Thursday, July 28, 2011

WHAT SHOES ARE YOU WEARING?


The human foot is a masterpiece of engineering and a work of art." 
~Leonardo da Vinci
                            

Can technology create a better foot? 
No! The human foot consists of 26 bones and 33 joints. The foot contains 31 muscles, 20 in the foot itself and 11 muscles that cross over the ankle from above. The foot is considered to have three subdivisions: the forefoot (front part of foot, including toes), midfoot, and hindfoot (rear part of foot, including heel). The foot has three arches. The medial longitudinal arch (of the inside border of the foot) is the highest and most important of the three arches. The lateral longitudinal arch (of the outside border of the foot) is lower and flatter than the medial arch. The transverse arch is at right angles to the longitudinal arches.  The arches of the foot are maintained not only by the shapes of the bones themselves, but also by the ligaments that tie the bones together.  In addition, muscles and tendons play an important role in supporting the arches.

What is up with all the weird shoes?

                            
Companies are trying to capitalize on this multimillion dollar enterprise. Everyone wants to run faster, jump higher or lose weight just by wearing a pair of shoes. The reality is that some of these creations are just fine, but others have potential hazards. What I find funny is that they are all trying to capitalize on bare foot technology.  Vibrams, bare foot runners make a minimalist shoe trying to keep the foot as close to naked as possible.  All the Rocker shoes (shape ups, et al) are based on the original MTB  shoe (Massi Barefoot Technology).
The human foot is completely unique from any other animal in the world because we have the biomechanics of efficiently upright walking. The foot has two important functions: weight bearing and propulsion. Both of these functions require a high degree of stability. We must be able to support the load of the body above. In addition, the foot must be pliable, each step we take our foot must be able to absorb the shock of hitting the ground and be able to adapt to standing and walking on uneven surfaces.  Furthermore the foot needs the ability to stiffen; this allows the foot to become a leaver, allowing the toe to push off and propel the body forward.  The multiple bones and joints  and arches of the foot give it pliability, stability and stiffness needed to perform optimally. 
As the foot hits the ground and the ground hits the foot with an opposite and equal force, a lot of energy is absorbed. A good foot will allow all 33 joints to help decelerate this energy, so it can be used to help propel the body forward. Not only that—a good foot will allow the joints above the foot to also help decelerate and absorb impact, and then use this energy for propulsion or un-loading.

When we walk with shoes, the first thing that usually hits the ground is the heel.  If the shoe alters these mechanics it can lead to problems in the hips, knees and back. The issue with rocker shoes is that they cause the heel strike to be very far back on the heel, leading to excessive extension of the knee. Additionally, as the foot rolls through the “roller sole”, joints, muscles and ligaments of the foot do not need to work. In essence, we are turning the foot off. The forces that are usually dissipated by the foot will now travel further up the chain and a joint higher up (knee, hip, and back) will take a bigger hit.

The bare foot shoes are designed to mimic how the foot was originally designed to work. The problems with these shoes are that over time many individuals feet have been in a variety of  wrong shoes and have sustained either minor or major injury. This generally creates a foot which is less then optimal.  Some of these conditions make it important for these individual’s feet to have a more cushioning or supportive structure.  When many foot issues exist, the barefoot shoes may not the best shoe for that individual to wear. Other than that, these shoes are great for a good portion of the population.

Ideally, these shoes can be worn by younger individuals and those without a history of foot problems. Caution needs to be taken for all who begin to wear them.  They need to be weaned into gradually. Let your foot get used to creating more motion and absorbing more forces. With proper break in time, most people have success in these shoes.

Is there a perfect shoe?

The multimillion dollar industry of athletic shoes strives to find the “perfect shoe.”

Even with so many options, improper footwear seems to be every place you look.  Most shoes, to some degree, inhibit the energy that would normally get dissipated in the foot. The law of conservation of energy states that energy cannot be created or destroyed; therefore, this energy just keeps traveling up the chain. The knee is the joint above the foot, and is the first in line to decelerate this energy. Since everything is connected in the body, what the foot doesn't do optimally will only be placed upon other joints up the chain.

In a nutshell, the optimal shoe is an individual fit.  There is no one perfect shoe.  Individuals need to find the most flexible and least restrictive shoe their foot can tolerate.

Can we believe all the hype and spokespeople?
NO!! This is a multimillion dollar industry. 
These companies want your dollars.  Brooke Burke did not get that body wearing shape ups!  When performing a research review, I could find no credible research studies on any of the Rocker Bottom shoes.  Most of the data is anecdotal or is based on a study performed on a small group by the company itself.  MTB has been brought to court over its misleading claims.  Sketches is under an increasing group if lawsuits from individuals who have been injured in the shoes.  In the case of Vibrams, most of the independent studies (Harvard, Scientific America) have been focused on only running benefits.  But, again most of the information is anecdotal.
In summary, think for yourself. Do not be influenced by expensive campaigns to sway your mind.  If it sounds too good to be true, it probably is!  There is not a cure all or magic pill for anything.  My best advice again is to find the most flexible and least restrictive shoe your foot can tolerate.  If you have numerous problems with your foot, consult a professional (Podiatrist, Orthopedic foot specialist) who can steer you to the right shoe or orthotic.



Sunday, July 24, 2011

Anterior Tibialis and the Peroneal Group
Jeanmarie Scordino M.Ed.
Exercise Physiologist

Let's take a look at the front side of the lower leg.  The two main muscle groups are the Anterior Tibialis and the Peroneal Group.  In most training programs these groups are rarely thought about. They are very important to how your foot functions so that you can walk properly. They aid in how your foot lands as you take a step and they help to push off for the next step. 

A great exercise for these muscles is a one leg squat, which trains much of the lower leg. It is especially good at firing up the muscles in the front of the lower leg (Anterior Tibialis and the Peroneal Group).  As you lower the body the foot stays flat on the floor, while the lower leg moves forward causing dorsiflexion of the ankle. The body, including the lower leg, is working to stabilize the body above it in all planes of motion. The ankle and the hip work together to lower the body. This exercise also helps to improve proprioception which is the bodies ability to sense where it is in space.

 TIP: If the exercise causes pain in the knee, try to sit back in to the hips more.

ONE LEG SQUAT

1.     Stand on one foot and place the non-weight bearing foot directly next to the opposite ankle. If necessary use support to hold for balance.
2.     Begin squating until you feel the tension in the lower extremity. Press your hips back so you do not jut the knee over your toes.
3.     Return to the start/standing position while driving the heel into the ground.
4.     Repeat the same movement pattern for 8 -10 repetitions.

 

Once you get the hang of this your can add intensity and  multi-plane motion by changing where you reach the raised foot. To increase motion in the sagital plane ( front to back) as you squat, extend the raised foot in front and/or behind you.  To increase the intensity in the frontal plane (side to side), reach your leg out to the side of your body and then reach it to cross in front and back of you.  Finally, to focus on the transverse plane (rotation), rotate the hips to the same side as you lower the body.

Monday, July 18, 2011

Hi! I'm Your Foot

Hi, I’m your foot!, I am often ignored till problems occur or you have found a fabulous pair of shoes for me. Unfortunately, many times those fabulous shoes are part of the problem.  Most people don’t know that 25% (that’s ¼) of all the bones in the body are in your foot, Me! I contain 26 bones in total( plus 2 sesamoid bone imbedded in the tendons), combine that with 33 joints, 107 ligaments and 19 muscles and I am an architectural masterpiece. Leonardo daVinci called me a "masterpiece of engineering and a work of art.” Only a small percentage of people are born with any foot problems. So why do 3 out of 4 Americans have serious foot problems in there lifetime?  It is neglect and lack of awareness to proper care and use, often times improperly fitted shoes, which bring on problems. Women tend to have 4 times more problems. High heels cause the body to lean forward leading to many back aches and the shortening of the calf muscles over time can result in knocking the spine out of alignment.  I do a magnificent job in balancing you body, there are message flung back and forth between me, the spinal cord, proprioceptors and the brain to constantly re-adjust to keep you standing tall.  Just wait till you start walking; now I go through a series of complex actions to propel you along. I take the initial shock in my heel and allow my foot to be loose and flexible to absorb the shock.  As you take a step, your weight shifts forward. I stiffen up so you have a nice firm surface which to propel off of and then the big toe sends you off with a great push. If any thing happens to disturb this balance of motion, the rest of your body is sure to feel it, especially your knees and low back.
It is important to take good care of me. First, good shoes are a must.  I enjoy walking bare foot on uneven surfaces though I generally prefer a good shoe on hard surfaces. Exercising me is one of the best things you can do if you don’t want to spend your golden years sitting on your bottom.  By creating movements that make me move in all planes of motion you contribute to improved circulation, and my ability to do my job.  If I loose motion in any direction, I will start to compensate. I stop doing my job as I should and that makes other parts of the body have to take on task they normally wouldn’t.  Often time this results in pain somewhere else in your body.

Remember to take care of me and wear good shoes. (More on this soon!) I’m glad we had this chat; I look forward to a great working relationship with you in the future!