What does health mean to you? Have you ever tried to define it? Would it mean getting back to sports you used to play? Or maybe the ability to find the pain free space to learn something new?

For me, it is about feeling grounded and centered. That is why I love the approach of Anatomy in Motion, because it allows people to regain their center and find access to parts of their body that have been overshadowed by other muscles and joints.

At Urban Wellness Clinic, we incorporate Anatomy in Motion as a way to help our patients become aware of their compensations from a dynamic movement perspective. This form of rehab is one of the many tools utilized when treating people with pain in their lower extremities, but also supplies answers to those who do not understand why certain conditions came about in their bodies without ‘cause’.

What is Anatomy in Motion?

Anatomy in Motion is a movement system that was developed by Gary Ward, a movement expert based out of the United Kingdom. His goal was to provide alignment to the body so that you could start to heal quickly and without any anatomical boundaries.

Gary Ward is also the author of “What the Foot” which is a book that dives into the idea of looking at the body from the feet up. As movement lovers, we look at the body as a whole rather than just at your pain point. A lot of information can be given by the way you ground yourself and how you walk. The patterns that have developed to keep one out of pain are not always able to hide when one is moving.

Anatomy in Motion, therefore, assesses and diagnoses based on your gait cycle. In one gait cycle, every joint in the body plays a role, even if just for a quick second. The training in AIM provides us with that sharp eye to see where your compensations could be hiding. Whether you are dealing with headaches, you have a specific pain point in your legs or you are a runner trying to perform better, AIM is a great way to get accurate feedback as to what your body is truly doing.

How does Urban Wellness Clinic implement AiM?

Although we come equipped with various tools in our toolbox to help provide you with the best care possible, we use AIM to not only make changes, but to observe changes. Our initial assessment of you includes both a static and dynamic assessment. A static assessment is one wherein we see how your body carries itself when it is simply standing and there are no additional forces being added. A dynamic assessment is one that incorporates movement, ie. how you walk. We assess your dynamic movement so that we can see how the joints of your body move, when they move, and if they are even moving properly. This is seen best through your gait cycle.

So, if you mention you have headaches, we watch your gait. If you mention you have hip pain on one side, we watch your gait. If you mention an old injury that was never treated (anywhere) in the body, we watch your gait. If you mention you have a surgical scar (anywhere) on the body, we watch your gait.

When we see that one joint of your body is not moving, then the odds that other joints along your kinetic chain are not moving as well as they should either. For example, if we are testing the strength of your gluteus maximus muscle, we can find how well it is functioning by assessing the hip, the knee and the foot. Majority of the time, one of those major joints along the kinetic chain is not functioning optimally, which in turn means that the glute muscle is not functioning optimally either.

How do we breakdown Gait patterns?

How do you get from one foot to another? Gait analysis and assessment is complicated since there are so many moving parts, no pun intended. We are looking at what your body is doing from the moment you initiate walking, let’s say with the right foot, until you set that right foot down again. In that one gait cycle, we are breaking down the following phases:

• Strike: The moment when the heel of your foot hits the ground.
  Suspension: This is the moment when the foot is flat on the ground and the only moment in gait when your foot pronates, ie the arch of your foot collapses for a moment so that your body can absorb the shock of the ground.
• Transition: After suspension phase, the arch of your foot begins to lift again or begins to supinate.
• Shift: When the body is preparing to get over to the other side so that your reference leg can begin the action of pushing off and propelling you forward.
• Propulsion: This is also known as ‘toe-off’ wherein the foot in reference is propelling off of the big toe to initiate the leg swinging in the air.
• Early Swing: The first half of the phase of gait where your leg is in the air.
• Last Swing: The second half of the phase of gait where your leg is in the air and starting to decelerate before striking the ground again.

These are the 7 main categories of your gait cycle. As you can see, each phase has a subtle movement that we are looking for. Furthermore, each cycle is then broken down by plane: sagittal plane, frontal plane and transverse plane.

And as if that was not all, we are also looking at the entire body and how it moves, not just the foot! So, it is safe to say that we have our patients walk multiple times so that we can get our eye on as many joints as possible and create the right movement plan in doing so.

A UWC patient case

A patient came into the clinic reporting pain in the left hip. The pain was localized and brought on occasionally with certain movements. There was no direct trauma to the hip as this was an insidious onset of pain that was noticed when going from sitting to standing.

The patient was cleared for a deeper hip condition through orthopedic testing and a detailed history. I then began to dive into the static and dynamic movement assessment. In standing, I had the patient rotate the upper body so that I could see how the feet responded and found that there was a lack of movement in the midfoot on the right side. Furthermore, there was a lack of hip flexion with gait assessment as well as a lack of push-off.

I broke down the gait pattern and chose exercises that would help promote the movements required. We worked on heel strike and hamstring activation first. The hamstrings attach to the pelvis so this is a major muscle group to look into when dealing with hip discomfort. If the hamstrings are not functioning as they should, then they will not be supporting the pelvis properly.

We then worked on push off for the right foot as we promoted hip flexion on the left with an Anatomy in Motion movement known as suspension. Suspension is the portion of your gait wherein you are about to propel yourself into a single leg stance. This helped the patient regain big toe mobility and also helped engage the glutes on the left-hand side.

I had the patient ‘walk the pattern in’ so that his body could get used to the movement we were trying to relearn. He reported feeling lighter on his feet and felt more stable into his pelvis. When testing the sit to stand movement, he did not feel any pain.

This exercise was prescribed to him as a daily movement routine 3x/day and as a dynamic warm-up before doing any of the other prescribed at-home rehab exercises.

If you are curious to know what your body’s current anatomical boundaries are you can reach out to us at Urban Wellness Clinic at hello@urbanwellnessclinic.com or reach us at 212-355-0445 to schedule your session. Let us help you find your center!

Yours In Health,

Dr. Monisha Mallik, D.C.