Anatomy in Motion
AiM: Gait Remedial Therapy without using Orthotics: A radical new approach to Gait.
Anatomy in Motion (AiM) is an extremely useful addition to the skills of the Chiropractor as with AiM the Chiropractor is now able to analyse the patient’s alignment in motion as well as statically (either standing on the treatment bench). As well as alignment in movement, Anatomy in Motion is particularly concerned with the “rebound” potential of the human body. If you think of throwing a ball, before the throw one’s body has to “wind-up” first. Now, if there is no wind-up, the throw will be very weak, regardless of how strong the muscles are. So, if you want to throw further, you need to wind-up more effectively.
A very ineffective strategy which would make little or no difference to one’s throw would be to make the chest and arm muscles bigger by, for example, doing the bench press exercise with weights. So, to be effective, all exercise needs to have these two components: the wind-up when the muscles get longer (technically the deccelerative, eccentric phase) and the shortening of the muscles (the accelerative or concentric phase). This means that much of what passes for exercise is just a waste of time in terms of real activity because it starts in a neutral position, contracts (concentric, shortening phase) and then returns to the neutral position. Bench press would be a good example of this. It makes the exerciser bigger and stronger but not in a particularly useful way.
Now if the Chiropractor applies this idea of exercise to gait, he can see exactly what happens. There is a wind-up, deccelerative phase when the gluteus maximus of the front leg in gait is lengthened. Plus, an accelerative, shortening concentric phase of the other gluteus maximus when the rear leg pushes off. This then is the simplest analysis of gait. Do you have a good enough wind-up? Do you have a good enough push-off? Of these two, the push-off, the concentric phase when the gluteus maximus contracts and shortens, is the easiest to see, to explain, to understand and to correct. The wind-up, eccentric, lengthening stage is much harder to see, understand, explain, feel from the inside and correct. Yet it is the crucial stage. The majority of the corrective exercises in AiM are of the eccentric, lengthening type. In other words they are focussed on the wind-up. In this approach Anatomy in Motion is highly unusual if not in fact unique.
The overwhelming majority of exercise systems focus on the concentric, shortening phase. Think of abdominal crunches or of pull ups or of bench press. In this AiM seems entirely at odds with the whole exercise world. When one learns one’s muscle, one learns how the muscle contracts. In Anatomy in Motion the focus is exactly the opposite way round. The question is how does the muscle lengthen or more precisely, which movement does the muscle decelerate? Welcome to the eccentric world! A very confusing place to be on first experience, whether one has Chiropractic training or not.
Observation of gait is key to AiM. So, the Chiropractor is able to observe the patient in “push-off” and wind-up and make the appropriate exercise recommendations and provide the appropriate treatment for the patient. In fact, gait is much more complicated than just two phases. Anatomy in Motion analyses gait over six phases: strike phase; suspension (load) phase; transition phase; shift phase; propulsion phase; and, swing phase. As gait is a two legged action, whilst one foot is passing through one phase, the other foot must be passing through a different phase.
According to Gary Ward, the founder, of AiM, strike phase on the left and shift phase on the right occur together. As do the suspension and propulsion phases. As do the transition and swing phases. This gives the Chiropractor three moments to look at a patient’s gait to get a clear view of what is happening in the patient’s body. Further, the Chiropractor observes the alignment of the patient in these six phases in all three planes of motion: the sagital (or front to back) plane which the Chiropractor best observes from the side. The frontal (or side to side) plane which the Chiropractor best observes from in front or behind the patient. And lastly, the transverse (or rotational) plane which the Chiropractor theoretically best observes from above (though it is unusual for this to be practicable).
Using Anatomy in Motion the Chiropractor will be able to correlate his findings from observation of the patient’s gait with his observations of the patient’s alignment on the bench. Let us suppose the Chiropractor observes in gait that the patient’s pelvis is always higher on the right than on the left, when the patient is observed from either the front or behind. In other words, the Chiropractor observes a tilt in the frontal plane. This should confirm what the Chiropractor has discovered statically on the bench by static observation and palpation. Now in AiM theory, when one shifts one’s weight into the right foot, it is normal for the right hip to be higher than the left. This is what should happen.
So, now the Chiropractor has another way of thinking about this patient’s problem. The Chiropractor can now see that the patient has become stuck in a particular phase of gait and needs to be helped out of this phase. Often in helping patients, Anatomy in Motion uses the innate “rebound” qualities of the body. That is, if the Chiropractor, helps the patient take the aberrant alignment even further in the “wrong” direction, then that will prime the body to rebound in the desired orientation.
Lastly, it should be mentioned that there is no independent scientific evaluation of the methods of AiM. This is partly because Anatomy in Motion is very new. But it is also because AiM presents such a comprehensive view of human gait that it would be difficult to see how any particular scientific experiment would be able to evaluate the AiM approach.
Until such a scientific evaluation takes place, all we have are individual case studies and anecdotal information. The word of mouth on Anatomy in Motion is very positive. Chiropractor Andrew Hunter DC decided to train in Anatomy in Motion and offer this service to his Chiropractic patients because of his own experience with his knee problem which AiM was able to help and which no other therapy or system seemed able to fix.
With Reference and thanks to Gary Ward, Founder of Anatomy in Motion and author of “What the Foot”‘ published in 2013 by Soap Box Books (available on Amazon).