Supportive Hard Shoes Linked to Knee Loading and Arthritis
Tuesday, March 30, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
A Rush University Medical Center study has found that supportive, stable shoes increases the load on the knee joints compared with flat, flexible footwear or going barefoot.
Researchers compared gait and knee joint loading of 31 patients with osteoarthritis while walking in flip-flops, barefoot, and wearing several types of popularly prescribed shoes. Clogs and stability shoes increased loads on the knee joints up to 15 percent over flat walking shoes, flip-flops or barefoot. Knee loading was roughly the same whether the subject wore flips-flops or walked barefoot.
Dr. Najia Shakoor, rheumatologist and lead author stated, "Stiffness is also a factor. We've shown in earlier studies that barefoot walking is associated with lower knee loads than walking with conventional footwear. It may be that the flexible movement of the bare foot is mechanically advantageous. The natural flex of the foot when it contacts the ground probably attenuates the impact on the joint, compared to the artificial 'stomping' movement created by a stiff-soled shoe."
"Clogs and stability shoes, conventionally believed to provide appropriate cushioning and support, actually increased the loading on the knee joints, as opposed to shoes with less 'support,' flatter heels and more flexibility."
The article stated, "A higher-than-normal load on the knees during walking is a hallmark of the disease, associated with both the severity of osteoarthritis and its progression."
Primary Source -Najia Shakoor, Mondira Sengupta, Kharma C. Foucher, Markus A. Wimmer, Louis F. Fogg, Joel A. Block. The effects of common footwear on joint loading in osteoarthritis of the knee. Arthritis Care & Research, 2010; DOI: 10.1002/acr.20165
Study authors felt they had to also issue a caution that people who will trip if they wear flip flops or have poor balance not to wear them, however it seems better to do simple function to improve balance and reduce cause of the falls rather than wrap people in shoe "straight-jackets" that are not good for them.
When I was small, I remember worrying that horses had to wear iron shoes. I asked the teachers in school if it hurt the horses' feet, and was told their feet don't feel anything (a myth). I asked if the metal increased the hard impact against paved streets and why didn't horses wear sneakers instead. I was told that sneakers were bad for you because they don't "support" (another myth). I asked why you needed anything to hold your own body up and why you couldn't have healthy feet without them. I asked if cavemen wore support shoes and incredibly, the teachers said that support shoes were important and barefoot was wrong and cavemen had to wear shoes or they would not be able to walk. Later I found that arthritis, lameness, and gait changes were higher in metal shod horses, and that new horseshoes were being made in urethane and other soft composites.
When I tell patients that hard supportive shoes are known to increase pain and problems, they say they wear them because their doctor told them to, their trainer, their aerobics instructor, and their physical therapist said they must. When I remind that hard shoes may be part of their knee and foot pain, they say that they got the shoes from their podiatrist or orthopedic shoe place. Doctors used to recommend smoking cigarettes for the several benefits they gave - calming nerves, better digestion. The two bad side effects (illness and death) were left out. It may be commonly repeated that you need hard supportive shoes however, untrue stories are common.
Readers were excited when I wrote about Sepak Takraw, a fast net game using feet, leaping windmill kicks, shoulders, and head, but no hands to volley a woven ball called a "takraw."
Readers asked if this kind of game exists in other world cultures. Here is one from Brazil, created in the mid 1960’s.
Footvolley combines beach volleyball with the ball-touch rules of soccer. Players score points by heading, chest butting, and kicking the ball with foot or knee over the seven-foot-tall net to the opponents’ court.
--- Read success stories of these methods and send your own. See if your answers are already here by clicking labels, links in posts, archives, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, click "updates via e-mail" upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Here is Fast Friday Fitness - Fun rows to strengthen your back, chest, arms, grip, and torso muscles, without bending over or forward, using commonly available objects, no gym needed:
To start, leave both feet on the ground. Hold a low study pipe, branch, or overhead handle. Lean far back, body straight. Bend both elbows to pull up and lower down as many times as you can. Improve by increasing the number of times, and how fast you can pull up.
Once you can hold on and pull up, increase strength and balance by lifting your feet to the overhead support. Hold on whatever way you want that is safe. Pull up and down.
Hold your body straight, not rounded as pictured. You will work your muscles harder, involve core muscles, and train knowledge and use of healthier positioning.
Rows are great and useful exercise. Instead of standing or sitting bent over, you can strengthen the same and more muscles without loading the lumbar discs. These incline rows are fun and useful for climbing, and building ability to do pull-ups.
Readers send in your straightened photo to be featured as the Fix for this Fitness.
When you send me your photos of fixing this and other fun things, send a photo sharing link of web-size, not high resolution, instead of e-mailing photos to me. Blogger isn't letting me upload directly, and when on the road, I don't have programs to resize. Have fun.
--- Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Fast Fitness - BIPOD Reader Prescription for Healthier Feet
Friday, October 09, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - BIPOD is a way to happier feet that you can do yourself at home. Reader Paul J sent in this gem in July. Other great work from him and other readers are still in the piles of mail.
For background: A shoe insert is any pad of any size, shape or quality that you put in your shoe for various reasons. Hard shoes are a common course of joint pain. Many shoes benefit from better cushioning and even a cheap soft insert for cushioning purpose can help that. Orthotics are different. Orthotics are hard shapes, specially fitted by a trained orthotist or sometimes a physical therapist with orthotic training. Orthotics usually cost a few hundreds of dollars. Orthotics are rigid forms to hold your feet in a specific position. There are also hard inserts with molded arch or other area advertised to change your foot posture. Sometimes orthotics and hard inserts make more pain or don't change the source of the problem. Most of the time, for non-paralyzed people, if the orthotic can make your foot change to a healthy position, you can do the same using your own muscles and sense of positioning. Using your own feet and ankle muscles is often healthier, more comfortable, and more likely to yield long term results.
Now Paul J's intelligent prescription:
"Bookspan Invisible Pain-free Orthotic Drops - BIPOD. Now you can walk, run, or stand without the pain of traditional hard orthotic inserts. BIPOD will revolutionize the way you stand. Read and follow product instructions, failure to do so will render this product ineffective. Attempts to walk, run, or stand without BIPOD is not recommended by our accountants.
"In order to reduce the burden on landfills, please follow the directions below to make BIPOD at home. You must use your brain and following all directions in order to get DHMO and CS (see above).
Ingredients: one tablespoon of cold tap water one tablespoon of tap water from hot tap, before it gets hot.
Mix for 4 seconds in a container that can hold 2 _ tablespoons of liquid.
"The left over mixture maybe placed in the refrigerator for later use or discarded in most plants."
Remember - get the point of healthy practices. Don't get bogged down on purchasing exercise machines and expensive devices that reduce your own body's involvement in your life, or trivial details of exercise "form." Get the big picture of easy healthier ways and enjoy improving your life.
Many readers' great stories are in the piles. Remember to read the instructions and concepts in articles on fixing pain first before asking what to do. Gain the benefits and better health and send in that story. Then we can all enjoy more instead of taking time plodding through and answering reader comments of, "I read your work on how to fix neck pain, will your stretches work?" and similar instances of missing the point. Would anyone help Hannah (or Cheryl?). She left the 36th comment asking if the stretches work on Fixing Upper Back and Neck Pain, which had already explained, along with the 35 questions and replies already there. Thanks!
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
---
Image of helping feet with brains by "lapolab" via Flickr
Your Muscles Are Your Orthotics for Arches, Knock Knee, and Knee Pain
Thursday, January 22, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
David from Belgium has been a success story and valuable contributor. He frequently makes us photos and movies showing how to fix pain and unhealthful fitness using Fitness Fixer techniques. He first left a comment on a post in 2007:
"I'm training to be a yoga teacher and I'd love to teach the right things to my pupils such as good posture. Your insights are very inspirational. After struggling with minor but persistent knee pain for some years, I was diagnosed with seriously fallen arches recently. I'm not really flat-footed, but ankles that drop inwards too much. (I could clearly see that on the video my podiatrist made of me walking on bare feet). In a week I'll be getting new orthotics. Though, after reading a patient's testimony on your site I decided to try and use my feet differently. So now on my walks to and from my day job I'm trying to walk 'right'. Rolling on the entire foot, heel to toes, leaning more on the sides and using all five toes. It feels awkward though and I notice that I often forget it. I wonder if this will 'fix' my feet eventually? Anyway, thanks for sharing your knowledge!"
I replied that it "fixes" arch positioning as soon as you do it. It is natural to control how you stand and move - the whole intent of functioning in a healthy way in life, and the intent of yoga (supposedly). It seems at odds to say that yoga teaches body awareness, strength, or positioning, then let ankles slump without control, and purchase devices to do it for you. Once you understand the purpose, it will not be awkward. It is the same as any other good posture.
Since then, David has consistently made good use of these materials, and shared many success stories. He has fixed various pain producing habits for himself and his students, fixed his mother's herniated lumbar disc by showing her healthy bending around the house - Bending Right is Fitness as a Lifestyle, and developed a new yoga system of healthier movement - Getting the Right Yoga Medicine.
Orthotics are rigid shaped devices, fitted by prescription, that specifically move and hold your foot in a certain position.
Orthotics are different from over-the-counter shoe pads that can help by cushioning impact.
Orthotics do not do anything you cannot do yourself using your own muscles and sense of positioning (kinesthetics).
It is a myth that only a device can move your foot and leg leg. Click the label "myth" under this post for all Fitness Fixer posts on fitness myths.
Try these in relaxed way:
Stand and see that you can raise your own arches back to normal, taught in the post Arch Support Is Not From Shoes. It takes only seconds.
Make sure you are also not pronating from higher up - Healthy Knees.
Remember, don't force. If it hurts, it's wrong. All you are doing is learning how to stand neutral, not tilted so much that you compress the joints.
The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.
During walking and running, a brief and small inward drop (slight pronation) occurs right after foot contact that creates part of the "spring" and propulsion. The idea is not to prevent all foot motion, but to not let the knee twist inward. You can do that with your own brain and muscles.
See if your answers are already here by clicking links, labels under posts, archives, and the Fitness Fixer Index. Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer - Click "updates via e-mail" - (trumpet icon) upper right. Find fun topics on See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
There are still people around the world, by the millions, without basics.
Blake Mycoskie created TOMS footwear to, "Produce stylish, comfortable, and practical footwear while improving the lives of children around the world."
TOMS press kits states they adhere to "No Sweatshops…ensuring both fair labor practices and minimal impact on the environment."
Mycoskie writes, “Inspired by a traditional Argentine shoe and challenged by continent’s poverty and heath issues, I created TOMS with a singular mission: To make life more comfortable. TOMS accomplishes this through a unique shoe and commitment to match every pair purchased with a pair to a child in need…no complicated formulas, it’s simple…you buy a pair of TOMS and TOMS gives a pair to a child on your behalf.
Privileged Western children may benefit from, even enjoy, practicing this type of gift giving, over spending on junk food and indulgent status items for themselves.
--- Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
Fast Fitness - Balance and Ankle Stability in the Dark
Friday, August 22, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - quickly improve balance and ankle proprioception - the ability of the ankle and foot to correct positioning, reducing sprain and fall potential.
This one helps balance for daily life, and also helps footing in darkness, which can be encountered on stairs, curbs, and late hikes.
Stand on one foot.
Balance on that foot with eyes closed. Switch feet.
Extend length of balance time with frequent practice.
Balance and proprioception are key to preventing and fixing ankle, foot, and balance trouble.
Obviously, don't do this near the stairs or the breakables. Use common sense to get started safely.
Here is Friday Fast Fitness - Train children's balance and grip strength, use your legs, and have family fun.
Have young children sit on your feet, and hang on (sensibly, parent's permission, and all that). Babies are born with a grasping reflex and are stronger than you may expect.
Do any variety of walking, marching, dancing, and range of motion, while standing, or sitting, while they act as natural strength and endurance trainers and floor dusters.
Teach sharing, enjoyment, physical skills, personal interaction, and all the good you can think of.
Outside of all the debates of whether leg weights are helpful or not, fun activity with your family can develop many strengths.
Last year, reader Ted fixed back pain by learning to use neutral spine during running and daily life. This week he checked in to say the back is still fine, and that he went on to fix other painful sites.
Fixing pain and injuries by doing some exercises may temporarily ease symptoms. Instead, you can stop the source of injury by making movement habits healthy while exercising and moving through daily life, so that you can get exercise at the same time that the area can heal, and the pain not return.
Ted writes:
"Dr Bookspan, last summer, you helped me return to running, and did an article on me and how the neutral spine fixed my back problem with running.
"The back is a NON ISSUE. Thank you so much.
"Currently, I am working on hip/hammy/knee issues (probably due to over-training). Just thought I would share a thought on the ''Duck Foot'' issue you had talked about (I read the Fitness Fixer religiously). While running on the padded infield of the Stadium Football Field, I was still noticing pains in my hip (caught my foot on the ''upswing'' during a run, hip has hurt off and on since October).
"I focused on my feet, specifically, how I pushed off after the foot-strike (very soft, I often scare other runners because they can't hear me coming up on them). A straight push off after the foot-strike made the pain go away (probably because it aligned my foot/knee/hip during the movement). Also, when the knee pain flared, tensing my quads made it go away.
"I have enjoyed reading your ''Running Articles' please keep 'em coming. AND Thank you for fixing my Back. Much Appreciated, Ted H"
To fix the source of pain, it works best to understand healthful movement retraining and not just "do" a series of rules. One important example is keeping feet parallel or facing forward. The idea is to understand that a straight push-off comes from keeping all the joints in the kinetic chain from feet to hip and spine from twisting in unhealthful ways, not just straighten one segment by twisting another. Yanking or forcing the feet straight is not the point of good positioning.
Ted has more helpful stories to come in future posts. Click these posts for more:
Raina and several other readers asked about plantar fasciitis.
On a house, a fascia is a flat horizontal surface just under the roof. In your body, a fascia is flat fibrous tissue that wraps your muscles and soft structures. You have fascia in several places. One is across the bottom of your feet. "Plantar” means the bottom of your foot that you "plant" on the ground. Your plantar fascia is the fascia on the bottom of your foot. Plantar fasciitis is an inflammation (-itis) of the fascia on the bottom of your foot.
Normal Plantar Fascia Action When you walk or run with your feet facing straight ahead, the line of bending of the foot is straight from front to back. Each step gives you a nice, built-in small stretch across the bottom of your foot. As you walk, run, jump, and move, your plantar fascia transmits body weight across your foot. It is part of shock absorption for your entire leg.
How Bad Movement Mechanics Hurts Several things can make the fascia tighten and hurt. Here are three. More to come in future posts:
1. When you walk or run with feet facing outward, the fascia loses the normal stretch. Over years of not getting its normal stretch, it becomes tight. Walking with feet facing outward also puts sideways forces on the fascia with each step instead of the needed stretch. Walking with poor shock absorption, banging down heavily with each step can amplify strain forces on a tight fascia. Every step you take on a tight fascia yanks on the heel where it attaches. Eventually the heel and bottom of the foot get irritated from the yanking and start to hurt. Irritation can eventually cause the bone to thicken to protect itself - a heel spur.
The tighter your Achilles and foot fascia, the more "normal" it feels to walk toe-out. In a circular problem, walking toe-outward is a common fascial tightener. It may be "natural" with tightness, but can increase tightness over time.
2. Letting ankles constantly sag into pronation (flattened arches) is another fascial strain. Keeping body weight more evenly around the sole of your foot, not pressing and downward on your arches, lifts the weight off the arch. Reader David from Belgium made us a great short video of easily changing from rolling in on the arches to holding straight in Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches.
3. Hard sole shoes and some fasciitis braces stop the sole from getting the normal lengthening while walking, stopping the pain from the stretch, giving the false impression that the injury is lessening. A negative cycle continues of shortening and continuing the source of the injury. Injections briefly make the area more prone to injury. Pain pills allow you to continue the injury process without pain telling you that it is wrong. Several kinds of anti-inflammatory and pain medicines interfere with healing. Wearing high heeled shoes raises the heel, shortening the length of the Achilles tendon, putting less stretch on the tendon, the lower leg muscles, and the fascia of the foot.
Fasciitis can be quickly stopped. It does not have to be chronic. "Doing" a few stretches does not undo a lifestyle of shortening, tightening, and straining. Forcing tight, artificially straight position instead of creating the length and use of the area that allows healthful motion, can create more pain in other segments. Use your brain and learn good body movement to allow it to heal and be functional.
Helpful links to move in healthy ways to stop plantar fasciitis:
The book Fix Your Own Pain Without Drugs or Surgery has a section on fasciitis, the many unhealthful lifestyle contributors, and simple lifestyle fixes to build into daily life and your exercise classes.
Fast Fitness - Sprain Prevention and Rehab Training
Friday, April 18, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - feel how your own muscles work to hold ankle position, so that you can have stable ankles without artificial shoe supports or bracing, which weaken the supporting muscles from disuse:
Stand with feet parallel and look in a mirror where you can see your feet, or just look down.
Rise to toe and hold
Keep body weight over big and second toe with straight ankle position as you remain on tip-toe. Don't let your weight shift over the small toes, allowing ankle to bend outward.
Click the arrow to see this short movie of my student Diana's feet, as she first allows rolling the ankle outward when rising to toe, then at second 3 in the movie, she uses ankle, foot and leg muscles to pull to straight neutral ankle position. She prevents outward rolling as she again rises to toes three more times.
Prevent rolling outward whenever you rise on toe or push off or land from a jump or step.
Developing positioning sense in the receptors of your ankles prevents the sprain-promoting position called inversion, and gains built-in foot and ankle muscle strength and stability. Nice foot stretch too. Practice balancing on tip-toe, and rising up and down without rolling outward every day.
Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches
Friday, April 04, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - feel how your own muscles work to hold arch support, so that you can have healthy arches without artificial shoe arch supports or orthotics, which weaken the supporting muscles from disuse:
Stand with feet parallel and look in a mirror where you can see your feet, or just look down.
Pull outward (straighten) until your arches rise and restore to neutral position, and your ankles are straight.
Learn to feel neutral position. Don't hold rigidly or roll outward. You gain built-in muscle strength and arch stability with each step you take.
Click the > arrow to see the short movie made for us by reader David from Belgium:
First he allows his weight to shirt inward, pushing his arch flatter toward the floor. At seconds 3 to 4 in the movie, he uses the outer muscles to pull to straight neutral ankle position. At seconds 8 to 9 he allows the arch to sag again, then restores and holds healthy arch from second 13 onward. The "exercise" is not to roll back and forth. It is just to learn to feel what allowing sagging too much feels like, and how to restore neutral position.
During walking and running, there is a small natural inward drop (slight pronation) that is part of the spring and propulsion. Allowing exaggerated sagging is like rounding your shoulders too much. Legs and feet have posture that you can control yourself. Use your own muscles and get free built-in exercise and arch support all day, and stop painful poor positioning.
Some people with existing abnormality or growths in the ball of the foot will roll inward (or outward) to get the pressure off the deformed area because standing straight hurts. See your doctor first. Remember, don't force. If it hurts, it's wrong. All you are doing is learning how to stand neutral, not tilted so much that you compress the joints. The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy. ---
Not long after, I saw Dennis running by at a fast clip, with beautiful neutral spine, good leg and foot alignment, and a light landing with each foot-fall. I asked him why he had asked about running lightly when his running was great. He said he had changed to running lightly after I worked with him on it. I asked if it made a difference and he laughed, "Of course. It used to hurt."
Dennis is muscular and squarely built. He used to leave an impression on the floor when he walked, and had knee, neck, and lower back pain after running.
Getting good exercise with healthy impact is fun, feels good, helps bone density, and probably is good for many body systems that benefit by impact and movement. Getting healthy exercise and enough bone loading is possible without jarring landings and transmitting damaging force to the joints. Dennis did several things to stop injuring his joints during movement:
He stopped letting his arches flatten downward. Using his own leg and ankle muscles, Dennis held neutral foot position maintaining a good arch without needing any inserts or special running shoe - Arch Support Is Not From Shoes.
Stopped letting the knees bend inward toward each other when running, and held neutral foot position - Healthy Knees.
Using the information in my classes, Dennis fixed recurring ankle injuries, and various back neck and other joint pain and went on to win medals in wrestling. His stories and photos will follow in reader success articles to come.
Here is Friday Fast Fitness for the intercalary year (Leap Year) - Leap to develop ankle and knee stability, leg power, and balance.
Leap to a point in front of you. Then leap back again:
Leap forward, landing on the other foot with soft shock absorption. Don't land hard, which jars joints.
"Stick" your landing, without wobbling or setting the first foot down.
Leap backward to the original foot and place. Hold your landing steady. Try several leaps forward and backward, then change the leading leg and repeat.
This skill is good fall reduction training, and ankle sprain prevention for many terrains.
When landing, keep ankle stable by preventing your foot from rolling to the outside. Info in the post No More Ankle Sprains Part II. Train knee and hip stability by preventing your knee from swaying inward upon landing - Healthy Knees.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links, archives at right, and the Index. For answers to personal medical questions - Replies to Medical Questions. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Walk Lightly - Shock Absorption for Happier Joints
Thursday, January 24, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
"Your tread must be light and sure as though your path were upon rice paper
"This rice paper is the test Fragile as the wings of the dragonfly
"Clinging as the cocoon of the silkworm When you can walk its length and leave no trace You will have learned" - Master Khan to Grasshopper in the 70's TV series Kung Fu
Walk, run, jump, and move lightly.
Movement is good for you. Muscles pulling on bones increases bone density. Vibration transmitted through the body from motion of running, dancing, jumping, and having fun is healthy, refreshing, and stimulates cell growth. A certain amount of impact from movement is necessary for health.
Banging down too hard with each step is not good for your body. It increases risk of joint pain and plantar fasciitis. I tell my students to stop jarring their joints without shock absorption when they walk and move and jump. One day, a student asked me "How?" Here are some things to try:
1. I asked the student to stomp his foot. Then I asked him to place his foot down lightly. That is how.
2. Use an analog bathroom scale. Step on heavily and see the numbers go up high. Then step on again lightly and see that the last number reached is a lower number. In sports medicine, we use force plates to measure ground forces when an athlete jumps or runs by.
3. While moving, make less noise. It doesn't mean to tip-toe. Walk and run with regular heel to toe gait, but lightly.
4. Try walking with a full-to-the-brim cup of hot coffee or any liquid. Don't tip-toe, just walk softly without spilling any.
5. Practice jumping in the air and landing softly. Bend your knees when landing. Increase the height of the jump, maintain soft landing. Work up to jumping down from increasing heights without making a sound, or much sound.
To prevent knee pain when rowing any craft or machine that uses foot bracing, foot wells, or other foot counter-force, do not push off the ball of the foot, pictured above.
Keep your heels down. Push off the whole foot, feeling the push-off through the heel. You will feel the more muscular strong push in the thigh and hip muscles, and the effort will shift off the knees. You will also get better stretch for the bottom of the foot, called the fascia.
Keep heels on the floor when doing leg press exercise and half squats for weight lifting and daily bending. Get more leg and hip muscle use and built-in Achilles stretch.
The prayer of the farmer kneeling in his field to weed it, the prayer of the rower kneeling with the stroke of his oar, are true prayers heard throughout nature. - Ralph Waldo Emerson
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Diabetes causes such serious health problems that the risk of death is twice as high for someone with diabetes compared to someone of similar age without. More than 20 million people in the US have diabetes (colloquially called "the sugar" disease) with 2 million a year more cases diagnosed every year. Exercise has been found to be a top factor to prevent and treat diabetes.
Three main types of diabetes are type 1, type 2, and gestational.
Type 1 diabetes, where the body does not make enough insulin (in the body organ called the pancreas), is treated with injected or inhaled insulin, although nutrition and exercise changes are a fundamental part of management.
An estimated 90–95% of cases of diabetes in North American are type 2. Type 2 diabetes is also called non insulin-dependent diabetes and obesity-related diabetes. Type 2 was rare until modern sedentary habits combined with mass sales of unhealthful food.
Gestational diabetes is generally a form of type 2 during pregnancy.
In the recent past, type 2 diabetes developed only in adults as they gained weight, reduced activity, and increased packaged, commercial, unhealthful foods. An escalating phenomenon of type 2 diabetes in children is now occurring.
Approximately 85% percent of adults and children diagnosed with type 2 are overweight and less active than they could be. Type 2 is increasingly being found to be best treated with more fun movement and less bad food, a win-win situation.
Several studies have found that exercise and healthier diet are more effective than medicine for people with type 2 diabetes. A recent randomized controlled Canadian study published in the Annals of Internal Medicine found that people with type 2 diabetes who began exercising developed better blood sugar control, both from aerobic exercise and resistance training. Not exercising yielded no improvements in sugar control. People who combined aerobic exercise and also lifted weights had the biggest improvement. It is not known in this study if results occurred because of the type of exercise mattered, or because the duration of exercise was greater in the combined exercise training group. According to an editorial co-published with the study, "Doctors should prescribe exercise to all type 2 diabetes patients who are healthy enough to work out."
In the past people with diabetes and diabetes-related complications were discouraged from exercise. However, exercise has been known in the past, with recent substantiating studies, to be the top factor to prevent and reverse diabetic problems. According to William Kraus, MD, of Duke University Medical Center, "Failing to prescribe exercise to patients with diabetes is simply unacceptable practice."
Things To Help
You do not need a gym or special clothes or equipment to get aerobic or weight lifting exercise.
Go outdoors for a break every day that you can, for fresh air, sunshine, and fun movement.
For both active and resistance exercise indoors and out, remember that daily healthful movement easily accumulates from your healthy bending, balancing while dressing, taking the stairs, and other daily real life movement.
Have fun - skate, bowl, cycle, walk, go dancing, gardening, shoot hoops, take food to shut-ins and get them moving too, with improvised exercise of moving arms and legs, clapping, singing, and having fun.
For fun exercise-as-lifestyle ideas, check through lists of Fitness Fixer posts, linked at the right of each article.
My post Hyperbarics for Diabetic Foot Injury gives more information on preventing amputations from diabetic wounds, and lists some of the ways that exercise reverses the contributors and complications of diabetes.
There is great hope. Have fun making a new healthier life.
Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier
Wednesday, August 29, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Ivy had serious sciatica with foot drop. She had knee and other injuries. She was in awful pain. In this kind of foot drop, the nerve cannot serve the muscles enough to lift the foot to walk normally. The toes drag. The foot hangs limply and slaps the ground with each step.
Commonly, someone with foot drop is put in a leg brace for life. One surgery done for foot-drop fuses the ankle so the foot is rigid and doesn't hang. Other problems come over years from changes in walking mechanics. For the terrible pain, patients are often directed to drugs and surgery. These are not healthy.
We changed that:
Monday's post Inspirational Ivy told the essentials of stopping the cause of the sciatic pain and nerve impingement, rather than treat the results with unhealthy means. Links to specific methods are there.
Sciatica, disc damage, facet pain, and impingement are results, not the cause of pain. They are not a diagnosis. When you have them, find what is causing them. Then you can reverse the cause: The Cause of Disc and Back Pain
Ivy followed my directions exactly and used her brain to understand how to get the intended results, not just "do a bunch of exercises." When she first began, she wrote,
"Over the past few days, I have been very conscious of my movements and, hey presto, I have not experienced any tingling or pain. I have to take total responsibility for every movement I make. I am constantly telling myself 'Think before you go to the fridge or need to pick up something off the floor - think lunges.'"
I gave her simple gait retraining. Ivy quickly discarded the cane she had used for nearly 7 months.
Ivy went on to teach several neighbors in her community how to fix their own pain. One story is posted in Each One Teach One.
In April 2006, Ivy wrote,
"It is nearly 5 months since I started your wonderful programme so I thought it was time that I gave you an update. I am fit and well, the sciatica has disappeared, if I get a little niggle in that area, I ask myself as to what have I done wrong, my left knee (IT Band) is no longer a problem, my balance has improved immensely and the "dropped" foot is great, in fact, when I go for my daily walk, I no longer hear the plop, plop of which I hated. I can also now wear "normal" shoes.
"Without your help and support and putting me on the right road so to speak, I would still be in constant pain plus making the chiropractor richer. Please note, I no longer go to him for treatment - I DON'T NEED HIM."
At age 70, Ivy is steadily improving strength and range of motion using healthy movement for daily life. She is eating healthful vegetarian food. January 2007 brought this note:
"The reason for this e-mail being that I feel somewhat excited re a remark made by the son of one of my fellow villagers. His very words being, "How did you become the woman that you are now. I have watched you over the past couple of years - when I first met you, you were obviously in a lot of pain, what is your secret?"
"I also sent the photos to my son and daughter-in-law who live in the US, they too, could see the improvement - they thought I looked great. Mind you, over that 2 year period, I gradually lost 20 lbs."
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life
Tuesday, August 21, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Reader Jill hasn't sent a photo yet, but her words are a beautiful picture. Her story can help many readers stop pain and improve strength and function for happier daily life.
In the post Lunges and Beans Jill commented on Celiac disorder, an immune reaction to foods with the gluten protein - principally wheat plus a few others. Symptoms can be baffling until identified as coming from gluten.
Jill writes: "I had bad and steadily worsening joint problems, especially in the knees, for ten years before I found out about my gluten sensitivity. By that time my legs were extremely weak from having been unable to put weight on a bent knee for so long.
"I let the knees heal without doing anything special for them until I hit a plateau, then started doing isometric exercise for the quads (the classic wall chair), then six months after that started running slowly on an elliptical trainer. Weightlifting exercises for quads, though, still left me hobbling.
"That's where I was when I found your blog, and since then I've been doing squats at every opportunity, which was very hard at first and got much easier. Along with the foot stretch you gave, the Achilles tendon stretch in the squats also caused tremendous improvement in my plantar fasciitis.
"After a few weeks of that you posted the stair climbing posts and now I'm having far less trouble on the large numbers of stairs I climb every day. I am shying away from lunges from long associating them with pain, but plan to get over that soon and try them (gently) according to your detailed suggestions.
"Your blog has given me an enormous number of ideas to help in rehabilitating my knees from the years of gluten, which has made an enormous improvement in my quality of life. Thank you for the care and skill you put into it."
Jill, thank you for your care and skill to write things that will help many, and to do empowered good work to shine again. I put the posts with their links. Everyone, add your favorites:
Strengthen Legs Without Knee Pain - Standing Lunge
Thursday, August 02, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Many people know they need to bend "right" but don't because it hurts their knees.
Bending right will not hurt knees. It will help fix one of the things that has been injuring them - bad bending habits which pressure and grind the joint.
Good bending will also give your knees the exercise they (and you) need.
Some knee patients are told to never "bend right" with a half-squat or lunge because it is bad for the knee. There are specific things about bending and straightening the knee that can increase certain kinds of pain, to be covered in future posts. Use your brain and try the following gently and safely. Done right, it should reduce knee pressure, not increase it.
How To Lunge:
Stand with one foot far in front of the other. Both feet face forward. (Left photo.)
Feet remain normal width from side-to-side, not directly in line front-to-back.
Lift your back heel. Don't turn the back toes outward. Look at your back foot and check.
Tuck your hip under (click "neutral spine" label for posts explaining how). You will feel a far better stretch and strengthener.
Bend both knees to lower straight downward. Don't touch back knee to the floor. Use leg muscles. Watch your front knee and keep it over your front heel, not sliding forward. (Right photo.)
Don't let your front knee sway inward.
Keep upper body upright and straight. (Right photo.)
Lower and rise several times, then switch legs. Keep feet still, not stepping forward and back.
Tips:
To keep healthy knee positioning for the front knee, peek downward to see your front knee and foot.
You should be able to see your front toes all the way through the bend.
If your knee slides forward covering your toes, you are shifting weight to your knee joint and off your leg muscles. This is one of two common ways to increase knee pain while bending. Letting the front knee sway inward is another.
Keep front knee steady over your front ankle, not sliding forward or inward. You will strengthen and stabilize your knees and legs instead of hurt them. You will feel more muscle use when you keep healthful positioning.
Lunge is a Lifestyle, not an Exercise to "do" 10 Times:
No need to go to a gym to do lunges. Use the lunge for daily bending around the house. It will add up to many lunges every day, built-in as fitness as a lifestyle. The posts How Often Should You Be Healthy? and Bending Right is Fitness as a Lifestyle give ideas of how to use healthy bending for normal daily life.
Benefits of the Standing Lunge:
Strengthen leg muscles
Strengthen the knee
Stop harmful forces on the knees from bad bending
Stretch the front of the hip of the rear leg
Stretch the Achilles tendon and foot of the back leg
Learn knee stabilization
Practice balance
Retrain healthful bending for daily life - transferring to function instead of just being an arbitrary exercise - free exercise all day
Retrain straight upper body position for bending - more functional exercise
Provide beneficial general exercise, warming which makes further movement easier, and healthful body movement.
Have fun practicing this now. You will need the standing lunge for tomorrow's Fast Fitness - Quick Warm Up. Enjoy.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
When I was small, I remember worrying that horses had to wear iron shoes. I asked the teachers in school if it hurt the horses' feet, and was told their feet don't feel anything (a myth). I asked if the metal increased the hard impact against paved streets and why didn't horses wear sneakers instead. I was told that sneakers were bad for you because they don't "support" (another myth). I asked why you needed anything to hold your own body up and why you couldn't have healthy feet without them. I asked if cavemen wore support shoes and incredibly, the teachers said that support shoes were important and barefoot was wrong and cavemen had to wear shoes or they would not be able to walk. Later I found that arthritis, lameness, and gait changes were higher in metal shod horses, and that new horseshoes were being made in urethane and other soft composites.
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