Biomechanical assessment at Sub 4 Health

I am now able to offer full biomechanical assessments at Sub 4 Health:

http://www.sub-4.co.uk/

So what does biomechanics mean?

Bio means Biological, so your body, and mechanics is how it works mechanically, so alignment and movement.  An assessment of this, looks at how you are aligned and how you move, to detect any abnormalities that could be causing problems for you.  It is good for prevention as well as cure!

So can abnormal biomechanics cause problems?

Essentially most injuries are caused by a multitude of reasons. This may be overload, weakness, inflexibility, not enough recovery, poor training methods and also poor biomechanics.  Essentially injury will have a biochemical, biomechanical and psychosocial influence of some degree.

For example:

The causes of Achilles tendinopathy are biomechanical faults, systemic diseases, smoking, age, activity level & obesity according to Van Sterkenburg (2011).

and:

Biomechanical factors, such as reduced muscle strength and joint malalignment, have an important role in the initiation and progression of knee osteoarthritis (OA) ( Fransen & McConnell 2009).

and:

Shin splints is caused by:

Training methods

Training surfaces

Muscle dysfunction / inflexibility

Shoe design

Biomechanics of running

(Yates & White, 2004).

So what is an example of a common biomechanical issue?

Leg length differences:
How common is it to have one leg longer than the other?

More common than you think!
In normal people, 96.7% were found to have a difference in leg length (O’Brien et al 2010).

What does the evidence say about the impact of having one leg longer than the other one?

Here is what various sources think is a significant amount:

Subotnick feels 3mm differences can increase the risk of running injury.

Friberg feels spinal compensations occur at a 5mm difference.

Brody disagrees with Subotnick and thinks running injury risk increases at 6mm.

Corrigan and Maitand think that you need more than 7mm difference to cause problems.

Giles found that the Lumbar facet joint angles change at 9mm.

Cyriax expects Low back pain to result from 10mm differences.

Harvey found that 10mm differences produced a greater prevalence of knee joint osteoarthritis .

Gibson found compensatory scoliosis at 15mm.

Any more than this amount goes without saying!

So what can be done to correct your abnormal biomechanics?

Obviously being a physio I would naturally say that exercises that strengthen, stretch and improve stability are the way to go, but this is difficult at the best of times and some things, you just can't correct in this manner. For example there is no exercise to lengthen a short leg! This would be where custom made Orthotics come into play.

Custom made Othotics (insoles):

Orthotics are a device that are designed to align the foot and ankle into the most anatomically efficient position. They are a biomechanical medical appliance that are custom made to correct your specific foot imbalances.

What does the evidence say about them?

Custom-made biomechanical insoles are more effective than no insoles for reducing shin splints (Yeung et al 2011).

A study by Gross (1991) looked at injured long distance runners. Out of these runners 31.1% had excessive pronation, 13.5% had leg length discrepancy, 12.6% had patellofemoral disorders, 20.7% had plantar fasciitis, 18.5% had Achilles tendinitis, 7.2% had shin splints and 4.9% made up the rest of the injuries. (I know it adds up to more than 100% but some runners had more than 1 issue)

With custom orthotics alone, 262 of the runners, (which was 75.5% of them) reported complete resolution or great improvement in their symptoms.

90% of the runners continued to use the orthotic devices even after resolution of their symptoms.

What can I do at Sub 4?

Well, Sub 4 health is the hub of biomechanics. From here I can offer you a variety of assessments, which include the very latest technology in kinetics (the study ground reaction forces) and kinematics (the study of movement) to find the cause of your injury. Some of these state of the art technologies are:

Pressure plate analysis:

This technology allows me to see exactly the pressure and forces that you place through your foot in standing and walking.

Video analysis:

This enables me to examine the way that you walk or run to detect any abnormal movements that are contributing to your injury.

Digital Pelvic Inclinometer (DPI):

This is unique to Sub 4 and it enables me to quantify pelvic alignment, to look for abnormalities such as torsion that can cause pain in the lower back, pelvis and further down to the foot itself.

Overall, Sub 4 offer different levels of assessment to suit each person:

http://www.sub-4.co.uk/patient-services/book-an-assessment/

Following the assessment, if orthotics are required then Sub 4 have the orthotic manufacturing on site, which means that you can have your brand new custom insoles on the very same day! 

So if you are wondering if I can help you then you can contact me via Hawkes Physiotherapy or Sub 4 health: 

http://www.hawkesphysiotherapy.co.uk/

or

http://www.sub-4.co.uk/