Have you ever wondered why some people have foot, knee, back, and hip problems and others don’t? Why is it that some seniors are more prone to falling while others don’t? Does a walker in an older adult improve or degrade the balance of an older adult, making it more likely they will fall in the future if they fail to use a walker? Why do some of us walk more efficiently than others. So many questions, yet so few answers from our healthcare providers. As I always say to my patients, the more we know, the less we know. Do we admit this to our patients? What if we, as providers, looked beyond the conventional wisdom of what we were taught and found solutions to back pain, leg pain, and even balance and vertigo? How you walk may be part of the answer to back and neck pain, balance, joint health, and more. Babies learn through neuroplasticity about their world, how to hold a bottle, how to roll over, crawl, and then eventually walk. Then speech appears, and we waddle with our flat feet until we are skeletally mature enough to walk more like our parents around the age of 5 or 6. We then continue to grow and develop through puberty, and during that time, we may have had injuries, and we adapt to those, too. We also adapt to our body mechanics, which we inherit from our parents. Some of this is discussed in my book Cheating Mother Nature, What You Need to Know to Beat Chronic Pain. The book challenges conventional wisdom to help people find those who are most likely to help them stay free of pain and learn to help themselves move and feel better as they age. We all adapt, but do we adapt well? Each decade brings new challenges, and ultimately, if we play the game better, age better, and have healthier lifestyles, it is likely that we will still be playing with our grandkids and the family dog well into our 70’s and 80s with the same hips and knees we were born with. We have normalized the arthritis narrative, the multi-specialist narrative, and in the USA, spend more for a healthcare system that bounces us around, while we get older and often less functional. In the world of musculoskeletal health and movement, simple is always better, and nothing is as simple as looking at the whole person. Our system ignores the musculoskeletal system and turns us into protocols while it cashes in on our misery as we age. Your chiropractor knows this and is taught to understand pain holistically, usually related to how we move. We are now at the threshold of understanding how the fascial system affects how this functions, and how years of adaptations affect how we walk and move. Movement runs every system of the body and is controlled from the brain down. When was the last time your doctor looked at how you move or walk when you have pain? Often, the secret behind why we hurt is understanding movement. Understanding gait while younger helps us understand how you feel, move, and function when we are older. Many of my lectures to my colleagues begin with an old video taken in the local park of people walking. I ask the seminar participants what they see. I then teach the seminar, and at the end, ask them what they saw. Some people were limping and didn’t know it, while others were walking more symmetrically. Others have different adaptations or rocked side to side. Most of the people had no idea I was watching them. Most had normalized what was stiff or sore and did not pay attention to anything that was not hurting. Some of them may have chronic problems and may rely on Advil to improve how they feel. As healthcare practitioners, it is our job to understand our patients. It is often difficult to get a full understanding in our small exam room, and patients often do not tell us everything unless we ask the right questions. Sometimes, the treadmill can tell us why they hurt when they are young, why their ankle or foot hurts, and even why they have upper body and neck pain. It may enlighten us as to why little Johnny is having shin pain at the age of 9 after playing soccer, and why using medication is a cop out in place of a better understanding of why they hurt. Addressing the problem may be as easy as understanding a growth spurt or a need for a foot orthotic to improve how they move, if needed. This non-harmful early intervention can help us feel and function better for years to come. The more active we are, the better it is for our overall health. Treadmill diagnosis can help us understand bad habits affecting how we feel and function. A treadmill is a machine that forces you to move at the pace you desire. The machine will execute that program for the time you entered. The machine has no idea that you are tiring out, nor does it understand that you are going too fast or too slow. It can show us on a video, the problems and bad habits affecting how you walk and move in a short video on my phone. The simple 30-second video can offer information that may change your life if you know what to look for. Over the years, patients have overcome foot pain, neck pain, shoulder pain, running issues, knee pain, and even back pain. A few patients, after helping them reset the timing of how they walk, using the treadmill as a tool, had overcome vertigo and sciatica when most doctors looked at their symptoms but did not know that how we move was causing it. Typical things I see on a treadmill evaluation. Inability to feel comfortable walking on a treadmill at even a low speed. Over and under striding of the legs and not taking full steps while walking. Stiff upper body with insufficient arm swing while we walk. physical restrictions. Dragging a leg. Rocking side to side. Holding on to the treadmill to stay at the high pace we selected. These are the most common. An imperfect gait affects the fascial system, which affects ground impact. The impact causes pain from walking in the feet, back, etc., and the fascia responds by becoming tighter over time. This is controlled partly by patterns memorized by the brain. Repatterning can be learned. Teaching correct patterns can make a lifetime of suffering turn into a lifetime of fewer problems. What I teach during treadmill evaluation. Screenshot Treadmill evals help me help you. You do not need a special degree to do this, although I spent 26 years as the medical director for USATF NJ and helped many runners with chronic problems by understanding gait, symmetry, and the effects of impact. I also developed my own theories about what the core is and does, which was recently reinforced by a study linking back pain to the fascial system. I have tested these theories using treadmill evaluation, which has helped me customize the approach to their individual needs. The reality is, we are all different. A doctors problem solving should consider this. Treadmill gait signatures are our own, and they offer clues as to why we hurt or may have future problems. Also, by helping someone change to a more desirable symmetrical gait, they walk and feel better, and solve chronic problems that can cause falls in their later years and cause joint problems to develop. In our evaluation, I show the patient what I see on the video and then do a second one to show them how it feels as we correct the issue. They are given a 6-month program that they can do on their own to change it, and they receive the videos. I can then reevaluate them in a few months and do the necessary work with them to help them improve how their chronic problems affect them. Patients who follow this plan improve and often solve chronic problems they had to live with. There is little risk and high reward. Correct a gait timing issue, improve how you walk, and feel, and improve your overall balance and walking efficiency. 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