Tuesday, January 18, 2011

Do These Shoes Make Me Weak?

In no way do I consider myself an expert on foot biomechanics, or any biomechanics for that matter. Whenever I do read some technical study or text on the subject my eyes glaze over in about a minute. However, one of the most often asked questions I get concerns shoes and the use of orthotics.

I can't tell you how many injured recreational and competitive runners I see that wear orthotics, but who are 1. Weak 2. Have significant joint restrictions in the hips and ankles 3. Possess some tissue/muscle tightness or restrictions, and want to know how they can get rid of nagging pain or tightness and get back to running.

Hint: All of those issues are related.

What I do know about the subject from working with practitioners such as Lenny Parracino, Gray Cook, Bill Hartman, and reading work by Gary Gray, Thomas Myers and others is that what happens at the foot when we move affects much of the rest of our body, which is why this article in today's New York Times really struck a note.

Some key quotes:

Then what, Dr. Nigg asked in series of studies, do orthotics actually do?

They turn out to have little effect on kinematics — the actual movement of the skeleton during a run. But they can have large effects on muscles and joints, often making muscles work as much as 50 percent harder for the same movement and increasing stress on joints by a similar amount.

As for “corrective” orthotics, he says, they do not correct so much as lead to a reduction in muscle strength.

In fact, he adds, there is no need to “correct” a flat foot. All Jason needs to do is strengthen his foot and ankle muscles and then try running without orthotics.

Dr. Nigg says he always wondered what was wrong with having flat feet. Arches, he explains, are an evolutionary remnant, needed by primates that gripped trees with their feet.

“Since we don’t do that anymore, we don’t really need an arch,” he wrote in an e-mail. “Why would we? For landing — no need. For the stance phase — no need. For the takeoff phase — no need. Thus a flat foot is not something that is bad per se.”

Whoah - more stress on the joints and it makes you weaker. Sign me up huh?

There is a lot to digest there, but I'll preface that by saying according to very smart osteopaths, PTs, and podiatrists I have heard speak on the matter there is a time and place for orthotics.

However, those same practitioners seem to agree that if there is not an acute injury, defect, or some outstanding reason then as the quotes above state orthotics may do more harm than good.

I have fairly high arches, which would lead "experts" at a running store to prescribe supportive shoes, and probably inserts. However I wear nothing but minimalist footwear such as Nike Frees and have recently been test wearing some free/five finger-like prototypes from Adidas, and can say for certain my feet, knees, and back are stronger and feel better when I train or walk around in these shoes and worse when I wear crosstraining shoes with more arch support.

In addition, I have had thorough assessments and treatment done by Dr. Parracino, who specializes in mechanics and builds orthotics. Despite doing a comprehensive gait and movement analysis while barefoot he didn't see any foot related problem but traced my back issue back to a hip capsule matter.

That along with the aforementioned work by Gray Cook etc... leads me to believe some of what that article addresses may apply to our shoes.

And what are the typical crosstraining shoe if not a low grade orthotic? It provides artificial support to the arch, and will affect how the foot moves and thus alters how the joints, bones, muscles, and tissue in the ankles, legs, and hips receive and produce force.

In 2009 Univ. of Texas Basketball strength coach Todd Wright gave an interesting talk at the Perform Better Summit on foot biomechanics and told us about a top NBA prospect he was training that was having some severe back pain that was preventing him from playing. Todd had exhausted his ability to fix this kid, so had him assessed in person by Gary Gray, who after watching this player move promptly traced the problem back to one of his feet. Something in his foot/sub talar was altering his gait, which then increased the stress up the kinetic chain, causing compensation in his back to the point of dysfunction.

Instead of prescribing orthotics Dr. Gray had Todd train this kid barefoot in the gym and do a battery of corrective work designed to fix the faulty movement pattern. Todd said the kid's back was quickly back to normal and he went on to sign a fat NBA contract.

Todd now has most all of his basketball players train barefoot in the gym. Other smart coaches and trainers, such as Jon Hinds, also advocate minimalist footwear or going barefoot.

We should be cautious however in saying everyone should train a certain type of shoe or barefoot if there is reason to suspect a foot issue. However, it seems we are just seeing the tip of the iceberg when it comes to research on movement quality and shoes.

For more resources I highly recommend Gary Cook's book Movement and Thomas Meyer's Anatomy Trains.

For more detailed information on the foot and how it relates to joints up the chain check out this excerpt on the joint by joint approach by Gray Cook.

Tuesday, January 4, 2011

Feedback To Keep On Track

No matter the vocation feedback is an important aspect of competency. We are constantly receiving feedback from our bodies, and should be training to improve the quality and perception of that feedback loop so that we move better.

When training another person I may ask for feedback to supplement what I see in how the person moves so that I can more effectively improve their performance and thus the results.

But once in awhile it's the clients that provide feedback on my performance, and more often than not it makes me feel pretty damn good about what I do. Over the first few days of this year I've gotten a couple of gems worth sharing.

The first is a person that had to go in for some intestinal surgery. This person's nurses were impressed that after only a couple of days she could sit up and roll over without pain, which the nurses attributed to the function and development of core musculature.

The surgeon further complimented her on a lack of visceral fat, which we all know to be the more dangerous sort, and which probably complicates the surgeon's job when digging around in there.

Made me feel pretty good about the real world benefits of the training we have been doing in the gym.

Another client is two weeks out from her due date for her first child, but you would never know it by how she is still kicking ass in the gym. Another person much earlier in her pregnancy that just joined our pre-natal small group training program couldn't keep up with her in Tuesday's training session.

I have expected her and the other women now in their third trimesters to start coming in complaining about back, shoulder, and neck pain, but that hasn't happened. I haven't seen any of their strength levels drop off either, which seems to help in making their pregnancies easier to get through.

Just goes to show the benefits of showing up and being consistant.

Another person had joined the Movement Program in order to address pain he was having while training for a marathon. All the typical symptoms - knee pain, IT tightness, hip/lumbar discomfort. We spent a couple of months improving his movement quality through getting his hips, ankles, and thoracic spine more mobile while improving glute function, core strength, and scapular function.

Funny thing. About the time he could do a respectable squat without compromising his lumbar spine, and when his scapula were properly moving his shoulder in a good range of motion he noticed that the pains had disappeared and he no longer became as fatigued on his runs.

That's not to say there isn't much room for improvement in our training at Edge, but I hope to be fortunate enough to receive more feedback like that in 2011. I know that I'll put in the many hours of continuing education to help make that happen.

As you move into the new year take a few minutes to review your progress over the past year, and consider what that tells you about what to change or improve concerning strategies to hit your goals.

One more shameless plug. We will be holding a workshop on smart goal setting and developing strategies to reach those goals on Saturday, Jan. 22nd, from 11am-1pm. See the Edge site for more information.