Thursday, April 15, 2010

Don’t Let Foot and Ankle Injuries Hold You Back!

As the summer approaches, many Americans are hitting the gym (and the pavement) to burn off the winter pounds and get into bathing-suit shape. But even more Americans are looking for a way to combat what many experts have targeted as the greatest threat to our health in the 21st century: obesity. Obesity has been linked to many of the leading causes of death and disability in America, from cardiac disease to diabetes to cancer. The combination of unhealthy fast foods and an increasingly sedentary lifestyle has left both adults and children with, on average, 17 pounds of extra weight. Those extra pounds can have many adverse effects on the feet and ankles as well. The reasons are simple; the more weight you carry, the more stress you place on the load bearing surfaces of your body and the more problems you will incur. But foot and ankle problems shouldn’t keep you from reaching your ideal, healthy weight.

The consensus among experts is that the most effective route to weight loss stems from a combination of healthy diet and an appropriate exercise program. A common “excuse” for not taking up and exercise program, or sticking to it, is the pain and difficulty that can result. Many of these aches and pains are located in the lower extremity, the knees, hips, ankles, and feet. But this should not ultimately be a deterrent to a successful exercise program. There are many options for exercise that can remove some, or all of the load placed on the lower extremity, yet still provide an excellent cardiovascular workout. Biking, swimming, rowing, and the elliptical machine all remove much of the joint stress of running while providing a comparable workout. Easing into an exercise program is important to avoid injuries as well as to keep from becoming discouraged by physical and psychological setbacks. Stretching, both before and after exercise, as well as warming up slowly is important to avoid muscle strains. Wear appropriate shoes for the activity. I recommend a reputable sport or specialty athletic shoe store. The staff will understand your goals and your foot type to fit you better. Shoes can be pricey, but consider them an important part of your athletic “gear”, just as you would a tennis racquet or golf clubs. Also, be sure to see your general physician to ensure that your cardiovascular system is healthy enough to undergo the increased strain from exercise.

Losing weight will both improve your overall health and decrease your incidence of foot and ankle problems. Foot and ankle issues should not stop you from reaching your goals. If you develop foot or ankle issues during your new exercise program, be sure to come in and let us help you. You can find us at .

Have a happy and healthy Spring and Summer!

Friday, April 2, 2010

Barefoot Running Basics

Barefoot running has seen a rise in popularity over the last few years, though it is of course a much older form of running than the more popular shod running. Barefoot running is thought of as a more natural method of running, where the shoe is not able to influence the biomechanical functioning of the foot. Barefoot running also leads to a more forefoot running style (versus heel to toe running), which causes higher activation of the plantar flexor muscles. We will examine some of the arguments for and against barefoot running, and discuss some steps you can take if you would like to try this alternate training technique.

A quick search for barefoot running online will lead to hundreds of web sites and blogs dedicated to barefoot running. Like most other alternate, against the grain ways of doing things, barefoot runners are passionate about their cause. Getting past the issues that some of the bloggers have with the shoe industry and their ideas on conventional norms, you can get to the core of barefoot running philosophy: get back to doing what we are designed to do. We weren’t born with shoes on our feet, so we don’t need them now.

Empirical studies support many of the claims of the barefoot running crowd, but with the understanding that there are people and conditions where barefoot running is not recommended. A Harvard study (which can be found at on barefoot running has focused on the importance of forefoot or midfoot strike in barefoot running. Approximately 75% of shod runners strike with the heel first, which several researchers have hypothesized can lead to some repetitive stress injuries. The Harvard team stresses, however, that no studies have proven that forefoot running will lead to fewer injuries than shod heel strike runners. There is also the possibility that barefoot running requires less energy than shod running, and not only because of the decreased weight. A study in the International Journal of Sports Medicine from 2005 (1) found that barefoot running increases the elastic energy storage of the ankle joint, which leads to more efficient running.

There are as many arguments against barefoot running as there are for. The most obvious of these arguments is the lack of protection that barefoot runners have on the plantar surface of the foot. This is especially important for diabetics or those with diminished wound healing capabilities. Barefoot running is less comfortable, and lacks the lateral support provided by running shoes that is important in preventing over-supination or over-pronation. Barefoot running also lowers the distance one can comfortably run, which may explain why we have yet to see elite-level marathoners remove their shoes.

Until more empirical data surfaces it will be difficult to recommend either for or against barefoot running. If you are considering a barefoot running program, be sure to follow some basic precautions. Be sure to run on a uniform, clean surface. Don’t run at night or if visibility is compromised. Take the transition slowly to avoid injury. Many shoe companies have come out with minimal footwear, a thinner more flexible shoe that mimics barefoot running. This is a good option for transitioning to a barefoot running program.

As always, if you develop foot or ankle problems after beginning this new program give us a call and come in for a visit. You can find us at . Enjoy the beautiful weather!

(1) C. Divert, G. Mornieux, H. Baur, F. Mayer, and A. Belli. "Mechanical Comparison of Barefoot and Shod Running." International Journal of Sports Medicine 26.7 (2005): 593-98