to and are affected by our movements and postures.

Man practicing Capoeira , brazilian martial Art. Sport science, biomechanics, information technology concept. Moving differently

 

How long will it take to make changes?

Well, it depends. It depends on how deep your restrictions are, what condition and health your tissues are in and to a certain degree your age too.

If we incorporate training and different movement into our lives, to gain balanced muscle tone, adequate joint range of motion then the body will adapt. The body-mind want to thrive!
Tissues (muscles and fascia) can become stiffer, more mobile, stronger and remodel to adapt to the load we place upon it. Collagen (which is what fascia is made of, along with elastin) has a half life of approximately 12 months. This means in order to change the tissues, to remodel them, it can take from 6 months to 2 years WITH new movement, WITH new pressures so that the tissues have to remodel to adapt to the new loads. It probably took years for you to feel any back pain, you've maybe had it for years too, so it will take a long time to change. But know that it can in the right environment.

podcasting concept, directly above view of headphones and recording microphone on orange background

The Podcast

There were a couple of things said in the podcast that struck me, which I've reflected on. The first one:


"we just move in the same way all the time and don't even think about it"


Like I said we are creatures of habit and efficient ones at that. We shouldn't need to think about the way we move, one of the reasons how we have evolved is so we can walk, talk and use our hands at the same time. We can multitask. But when our movement pattern become strained we need to re-ignite our awareness, find a new centre, find a new pattern. For that we need to become aware of the one we can first in order to change it.


Another statement I wanted to discuss:


"some of the best high-end athletes have the most awful biomechanics (visibly)"


Biomechanics isn't always about looking 'perfectly aligned' within the plumb line. For a start some of the best long distant runners like Haile Gabreselassie have what we might see as 'flat feet' or overly pronated. Flat feet isn't a problem if the foot (and the rest of the body above it!) is not stuck in pronation and importantly if it can come out of pronation, but more about that in another blog. Athletes are hugely adapted to what they do, they train a lot and have a whole team around them to keep them right both mentally and physically. But they can still get injured if their biomechanics aren't efficient and if they cause repetitive strain too.

For us mere mortals, the weekend warriors, the triathletes, the musicians and manual labourers, we would do well to add variety to our training. If you're a strong muscular body builder then you might benefit from a good stretch once a week. If you're bendy, more resistence work would be good. If you're balance is wobbly, work on that. Better still come to my Pilates classes! All bases covered there.

Details of the podcast will be added here once its been published.

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