Archive for the ‘General Health’ Category

Increasing Support for the Lightly Shod

An interesting blog article from the folks at Podiatry Today:

Do Running Shoes Still Need Heels?

by Nicholas A Campitelli DPM FACFAS

Has anyone ever pondered the fact that almost every shoe we put on our feet contains a “heel”? This is true whether it is a $200 motion control running shoe or simply a dress shoe that has the ¾-inch heel to accommodate our perfectly hemmed slacks. Let’s not leave out the eye catching high heels that we all tell our patients are biomechanically inappropriate.

Surprisingly, it’s not simply 1 ½-inch pumps that can be wreaking havoc for our patients’ feet. It may very well be the majority of shoes that most of us are wearing.

Is the heel still necessary, especially in a “running” shoe?

The running shoe has many origins but many agree that athletic shoes began with a canvas top and rubber soled shoe that became known as a sneaker when U.S. Rubber used the brand name Keds to sell the first sneakers in 1917.1 The next major milestone came in the 1970s when William Bowerman and Phil Knight created the Nike running shoe. These early shoes had little if any cushion and for the most part had a negligible heel.

Over the next 40 years, we have seen the height as well as the cushion gradually increase. These developments inadvertently made runners adopt a “heel to toe” gait or “heel strike” when running. Bowerman and W.E. Harris authored a primer entitled Jogging: A Physical Fitness Program for All Ages in 1967.2 In this very popular book, they noted the most efficient way to run should be landing or striking on the heel first. The authors specifically stated that forefoot striking is incorrect and not the proper way to land.

Bowerman and Harris had no scientific basis for this explanation. Several years later, they went on to create a running shoe that contained a cushioned heel. They speculated that in order to run faster, one should stride longer and that by striding longer, runners needed to land on their heels. This is one of the “primitive” reasons for the introduction of a cushioned heel. As far as increasing our speed or becoming an efficient runner, we now know from the work of Daniel and colleagues that longer strides are not as important as cadence.3

This heel height has been referred to as “drop,” the distance in height between the heel of the shoe and the forefoot. Today, traditional running shoes have an average drop of 12 mm with the heel being 24 mm and the forefoot being 12 mm. This design encourages an unnatural gait, resulting in the heel hitting the ground first and followed by a rapid “slapping” of the forefoot.

A literature search will yield numerous articles discussing running biomechanics but unfortunately, we have yet to see any hard evidence as to what is the proper way to run. The majority of Root’s theories about running biomechanics involved heel striking first.4 However, that is simply what they were — theories. I agree that his work and publications are magnificent, wonderful and have meant a lot for our profession. However, we cannot use this as evidence-based medicine to treat our patients’ disorders in every aspect.

This can be very difficult to swallow but pronation as described by Root becomes irrelevant when we describe forefoot striking as we see pronation occurring with the entire foot and then ending just as the heel touches the ground. His definition, although described as movement of the foot, focused on the motion of the subtalar joint.4 Pronation in this manner becomes an ideal shock absorber, utilizing the motion of the midtarsal joints as well as the subtalar joint.

Root’s evidence came from previous texts, examination of patients and cadavers to then create what he referred to as “normal values” for the given range of motions. Root never went on to produce any randomized trials or studies that could demonstrate that injury was more likely a result of not having the so-called “normal values.”

Ankle equinus is one specific pathology Root discussed that has become very important when discussing lower extremity injuries. Root described ankle equinus as the inability to obtain at least 10 degrees of dorsiflexion at the ankle joint.4 He also emphasized that when we assess the subtalar joint in a neutral position, the ankle joint should be at 0 degrees with respect to dorsiflexion and pronation. Root also noted that by having the ankle in a plantarflexed position, we see uncovering of the talar head and thus an increase in the propensity for the subtalar joint to become hypermobile.

Interestingly enough, what happens when we place our foot in a traditional running shoe? We plantarflex the ankle joint and function with our foot in ankle equinus. We spend so much time educating patients on the effects of ankle equinus and runners abandon it all within seconds by lacing up a traditional running shoe.

Editor’s note: Dr. Campitelli has disclosed that he is an unpaid Medical Advisor for Vibram USA.

References

1. Available at http://news.bbc.co.uk/sportacademy/hi/sa/athletics/features/newsid_3935000/3935703.stm.

2. Bowerman WJ, Harris WE. Jogging: a medically approved physical fitness program for all ages. Grossett and Dunlap, New York, 1967.

3. Daniels J.T. Daniels’ Running Formula, Second Edition. Human Kinetics, Champaign, IL, 2005.

4. Root ML, Orien WP, Weed JH. Normal and Abnormal Function of the Foot, Volume 2. Clinical Biomechanics Corp., Los Angeles, CA, 1977.

 

AMMA Welcomes New Therapist: François Minani

Survivors of the 1994 Rwandan genocide, François Minani, his seven children and one grandchild spent a year and a half as refugees in the neighboring country of Burundi before being offered asylum by the United States Government. Their sponsor, First Broad United Methodist Church, helped them to feel at home in Kingsport and enabled them to settle into the community. The younger children headed off to school while François and the older ones went to work and to college.

At home in Rwanda, François had obtained a master’s degree in biology from the National University of Rwanda and had worked as a high school biology teacher and later as education officer for the Mountain Gorrilas Project. Not being used to the physically demanding jobs that he took on in Kingsport, François developed very serious upper back pain due to overuse and repetitive strain. It reached the point in which he stopped working and received intensive care at a rehabilitation center for four months before returning to work. He later developed severe lower back pain. For five years, he vainly tried everything from painkiller medicines and back support belts to a chiropractor. A friend and co-worker then referred him to a chiropractor working with a massage therapist. At every session François received therapeutic massage before being seen by the chiropractor. After only two months of intensive therapy his pain was gone forever! Having experienced dramatic results from this type of care, François decided he wanted to go to massage school so that he too would be able to help others feel better in this way.

With his strong background in science, thousands of hours of hands-on experience and several years of hard work at the Durham, NC Massage Envy location, François is ready to give back to Kingsport and the Tri-Cities area as a whole. We are pleased that François has chosen to join us. He specializes in working with expectant mothers and people dealing with fibromyalgia, chronic fatigue and depression, as well as upper body pain and stiffness and the modality of cranial sacral therapy. He also gives wonderful Swedish, Deep Tissue, Reflexology, Sports and Hot Stones massages.

In his spare time, François enjoys walking by the river in his neighborhood, landscaping and vegetable gardening, playing with his grandchildren and spending time with his new bride, Benie.

François offers sessions at AMMA on Tuesdays, Thursdays, and Saturdays. Reserve a session with him now before his schedule fills up! He is also offering an introductory rate for a limited time. To speak with him or to arrange an appointment, contact the Appalachian Medical Massage Associates office at 423-288-2662 or call François directly at 423-863-0390.

 

Hans Rosling’s 200 Countries, 200 Years, 4 Minutes

Ah, The Joy of Stats, compliments of BBC4 and YouTube!

This is a fascinating presentation to watch and a great reminder of the advances that society has made over the last two centuries. Let’s hope that our diets of processed foods and more sedentary lifestyles don’t start reversing the trend!

 

Holiday Foods

Marie Browning, Certified Holistic Nutritionist and Certified Holistic Life Coach, recently sent out these helpful tips for making healthy food choices during the holiday season.  We like her suggestions so much that we’re passing them on to you word for word:

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. . . the holiday grazing has begun!  The average person will gain 3-6 pounds over the next three weeks, and most will keep the weight permanently.  Having some effective strategies for holiday eating can make it easier to avoid this and can help you feel better in the process.  Below are some tips I hope will be useful for you.

Shopping and errands

Always have a meal plan for the day. Decide ahead of time if and where to stop for lunch. Natural food grocery store cafes are great places to try new foods while enjoying salad, soup, and hot food bars. Sitting down for a real meal gives everyone a break and encourages wiser food choices.

Keep an insulated bag in the car pre-packed with crackers, nuts, nut butter packets, and water. My bag also holds small paring knife, a cloth napkin (to protect clothing), and a spoon & fork.  By grabbing cheese, fruit, or yogurt as I go out the door, I avoid getting too hungry between meals.  I take along my favorite tea in an insulated mug, too, which saves money and avoids temptation.  You know how it goes, you stop for coffee, buy a mocha latte, and the muffins smell good, and you’re tired, and … before you know it, you’ve spent $15, and a day’s allotment of calories! An hour later, you’re crashing and cranky. Or, the kids are fussy and you pull into the nearest junkfood-land joint.  Planning ahead eliminates these scenarios altogether.

Park as far away from store entrances as possible to slip extra steps into the day, and take the stairs whenever you can.  All those 1 minute jaunts can really add up.

Read the rest of this entry »

 

Best Stretches for Office Workers

This About.com guide by is a great primer for all you computer jockeys out there. . . . http://exercise.about.com/od/flexibilityworkouts/tp/officestretches.htm

 

All You Need To Know About Raking Leaves

Raking leaves is great exercise and on Autumn’s “To Do” List, but for many of us, a long day of raking can yield soreness and even injury.

the folks at Performance Physical Therapy in Rhode Island have put together some nice information about raking leaves . . . . In other words, how to do so without injuring ourselves!

So, give it a read and give it some heed.  Your body will thank you!

Read here: http://www.performanceptri.com/_fileCabinet/raking.pdf

 

Faith In Action


Dr. Anne Brooks, physician and Catholic religious sister, serves our brothers and sisters in the Mississippi Delta. Saul Gonzalez of Religion and Ethics Newsweekly shares the work of Dr. Brooks.

 

Hooray for D.C. Schools!

Schoolchildren in Washington, D.C. are set to benefit during the upcoming school year. The city’s schools will no longer serve flavored milks or sugary cereals.  We were surprised to learn that an 8 oz. serving of chocolate or strawberry flavored milk contains as much sugar as Coca Cola or Mountain Dew!  While the sodas have been banned from the school system since 2006, these sugary milk drinks have remained part of the children’s daily diet.  Combine it with standard items on the school breakfast menu (sugary cereals and pop tarts) and the kids consume consume a meal consisting of 60 grams of sugar before classes even begin. . .  That’s the same as 15 teaspoons of sugar – over 1/4 cup!  How was this ever considered a good idea?

Read the article at Better D.C. School Fund blog:

http://betterdcschoolfood.blogspot.com/2010/06/dc-schools-to-discontinue-flavored-milk.html

 

High Fructose Levels Make Fat Cells Fatter

We all know that fructose isn’t exactly health food, but can lead to a world of ills. . . .

Thanks to Raj Mehta for this link that gives another reason to avoid high fructose corn syrup:

http://timesofindia.indiatimes.com/Life/Health-Fitness/Health/High-fructose-levels-make-fat-cells-fatter/articleshow/6078353.cms

 

Some Anti-Depressants Interfere with Breast Cancer Treatment

Tamoxifen is frequently prescribed as treatment for estrogen-based cancers, but the Harvard Mental Health Letter reports that some antidepressants may interfere with the drug’s anti-cancer properties.

Three antidepressants—paroxetine (Paxil), fluoxetine (Prozac), and bupropion (Wellbutrin)—should be avoided while taking tamoxifen. These antidepressants are also used to treat hot flashes and aid with smoking cessation.

If you are taking both tamoxifen and one of these three drugs, please consult with your physician.  The article notes that other antidepressants are less likely to interfere with tamoxifen. Better options for women taking tamoxifen include venlafaxine (Effexor), desvenlafaxine (Pristiq), and mirtazapine (Remeron).

http://www.health.harvard.edu/press_releases/some-antidepressants-interfere-with-breast-cancer-treatment?utm_source=twitter&utm_medium=socialmedia&utm_campaign=061510_tw