Hendrik Scheepers Biokinetikus

01/05/2024

28/04/2024

6 Stretches for Back Pain Relief

https://goto.healingthroughmovement.com/btl_04_27_24

26/03/2024

Compensated and uncompensated hip drop in adolescent patients with various hip pathologies. 💡

🚶‍♀️ Trendelenburg gait is traditionally described as an excessive pelvic drop on the swing limb side during single leg stance (SLS) [https://europepmc.org/article/nbk/nbk541094]. This occurs when the hip abductor muscles of the stance limb are unable to produce enough internal force to counteract the external (body weight) moment required to stabilize the pelvis.

🚶‍♀️ During Trendelenburg gait, the compensatory strategy to reduce hip load is typically excessive ipsilateral trunk lean. By shifting upper body weight over the stance limb, center of mass (CoM) is brought closer to the hip joint center (HJC), thereby reducing the lever arm length of the external moment, unloading the hip, and reducing demand on the ipsilateral hip abductors. [https://pubmed.ncbi.nlm.nih.gov/33128962/, https://pubmed.ncbi.nlm.nih.gov/28918356/]. This is broadly regarded as a “compensated Trendelenburg gait”.

👉 Contrary to this gait strategy, contralateral pelvic drop without a trunk lean is regarded as “uncompensated Trendelenburg’”.

📘 Anable and colleagues investigated the prevalence of uncompensated Trendelenburg among various adolescent hip pathologies (n=152) clinically diagnosed with acetabular hip dysplasia, femoroacetabular impingement, Legg-Calvé-Perthes, or slipped capital femoral epiphysis.

🔀 The authors defined ‘excessive ipsilateral trunk lean’ as ≥ 4.8°. Any patient that demonstrated ≥ 5.4° of pelvic drop and no excessive trunk lean was thus categorized into the ‘pelvic drop’ group (uncompensated Trendelenburg), with all remaining patients representing the ‘stable pelvis’ group (compensated Trendelenburg).

🔀Hip load was assessed preoperatively, in part, via the internal hip abduction moment impulse during SLS (‘hip impulse’) (Nm/kg-s), a value that has been shown as a robust way to quantify load on the articular surface of the hip during gait. [https://pubmed.ncbi.nlm.nih.gov/7293346/]. Furthermore, they meased side-lying hip abductor strength and pain data.

📊 Dysplasia patients represented the highest proportion of the pelvic drop group (46%).

📊 The pelvic drop group showed a significant increase in self-reported hip pain (p = 0.011), maximum hip abductor moment (p = 0.002), and peak coronal power absorption at the affected hip during SLS loading response, (p < 0.001) while showing no difference in abduction strength (p = 0.381).

☝️ Contralateral pelvic drop independent of a trunk lean compensation (i.e. uncompensated Trendelenburg) may lead to increased loading of the ipsilateral hip among adolescent hip pathology populations. As the contralateral hemipelvis drops during SLS, a large amount of hip adduction is introduced to the stance limb. This orientation of the pelvis over the femoral head reduces weight bearing area of the hip and shifts the HJC laterally with an increase in peak contact pressure [https://pubmed.ncbi.nlm.nih.gov/22134707/].

☝️ Without trunk lean shifting CoM laterally to compensate, the external moment arm to the HJC may ultimately be increasing in length. The longer moment arm creates an increased coronal hip load that is not being adequately supported by the hip abductor muscles. Considering the known insufficiency of hip abductor musculature in Trendelenburg walkers, it is thus inferred that the increased hip load is being predominately supported by passive, elastic hip structures, such as the iliofemoral ligament and labrum.

👉 As hip abduction strength did not reveal a relationship to pelvic drop. It is becoming likely, according to recent literature, that maximal exertion strength is not an adequate measure to assess the insufficiency of the hip abductors that brings on Trendelenburg sign. [https://pubmed.ncbi.nlm.nih.gov/21116011/, https://pubmed.ncbi.nlm.nih.gov/22797529/, https://pubmed.ncbi.nlm.nih.gov/33076947/, https://pubmed.ncbi.nlm.nih.gov/23587766/, https://pubmed.ncbi.nlm.nih.gov/9384429/]. Another possible reason for the lack of difference in hip abductor strength (despite high abductor demand in the uncompensated Trendelenburg gait group), might be masking of hip abductor insufficiencies in early childhood. With puberty however, a rapid gain in height and weight that increases load demand of the hip abductors could reveal uncompensated Trendelenburg as these adolescents try to maintain the same walking speed.

👉 As many gluteus medius strengthening exercises are performed in positions that are not used during gait activities and most focus on concentric activation of the gluteus medius while this muscle is regularly challenged eccentrically, weight bearing hip abductor strengthening with a focus on movement control might be an important exercise consideration to improve movement control. [i.e. kettlebell walking with kettlebell held opposite to the targeted hip, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628027/ (s. picture in comments), resp. gait with arm elevation of the contralateral side https://pubmed.ncbi.nlm.nih.gov/18037294/ or biofeedback during gait, https://pubmed.ncbi.nlm.nih.gov/11606020/).

Illustration: https:/Illustration: https://link.springer.com/chapter/10.1007/978-3-031-37804-1_5

25/02/2024

Heart valve disease includes a range of conditions that occur when any of the heart’s four valves don’t work properly.

has an assortment of tools and resources for you and your patients, including the newly updated CardioSmart Heart Explorer app.

The app features new videos about TAVR, left atrial appendage closure, and mitral transcatheter edge-to-edge repair and supports treatment discussions between patients and their health care teams when talking about and prevention options.

Learn more: bit.ly/3I5ZJXV

17/02/2024

What is the difference at the highest level? Belief.

Belief is always a CHOICE and what surprises me is not everyone opts in.

Some of you are rolling your eyes but stick with me. Studies prove it: "Belief-reinforced awareness becomes our biochemistry. Each and every tiny cell in our body is perfectly and absolutely aware of our thoughts, feelings and of course, our beliefs."*

Depression FEELS physically terrible even if it is happening in your mind. You create the biochemical stew in which you create your physical reality.

From a logical perspective it also makes sense: believing in yourself grants the time and space to figure it out. If you are overcoming an injury, are dealing with crappy symptoms of menopause, or didn't make the time cut at Ironman/Boston.. the singular tool you need to have in your arsenal is belief. It is a special sauce you pour on everything that creates the commitment to continue and figure it out.

Belief is, in a nutshell, the way you CHOOSE to perceive reality. I can't tell you the number of times people haven't actually agreed with how I saw reality. That is, until I showed them.

Here is a thought for your weekend: "If you don't change your beliefs, your life will be like this forever. Is that good news?" - W. Somerset Maugham

Train for a rad life 💫



*Sathyanarayana Rao TS, Asha MR, Jagannatha Rao KS, Vasudevaraju P. The biochemistry of belief. Indian J Psychiatry. 2009 Oct-Dec;51(4):239-41

06/02/2024

Midmar myl hier kom ons, sterkte vir die laaste paar oefening coach, sien jou Sondag.

25/01/2024

Sterkte aan al ons lede wat regmaak vir die Midmar myl. Nog 3 weke dan maak ons so.

10 + 11 Feb 2024

06/01/2024

Kom ons begin die jaar reg!!!

05/01/2024

We looked at over 50 fizzy drinks that are available in South Africa and compared their sugar contents.

18/12/2023

Gratitude is the key to unlocking the beauty of the present. Like if you agree 👍

15/12/2023

Afsluiting saam met n klomp spesiale mense

15/10/2023

You don’t need supplements to build muscle, lose fat, and get healthy. But the right ones can help.

05/07/2022

"Bicycle is the slow death of the planet."

A banker made the economists think this when he said:

“A cyclist is a disaster for the country’s economy: he doesn’t buy cars and doesn’t borrow money to buy. He don't pay insurance policies. Don't buy fuel, don't pay to have the car serviced, and no repairs needed. He doesn't use paid parking. Doesn't cause any major accidents. No need for multi-lane highways.

He is not getting obese.

Healthy people are not necessary or useful to the economy. They are not buying the medicine. They dont go to hospitals or doctors.

They add nothing to the country's GDP.

"On the contrary, each new McDonald’s store creates at least 30 jobs—actually 10 cardiologists, 10 dentists, 10 dietitians and nutritionists—obviously as well as the people who work in the store itself."

Choose wisely: a bike or a McDonald's? It's something to think about.

~ Emeric Sillo

PS: walking is even worse. Pedestrians don't even buy a bicycle!

*Posted by Jessica Maria Dwyer on Linkedin (https://www.linkedin.com/in/jessdwyer/)
**Photo credit: Franz-Michael S. Mellbin (2011)

16/06/2022

16/06/2022

11/01/2022

23/10/2021

The heck you are... 😂💀