Posts Tagged ‘feet’

Heal Your Bunions

We’ve often worked with people to help decrease the torsion that occurs in feet creating bunions. However, the other half of the work is waking up the weakened muscles which stabilize and ground the big toe.

Check out the following video to learn two simple (though perhaps not easy) exercise to help with bunions!

Mary Bond shares more about bunions on her blog: http://healyourposture.com/

 

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.

 

M.E.L.T. the Pain Away!

by Paul Vachon

Many of you with whom we’ve worked have heard us encourage the use soft and progressively harder rubber balls for self massage of the bottom of the feet. In our culture of shoes, it is very common for our feet and lower legs to get rigid and the muscles weak. Hard soled shoes don’t allow for the natural bending and twisting of the feet which relates all the way up the body. We often forget how to spread or grip with our toes. The additional confining of our walking to only flat surfaces also takes out movements that are common and natural with uneven ground. If you’ve ever walked on cobble stone roads or a bumpy trail and found it difficult, it’s probably due to a few factors. Either you were in high heels, which I have to say are not the best functional shoes ever created. And/or your feet and lower legs were not accustomed to the constant change of surface. With more minimal shoes and flexible soles, we begin to feel the ground under us, and as a response the muscles in our feet and legs learn to quickly adjust and respond to the changing terrain.

Last year while visiting Manhattan for Amber’s strings camp, I went to the YMCA nearly every day and with those visits was able to try out several classes of which I’d never heard. I was like a kid exploring a new playground for the first time!! One of them is M.E.L.T. It is a class which utilizes foam rollers and rubber balls to work on the myofascia, to create length and increase suppleness. I liked this class so much I asked where one could get trained to teach classes. Unfortunately there are only classes in NY and CA so I’ve not made it to any of the trainings. It’s not cheap, either. If anyone would like to sponsor me to get trained, I’ll come back and teach classes!

As a member of Associated Bodywork and Massage Professionals, we receive weekly updates and news articles. One of them had to do with MELT and offered $10 off the regular price for the Hand and Foot Treatment Kit. I’m planning on purchasing a set myself and know there are several of you who have voiced interest in this kit.

“Sue Hitzmann’s M.E.L.T Hand and Foot Treatment is a self-therapeutic system that can address neck and low-back pain, arthritis, bunions and carpal tunnel syndrome. It removes stress through neurofascial techniques, taking no more than 15 minutes, 3 days a week. The kit includes six M.E.L.T treatment balls, and a Bunion Reducer band as well as a one-hour instructional DVD and 24 page instruction manual. M.E.L.T. is available for $39.95 at www.meltmethod.com.

You can get $10 off the kit through Feb. 28th, 2011, using M.E.L.T.-MBM as a coupon code.” I am not affiliated with this company, but feel our clients, friends and family could all benefit from this! If you have any questions please call or email at 288-2662 / paul at ammatn dot com.