5 Mechanical Causes of Injuries and Pain Syndromes: Video Intro

How You Carry Your Stuff May Not Be So Good

I chose Laurie because of how colorful she was here to demonstrate the principle of Equal Loading.


Most of us carry too much on one side of our bodies. I love to carry my gym bag always on my right shoulder, even when I was having left hip pain. Remember that the right shoulder works in harmony with the left hip and vice versa. It is important when you have musculoskeletal problems to see if how you typically carry your handbags, grocery bags, etc. has a negative or positive impact, and then make changes accordingly. Here  Laurie demonstrates the principle of Equal Loading to even out the pressure exerted by the contents of these bags.

By looking at Laurie, you can see that her right shoulder is lower and more rounded. This makes it easier to carry objects on her left shoulder. Since her problems primarily concern the left side, it is important to share loads equally on both sides. 

Right Handed vs Left Handed: Affect on Lower Extremity Mechanics

Ask any ballet dancer if they are dominant on their right or left side because they are right handed or left handed and they will say no!!! They spend their whole careers fighting any dominance of strength and coordination from being right or left handed. But for most of us, we use one side of our bodies alot better, stronger, gracefully, than the other side. I am right handed and I have long played basketball as if I have no left hand--pretty gruesome sight to behold at times!!

If you are right handed, your right side is your movement side (the side you kick the ball with), and your left side is your support side (the one you plant for stability before you kick the ball). And vice verse if you are left handed. And there are shades of this that I see in patients, and myself, from very dominant handed to almost ambidextrous.

So a very common pattern of problems I see concerns the instability (weakness) on the support side. This can be very dangerous and slows down or speeds up rehabilitation. For an example, let us take a left ankle sprain in a right handed patient. The injury is to their support leg. The leg they support with is technically unsupportive. And this dramatically slows down rehab. The more dominant they are to their right side, and the more they relie on the left side for support, the more a left sided ankle sprain is disabling. Patients also hate to make their movement leg into their support leg. It feels so unnatural to them. So, it is much better for a right handed patient to sprain their right ankle, they seem to heal from and handle this injury better. When a right handed patient sprains their left ankle, they must regain that stability as quickly as possible with boots, braces, casts, taping and strengthening exercises. When a right handed patient sprains their right ankle, the goal is protecting it, but emphasizing getting motion back fast.

I hope this explains a common problem seen in a podiatry practice when an injury occurs to one side. I like to ask if they are right or left handed to make some correlation with the movement side vs the support side. I have seen many variations of problems created with this phenomenon. Recognizing this syndrome can help in subtle ways patients recover sooner.

 
I need to spend some time in another post discussing Good Leg Bad Leg Syndrome which ties into this syndrome of Right Hand/Left Hand Dominance.

High Heels Shoes: A Fashion Accessory with Biomechanical Implications

High Heel Shoes have been loved and maligned for years. A True Love Hate Affair. From a Podiatrist's perspective, these wonders of the fashion world  have many interesting biomechanical aspects. The video above points to the pros and cons of wearing high heel shoes. The possible positive benefits include:

1. Greater Arch Support over Flats
2. Better Forward Shift of Body Weights over Flats
3. A More Relaxed Hamstring, with Less Lower Back Tension
4. With regular use, Foot, Ankle, Knee, and Hip Strengthening
5. Heel Lift producing less strain on Achilles Tendon

But, these are weighed down by the possible negative effects including:

1. Toe box crowding with gradual development of bunions and hammertoes
2. Ankle and Knee in more unstable positions
3. Positional Changes in the Low Back which may produce or aggravate symptoms
4. Gradual shortening of the ankle tendon, and hamstrings with possible symptoms

Four very common recommendations for regular high heel wears include: A) stretch the Achilles 3 times daily, B) stretch the hamstrings once daily, C) vary the heel height several times a day, with the lower or high heeled shoe having more toe box (yes, switch shoes--possibly a chance to shop!!), and D) use bunion protection with medium gel toe separators and Yoga Toes (or knockoffs)--see the separate post on Tips for Bunion Care and other related posts. I hope these simple, but effective,tips can allow you to wear high heel shoes for many years to come.