By Carol Montgomery, GCFP CM
- Move a foot forward.
- Move the other foot forward.
- Repeat until you reach your destination…the bathroom, the kitchen, the mailbox, up a hill, the grocery store.
Oh, if only walking were only that simple.
The joyful feeling of freedom in movement is often appreciated only when interrupted or unavailable. Over the years, your gait, or the pattern of how you walk from point A to point B, decides if walking facilitates health and wellness or facilitates disease. Walking is beneficial when your nervous system can access options of mobility and stability embedded in healthy gait patterns. A proficient gait allows for pleasurable exertion when navigating uneven ground or stairs. An integrative gait allows for variance in speed and turning that reduces fall risk. A high-quality gait pattern alters the brain’s white matter organization, improving cognitive flexibility, processing speed, and fluid intelligence. What do you need today that allows you to experience better walking? What is it that will enable you to embody an efficient gait that will inadvertently go on to impact the quality of your life for as long as you live?
Gates within Gait
This article will focus on one of several gates that is part of Integral Human Gait™ theory, a comprehensive map of walking: the ankle joint. A gate is an opening and an opportunity for change, metaphorically representing specific aspects of our body, namely, our joints. The image of a gate can reflect the joint’s capacity to move systematically and proportionally. One gate or joint can evoke a series of joints to move. This series of movements is known as the kinematic chain. Gates can help us understand how the nervous system uses our body parts or joints to create specific patterns of activity embedded in all functions. Kinematic gates are patterned or linked together for mobility or stability. Within the walking pattern, these gates allow us to stand on one leg with confidence (stance phase of gait) as the other leg leaves the ground and moves through the air (swing phase of gait). Examples of the gates of mobility would be the: ankle, hip, ribs, shoulder, thoracic spine, shoulder girdle, upper cervical spine, mandible, eyes, and wrist.
Mobility is not just a range of motion or the ability to stretch muscles or tendons across the joint. Functional mobility is precise motion within a joint that improves the joint’s capacity to receive and transmit pressure while at the same time minimizing joint shear, compression, and compensation. The nervous system constantly monitors each gate accessing its availability within a functional movement pattern. Why? Because the nervous system has clear and specific strategies to maintain a safe, efficient, consistent, and practical relationship with gravity. To what end? So we don’t fall. The nervous system listens to incoming sensory information from the skin, joint capsule, ligaments, tendons, vessels, organs, bones, and fascia. It executes muscular and fascia contractions along the most available and efficient kinematic gates to keep us upright and safe.
From Amazing to Usable
The Feldenkrais Method® of somatic education allows us to discover how our parts are related to a much greater whole. Becoming more self-aware enables the nervous system to select movements that will relieve physical stress, help prevent future injury and improve performance. Awareness, or the ability to monitor what we are doing, enables us to consciously choose something different, interrupting a pattern or habit that has outlived its usefulness. This interruption allows the nervous system to access a more pleasurable, efficient, and organized way of walking, improving physical comfort, emotional well-being, security, and happiness. Intentional and guided explorations can lead to whole-body integration – adjusting and aligning all body parts for a healthy gait pattern.
Ankle Joint Mobility
Ankle joint mobility plays a pivotal role in the nervous system’s ability to activate quality movement patterns not only in walking across level and unlevel surfaces but also when sitting down and standing up from chairs, climbing up and down stairs or hills, squatting, and getting down to and up off the floor. The ankle joint is also our first line of defense that the nervous system uses to restore a loss of balance and prevent us from falling. The ankle joint has excellent potential to accommodate changes in our center of mass and head alignment. The feet provide the base of support for restoring postural stability and a position of uprightness. Designed to move in all directions, the ankle joint can move up and down (dorsiflexion/plantarflexion), move in and out (inversion/eversion), and move arch down and arch up (pronation/supination).
Let’s focus on just one of these: dorsiflexion because studies have shown that losing the ability of the ankle to bend in this way as we age increases fall risk. Right now, whether you are sitting, standing, or lying, look at your leg and foot. Now, bring the front of your foot closer to your shin bone. This is dorsiflexion. If you are sitting, slide the foot back under your chair and notice that the shin bone is getting closer to the front of the foot.
When you are walking, and one leg begins to swing in the air, the other leg is momentarily bearing your weight. When you are standing on one leg, that ankle must be able to dorsiflex. The motion of the shin bone must be able to move toward the top of the foot, decreasing the angle of bend across the ankle joint. This bending results in a lengthening of the muscles and tendons of the calf and the sole of the foot. * insert drawing
Studies tracking ankle mobility observed a decrease in dorsiflexion across the lifespan each decade. Insufficient range of dorsiflexion motion is just one contribution to a loss of stability when walking. The nervous system receives and integrates sensory information from three primary sources or systems: Somatosensory (proprioception), Visual and Vestibular. It is easy to see that previous leg fractures, sprain or strains, or osteoarthritis of the great toe or ankle joint throughout our lifetime conceivably contributes to a decrease in ankle dorsiflexion as we age.
Additionally, neurological conditions that result in foot drop, such as a pinched nerve in the lower back, post-polio syndrome, cerebellar vascular incidents, or stroke, also play a significant role in losing weight-bearing dorsiflexion. More commonly, we gradually lose the ability of the ankle to bend as needed throughout the day by simple choices such as avoiding low sitting chairs or toilets, stairs, unlevel surfaces, or walking long distances. Even the fear of falling, pain, or fear of pain and age-related strength changes influence our habits.
How Much Ankle Dorsiflexion Do You Need?
Functionally available dorsiflexion is different depending on whether the knee is allowed to bend or be kept extended. Although 40 degrees of weight-bearing dorsiflexion is considered ‘normal,’ it is generally agreed that 20 degrees is workable, and a minimum of 5-10 degrees is required for level surface walking. However, descending stairs or inclines and squatting to pick something from the floor require more ankle dorsiflexion.
Expanding Thinking Beyond Range of Motion
Improving the ankle gate is not just about improving mobility. For some, the ankle joint has lost its ability to control movement, demonstrating and showing up as a loss of mobility. Unfortunately, this is due to a lack of awareness of healthy movement patterns. Our bodies do not automatically move in healthy ways. The nervous system is incredibly astute in its ability to compensate, keeping us moving forward and from falling. It drives our body parts to expend the least energy. It uses only the parts of ourselves that it perceives as available and capable for the functional need at hand.
Like the nervous system, the Feldenkrais® practitioner always thinks of the whole body. Functional movement patterns use the muscles, joints, and variations of one’s center of mass to reduce effort and improve efficiency. Ankle mobility can disguise, ‘hide’ or compensate for other gates needed during walking such as hip, thoracic spine, and toe mobility. Most people have no idea when these ‘gates’ within gait are compromised or when their habitual activity level changes. The critical thing to remember here is that all of us have the power to change our movement habits for a better life. Whether you are a professional athlete, musician, grandma, or healthcare professional, we can reduce pain and improve function. With a willingness to explore, click on the link and experience just one of many somatic movement explorations we use in our Integral Human Gait classes: Restoring Postural Reflexes and Balance and Gait for Wild Human Potential.
Carol A. Montgomery is the founder and owner of Montgomery Somatics, private physical therapy and somatic education center dedicated to initiating paradigm shifts in the fields of healthcare, wellness, and movement. She holds a Master’s Degree in Physical Therapy and is a Guild Certified Feldenkrais PractitionerCM and a Senior Trainer in Movement Intelligence. Carol is co-creator of Integral Human Gait theory and has written about the Feldenkrais Method for The Feldenkrais JournalTM and the Alternative and Complementary Therapies Journal. Her website www.MontgomerySomatics.com
The Seated Strap Stretch, a free lesson from Carol Montgomery, who guides you through a Feldenkrais somatic exploration to discover how ankle and hip mobility can improve your gait, walking with more ease and confidence. Watch here!