New Years Resolution Mistakes

Happy Holidays! Now that we all have had our fill of eggnog and fruitcake, it’s time for: New Years Resolutions! Which brings me to my next blog post. As a former personal trainer, I cannot help but observe my fellow exercisers mistakes at the East Hills Health Club and Michigan Athletic Club. I do refrain from giving my advice when it is not asked, but there is no reason I shouldn’t post my observations for your benefit. I would also like to add that the personal trainers there are top notch, and I have never witnessed trainers employing any improper techniques at either gym. This is by no means a scientific review of existing literature, but rather a personal observation from someone who has worked in 5 different gyms and health clubs, and has frequented dozens more as a customer. Here are some of the most common mistakes:

1. Working out on the Stairmaster or Elliptical machine while leaning your weight on the side bars. I fully realize that leaning like this makes it easier, but it certainly does not make it better. It would be better to use your “core” muscles by supporting your own body. If you can’t do this, maybe you should switch to a seated stationary bike or recumbent bike. 2. Performing abdominal crunches by the hundreds, but not doing any low back (erector spinae) exercises. Consider anything around your mid section as core. This includes rectus abdominus, transverse abdominus, obliques, quadratus lumborum, and erector spinae,. Personally, I feel that gluteal and hip musculature should also be considered as core. I also think that if you need to do more than 40 reps of any exercise to get a good workout, you need to switch to a more difficult exercise.

3. Performing the “lat pull down“ behind the head. Yes I know that sometimes that is what the picture says on the machine shows. What happens is that the exercise becomes more a biceps and shoulders movement, and not the “lats” or latissmus dorsi. If you pull the bar down to your chin rather than the back of your neck, you will get a much stronger latissmus contraction. Also avoid bring it down past your shoulder level, as again this recruits entirely different muscles. 4. Squatting on the Smith Machine. It may seem like a safer alternative to free weights, but the Smith Machine travels along a fixed straight line, whereas the natural path for a squat is more of an arch. There is also a natural benefit to free weights, as you need to recruit more muscles to balance and stabilize the weight. It also mimics normal lifting movement patterns, thus enhancing “muscle memory” and reinforcing good lifting form outside of the gym.

So now that you are better informed- have at it! And please try to persist past the second week of January.

Mark your calendars! Because on September 18th, chiropractic turns 117. It was on this day back in 1895, from his office on the second floor of the Ryan Block building in Davenport, Iowa, that D.D. Palmer delivered his first adjustment — an adjustment that not only changed the life of his patient, but the lives of millions that would follow the birth of this new profession of chiropractic. So, just what did the first chiropractic patient complain of? Well, it may surprise you, but it wasn’t back pain, neck pain, or even headaches. No it was — get ready for this — deafness! His patient, Mr. Harvey Lillard, explained that for the past 17 years he had been unable to hear out of his left ear after an incident in which he exerted himself while working in a “cramped, stooping position,” when something gave way in his back — immediately bringing on the deafness. Palmer wrote that Mr. Lillard was so deaf that he couldn’t hear the ticking of a watch or the racket of a wagon on the street. Upon examining the gentleman’s spine, Dr. Palmer found what appeared to be a misaligned vertebra in the mid back region. Hypothesizing that this misalignment could be the cause of the hearing problem, he persuaded his patient to allow him to realign it. And align it he did! Almost immediately following the adjustment, Mr. Lillard could hear again! Chiropractic, a cure for deafness? Palmer probably thought so at first. But the fact is, chiropractic is not a cure for anything — not even back pain. Chiropractic, as D.D. Palmer would soon find out, was a way of simply allowing the body to work better by removing nervous system interference due to structural misalignment or dysfunction of the spine. Mr. Lillard’s deafness happened to have a structural component to it. Not every condition has a structural component, and certainly not every time. As far as deafness goes, a structural malposition of a vertebra is not by any means commonplace. Thankfully it happened to be on that September day in 1895. For it was this incident that encouraged Palmer to study further and later learn that by optimizing one’s spinal function and position, greater health would come about and maladies tended to disappear.

Backpack Misuse Leads to Chronic Back Pain

Back pain is pervasive among American adults, but a new and disturbing trend is emerging. Young children are suffering from back pain much earlier than previous generations, and the use of overweight backpacks is a contributing factor, according to the American Chiropractic Association (ACA). In fact, the U.S. Consumer Product Safety Commission reports that backpack-related injuries sent more than 7,000 people to the emergency room in 2001 alone. This new back pain trend among youngsters isn't surprising when you consider the disproportionate amounts of weight they carry in their backpacks - often slung over just one shoulder. A recent study conducted in Italy found that the average child carries a backpack that would be the equivalent of a 39-pound burden for a 176-pound man, or a 29-pound load for a 132-pound woman. Of those children carrying heavy backpacks to school, 60 percent had experienced back pain as a result. Preliminary results of studies being conducted in France show that the longer a child wears a backpack, the longer it takes for a curvature or deformity of the spine to correct itself. The question that needs to be addressed next is, 'Does it ever return to normal?'" The results of these types of studies are especially important as more and more school districts - many of them in urban areas - remove lockers from the premises, forcing students to carry their books with them all day long. The problem has become so widespread, in fact, that the California State Assembly passed legislation that would force school districts to develop ways of reducing the weight of students' backpacks. Similar legislation is being considered in New Jersey as well. The ACA believes that limiting the backpack's weight to no more than 10 percent of the child's body weight and urging the use of ergonomically correct backpacks are possible solutions. What Can You Do? The ACA offers the following tips to help prevent the needless pain that backpack misuse could cause the students in your household. • Make sure your child's backpack weighs no more than 5 to 10 percent of his or her body weight. A heavier backpack will cause your child to bend forward in an attempt to support the weight on his or her back, rather than on the shoulders, by the straps. • The backpack should never hang more than four inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking. • A backpack with individualized compartments helps in positioning the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child's back. • Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry-and the heavier the backpack will be.

A New Paradigm: Nik Wallenda walk

A new paradigm is needed in the realm of foot dysfunction. As stated earlier there is about one quarter of the population that is born with very low arches, aka "flat-footed". These people can be found in professional sports of all kind. Should these people be considered "defective?". A better viewpoint is to look at them functionally. Do their feet function like others? Speaking from experience, sometimes yes, sometimes no. Another paradigm shift needs to occur in orthopedic research. The vast majority of experts in gait analysis still divide it into: heel strike, stance position, toe off. Why is this flawed? There are 2 major deveopments we need to consider when looking at gait and footwear. Only in the recent past of humans(in the history of humankind) have these 2 things occurred: 1. We developed cushioned heels on our shoes. 2. We developed flat paved roads and flat surfaces in all of our buildings. These 2 changes have made our feet lazy. How? We can be relatively certain that when we step forward, the road will be flat and our feet will be cushioned when they hit the ground. Thus, we land heel first. Close your eyes and imagine you are on a path of large rocks that traverse a small river. The rocks are all different shape and slightly wet. Now imagine your first step onto these rocks. Will your heel hit first? Not likely. Your toes or the balls of your feet will. The forefoot is much more effective at sensing the surface and making the appropriate adjustments as you move. Look at the recent footage of Nik Wallenda crossing the Niagra Falls on a tightrope. He would certainly not get very far walking heel-toe, heel-toe. To sum things up, if you have foot pain, knee pain, hip pain , or low back pain, it is worth your while to go see a health professional who is looking at your feet structurally, functionally, and with an open mind.

Copernicus and feet

In 1543 Nicolaus Copernicus, a polish astronomer, published "On the Revolutions of the Celestial Spheres", proposing the idea that the earth revolved around the sun. For years, decades and even centuries following, this idea was fiercely debated by philosophers and scientists. In 1992 the Pope finally admitted this to be true, officially making it the Catholic Church's beleif. Certainly most people accepted this theory much earlier, but this demonstrates how new ideas take time to become accepted into the mainstream. Personally, I like to test new theories as they arise and therefore my thinking may change along the way. If you had asked my 5 years ago about barefoot running I would have said it's crazy. Most chiropractors and podiatrists still advise against it. My own running style has changed recently as a result of the trend in thinking. I switched to a less supportive "minimal" style running shoe. I do run barefoot on occasion, but only as a traning tool. I have, however, changed from a heel-striker to a midfoot/forefoot striker depending on the speed I run. I also recently attended as chiropractic seminar on physical therapy that proposed less importance of human biomechanical structure, and more importance of biomechanical function. These two new ideas initially made no connection, but as I run and move differently, it becomes apparent that there is a direct relationship. What your feet are doing now, i.e. pronating or supinating or inverting or everting, is not as important as which muscles activate properly and are effective at stabilizing the foot, and hence the whole human frame. Not to disregard structure entirely, but to use it as a guide to detecting a functional problem. A review of the literature indicates that 20-30% of the population is born flat-footed. Should this be considered "defective"? Many of these people have gone on to become professional athletes. It all boils down to one thing: reconnecting with your body. Regardless of your structure, your body can and will adapt to find a way to do what your body is telling it to do. To be continued.

Weeding Out Back Pain

Dandelion pulling season is in full swing here in West Michigan. If you are like me and don't use pesticides on your lawn, you need all the help you can get in the war against dandelions. Here is a handy device that helps pull weeds with long taproots such as dandelions, without the need to bend over. My advice: Save a trip to a chiropractor, use the Fiskars weed extractor!

Fiskars UpRoot® Weed & Root Remover
Description (from the Fiskars website)
Wipe out weeds without using chemicals or straining your back!
Our UpRoot® Weed and Root Remover makes it easy to remove invasive plants from your lawn without kneeling, bending over or using harsh, costly herbicide. It features four serrated, stainless-steel claws that grab weeds by the root for clean removal, plus an easy-eject mechanism on the handle that clears the head between uses. The durable aluminum handle is extra-long to help you reach every weed without kneeling or straining your back by bending.

Features
Ideal for removing dandelions, thistles and other invasive weeds without kneeling, bending or using harsh, costly herbicide
Four serrated, stainless-steel claws firmly grab weeds and roots
Foot platform makes it easy to step down and maximize force to penetrate tough soil
Easy-eject mechanism on the handle clears tool without forcing you to bend over and remove it by hand
Long handle makes weeding easy for anyone who has trouble kneeling or bending

The Pros and Cons of Barefoot Running

Timing is everything. The combination of the release of vibram five finger shoes, the publishing of the book Born to Run by Christopher McDougall in 2009, and an article published in Jan 2010 of Nature journal made for the perfect storm. In the aftermath, the idea of barefoot running had coalesced in the public consciousness. Given that our ancient ancestors certainly walked and ran barefoot, it would seem logical to conclude that we have the capability of going back to barefoot. But- is it really the best way to avoid injury? Before you ditch the shoes and run free, let’s take a look at the evidence.
Vibram Five fingers were apparently not originally designed for barefoot running. Vibram has been known for many years as leading developers in mountain climbing footwear. As their websites states “Bramani and Fliri developed the first barefoot shoes then showed the concept to Vibram USA president & CEO, Tony Post. As a former collegiate runner, Post quickly became a firm believer in the benefits of natural running* and fitness training. “ It is apparent that the shoe did not originate from the idea of using it for running, but once designed, the application was immediate.
The book “Born to Run” was a national bestseller and a Forbes and Washington Post Best Book of the Year 2010. The book was about a tribe of superhuman runners in Mexico- the Tarahumara . They are reportedly incredible distance runners wearing nothing but primitive sandals on their feet. But are they great runners because they lack modern footwear, or perhaps because of a genetic predisposition? Keep in mind they have never worn modern shoes, and they do not run or walk on modern flat surfaces such as pavement , cement, hardwood flooring, etc.. These people are not required to wear shoes in public, to work, etc. Can we assume that because they can run ultra marathons in sandals on their Mexican trails, we can go barefoot on our hard flat surfaces?
Daniel Lieberman did a study at Harvard in the fall of 2009 to analyze the foot strike patterns of people wearing shoes vs. people not wearing shoes. This research suggests that most modern shoe wearers land on their heels when running, and most barefoot runners land on the forefoot or “balls of the feet”. He further states "controlled prospective studies are needed to test the hypothesis that individuals who do not predominantly RFS[rear-foot strike] either barefoot or in minimal footwear, as the foot apparently evolved to do, have reduced injury rates". This certainly does not sound like conclusive evidence of the benefits of barefoot running. He is however putting forth a hypothesis.
There is some evidence to suggest that metatarsal (foot) stress fracture have been associated with barefoot running. (Barefoot-simulating footwear associated with metatarsal stress injury in 2 runners. Giuliani J, Masini B, Alitz C, Owens BD. Orthopedics. 2011 Jul 7;34(7):e320-3. doi: 10.3928/01477447-20110526-25) Anecdotal evidence also suggests that gastrocnemius (calf) strains are common as well, since this muscle is responsible for absorbing the shock that the heels would take on a rear-foot strike.
So why have people sworn by this technique to eliminate shin splints, back pain, and knee pain?
Look at the barefoot runners’ running posture, stride and foot strike. The runners are usually much more upright with good posture, running very light on their feet, and landing on the balls of their feet. The heels usually only “kiss the ground”, if they touch at all. Most likely their running style was very different from when they wore shoes. With shoes on, padding on the heel and arches allows for much greater pounding on the feet with very little sensory input. So is it the fact that they are barefoot, or is it the way they run when they are barefoot that makes a difference?
Mechanoreceptors and proprioceptors are nerve sensors in our feet that help us sense pressure and joint position. They function to correct joint position in our feet on uneven and varied terrain. Barefoot proponents suggest that these nerves are likely turned off when we walk and run exclusively on our flat modern surfaces with ultra cushioned and supportive shoes . Perhaps our feet do not get sufficient feedback from the contact with the ground to get accurate foot-brain connection.
Under the right circumstances, can barefoot running stimulate those mechanoreceptors and proprioceptors to teach us to better sense of what is going on with our feet? Or better yet, to strengthen the muscles and tendons around the foot and ankle to provide better support when we do wear shoes (which will be the majority of our lives-like it or not). This is certainly possible. But runners nowadays have been able to ignore the signs and symptoms of overuse and trauma with their cushy shoes and push the limits of their body’s abilities with little more than some shin splints or knee pain as punishment. It is essential that we reconnect with our feet as we make this transition. No longer is it “no pain no gain”. If it hurts-stop.
If you are considering going barefoot yourself, one thing to consider is mileage. If you are the type of runner who is not happy unless you complete 50 miles per week, the transition to barefoot will be frustrating. Most barefoot advocates recommend starting slow-very slow. It will be months before your feet and calves can build up to that type of mileage.
Other forms of exercise that are performed barefoot can aid in this transition, and help re-establish the foot-brain connection. Yoga is already a great adjunct to running , by creating more flexibility in the hips, and core stability in the torso. The various foot and ankle positions involved in Yoga positions could possibly help reignite these neural connections.
You may be asking yourself-why hasn’t more research been done on this topic? This is a great question. Perhaps the shoe companies are afraid that the results will show barefoot is better-so they are afraid to do them. Or maybe physicians are afraid that they’ll find out what they’ve been telling patients for years is wrong. Maybe the barefoot technology companies like Vibram are afraid their products do not actually reduce injury rates. Whatever the reason, don’t let yourself be fooled by the “experts”. Check their qualifications -they are likely just trying to sell you a product.
Lastly, be certain to listen to your body, weather you wear shoes or not. Please realize that what works for one person may not work for another.

Ugg! My back hurts! The trend toward less supportive shoes.

Yes, it is certainly looking more like spring here in West Michigan. Nevertheless, women of all ages can be spotted wearing the fashionable yet non-supportive boots called Uggs. In fact, poor footwear has become a year-round trend. Summer time is even worse with the women wearing flip-flops, flats, or even no shoes at all.

The more recent trend towards barefoot running and minimal support shoes hasn’t helped much either. “Five finger vibrams” are no more than gloves for your feet. Product information suggests that you can strengthen your feet and allow the body to move more naturally. This is a very compelling argument. So what should you make of it?

Let’s look at the poor support shoes first. Wearing shoes like flats, Uggs and flip-flops provide no arch support your feet. People are surprised to find out that feet actually have 3 arches, medial, lateral and transverse. Any or all of these arches can collapse with injuries such as ankle sprains, or with chronic wear and tear. Similar to a three legged stool, when one or more of these supports is weak, the overall structure loses stability. Arch deterioration often occurs with people who are overweight, or athletes, or with those whose occupations require them to be on their feet all the time. These arches need support. The feet are the foundation for your body. Your body is only as strong as your foundation. Biomechanical collapse of the ankles, knees, hips, pelvis, and spines can and will result.

Another problem is that we often wear out our arches unequally. Imagine, for example a person who played a lot of basketball in high school, and has sprained his right ankle numerous times. The inside (medial) arch has fallen, creating a “rolling in” of the foot (pronation). When this person turns 30 years old, and suddenly wants to start running for health reasons, their right ankle continues to provide inadequate support, causing their knee and hip to rotate inward, and they end up with outside (lateral) knee pain commonly called IT Band Syndrome, and low back pain due to stress at the sacroiliac joint.

Women who wear flats, Uggs and flip-flops have the same problems with uneven loss of the arches. Just like with runners, those who pronate only one foot will have the same internal rotation of the right knee and hip, and the same uneven pelvic alignment causing low back pain. Oppositely, those who supinate more due to a loss of the outside (lateral) arch are more likely to have hip pain. Others may have excessive pronation on both feet. This type of supportive collapse will sometimes result is upper back and neck pain. What happens is a forward pelvic tilt creating increased curvature in the low back. This will create a corresponding increased curve in the upper back and then result in an excessively forward head. Even headaches can sometimes be traced back to the feet.

So what should one make of the claims of improved strength, range of motion and balance of your feet with “barefoot” shoes? These claims do have merit, but only in how you use the shoes, or perhaps lack of them. If you use barefoot running as a training technique, and do no more than 15% of the longest run, you can train your muscles, ligaments and tendons to better support those arches naturally. However, problems often arise with runners training barefoot longer distances than this, or with too quick of an initial increase in mileage. Stress fractures in the metatarsals and tibias of these runners tell the story. These people often have switched to barefoot running for relief of their shin splints or IT Band Syndrome, but end up with stress fractures instead.

So what does one do if you have back pain, hip pain or knee pain? First thing to do is: please wear shoes. Consider that not wearing shoes is generally unacceptable in public, on the job, and in many convenience stores (no shirt, no shoes, and no service!). So we had better get used to the idea of having shoes on our feet. Secondly, since we must wear shoes most of the time, and we live in a flat environment, please make sure these shoes have support. This is, of course, unless you live in a cave with no flooring and no paved roads. Most shoe store salespeople have some basic knowledge of which shoes have good support. Thirdly, if you really want to get some use out of the minimal support shoes you have already purchased, don’t run more than 15% of your total long run in them. Or you can also take up rock climbing as a hobby.

If the shoes seem to have good support, yet you still have foot pain or shin pain, more support might be needed. Podiatrists are often adept at fitting you to custom made orthotics. See your chiropractor if you suspect your back pain, hip pain or knee pain is coming from your feet. Many people don’t realize that Chiropractors are trained to correct malpositions of any joint in the body including feet, knees and hips, as well as spines. Proper foot alignment is essential for any human that is more advanced than a Caveman. Ugg!