Fat Busting Shoes?

As we have been looking at the advantages and disadvantages of barefoot running I thought it would be appropriate to look at the new revolution of oddly shaped shoes.  These shoes such as “Shape-ups” by Skechers and “EasyTone” by Reebok tout huge fitness results but, the question is, do these shoes produce their advertised results? And, more importantly, do they have the ability to cause injury?  First, an overview….

Reebok’s shoes describes a revolutionary technology where they have pads of moving air on the sole of the shoe which mimic walking or running on an unstable surface.  They explain that this makes your muscles work harder throughout the day, causing increased activation of the gluteus maximus (bottom), hamstrings, and calves.

Skechers “Shape-ups” also describes a ground-breaking technology where they have a dynamic rolling bottom on the sole.  According to Skechers this makes you feel like your heal is sinking into sand as you walk forcing you to activate your muscles more to get towards your next step.  The advertised benefits include more toned legs, back, and abdominal muscles, reduced body fat, improved circulation, and improved posture.

But, if my last two blogs show how we should be decreasing the amount of shoe wear that we put on our feet, is it really good to have these shoes which further alter our gait mechanics?  While Reebok does not actually show us any of their research articles, Skechers reports many clinical case studies that back their findings.  Their articles show an increased amount of weight loss, an increase in hamstring and calf muscle activation, and improvement in low back endurance.

So, do you buy them or not?  First, I must emphasize that under each clinical case study for Skechers there is a statement: “These independent case studies where commissioned by SKECHERS.  Results may vary from person to person”¹    This breaks rule number one in “research 101.”  You must gain your research based knowledge from peer-reviewed articles that are not endorsed by the company that is selling the product.  There is no way to tell if the money that Sketchers paid the researchers persuaded their outcomes. Second, according to Matt Powell of SportsOneSource, a sneaker analyst, the sales of these shoes “represent the fastest-growing segment of the $17 billion-a-year athletic footwear industry. It's a market driven by a customer base that is 90% women.”²  Anytime we see such a sharp increase in a product we must ask ourselves if this is due to a truly innovative product or fads and good advertising.

Without ever putting a pair of these shoes on I have some problems with their design.  Destabilizing the foot during walking, especially in a deconditioned person, will lead to problems of the knee (knee cap tracking problems causing pain), the Achilles tendon (increased stresses causing pain and possible tears), the plantar fascia (causing arch pain) or even falls causing serious injuries.  I have heard stories of people developing fractures from wearing these shoes after stepping awkwardly and “rolling their ankles.”

Wendy Shore of Johns Hopkins, says “consumers would get the supposed health benefits of toning shoes and save money if they skipped buying the shoes, then bought one less bagel a day — and walked an extra block."²

As a physical therapist I cannot say that I support the use of these sorts of shoes at this time.  Yes, my opinion may change as more peer-reviewed research articles are presented in respectable medical journals but without the evidence of true health benefits along with the high risk of injury these risks of these shoes outweigh their benefits. 

And as mom always told me, if it sounds too good to be true, it probably is.

References:

1.       http://www.skechers.com/info/shape_ups_clinical_case_study

2.       http://www.usatoday.com/sports/2010-06-30-toning-shoes_N.htm?csp=usat.me

Barefoot Running: Part II

In our last installment we introduced the concept of barefoot running and some advantages that it has over our current trend of running with footwear that controls heel strike, supination/pronation, and gait mechanics of the lower limb. Today I plan to discuss how you can begin a proper barefoot running program.

DISCLAIMER: Before I even get started on this subject in no way am I telling anyone to go out and run barefoot tomorrow.  There is still extensive research that is being conducted in this area and before we fully understand the biomechanics of running without shoes; any use of the technique should be used with extreme caution.  YOU SHOULD VISIT YOUR PRIMARY PHYSICIAN AND/OR PHYSICAL THERAPIST FOR A COMPLETE GAIT ANALYSIS AND GET ANY MEDICAL CONDITIONS CLEARED BEFORE ATTEMPTING A NEW EXERCISE TECHNIQUE. 

First I must cover some disadvantages to running without shoes in our modern urban environment.  If you have been running for a long time with running shoes you have slowly been trained to hit with your heel first before rolling onto the midfoot and then forefoot.  I bet you can imagine that if you went out and “hit the pavement” for a nice run with a strong heel strike that you would be in a lot of pain (especially in the heel).  When transitioning into running without footwear we must retrain our bodies to run striking first on the midfoot or forefoot (middle or balls of the feet respectively).  Other problems also will arise including stepping on sharp objects such as rocks, sticks, or glass.

So how do you get started?

First you MUST see your physician or physical therapist to make sure you are healthy and strong enough to begin a new training technique

Secondly, you need to know how to land on your midfoot or forefoot.  When running in this style you should land on the ball of your foot softly while gradually letting your heal come to the ground.  This is harder than it seems and should be attempted at slow speeds to start.  This form of foot strike will likely make you use muscles in your feet and lower leg that have not been used sufficiently so following the tips below will help you get started.

1.       Start your new program while progressing slowly.  Remember these muscles are going to be used in a different way causing fatigue and possible strain. This can be reduced by first beginning to walk around barefoot.  When beginning running you should start with a very short distance at slow speeds and “increase your distance by no more than 10% per week.”¹ If you find that your feet are sore you should take a few days off for full recovery.

2.       Land gently on your foot; there should be no pounding.

3.       Take small strides.  Do not over step while running.

4.       Stretch you leg muscles!  Barefoot running will make you use your gastrocnemius (calf muscle) and hamstring more causing tightness and fatigue.    

5.       Stop if it hurts!  This should not be a painful process.  If you notice any pain in any part of your foot or in your calf you should stop your training and talk to your physical therapist.

Good Luck!

1.  http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html

Barefoot Running: Part 1

Ever since the release of the book Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen, I am asked more and more by my patients if barefoot running would benefit their current orthopedic complaints.  This book by Christopher McDougall explains the running style and philosophy of the Tarahumara Indians of Mexico’s Copper Canyons. So why should we run barefoot? 

DISCLAIMER: Before I even get started on this subject in no way am I telling anyone to go out and run barefoot tomorrow.  There is still extensive research that is being conducted in this area and before we fully understand the biomechanics of running without shoes; any use of the technique should be used with extreme caution.  YOU SHOULD VISIT YOUR PRIMARY PHYSICIAN AND/OR PHYSICAL THERAPIST FOR A COMPLETE GAIT ANALYSIS AND GET ANY MEDICAL CONDITIONS CLEARED BEFORE ATTEMPTING A NEW EXERCISE TECHNIQUE. 

The main focus of barefoot running is that we as humans have been running since the beginning of time; whether it was away from danger, towards a moving target for food consumption, or for fitness alone.   Before the 1960’s running was completed with minimal to no footwear.  Our current data is slim but we do know that approximately 30% of all runners get hurt each year—an astonishing number.¹  Current and further research is in the works to compare running with and without footwear. 

In the days before running shoes humans would run with a “Midfoot strike” where their whole foot would essentially hit the ground at one point with the ball of the foot often striking the ground before the heel.  Modern shoe wear has conditioned us to land on the heel first while constricting normal foot movements such as supination and pronation.  We can understand where shoe makers are coming from; they have added a nice big cushioned heel and have given us support throughout the foot.  Both of these additions to shoes help distribute forces throughout the foot.  It allows landing on the heel to be a comfortable experience and limits excessive pronation or flattening of the foot.  These modern additions to shoe wear lead the athlete to “prefer” to land on the heel secondary to the cushioned feeling.  The problem is that there is some anecdotal evidence that this constant heel strike causes increased ground reaction forces leading to common running injuries such as ankle sprains, shin splints, and patellofemoral (knee cap) pain.

Since modern shoe wear might be contributing to common overuse injuries and since humans have been running for 1000s of years without shoes, current research is investigating the use of barefoot running as a common training protocol.

Be sure to come back and check out the next installment as we will introduce some ways the common runner can begin a barefoot running regimen.  Until then keep those shoes on….

1. http://www.barefootrunning.fas.harvard.edu/1WhyConsiderFootStrike.html

Live a Healthy Life with Prevention

American’s today are beginning to throw the word “prevention” around a little more when it comes to their health.  As we discussed in our last blog, taking minor steps in the correct direction can decrease our chances of heart disease and dementia.  So besides getting an annual physical exam and teeth cleaning what can you do to stay healthy?

EXERCISE – This is the easy one.  Exercising, especially in low impact sports such as swimming, bicycling, yoga, or tai chi can help with increasing you cardiovascular endurance while maintaining both strength and flexibility.  The more your body is prepared for the unexpected, whether it is a simple fall or the need to run from a tiger in the safari, the less of a chance you will be injured during the process. 

WEIGHT CONTROL – In physical therapy when a patient cannot perform weight bearing activities because of joint pain or recent surgery physical therapists often put the patients in some sort of off-weighted environment such as a pool.  This is because increased weight on joints leads to breakdown of cartilage, ultimately causing osteoarthritis and pain.  If a person already has osteoarthritis the added weight of a couple pounds can significantly increase pain and disability levels.  Studies show that losing just 10 pounds can reduce the risk for osteoarthritis by 50%.¹

AVOID INJURY – I know what a lot of you are thinking here.  “Of course, we all try to avoid injury so that we do not need to visit health care practitioners.”  But there is more to this.  I would say that about 50-60% of all Achilles tear injuries that I see in the office are people who are “weekend warriors.”   If you are stuck at a desk 5 days a week for 9 months and then decide to partake in a full contact basketball tournament on Thanksgiving  day your are probably a “weekend warrior”.  Your chance of injuring yourself is tremendous; if you are not prepared for sports you will be injured.  Make sure to prepare for your upcoming sporting events by exercising regularly in order to increase your cardiovascular endurance, strength, and flexibility.

Take care of yourself today.  It can save you from pain in the future.  The pain is not just physical but can also be financial.  Protecting your body, especially your joints can save you thousands.  If you don’t exercise, are overweight, or partake in high impact sports you are at risk of wearing down the cartilage in your joints, creating pain, an ultimately causing you to spend up to $50,000 for a joint replacement, not including time away from work. 

If you are currently not maintaining this level of exercise or you need guidance on how to perform exercises correctly Hayashida and Associates offers many options such as Pilates, and both  one-on-one personal training and group fitness classes.  Prevent injury and live a healthy life.  The choice is yours!

1. Fingertips. http://massage.largeheartedboy.com/

Eat a Mediterranean Diet...For Your Heart...For Your Brain....For Your Health!

The common theme nowadays is to find ways to decrease the cost of medical services.  Part of this is done by prevention techniques that are often not covered by insurance companies.  The general population is quickly finding out that they need to take care of themselves whether it is by diet or exercise in order to save on their health care dollars.  It has been long believed that by partaking in a Mediteranian Diet one can keep a heart healthy and avoid extensive heart disease; the largest killer in America.¹

The Mediterranean Diet consists of eating large quantities of fruits, vegetables, grains, beans, nuts, olive oil, and fish.  Low to zero quantities of dairy, saturated fats and red meat are eaten.  Wine is moderately drunk in a Mediterranean diet.

Recent research shows that the Mediterranean diet not only helps with heart disease but can also decrease the chances of suffering from brain infarcts, which can be thought of as mini-strokes that cause mild cognitive changes such as memory loss, like we might see in beginning stages of dementia. 

“Researchers found that people who most closely followed a Mediterranean-like diet were 36 percent less likely to have areas of brain damage, compared with those whose eating habits were furthest from the diet.” ²

This news is important for those in America, as it is believed that 1-4% of all Americans over the age of 65 have some sort of dementia, a number as large as 4.5 million people, according to the Mayo Clinic.

This new information, although not completely correlated, can help prevent dementia-related illnesses.  As we all know, “knowledge is power.”  Now is the time to become healthier.  It makes financial sense to take care of yourself; Save money, live healthy!

      1. American Heart Association; 2010. http://www.americanheart.org/presenter.jhtml?identifier=4644

      2. CNN Health; February 8, 2010. http://www.cnn.com/2010/HEALTH/02/08/mediterranean.diet.brain/index.html?eref=rss_topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fcnn_topstories+%28RSS%3A+Top+Stories%29

We've Moved Our Goleta Clinic!

We are excited to announce that we have relocated our Goleta clinic just down the street to a new location at Twin Lakes Golf Course. As you know, we have occupied the space in the Costco shopping center for the past 6 years. Starting Monday May 3, we began offering the same unparalleled care from our new location at 6030 Hollister Ave in Goleta. To insure that the transition is smooth, the same 3 therapists that were treating at the Marketplace clinic have moved to the Twin Lakes location and will continue treating their own patients. Also, our Santa Barbara location remains in the same spot at 2921 DeLaVina St just below the Trader Joe's.

To celebrate the grand opening, we will be holding an Open House on May 22 from 11am-4pm at the new location. This will be a chance for us to introduce the facility to our loyal patients and referring physicians. We will provide refreshments and also be giving away prizes.

Hope to you see you there!

DPT, MPT, OCS, CSCS...What does it all mean?

It's pretty obvious that the letters behind your therapist's name indicate the type of degree and certifications they have. But what do they all mean? To cure your curiosity (and brag a bit about our therapists) I will enlighten you.

All of our therapists have a MPT or DPT from one of the 200 accredited Physical Therapy schools nationwide. MPT refers to a Masters of Physical Therapy. This degree was more common for PTs who got their degree 10+ years ago. Because the profession has progressed significantly over the past 10 years, the competition between grad schools and the knowledge of Physical Therapy has become more advanced. Therefore most PT schools offer the Doctor of Physical Therapy (DPT) alone now.
Almost all of our Physical Therapists have received their Doctor of Physical Therapy degree placing them in the top 8.1% of physical therapists nationwide. Those with MPTs have been in their professional careers as physical therapists for 10+ years and are in the process of their transitional DPT program in order to be on top of the latest PT findings. In summary, both degrees signify the completion of the current requirements needed to enter the profession and also represent the completion of a comprehensive program and the fulfillment of the high standards of clinical performance in professional preparation.

Now that we have that our of the way, what is an OCS? OCS stands for Orthopedic Clinical Specialist. This is a certification given by the American Physical Therapy Board of Specialities and is achieved only by completing a list of rigorous requirements. To obtain this degree a therapist must have 2000 hours of clinical practice in Orthopedic physical therapy. Once this is complete they can apply to take the nearly 8 hour exam covering all aspects of orthopedic diagnoses, treatment and physical therapy patient care. Only the top 2% of physical therapists in the country have this certification and four of our seven therapists belong in that top percentile. This is more than any physical therapy clinic in the tri-county area.

Finally, the CSCS indicates that the therapist or personal trainer, in this case, is a Certified Strength and Conditioning Specialist. To earn this certification, one must have a bachelors degree from an accredited institution or be a college senior enrolled in an accredited institution. They must also be CPR and AED certified. Once these prerequisites are met, the individual may take the 4 hour exam which consists of a scientific foundations portion and a practical/applied portion all dealing with exercise science, program design and nutrition. Physical Therapists often get this certification because of their passion for exercise science and optimal body functioning.

In addition to all of these degrees and certifications, our therapists are actively involved in continuing education immediately after receiving their degree. They take multiple courses each year with their colleagues in order to stay on top of the newest findings in their field.

As you can see, our therapists have spent quite a bit of time in school and embrace the opportunity to learn more every day. Their quest for more knowledge is fueled by the reward for their efforts. These rewards are evidenced by more successful outcomes for their patients in shorter periods of time.