running

The Minimal Shoe Debate Heats Up

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If you’re an exercise geek like me then you may take interest in the latest goings-on over at Zero-Drop, a very fine minimalist running blog.  Three posts are worth reading: “ASICS Have Really Dug In Their Heels,” “The ASICS ‘Minimalst’ Shoe Debate Continues…,” and “The Other Shoe Has Dropped: Dr. Craig Richards Challenges ASICS and Other Shoe Companies.”

It seems that shoe company ASICS is not jumping on the minimal shoe bandwagon like most of their competitors.  ASICS shoe designer Simon Bartold is quoted in the article and he speaks fairly derisively of the movement toward flatter, thinner and more flexible shoes. He demands proof that minimal shoes are healthy and useful for runners.  (Meanwhile, there’s certainly no proof that modern, “good” running shoes are healthy either.)

What’s most interesting however isn’t the article itself but rather the spirited exchange that follows in the comments section where Bertold and the blog author go back and forth over the scientific particulars of this issue.  The discussion gets quite heated and the drama even spills over to another blog. “ASICS vs Zero Drop, Minimalist vs. Maximalist” comes from the great minimalist site, Runblogger.  It’s a very thorough examination of the type of proof that Simon Bertold demands.  The article in fact draws a comment from ASICS’ Bertold that that might be seen as a little bit of backpedaling.

The issue of science and scientific “proof” is a prominent feature of these discussions.  It’s unlikely that any one study will prove 100% whether or not any type of shoe–or no shoe at all–will cause or prevent a given type of injury.  There are many many variables that go into an injury or lack thereof.  (Interestingly, several studies suggest that conventional “good” running shoes matched to foot type do nothing to prevent injuries.)  Further, just because a rigorous study hasn’t been done doesn’t mean that a given cause-and-effect relationship doesn’t exist.  Minimal shoe/barefoot running may or may not in fact be healthier for most people than running in a conventional running shoe but there may be no powerful study that exists that proves either condition.

There’s nothing wrong with examining the anecdotal evidence either.  It’s often the anecdotal stuff that motivates someone to study something, and there’s a lot of anecdotal evidence out there supporting the idea that less shoe is better than more shoe.  I can speak from my observations of clients in the gym (as well as my wife and my own condition) that many people move better and feel better in minimal shoes.  I’m not the only one observing this.  In fact the shoe companies making minimal shoes are responding to the requests of their customers.

Finally, if you find all of this interesting, then you should get over to a recent post at the Science of Sport.  The barefoot running debate: Born to run, shoes & injury: the latest thinking is a remarkably in-depth discussion on the shoe issue.  The Sports Scientists take their subjects very seriously and they always get deep into the science behind athletics.  They discuss the important of running technique and the idea of how to transition from a conventional running shoe to the barefoot/minimal running style.  Very informative stuff there.

 

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Avoid Cramping This Spring

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The warm weather is trying to break through to us and we’re all itching to run and/or bike. You may be at particularly at risk for cramping at this time of year though. Why? First some background on salts, muscles and muscular contractions.

Salts (aka electrolytes) specifically potassium, sodium, and especially calcium are key components of muscular contractions. Without them we may either experience muscular weakness or uncontrolled muscular contractions–cramping. We get these salts through our food and drink. We tend to lose these salts through sweating. Prolonged exercise and/or exercise in the heat typically requires us to consume more salts than we would during short bouts of exercise or exercise in the cold. Now, on to the particulars of cold-to-warm weather issues.

As it turns from cold to warm weather, our bodies are also adjusting the degree to which we sweat out our salts.  During the cold, our bodies will fork over the salt quite readily. We retain more salts during the warm weather.  So let’s say we get a nice warm day and we decide to get in a long run or ride.  We may be exercising like it’s warm but we may be sweating out salts like it’s cold. This is prime time for cramping.

Here are some ideas to avoid cramps:

  • Salt your food. You’re an exercising athlete and you need salt. Unless you have high blood pressure, you should be fine.
  • Keep a sports drink with you. Drink when thirsty and stop when you’re satiated.
  • Eat a wide variety of fruits and vegetables.  These contain electrolytes.
  • Don’t overhydrate. Too much water will dilute the salts in your body.
  • Consume dairy products. Calcium is important for bones but it’s also massively important for muscular contractions. It’s rarely found in sports drinks though.
  • Ease into warm weather activities. Your body will adjust to retain salts if given some time.
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Orthotics Are a Mystery

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“I guess the main thing to note is that, as biomechanists, we really do not know how orthotics work.”
– Dr. Joseph Hamill, University of Massachusetts professor of kinesiology

Orthotics.  Some people swear by them.  Some people swear at them.  (That would be me.)  Some of them cost a few bucks at the grocery store.  Others cost several hundred dollars and must be fitted at a podiatrist, physical therapist or chiropractor.  So what about them?  Do we need them or not? (And if they are important for our health, how did the Egyptians, the Romans, Gengis Kahn, the Vikings, etc. ever manage march across the earth and conquer everything in site without them?)

All runners and other fitness enthusiasts–anyone who wears shoes really–must read the latest dispatch from the New York Times Personal Best section titled Close Look at Orthotics Raises a Welter of Doubt.  It’s a fascinating discussion on how and why orthotics may or may not work.  As the quote above indicates, no one really seems to know what these things actually do for the feet.  There are several important points in the article.

Analysis of Orthotics

Dr. Benno Nigg, professor of biomechanics and co-director of the Human Performance Lab at the University of Calgary in Alberta has made a career of researching orthotics. He makes a point that I’ve observed in my own experience with orthotics, namely that they tend to work in the short-term.  However he says that idea that they are supposed to correct mechanical-alignment problems does not hold up.

Further Dr. Nigg says, “If you do something to a shoe, different people will react differently.”  Different feet react differently: One person might respond by increasing the stress on the outside of the foot, another on the inside. Another might not respond at all, unconsciously correcting the orthotic’s correction.

The article discusses something I’ve heard discussed among those who make orthotics.  That is, there are different ways to make orthotics.  Depending on where you go, you’ll likely get a different device.  Dr. Nigg conducted a study in which a runner went to several different orthotics makers and each one made him a distinctly different orthotic to “correct” his pronation.  He liked two of them–yet they each were made differently.  More research by Dr. Nigg yielded the following:

“They (orthotics) turn out to have little effect on kinematics — the actual movement of the skeleton during a run. But they can have large effects on muscles and joints, often making muscles work as much as 50 percent harder for the same movement and increasing stress on joints by a similar amount.”

“As for ‘corrective’ orthotics,” Dr. Nigg says, “they do not correct so much as lead to a reduction in muscle strength.”

Support for Orthotics

Several seemingly well-educated people voiced support for the use of orthotics.  Jeffrey P. Wensman, director of clinical and technical services at the Orthotics and Prosthetics Center at the University of Michigan makes a sound argument when he says the key measure of success is his patients feel better in orthotics.

(On that note, I think it’s wise that if you’re in an orthotic and feeling good, running fast and all is well, then don’t change anything.)

Seamus Kennedy, president and co-owner of Hersco Ortho Labs in New York says there are hundreds of papers and studies showing that orthotics can treat common foot ailments.

So maybe there’s a lot of solid evidence in favor of orthotics right?  Well… The article states:

“In one recent review of published papers, Dr. Nigg and his colleagues analyzed studies on orthotics and injury prevention. Nearly all published studies, they report, lacked scientific rigor.”

Maybe the lesson is to be skeptical of orthotics makers who show you evidence of the benefits of orthotics.

What About Flat Feet?

The article goes on to profile someone who has flat feet and his quest to “correct” this issue.  Every orthotics provider he went to attributed his injury to his previous poorly made orthotics and goes on to provide him with different orthotics.

(The article mentions this fellow has an “injury” though there’s no mention of what this injury is.  I’m not sure if we’re to take his flat feet as an injury.)

Dr. Nigg explains that flat feet shouldn’t be any problem.  Our arches are an evolutionary leftover of when we used to grip trees with our feet.  This is interesting to me because I recall reading elsewhere a study of third-world populations that never wear any sort of supportive shoes.  Their feet tend to be flat yet there are far fewer numbers of the type of musculoskeletal injuries we have in the U.S.  So maybe these all important arches aren’t all that important?

My view on all this is that orthotics are of limited use and the science behind them is quite murky.  I’ve used several different types of orthotics and I’ve had either no results or I’ve experienced increased discomfort.  I think they are far from an essential component for human health and performance.  That said, on an individual basis, an orthotic may be very helpful.


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More News & Questions on Stretching

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Stretching–and whether or not to do it–is one of the most debated issues in health and fitness.  What’s the final verdict?  (I’ve given my opinions a few times already here, here, and here.)  Does Stretching Before Running Prevent Injuries comes from the New York Times and it’s the latest comment on the issue.  The article discusses a study from USA Track & Field that involved about 3000 runners over the course of three months.  These subjects were split into two groups: one group followed a pre-run stretching routine, the other group did not stretch.  (From the description, the stretching group engaged in static isolated stretching, or what many of us would recognize as stretching: bend over and stretch the hamstrings for 20-30 seconds for example.)  Both groups followed the same running program.  The result?  Both groups experienced the same injury rate.  Thus, pre-run static stretching does not appear to help guard against injuries.  There is an exception though.

The study states:

“If runners who normally stretch prior to running were assigned to stretch, they had a low risk of injury but if they were assigned not to stretch, the injury risk was double those who kept stretching. It’s this result that most startlingly exhibits why people consider stretching to prevent injury. This study shows that those who are comfortable with their pre-run stretching routine should maintain it. They risk injury if they discontinue their pre-run stretching. For runners comfortable without pre-run stretching, they don’t necessarily improve their injury protection by starting a pre-run stretching routine.”

As I see it, the broad point to take from this observation is that any changes to your program should be undertaken slowly.  That goes for adding speed work, hill work, more mileage or engaging in barefoot running.  Sudden dramatic changes may leave you sidelined.

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Music, Exercise & the Nervous System

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Four laps around this radio equals a mile.

Many of us listen to music while we exercise.  (Some of us even proceed to sing and dance too.)  Do you think it makes you stronger?  Faster?  Is it easier for you to grind through your workout with music?  The New York Times Health Section tells us more about why we like music and how it affects our performance.

The Times piece describes research done at Research Institute for Sport and Exercise Sciences in Liverpool, England.  Twelve male cyclists listened to music set to three different tempos.  Popular music was played either at the regular tempo, increased by 10 percent, or decreased by 10 percent.  Researchers tracked heart rate, power output, pedal cadence, enjoyment of the music and perception of exertion.

Participants rode faster, produced more power, had higher heart rates and enjoyed the faster music more.  In contrast, slower music brought on slowe rides, less power, lower heart rates and less enjoyment of the music which stayed the same.  Interestingly, participants perception of their effort didn’t drop with the increased music but rather it went up.  Seems the music motivated them to ride harder. 

There may be an upper limit to the effect of music on our performance though.  Research shows the following:

“While running on a treadmill at 85% of aerobic capacity (VO2max), listening to music will not make the task seem easier in terms of information that the muscles and vital organs send the brain. Nevertheless, the runner is likely to find the experience more pleasurable. The bottom line is that during a hard session, music has limited power to influence what the athlete feels, but it does have considerable leverage on how the athlete feels.”

What we’ve got here is a nice thorough intermingling of auditory input, psychological motivation, and physiological performance.  It’s fascinating that though we may very much feel the effect of exhaustive work, we can through music actually perceive the work differently.  Does anyone still think there’s some sort of difference between the “body” and the “mind?”

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Goodbye Plantar Fasciitis???

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This is a quick update to my recent plantar fasciitis posts (Part I and Part II.)  I met recently with Denver-area Z-Health movement specialist Brain Copeland and it seems he may have helped me find a titanic breakthrough in my PF!  Briefly, he assessed whether or not my arms and legs were coordinated properly during gait.  He used muscle testing as part of this assessment.  Turns out I had really only been cheating at walking and chewing gum.  My gait looked normal enough but I was weak in certain positions where I should’ve been strong, and I was strong in some positions where I should’ve been weak.  He then introduced cross-crawl patterns to me.  Since then, my PF pain has decreased significantly and it has stayed that way.  (I saw him on Saturday and this is Wednesday.) In some circles, this is known as a “WTF?” moment.

“Imagine you hire three people to work at a company to perform three separate jobs. But two of the employees are trying to do the same job and the third job is getting neglected. This is how I envision neurological disorganization.” Brian Copeland, Z-Health Movement Specialist

Goofy? Yes. Effective? Also yes!

The Cross-Crawl

Cross-crawl patterns are, as the name implies, movement patterns that resemble crawling.  That is, the right arm and left leg converge and vice versa for the left arm and right leg.  These are remarkably easy patterns and they can be created while standing, seated, prone or supine.  Some of this stuff resembles some goofy old-school “aerobics” class movements (‘Knee to elbow everyone!!”)  The supine cross-crawl looks like the “dead bug” ab exercise while the prone cross-crawl is essentially the same as the “bird-dog” low-back rehab exercise.  Still another version looks like some sort of Irish jig.  Fun stuff right?!  (The good news is these moves are really easy and at least in my case, very powerful.)  I’ll post video of cross-crawls soon.

What’s at Work Here?

I asked Brian Copleand several questions:

Q: Who might benefit from cross-crawl patterns?

A: “Everyone can benefit from cross-crawling patterns as the movement helps strengthen certain neural pathways in the brain that are beneficial. For instance, when you run, jog or walk and you step forward with your right leg which arm swings forward? It better be your left or you are a toy soldier. This cross lateral pattern of movement is key in both athletes and non-athletes. If you ever see a martial artist throw a very powerful kick with their right leg you will see their right arm go back and left arm come forward. This has to do both with rotational force and rotary stability in the trunk to maintain balance. So cross crawling movements are basically a part of our everyday lives. When the movement patterns become switched then we see all number of strange neurological issues arising such as unexplained pain that has no pathological explanation, clumsiness, troubles with memory and other cognitive issues depending on the severity of the neurological switching.”

Q: How do we identify those who may have this neurological switching?

A: “There are some specific tests that a Level 4 Z-Health Exercise Therapist can give to ascertain if someone has neurological disorganization and no one should self diagnose, but having said that people can get an idea if they have this by looking for the following things. Typically someone will have had some head trauma at one point in their life, even if it was as a child. People might be socially awkward and not know why. People may have a hard time remembering things and have to be shown something over and over again. People will often say things like, ‘things always work different for me than other people,’ and they don’t know why. Frequent clumsiness is a possible indicator as well.”

Q: What do cross-crawls achieve?  Can you describe what these patterns do for our brains?

A: “Well that is the $64,000 question. Researchers are still discovering the how and why but for now we know that it does work. As I’ve been told before, science is the observation of repeatable phenomenon. So even if we don’t have the full picture yet we know that it works. But if I may hypothesize just a little… It is classically understood that the left hemisphere of the brain controls the right side of the body and vice versa, there is some variance in there but as a general rule it is true. We also know that many of the natural movement patterns that we have are cross-lateral in nature, in other words right leg, left arm and vice versa. These patterns help to stabilize our torso and provide balance and efficiency of movement.  Now imagine if all of a sudden the right hemisphere of your brain decided that it would control the left side of your body, except it would also control the right thumb but not the fingers. Now the left side of the brain is having signal feedbacks or misfires as it tries to control your right thumb. Now the pre-cognitive brain (the automatic part that controls the behind the scenes stuff) encounters confusion and we reach what Z-Health founder Dr. Eric Cobb, D.C. calls a threat response. I can already tell that I am about to open a whole can of worms so I’ll digress a little. Imagine you hire three people to work at a company to perform three separate jobs. But two of the employees are trying to do the same job and the third job is getting neglected. This is how I envision neurological disorganization.”

Q: What else should we know about cross-crawl patterns?

A: “Well there is always more to know but it can become quite complex. I would just say make them a part of your daily warm up for your exercise routine, 20 or so should suffice as preventative medicine. If you have neurological disorganization you may need to do more reps than that. And ultimately each person will respond uniquely different, the amazing and frustrating thing about the human body.”

“Folks can learn a little more about Z-Health and how the human nervous system has an impact on both the pain we feel and our potential for athletic ability by checking out these articles: What is Z-Health and Why It Works and How to Eliminate Pain, Stiffness and Weakness Forever.”

So that’s a fairly thorough discussion on cross-crawling and why it may work.  I don’t want to promote cross-crawling as a magic cure-all panacea for everyone.  That said, these are very easy movements to execute and they may very much be worth a try.  If you have lingering pain that isn’t responding very well to treatment, give cross-crawling a shot.  In my case I’ve had tremendous results.  (Now of course the challenge is to remain conservative as I add back in running, biking, etc.  The temptation is to ramp up to 1000 mph.  Not a good idea.)

Further information on cross-crawl patterns can be found at the following sites: Head Back to Health, Natural Health Techniques.

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Hello Plantar Fasciitis :-( Part II

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Part I of this post ended mid-way through my explanation of various strategies to combat plantar fasciitis (PF).  Here are more treatment methods.

Taping

Various taping strategies may be used to help alleviate PF symptoms.  Tape should help support the arch of the foot and help shoulder some of the burden borne by the plantar fascia.  There are two options.  First is the traditional white athletic tape.  This stuff can be rigid and uncomfortable but possibly effective.  Here’s a video on how to apply athletic tape in order to relieve PF.  And here is a slightly different method.

The other taping option is elastic therapeutic tape, (aka Kinesio tape.)  Elastic therapeutic tape became popular during the 2008 Beijing Olympics where many athletes were seen wearing the strange, multi-colored blotchy looking stuff on their legs, shoulders and other body parts.  Kinesio tape supposedly goes beyond simply providing support to injured areas but also may influence the healing process.  Here’s resource on how to apply this stuff.

Night Splints & Socks

For anyone interested in a more medieval approach to PF, you may enjoy the night splint.  Similar to the night splint is this specialized sock.  Both items are designed to provide a prolonged stretch to the plantar fascia and Achilles tendon while you sleep.  I recently spoke to an employee at a local running shoe store and she said these things are fairly uncomfortable.  Still, several posts I’ve read on various forums proclaim these things as useful.

Other methods

This guy swears by walking on gravel in his sock feet.  I think it must be the same principle as using a golf ball to break up the scar tissue associated with PF.  Other sources suggest freezing a can of coke and rolling it underneath the foot.  Here’s an example of a specific plantar fascia stretch from which some folks have had success.

I would suggest staying away from cortisone injections.  Cortisone is a powerful steroid that can provide very quick relief from PF pain.  The big drawbacks are 1) it’s a symptom treatment; it doesn’t fix anything, and 2) too much cortisone weakens connective tissue thus creating a risk of a rupture.

Nor can I see much benefit to plantar fascia release surgery.  This again doesn’t solve a problem but may create more problems.  Part of this surgery includes cutting the plantar fascia in order to release tension.  Problem is the plantar fascia is a major shock absorbing part of the body.  Altering that structure doesn’t seem wise to me.

My Strategy:

As I’ve thought about my own PF, I realize a couple of things: 1) I changed my gait and therefore changed how my tissues were being stressed.  2) I simply didn’t give myself enough time to adapt to this change.  3) I believe my PF is part of a larger puzzle involving faulty movement patterns.  Here’s my plan.

Rest

The one common theme I’ve seen and heard from those who’ve overcome PF is that rest is necessary.  Damaged tissues must be allowed to heal.  Therefore, I’ve greatly reduced my running and biking.  There seems to be no way around it.

Joint Mobility

If, as I believe, I have faulty biomechanics (i.e. I don’t move well) then no matter how much I rest and treat my injury, I can expect it and/or other similar symptoms to return once I start running again.  Thus I must search out those resources that will help correct my movement problems.  Z-Health is my chosen rehab system.  Why Z-Health?  Because the Z-Health methodology recognizes that there is probably more to my PF than simply heel pain.  My whole body–especially my nervous system–must be addressed in order to move better.

Z-Health has helped tremendously with my back and shoulder pain, and I’ve seen numerous others improve their performance through Z-Health.  I’m a certified Z-Health trainer but I recognize that I can’t solve all my problems on my own.  Twice recently I’ve visited with certified Z-Health practitioner Brian Copeland of Core Fitness in Aurora, CO.  I’ve been very impressed with my results thus far–especially after yesterday.  We did further testing on my neurological system and found that certain fundamental aspects of my movement coordination aren’t functioning quite correctly.  Among several exercises, we recently implemented cross-crawl patterns into my process.  All I can say is I’m stunned at how much better my heel feels!  In 24 hours the pain has subsided very significantly.  I believe correcting my movement patterns is the most significant and most complex part of my plan.

Structural Integration

I haven’t experimented much with massage though I’m aware of its role in many athletes’ lives.  Structural integration (Rolfing is a type of SI) involves manipulating connective tissue including the fascia.  In this way, my body should interact better with gravity.  Posture should improve, pain should diminish and I should move better.  Donielle Saxton is the Denver-area massage therapist with whom I’ll be working.  The details and principles behind this process is really fascinating.  For further information check out Anatomy Trains and KMI (Kinesis Myofascial Integration).

Cold Laser

Finally, I’m getting a bit of cold laser therapy at Mederi Health in Denver.  This is pure symptom treatment–and I’m OK with that.  Reducing the pain should help calm my nervous system and speed my return to normal function.

Shoe Insert and Taping

I recognize that my arch may need some help.  Therefore I’m going to bolster the area by way of a grocery store-bought arch support and Kinesio tape.

We shall see what happens.

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Hello Plantar Fasciitis….:-( Part I

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Ouch...

Here is a major drag in my life.  I’ve run into injuries off an on over the past few years.  Just as I get healthy a new one seems to crop up: back pain, shoulder pain, Achilles tendon pain…  The latest and greatest issue is heel pain aka plantar fasciitis.  (I’m going to call it PF.)

Minor symptoms showed up a few months ago but they sort of came and went.  Pain on the outside of my heel wasn’t severe and it faded out rapidly.  (I associated plantar fasciitis with pain along the inside of the arch of the foot.)  I’d been running some and biking a lot.  I’d changed my gait and I was running a good bit in my Vibrams–and I was feeling really good!!  (Interestingly, my new gait pattern had helped my Achilles tendon pain.  Seems I shifted the stress elsewhere.)

I’ve read up on the issue.  What have I found?  It seems that one person’s PF is very different from another’s PF.  Some runners insist that once they went barefoot, their PF went away.  Other runners swear by the opposite end of the spectrum and that orthotics were the cure.  Still many many other runners have tried many different treatments but with limited success.  Some people suffer with PF for a few weeks or months.  Others deal with it for a decade.  Much of PF is a big mystery.  What’s important here?

Causes of plantar fasciitis:

This is hard to figure out.  Like most things involving bodily pain,  there’s likely more than one cause.  “Improper footwear” is one culprit.  Biomechanical glitches such as leg-length discrepancy or tight calves also get blamed, as do high arches, low arches, leg length discrepancy, poor glute firing patterns, tight illiotibital bands.  Some sources suggest that PF is due to trigger points, or knots in the muscles.  There are many potential culprits for this crime, and most likely some of them are working together.

(I’ll go a little further and suggest that all these issues have causes.  If we’re not asking WHY the arches/glutes/IT bands/trigger points are tight/slack/dysfunctional then we’re definitely not getting to the true cause(s) of PF.)

Improper footwear is an interesting issue.  Much of the conventional wisdom says we should run in well cushioned shoes that fit our foot type, support our arches and guide our feet properly.  Funny thing is military studies such as those discussed in the previous post show that footwear matched to foot type does nothing to decrease running related injuries.  Ask barefoot runners and they’ll tell you that any footwear is improper footwear.  So what is improper footwear?  Seems it’s dependent on the eye of the beholder.

Treatment of Plantar Fasciitis:

Conventional treatment includes rest, ice, anti-inflamatory medication.  Orthotics are often prescribed as are calf and foot stretches.  Further pharmacological treatment may include a steroid shot.  That’s the conventional stuff.  What else is there?  Well, there are a multitude of therapies and strategies.  As I mentioned, it seems that every case of PF is different from every other case.  Therefore there are many variations on treatments.

Massage

Rolling a golf ball, lacrosse ball or similar ball along the bottom of the foot helps many PF victims.  This is supposed to help break up scar tissue and keep the plantar fascia supple.  A similar strategy involves using a foam roller to massage the calf, hamstring, illiotibial (IT) band, glutes, etc.  These are forms of self-massage.  More formalized massage methods may proove beneficial.  Myofascial release, Active Release Therapy (ART), deep tissue massage, trigger point therapy, Structural Integration (aka Rolfing) are examples of massage-type techniques that may prove beneficial in addressing PF.

Shoes

Lots of options here!  From barefoot to orthotics and all points in between, what you put on your feet (or possibly take off of your feet) may strongly influence PF.  This series of posts on the Runner’s World Forum encapsulates the issue very well.  One poster emphasizes wearing orthotics ALL THE TIME, while another poster says, “I think the thing that finally was a breakthrough for me was walking barefoot in the sand.”  I’ve found very similar statements throughout my reading.  So while there doesn’t seem to be any one shoe-based solution for everyone, consider the idea of changing footwear.

Orthotics are usually expensive.  Cheaper options include grocery-store bought arch supports and heel cups.  Superfeet and Sole Supports are similar to orthotics but also less expensive.

Joint Mobility/Strengthening

Weakness of the foot muscles may be causing your PF.  Therefore, strengthening the foot and lower leg and improving mobility/stability is vital.  We may not spend much time thinking about strong feet but hey, we only have to use them all the time every single day right?  Maybe it’s actually important!   I look to Z-Health R-Phase and I-Phase drills to enhance neural communication and awareness in feet and lower legs.  I’ll give some examples.

Start by simply moving the foot and ankle in all available directions.  Make circles with your feet.  Turn the sole in and out.  Flex and extend the toes along with the rest of the foot (make foot waves).  Ball-of-foot circles, toe pulls, and knee circles may help as well.  You must concentrate and try to make the movements as smooth and refined as possible.  Stay relaxed and breathe.  Single-leg balance drills may be beneficial too.

My personal opinion is that at some point, barefoot or minimal shoe work should improve foot strength.  (Again, some people insist this is the key to their overcoming PF.)  It may be too much though if your foot is injured.  The plantar fascia may be further damaged if you overload the region.  So it may be a progression similar to adding weight to a strength program or mileage to a running program.  Start with a small amount of barefoot balance work while still wearing whatever supportive footwear you’ve got.  You may gradually add in more barefoot work if the pain decreases.  Back off if the pain increases.

Ultrasound, Cold Laser, Shockwave Therapies

Physical therapists and chiropractors often use ultrasound therapy on soft-tissue injuries.  The idea is to bring heat to the area and facilitate healing. Research is mixed on effectiveness.

Cold laser therapy is a somewhat new therapy that may aid healing of PF.  The evidence is unclear though.  Research continues as to what wattage laser is ideal, what wavelength should be used, and how often one should receive treatment.  A Runner’s World article profiles one runner’s positive experience with laser therapy.

Extracorporeal shockwave is yet another electromagnetic method of addressing soft-tissue injuries.  Similar to ultrasound and cold laser, research is mixed, which shouldn’t be surprising.  If we’re dealing with a problem that may have multiple and varied causes it makes sense that one or another type of therapy may or may not be effective.  Further, ultrasound, laser and shockwave therapies deal with focused energy.  That energy can vary in terms of power and wavelength.  An injury may be exposed to varying amounts of energy for varying amounts of time.  Thus there are numerous factors that may or may not lead to healing of PF.  Lots of choices….

I’ll continue this post with a look at night splints, walking on gravel, magical ceremonies and everything else used to drive out the evil spirit that is Plantar Fasciitis (plus my own strategy in overcoming this issue.)

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Selecting Shoes by Foot Shape

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Results of three military studies showed that prescribing shoes based on foot shape made no difference in the rate at which injuries occurred in Army, Marine and Air Force basic trainees, who spend quite a bit of time running. That’s “no” as in none, sports fans.

Any runner is familiar with the idea that certain shoes are made for certain types of feet.  We’ve got motion control shoes, neutral cushioned shoes, stability shoes….  The idea being that these different types of shoes help guide feet in the healthiest most efficient manner.  This concept has been challenged by three military studies.  Army, Air Force and Marine studies all had similar results.

“We found no scientific basis for choosing running shoes based on foot type,” said Bruce Jones, M.D., injury prevention program manager at U.S. Army Public Health Command (Provisional), Aberdeen Proving Ground, Md.

The most recent study looked at 1400 Marine recruits.  Men and women were randomly assigned into two groups.  One group got shoes matched to their foot type, the other group received stability shoes. Similar to Army and Air Force studies, the recruits with shoes prescribed according to foot type experienced the same rate of injuries as those in the control group, regardless of other factors, such as age, sex, race and smoking habits.

I wonder what the shoe companies have to say?

These findings echo statements found in Noakes’ Lore of Running.  He refers to a study by Stacoff (1998) of orthotics.  The study found that the orthotics–thought to control pronation of the foot–didn’t actually change ankle motion in the test subjects.  Though this study refers to orthotics, it’s quite likely that shoes designed to control pronation produce similar results.  So if shoes are prescribed to a runner based on his or her foot strike pattern, and if we’re expecting to see that foot strike pattern altered in a certain way, then the expected outcome is unlikely.

That’s not to say the right shoes and/or orthotics won’t work for an individual.  But the mechanism by which these shoes and inserts work is unclear.  At the very least, these studies suggest that we don’t really know why a certain shoe or orthotic may work for someone.  Nor can we predict accurately the right type of shoe/orthotic someone needs based on looking at their foot type.

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Strength Training for Runners: Part II

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These make you faster. Lift them. Don't run with them.

In Part I of this post I discussed some of the evidence and ideas behind the idea that distance runners benefit from explosive movements and heavy strength training.  In Part II I’ll discuss some of the exercises and workouts which you might incorporate into your current program.

First, when we talk about strength or “resistance” training programs we can think of several methods including plyometric or jumping exercises, weights, hill running or running with parachutes attached to the runner.  This discussion will focus on jumping exercises and weight exercises.

Jumping Exercises

Also known a plyometrics, these exercises include but aren’t limited to the following:

Be careful with depth jumps.  Impact forces generated from landing off of a box can be enormous depending on the height of the box involved.  Think of box height like you would weight on a bar.  Start with a low box and work up to higher boxes.

Weight Exercises

These are total body exercises employing barbells.  Avoid machines like leg extensions and leg curls.

Frequency

Plyometric and strength work should not be used more than three times per week.  Rather than simply pile this work on top of your endurance work, two sources (here, here) suggest replacing 20%-30% of endurance training time with explosive or weight training.  The point being that you don’t need to spend very much time doing this work in order for it to be effective.

Reps & Sets

– Bounding: You may think of bounding in terms of distance or reps.  This is short duration/short distance.  For example, bound the length of a basketball court or for 20-30 yards.  Or bound for up to 10 reps.  Start with two sets and add one set per week up to 10 sets.  Recover fully between sets.  THIS ISN’T ENDURANCE WORK.

– Box jumps, power step-ups: Go no higher than 10 reps.  Use the same set scheme described above.  Recover similarly.

– Depth jumps: Again, be careful.  Go no higher than six reps per set and no higher than 10 sets.  Recover at least 30 seconds between jumps and recover fully (up to three minutes) between sets.  Only use depth jump workouts once per week.  Progress to depth jumps only after several weeks (2-3) of jumping and bounding.  Don’t start with depth jumps.

– Weight exercises:

Lift heavy and always use perfect technique.  The rep range is 1-5.  Work to the point where you know you can get one more rep and stop.  (For more on this topic, read Train to Success Part I and Train to Success Part II.)  You may get more reps just get them in subsequent sets.  Use as few as two sets when you begin and progress over the course of weeks to as many as 10 sets.  (10 sets of 2 reps for instance.)

A good method of tracking your lifting is to multiply weight x reps x sets.  For instance: 200 lbs x 3 reps x 5 sets = 3000 lbs.  If you’re doing three workouts per week then you can add the totals together to get your weekly score.  Follow the 10% rule for running with your weight program, that is add no more than 10% per week either through weight or volume to your weekly score.  You may use the same scoring method for your jumping work.

Jumping or weights?

You could use an infinite combination of jumping and/or weight exercises but why not keep it simple?  For example, you could use one jumping exercise exclusively for all workouts for one to three weeks then use one weight exercise exclusively for the same amount of time.  Take a week off then start over with new exercises.  The research suggests that it doesn’t take a lot of time or many exercises to get the results you want.

Workout intensity should build over the weeks.  Take a break then start over at a slightly higher intensity than where you previously started.  Your workouts may vary during the week.  Don’t set your workouts in stone.  Depending on how you feel you may use higher or lower volume (reps and sets) or you may vary your intensity (weight).   All of this variation is known as known as periodization.

Is it working?

The research suggests these methods work to increase running ability.  One way to make sure you’re progressing is to test yourself.  This is fairly easy.  Select any distance you want (1 mile for instance) over a standard course.  Run the mile each week and track your time, average heart rate and rate of perceived exertion (RPE).  If you are progressing then your run time may decrease, and/or your average heart rate may drop, and/or your RPE may drop.

What else?

Remember to taper your gym work as you would your running work.  Don’t start a new strength program in the middle of your season.  Start this program before the competition season.  Workouts should be brief and robust.  Done correctly, these workouts should not negatively impact your run workouts.  To that point, strength workouts should be separated from your hard running workouts.  Both your strength workouts and your runs should be high-quality.

Engage in some sort of dedicated joint mobility program before, after and possibly during your workout.  Z-Health is a fantastic method to prepare your body and nervous system for hard work.  Addressing joint mobility and joint awareness will keep you pain free and performing at your highest potential.

Don’t lift weights in your running shoes!  They’re not made for that.  Running shoes put your heel up on a wedge which may promote hyperextension at your low back.  Further, the squishy cushioning will impede proprioception or your sense of how to interact with the ground.  Choose a flat-soled shoe preferably with a thin sole.  The Converse Chuck Taylor is a good choice as are Vibram 5-Fingers.

(Are you sure I won’t bulk up???)

YES!  If you could bulk up you would’ve already bulked up.

In conclusion…

It may seem counterintuitive that distance runners can benefit from heavy weight lifting and explosive jumping exercises.  These things don’t much resemble distance running!  However the evidence is in and it’s growing.  Don’t waste your time in the gym doing high-rep/low-weight lifting–stuff that feels like endurance work in other words.  Leave the stuff that feels like endurance work… for… well… endurance work!    Use your time in the gym to build strength.

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