Posts tagged “Running

Foot Fetish Part 3

Topic: Myths about barefoot running

Intended audience: Runners

Essay Map: Educating yourself about the facts of running barefoot (if that’s your goal), will allow you to safely transition from thicker soled running shoes.

I’m back with part 3 of Foot Fetish. In the second post, we went over two reasons why barefoot running could be detrimental to people who are overweight, or have bad knees. In part 3 we will look at orthotics and plantar fasciitis.

Once again, you’ll be reading direct quotes from Nicholas A. Campitelli, DPM, FACFAS. I will place my views, and opinions in underlined italics with my initials AH.

“Barefoot running, minimalist running and natural running are all terms that describe running in a manner that allows our foot to function the way it was designed (or has evolved). This happens through the use of little or no shoe at all. Many runners suffering from chronic injuries are adopting this way of running and are experiencing relief of symptoms to find themselves running with enjoyment and a more relaxing form.”

The key word is many not all. AH

I too have been cured of a running injury, which I suffered from for over eight years after transitioning my gait to that of a “barefoot” runner. Without further ado, here are the 10 myths of barefoot running.”

 

Cured is a provocative word to use, as it might lead readers to assume barefoot running will cure them as it did the author. As a DPM I’ll guess that he might have started some sort of regimen to help in his ”curing” i.e. flexibility, mobility, and/or strengthening exercises He also could have added a warm up ”movement prep” and “cool down” to his routine. AH

 

How Do Orthotics And Plantar Fasciitis Come Into Play With Barefoot Running?

I can’t do barefoot running because I need to wear my orthotics. Orthotics has become more over-utilized in the practice of podiatry then ever before. It is very common for me to see runners present in my office with plantar fasciitis, a normal arch, cushioned running shoes and orthotics they have worn. When running barefoot or in a minimalist shoe, we do not need to control motion at the rear-foot because heel striking is not occurring and “excessive pronation,” as described by Root, does not occur. While we have numerous studies that do not support the use of orthotics for running injuries alone, it becomes a challenge to convince the patient they are not needed.

I have plantar fasciitis so barefoot running would be too painful. This article was not intended to discuss the pathomechanics or treatment options of plantar fasciitis. However, we are anecdotally seeing resolution of symptoms in those who adopt this style of running. One potential explanation is the development in strength we see to the intrinsic musculature, specifically the abductor hallucis muscle, which is a primary supporter of the arch.

Another overlooked phenomenon is the fact that the majority of running shoes place your ankle into plantar-flexion. This forces the body to compensate by increasing lumbar lordosis and increasing pressure to the heel as opposed to having more even distribution throughout the foot.

As a Fitness Professional, I am faced with these two obstacles all the time. What can I do? Well, I can’t diagnose, as that’s not in a Fitness Professionals scope of practice. I will not challenge or criticize the clients Dr. or who ever prescribed the orthotics. If the client chose their treatment on their own I would not criticize them either. All that would do if create a wall and devalue us as professions, not to mention coming off appearing like a know it all, and we all know those are the ones that really don’t know anything at all.

I would instead offer other options, modalities of exercise if you will, self-myofascial release with a tennis ball (soft) and slowly progress to a baseball (medium), then a golf ball (hard). Vibration training i.e. Power Plate would be a good way to “melt” the connective tissues beneath our feet (hydrating), while at the same time, triggering muscle contractions in the foot, which would strengthen the foot. This would improve our natural arch support and likely reduce plantar fasciitis. If you work with the client as a “guide on the side” versus ordering your clients “sage on the stage” you’ll empower them, which will make them more open to various methods of exercises, some of which might be the “one’ that finally helps your client overcome their discomfort. AH

 

 


Foot Fetish part 2

Topic: Myths about barefoot running

Intended audience: Runners

Essay Map: Educating yourself about the facts of running barefoot (if that’s your goal), will allow you to safely transition from thicker soled running shoes.

I’m back with part 2 of Foot Fetish. In the first post, we went over the a few perceptions on barefoot running like how it leads to stress fractures, and how if you have flat feet, you’ll need support. In part 2 we will look at weight, and knee issues.

Once again, you’ll be reading direct quotes from Nicholas A. Campitelli, DPM, FACFAS. I will place my views, and opinions in underlined italics with my initials AH.

“Barefoot running, minimalist running and natural running are all terms that describe running in a manner that allows our foot to function the way it was designed (or has evolved). This happens through the use of little or no shoe at all. Many runners suffering from chronic injuries are adopting this way of running and are experiencing relief of symptoms to find themselves running with enjoyment and a more relaxing form.”

The key word is many not all. AH

I too have been cured of a running injury, which I suffered from for over eight years after transitioning my gait to that of a “barefoot” runner. Without further ado, here are the 10 myths of barefoot running.”

 

Cured is a provocative word to use, as it might lead readers to assume barefoot running will cure them as it did the author. As a DPM I’ll guess that he might have started some sort of regimen to help in his ”curing” i.e. flexibility, mobility, and/or strengthening exercises He also could have added a warm up ”movement prep” and “cool down” to his routine. AH

 

I weigh too much. While this is a common excuse to not run, being overweight is not reason enough not to run barefoot or in a minimalist shoe. In 2010, Leiberman and co-workers were able to demonstrate that habitually unshod runners were able to generate smaller collision forces than shod heel strikers.6 In other words, by forefoot striking, we decrease the force that transmits through the lower extremity, thereby reducing torque forces to the ankle, knee and hip joints.7 Clearly, we can see that if people weigh 250 lbs., they would be placing more force through their joints by heel striking then by landing on their forefoot”.

I agree that you can decrease the force transmitted through the body by changing your strike, however I believe the writer is overlooking a critical component. If someone is overweight, odds are they have not been exercising regularly, could be sedentary, but most importantly not conditioned to start a running program. When I say unconditioned, that could mean that the individual might not have the cardiovascular endurance of more importantly the muscles, and connective tissues of the body lack the strength and endurance to handle any type of force transmitted through the body. AH.

Would Bad Knees Inhibit Barefoot Running?

“I have bad knees. Osteoarthritis of the knee is a common concern among many runners, especially older individuals who have run the majority of their lives. There are many theories as to why running is bad or even good for your knees. So many in fact that elliptical machines were invented to be used as a form of exercise similar to running without causing excess pressure to the joints.8 However, these elliptical machines do not reproduce anatomical motions and an in vivo force analysis reveals there is less force with walking than with an elliptical trainer”.9-11

You can’t out run time, age will eventual catch us all, and osteoarthritis is an age related condition. I have not read the study on elliptical machines versus walking, however from personal experience, both are less stressful to my body than running and the elliptical machine can get me to train all my cardio zones better than walking. What I would suggest though is that you may want to talk with your doctor in regards to supplementation like joint support. As a personal trainer what I would recommend if you haven’t yet, is to start a mobility/flexibility and strength program. I would emphasize the ankles and hips, because allowing full ROM in those respective areas could take some of the workload (force transmission) away from the knee, and transmit it throughout the rest of the body like we are designed to do. AH.

 

“As I noted previously, we know that ground reactive forces are greater with heel strike in comparison to unshod or barefoot runners who adapt a more forefoot strike pattern.6 Numerous studies have demonstrated higher ground reactive forces and mechanical stresses to the knee while running in traditional running shoes as opposed to barefoot.12-13 A recent study published in the British Journal of Sports Medicine looked at patients with knee osteoarthritis over 12 months and found no difference between wearing a lateral wedge orthotic versus a control flat insert.14 Similarly, a systematic review of literature demonstrates that external knee adduction moment and pain associated with knee osteoarthritis is higher in individuals wearing sneakers in comparison to those who do barefoot walking”.15

 

When I complete the 10 Myths of barefoot Running, I will post all of Nicholas’s bibliography for referencing.

 

Reference:

Campitelli A. Nicholas (2012 January) Tackling the 10 Myths of Barefoot Running. Podiatry Today Volume 25 Issue1.


Foot Fetish

Topic: Myths about barefoot running.

Intended audience: Runners,

Thesis: To help runners sort through the facts and fictions of barefoot running.

Essay Map: With the proper education you can enjoy barefoot running (if that is your choice). This article will help better prepare you for the road ahead.

I stumbled across an article on Facebook, posted by Rodney Corn from Podiatry Today. The article was called “tackling the 10 myths of barefoot running”. Written by Nicholas A. Campitelli DPM, FACFAS. In the upcoming blogs, I will post sections of the article so we can digest this information a little bit at a time. This will give us time to fully digest some of the concerns that can come about from barefoot running.  I will have some input of my own which will be underlined with my initials AH.

 

“Barefoot running, minimalist running and natural running are all terms that describe running in a manner that allows our foot to function the way it was designed (or has evolved). This happens through the use of little or no shoe at all. Many runners suffering from chronic injuries are adopting this way of running and are experiencing relief of symptoms to find themselves running with enjoyment and a more relaxing form.”

The key word is many not all. AH

I too have been cured of a running injury, which I suffered from for over eight years after transitioning my gait to that of a “barefoot” runner. Without further ado, here are the 10 myths of barefoot running.”

 

Cured is a provocative word to use, as it might lead readers to assume barefoot running will cure them as it did the author. As a DPM I’ll guess that he might have started some sort of regimen to help in his ”curing” i.e. flexibility, mobility, and/or strengthening exercises He also could have added a warm up ”movement prep” and “cool down” to his routine. AH

 

Barefoot running leads to stress fractures. Without a doubt, the most common concern with barefoot or minimalist running is the development of a stress fracture. While there have been documented cases of this in the literature, stress fractures occur as a result of a change in activity without gradual adaptation and are not directly related to the shoe gear or lack thereof.1 We actually should see a decrease in the likelihood of stress fracture given the change in stride and cadence that one acquires while running barefoot.

  I bold faced this sentence, because I felt was an important statement. AH

Stress fractures occur secondary to overuse without the body having adapted adequately as proven by Wolff’s Law.3 In fact, if we adhere to Wolff’s law in theory, we should see weaker bone trabecular patterns on those wearing cushioned running shoes due to decreased intrinsic muscle strength, resulting in a proportional decrease in the force acting on the respective bone.”

Trabecular patterns: an irregular meshwork of stress and stress-related struts within a cancellous bone.

I have flat feet and I need support. Lees and Klemerman have demonstrated that there is no correlation between foot type and running injuries, specifically with a pes planus deformity.5 During barefoot running, we avoid heel striking and land more on our forefoot or midfoot. Once the forefoot strikes the ground, pronation of the entire foot begins (not isolated pronation of the subtalar joint) and continues until the point where the heel touches the ground. Arch height becomes irrelevant, as does the commonly described concept of pronation with the heel striking the ground first. With a forefoot/midfoot strike, pronation is very beneficial and helps to absorb shock.”

On top of that studies shows and research articles state that flexibility, mobility, and strength exercises can reverse flat feet as one of the causes associated with flat feet is weakened muscles and other connective tissues. AH

Reference:

Campitelli A. Nicholas (2012 January) Tackling the 10 Myths of Barefoot Running. Podiatry Today Volume 25 Issue 1.


Have a drink on me!

With the weather changing from extreme heat to colder temperatures, it is as important as ever to make sure you are properly hydrated before, during, and after you exercise. “Staying hydrated is essential for everyone, but athletes have an even greater need to maintain proper hydration. Water is the most important nutrient for life and has many important functions including regulating temperature, lubricating joints and transporting nutrients and waste throughout the body” (Quinn 2011).

What can happen through dehydration? With as little as a 2% decrease in your body weight through sweating, your heart will begin to work harder to circulate blood. Muscle cramps, dizziness, fatigue, and heat illnesses i.e. heat exhaustion and heat stroke have been known to occur. Some of the causes of dehydration include inadequate fluid intake, excessive sweating, not replacing fluids lost during and after exercise, exercising in dry extreme weather, and drinking only when thirsty.

Everyone is different when it comes to how much we sweat, how much fluids we lose through exercise, and how our hydration levels are to begin with. That being said it is difficult to provide “SPECIFIC” hydration guidelines for us to follow. Two simple assessments to see if you’re adequately hydrated are,

Monitoring urine volume output and color:

A large amount of light colored, diluted urine probably means you are hydrated; dark colored, concentrated urine probably means you are dehydrated.

Weighing yourself before and after exercise:

Any weight lost is likely from fluid, so try to drink enough to replenish those losses. Any weight gain could mean you are drinking more than you need.

How do we lose water/fluids through exercise? I’m of the opinion that we must know before hand what the environment that we are going to train in is like. We “CAN” control how we eat, sleep, move, rest and hydrate, but we can’t control the elements that Mother Nature throws our way. We are at her mercy and to an extent the same goes for our landscape (topography). Here are some things to consider,

High Altitude:

Exercising at altitude increases your fluid losses and therefore increases you fluid needs.

Temperature:

Exercising in the heat increases you fluid losses through sweating and exercise in the cold can impair you ability to recognize fluid losses and increase fluid lost through respiration. In both cases it is important to hydrate.

Sweating:

Some athletes sweat more than others. If you sweat a lot you are at greater risk for dehydration. Again, weigh yourself before and after exercise to judge sweat loss.

Exercise Duration and Intensity:

Exercising for hours (endurance sports) means you need to drink more and more frequently to avoid dehydration.

OK, so how much water and or fluids should we consume before, during, and after we exercise? If you are training regularly, you will probably need between one half and one whole ounce of water (or other fluids) for each pound of body weight per day. To determine your baseline range for water   requirements, use the following formula:

Low end of range= Body weight (lbs.) x 0.5 = (ounces of fluid/day)

High end of range=Body weight (lbs.) x 1 = (ounces of fluid/day)

For example, if you weigh 150 pounds, your approximate water requirement will be between 75 and 150 ounces each day.

When to Drink Water During Exercise:

Begin the day with a large glass of water each morning, whether it’s a training or a rest day. On training days, the following schedule works well for most athletes:

Water (Fluid) Intake Schedule

Before Exercise:

Drink two to three cups of water (16-24 oz.) within the two to three hours before your workout. Drink 8-10 fl oz. 10-15 min before exercise

Weigh yourself immediately before you begin your workout.

During Exercise:                                                        

Drink one cup (8 oz.) of water every 15 minutes.

If exercising longer than 90 minutes, drink 8-10 fl oz. of a sports drink (with no more than 8 percent carbohydrate) every 15 – 30 minutes.

After Exercise:

Weigh yourself immediately after you finish your workout.

Drink two to three cups of water (16-24 oz.) for each pound lost during exercise.

How Much Water to Drink During Endurance Exercise:

If you are exercising at a moderate to high intensity for more than 90 minutes, you will want to consume more than plain water. You need to replenish glycogen stores with easy-to-digest carbohydrate. Sports drinks can be an easy way to add the necessary energy. For longer workouts, choose a drink with 60 to 100 calories per eight ounces and consume eight to ten ounces every 15 to 30 minutes based upon your preference.

For those exercising in extreme conditions over three, four or five hours, you’ll need to replace electrolytes. A complex sports drink, NUUN tablets, or other foods will help provide the needed calories and electrolytes required for continuous performance.

“Although rare, athletes can drink too much water and suffer from hyponatremia (water intoxication). Drinking excessive amounts of water can cause a low concentration of sodium in the blood – a serious medical emergency” (Quinn 2011).

Until next time,

-Arthur-

 

Reference:

Quinn, E. (2007 December, 2) ACSM clarifies indicators for   replacement. http://sportsmedicine.about.com/cs/hydration/a/022504.htm

Quinn, E. (2011 April, 15) What to drink for proper hydration during exercise? http://sportsmedicine.about.com/od/hydrationandfluid/a/ProperHydration.htm

Quinn, E. (2011 August, 24) How much water should you drink? http://sportsmedicine.about.com/od/hydrationandfluid/qt/How-Much-Water-Should-You-Drink.htm


Alleviating Pain: It’s the shoes!

The second of a series of blogs on staying healthy

Last I left you I mentioned the idea of working out barefoot or in minimalist shoes to strengthen the all-important foot.  Knees hurt?  Lower back hurts?  If so, there is the strong possibility the pains in the aforementioned areas originated down below the knees.  By now, most of you already have heard why due to the popularity of barefoot shoes – Our feet have basically ‘turned off,’ due to heavily cushioned shoes and orthotics, and become weaker.  This in turn has lead to unnatural changes in pronation, gait, etc..

What does this have to do with your aching knee or back?  Everything, duh.  Let me explain by example:

Okay, stand up.  Seriously, stand up.  Do so in a bilateral stance with your feet about hip width.  Now, rotate your torso side to side and pay attention to what your feet are doing.  They should be rolling side to side as you rotate.  In short, that is pronation and supination.  Now, do it again but roll in both feet and focus on keeping the inside of each foot in contact with the floor as you rotate your torso.  In other words, don’t let your feet naturally roll side to side.  How does that feel?  Not so good I would expect – especially in your lower back.

Do it again, but this time, roll both your feet to the outside.  As you rotate, don’t let the inside of the feet touch. Once again, didn’t feel as good as when you allowed your feet to roll side to side huh?

Now, think about what happens when you walk without proper pronation and supination, or worse, run miles at a time.   Because (breaking news) your hips rotate back and forth contralateral to the shoulders when you walk or run, and your feet should pronate and supinate to properly distribute the forces it encounters.  When the feet don’t do their job the rest of the body can’t move like it’s supposed to.  Think of the pressure you felt in your lower back when you rotated without allowing the feet to roll naturally.  Multiply that by a few thousand and now you can see why pain can develop in the lower back or knees.

In short, that is why it may be a good idea to wear shoes that allow the feet to do what nature intended.  Just do so in moderation.  Don’t, and I mean DON’T, go out and buy a pair of Vibram FiveFingers and run a 5k.  Your calves won’t appreciate it.  Start off walking around in them for a half hour or so.  Wear them as you strength-train.  If you intend to run in them, try jumping rope first for 30 seconds to a minute to begin with and build up.

So now you are saying “eureka!”  I have found the cure to my aches and pains.  Not so fast Sparky – what you found is the start to recovery.  As I mentioned in my last blog, the entire posterior chain needs to be strengthened to combat problems caused by the modern lifestyle.

Next, we’ll go back to basics and discuss some of my favorite exercises for strengthening the rear such as the deadlift, the good morning, and the squat.

Chris Lewis


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