A Typical First Visit:
Structural Fingerprint Exam
We perform a complete head-to-toe checkup at your first visit, and look at you’re the architectural structure of your body, in a similar way an architect looks at the foundation of a house. This assessment helps identify your stress points and provides information to minimize your body's degeneration by using active and passive modalities.
Just like each fingerprint is unique, every patient's body is unique due to genetic make-up, prior traumas, exercise program, diet, weight, shoes worn, mattress slept on, habits, activity level and psychological profile. These basics contribute to how your body aligns. A misalignment in the position of your head in relation to your body, or having one raised hip or shoulder, contributes to the "aches and pains" in your life. A visual evaluation is performed, looking at your body from the back, side, and front in the standing position.
During a WinPosture analysis, your center of gravity is evaluated, based on your foot pressure. You stand on a platform similar to a scale, that measures your stability, postural sway and placement of center of gravity in under one minute. The effort required to maintain an upright position is calculated.
A detailed report is printed based on your findings. The process is then repeated after care at the Rubin Health Center, so you can see the benefits of our treatment for yourself!
WinPosture is a tool for us to scrutinize posture, balance, coordination and active care. We can assess falls, orthopedic and neurological injuries, neuromuscular rehab, lower spine and extremity range of motion and strengthening exercises.
Digital Foot Scan
Your feet are the foundation of your body, supporting you when you stand and move. They help protect your spine, bones and soft tissues from damaging stress. Your feet perform better, and your body is more balanced, when all their muscles, arches and bones are in their ideal stable positions.
Research shows that flat feet transmit stress to your ankles, knees, pelvis and ultimately your spine. Healthy feet have 3 arches. If there is compromise of one arch, the other 2 must compensate and are subject to additional stresses. These imbalances may occur even if you’re not experiencing foot pain. Though they may go unnoticed for a while, they contribute to postural misalignments, pain throughout your body and fatigue.
We, at the Rubin Health Center, know that alleviating pain in one part of your body often requires treating a different part. The pain you feel in your neck could be caused by a misalignment in your spine that is caused by unbalanced positioning in your feet. Like a domino effect...
This is why, at your first visit, we will scan the bottom of your feet, both statically and dynamically, so that we can identify any imbalances that are radiating into your body from the ground up.
In some cases, orthotics
may be required to correct your imbalances. Should our doctors assess that you need them, the information from your scans will be used to make a pair that is 100% customized to your needs. Best of all, these customized orthotics will also be fitted to the type of shoes you wear, from high hills, to sandals, dress or athletic shoes. Rest assured that we will help you put your best foot forward!
It may be necessary for us to take x-rays during your very first visit. We use digital technology which has the benefits of being less invasive to the body because of the lower level of radiation, but also allows instant review by the doctor who will be able to go over them with your during your report of findings visit.
Applied kinesiology (AK) is a form of diagnosis using muscle testing as a primary feedback mechanism to examine how a person’s body is functioning. We, at the Rubin Health Center, use applied kinesiology as a specific diagnostic tool to determine the best therapy for our injured patients.
Since AK draws together the core elements of many complementary therapies, it provides an interdisciplinary approach to our patients’ health care, from specific muscle treatments designed to normalize muscle activity to treatments designed to aid other damaged tissues like skin, ligaments, tendons and joints.
Because our Doctors are using applied kinesiology, they have a distinct advantage over other practitioners as they have specific diagnostic tools to determine the best therapy for the injured athlete. These tools range from specific muscle treatments designed to normalize muscle activity to treatments designed to aid other damaged tissues like skin, ligaments, tendons and joints.
Applied kinesiology interactive assessment procedures represent a form of functional biomechanical and functional neurologic evaluation. The term "functional biomechanics" refers to the clinical assessment of posture, organized motion such as in gait, and ranges of motion. Muscle testing readily enters into the assessment of postural distortion, gait impairment and altered range of motion. During a functional neurologic evaluation, muscle tests are used to monitor the physiologic response to a physical, chemical or mental stimulus. The observed response is correlated with clinical history and physical exam findings and, as indicated, with laboratory tests and any other appropriate standard diagnostic methods. Applied kinesiology procedures are not intended to be used as a single method of diagnosis. Applied kinesiology examination enhances standard diagnosis, it does not replace it.
Observational Gait Exam
Being able to move efficiently is important in avoiding injuries. Having joints capable of providing sufficient movement and muscles capable of producing sufficient force is vital to generate an efficient gait cycle. If joints are stiff (usually caused by muscle tightness), limiting range of motion, or muscles are weak, the body must find ways of compensating for the problem, leading to biomechanical abnormalities.
Examples of biomechanical abnormalities include:
- Increased Q angle
- Hip hiking (or hitching) - lifting the hip on one side
- Ankle equinus - limited ankle dorsiflexion
- Pelvic tilt - can be either anterior, posterior or lateral
Biomechanical problems such as these are usually caused by muscular imbalances (tight muscles working against weak muscles), although they can sometimes be caused by structural problems, such as leg length discrepancies resulting in hip hiking.
Gait analysis usually involves walking or running on a treadmill. In some cases, our doctors will simply watch the way that you move, looking in particular at your feet, ankles, knees and hips.
Many injuries are often caused, at least in part, by poor biomechanics. Runners and athletes whose sports require a high level of running and jumping should make sure they have had a gait analysis and buy the correct footwear to avoid future overuse injuries. The following are a list of common overuse injuries associated with poor gait biomechanics:
- Shin splints
- Plantar fasciitis
- Iliotibial band syndrome (runners knee)
- Patella tendonitis (jumpers knee)
- Patello-femoral knee pain
- Achilles tendonitis
- Lower back pain
One way that you can get an idea for yourself whether you pronate, supinate or have a neutral foot strike is to look at the wear of your trainers or shoes. These must be shoes which you worn a lot so that there is a pattern of wear on the sole.
The Gait cycle in walking and running
The gait cycle is the continuous repetitive pattern of walking or running. The gait cycle is split into two main phases, stance and swing, with one complete gait cycle including both a stance and swing phase.
The stance phase is the period where the foot is in contact with the ground and equates to 60% of the cycle when walking. The swing phases makes up the remaining 40%. During walking there is a period called double stance, where both feet are in contact with the ground. The swing and stance phases can be further divided into:
- Heel strike - The point when the heel hits the floor
- Foot flat - The point where the whole of the foot comes into contact with the floor
- Mid stance - Where we are transferring weight from the back, to the front of our feet
- Toe off - Pushing off with the toes to propel us forwards
- Acceleration - The period from toe off to maximum knee flexion in order for the foot to clear the ground
- Mid-swing - The period between maximum knee flexion and the forward movement of the tibia (shin bone) to a vertical position
- Deceleration - The end of the swing phase before heel strike
When running, a higher proportion of the cycle is swing phase as the foot is in contact with the ground for a shorter period. Because of this there is now no double stance phase, and instead there is a point where neither feet are in contact with the ground, this is called the flight phase. As running speed increases, stance phase becomes shorter and shorter.
Corrections to your Gait Cycle
If it is found that there is an abnormality of your gait cycle, this can usually be corrected with a change in footwear, the use of orthotics or an exercise program.
Running shoes usually cater for those who either overpronate, oversupinate or have a neutral position. It is important to make sure you have the right running shoes for your style of running, and we can help you decide what is right for you.
Posture and Ortho-Neuro Assessment
Looking at your posture front, back and side ways is another measurement that may be performed during your first visit. The patient is asked to stand in front of a grid and a picture is taken multi-directionally. The data is then analyzed by our doctors who will use the information to recommend the appropriate care plan.
Our doctors will also perform an ortho-neuro assement, not only during your first visit, but every time you come in. This protocol is one of the key elements to choosing the proper care one may require.
Q Angle Measurement
The Q angle is an important predictor of biomechanical abnormality throughout the lower limb. It is a measurement of the angle between the Quadriceps (Rectus Femoris is usually used) and the patella tendon. This provides useful information about the alignment of the knee joint, which if outside of normal ranges, can be a precursor for overuse injuries.