Friday, March 30, 2012

Gait and Posture

I often, in the midst of a busy Orthopedic practice, considered surreptitiously taking videos of my medical colleagues as part of a study of posture and gait. Observing the unique features of healthy men from the standpoint of the normal variants of gait and posture is of some interest to those of us concerned with musculo-skeletal anatomy and physiology! The long hospital corridors allowed me to clearly identify individuals I knew well, whose features were unclear from the distance, but whose gait and posture were identifiers. The good orthopedic surgeon was always aware of the need to observe the patient walking, sitting and standing as part of their assessment, apart from the necessity to do so where pathology existed. You can't always know abnormal, if you don't know the range of normal. For years I idly considered writing a chap book on the subject, or a chapter, based on my study but never got around to doing it, and now it's too late. Any way, it may have been too intrusive and earned me enmity! Still, I fondly remember examples! Drs. X and Y had short heel cords. A tight tendo achilles leads to a bouncy gait. The stride has a high amphlitude, so more energy is required to achieve the same distance. They would make a poor waiter or, in another era, a bad footman. A lax tendo achilles would lead to a low amplitude glider gait. They might say, no spring in his step! Good waiter material! Dr. Z had a military officer background. He stood erect and his head and eyes were directed upward to heaven as he marched down the hall! His gait and posture had an ethereal quality! Drs. A and B were topmost physicians and mild enemies. Nevertheless they required to speak of matters as they met in the hall. As they stood and talked of weighty matters they slowly rotated to the right in tandem, as it were, getting to the most vulnerable side of one another simultaneously! Pushmepullyou! The more florid variations of gait and posture are the most interesting but all of us have unique characteristics only modified from time to time by the state of mind. Mind- body activity will alter, but not fundamentally change. I have a neighbor who has a PhD in Industrial Ergonomics. My missed opportunity was to fail to do a collaborative paper with her at the right time. Oh well!

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