Tag Archives: ironman

Impaired Core Stability as a Risk Factor for the Development of Lower Extremity Overuse Injuries: A Prospective Cohort Study

A weak core can increase your chances for lower extremity injury during exercise!

The core is important for your lower back and neck health for sure. It’s also very important for extremity health. If you have been dealing with an arm or leg injury (extremity) that has not been getting better with treatment, it might be good to add in some core exercise to improve outcomes.

Take Home Message from the study: A college freshman with dynamic postural control limb imbalances, decreased hip extension strength, or decreased core muscle endurance during bridging exercises is more likely to develop a lower extremity overuse injury.

Muscle as viewed through an electron microscope!

This is a pretty cool picture. Can you believe the detail? The red in the picture is the muscle and the white stuff is the connective tissue is called fascia. A painful area in a muscle can be caused by damage to one or both of theses structures!

What type of running shoe I get part 2

Part 2:

Ok, we’ve worked on any muscle imbalances, fixed any joints that needed fixing and now we’re working on running form. What’s next is everyone’s favorite: running shoes

Let’s talk about running shoes!

When I’m looking for a running shoe these are the things I look for:

  1. Heel to toe drop:

This a zero drop shoe.  That means the heel and toe are at the same level.

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Here’s a large heel drop.

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Now which one to choose?

You can not use a zero drop shoe if you were using a running shoe (with a large heel drop) like the one above your whole life. Doing that you would destroy your Achilles tendon and calves. 

I would suggest using the lowest heel to toe drop you can tolerate. better to error on a bigger drop then lesser drop.  You can always go lower the next shoe.  This will lower your chance of soreness.  Remember change can take time, don’t rush things

2.  Where the shoe bends:

I like the shoe to bend where my big toe bends which is the “knuckle” part of the big toe.  It only makes sense that the shoe bends where the body bends.

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3.  The toe box:

The toe box is the space around the toes.  Take your foot out of the shoe or sneaker and take a  look.  I bet it does not look like your shoe.  Most people don’t have elf shaped feet.

A big toe box gives more room for your foot and toes. The second picture is an insert( black one) from a shoe with a big toe box.  My foot does not spill over the insert(green one) like the first picture.  

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If you have any question please call the office! Or you could bring your shoe in and we can go over it in person.

What type of running shoe should I get part 1

I’m going to do a multi-part blog on running and running shoes! Running and advice on the proper shoe are topics often brought up in my clinic so why not share for easy reference?

Starting with part one:

Here one question I get often:  I’m going to start to run to get in shape, so what brand (x) of running shoe?

There so many variables that go into the question.  Your biomechanic faults/deficiencies, anatomical variants,  the current level of your strength, the current level of fitness, what is your running form/style. Plus add in what you do for a living.  A construction worker has different stress on the body then a person who sits at a desk all day.

In my opinion, it’s better to start with yourself.  First, improve your body and then work on your running mechanics.   After, try to find the best style of running shoe based on comfort.

I like to take a “ground-up” approach.   The first thing to do is to make your foot and lower extremity better.  Fixing any joint dysfunction and then working on making your body stronger and more flexible is a great start.

Next is to improve your running form. I would video record the person running and make any necessary correction.  RUNNING is a SKILL and will need to be practiced.  

After doing all of the above, the patient will be less likely to get injured.  Plus it will be easy to find the right running shoe.

When Is Standing Too Much?

When Is Standing Too Much? The new craze in standing at your desk has many asking if standing is for them, and how long should they stand for? Does everyone need a standing desk?

Standing can help with neck and back pain if done correctly!

If you get a sit to stand desk don’t start standing for 8 hours right away.  

Most start at 15-20 mins within the hour in the beginning then it grows to 4-6 hours per day after 30 days. Start off slowly- taking breaks. Listen to your body. The flat surface and flat shoes (no heels!) Weight distribution right below hips and arms at a right angle looking straight ahead and slightly down.

The human body is designed to sit and stand throughout the day. There are many ways to get your standing throughout the day without the need for a sit-to-stand option.

• Sit-to-stand options can be useful and make the ability to stand more readily available.

How much protein do you need per day?

How much protein do you need per day?

As with most things in nutrition, there’s no simple answer. Your individual needs will depend on your health, body composition, the main goal you have, and level of physical activity (type, intensity, and duration). Even when taking all of this into account, you’ll end up with a starting number, which you’ll need to adjust through self-experimentation.

Daily requirements are expressed in grams of protein, either per kilogram of body weight (g/kg) or per pound of body weight (g/lb).

  • If you’re of a healthy weight and sedentary, aim for 1.2–1.8 g/kg (0.54–0.82 g/lb).
  • If you’re of healthy weight, active, and wish to keep your weight, aim for 1.4–2.2 g/kg (0.64–1.00 g/lb). Try for the higher end of this range, as tolerated, especially if you’re an athlete.
  • If you’re of healthy weight, active, and wish to build muscle, aim for 1.4–3.3 g/kg (0.64–1.50 g/lb). Eating more than 2.6 g/kg (1.18 g/lb) is probably not going to lead to greater muscle gains, but it can minimize fat gains when “bulking” — i.e. when eating above maintenance in order to gain (muscle) weight.
  • If you’re of healthy weight, active, and wish to lose fat, aim for 2.3–3.1 g/kg (1.04–1.41 g/lb), skewing toward the higher end of this range as you become leaner or if you increase your caloric deficit (hypocaloric diet).
  • If you’re overweight or obese, aim for 1.2–1.5 g/kg (0.54–0.68 g/lb). You do not need to try to figure out your ideal body weight or your lean mass (aka fat-free mass). Most studies on people with obesity report their findings based on total body weight.
  • If you’re pregnant, aim for 1.66–1.77 g/kg (0.75–0.80 g/lb)
  • If you’re lactating, aim for more than 1.5 g/kg (0.68 g/lb)
  • If you’re vegan or obtain most of your protein from plants, then protein requirements may be higher due to the inferior protein quality (both the EAA profile and bioavailability) of plant-based proteins relative to animal-based proteins.

https://examine.com/nutrition/how-much-protein-do-you-need/#summary1

Congratulations, Bob!

bobmiller

We want to say a huge congratulations to one of our amazing patients! Bob recently completed the “Strolling Jim” UltraMarathon. This race included 4,000 feet of elevation, 4,000 feet of decline and a total of 41.5 miles! What an accomplishment, Bob! We are so proud of you!
We also received the message below from Bob after his race. We are so glad we could be a part of your journey. 🙂
“Thank you to Dr Steve and Nickie for, without whom, I could not have achieved my goal of finishing my latest UltraMarthon of over 40 miles and 4000 ft elevation AND 4000 of decline. Thank you Dr and Nickie!!!!!”

If you’re training for a race Dr. Steve can help! Call the office and get race ready!

Strengthening the Glutes Can Help Back Pain!

Here’s a great exercise to help strengthen the Gluteus medius.

Myofascial pain syndrome (primarily involving the gluteus medius) is present in the majority of patients with LBP (73%) , sciatica (50%), and LBP with sciatica (85%).”

Kameda M, Tanimae H. Effectiveness of active soft tissue release and trigger point block for the diagnosis and treatment of low back and leg pain of predominantly gluteus medius origin: a report of 115 cases. J Phys Ther Sci. 2019;31(2):141-148.

It hurts when I do my rehab exercises!

What to expect when starting rehab or exercise program?

It’s normal for the pain to increase when starting any rehab or exercise program if you have chronic or persistent pain.  This is normal and over time this will improve.  Exercise/rehab will decrease the pain over time.  It will take time.  So stick with it and you’ll get better!

Here’s a nice paper that goes into the mechanism of how exercise works.

Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena

https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP273355?fbclid=IwAR00pU_w5lH5XFbzyQl97uiP8nlntGXiqQppQPLKlPqZ3bSeo0-1M907vKs&

Did You Know Exercise Could Do This?

 

Exercise can:

1.     Help control weight (weight loss and weight maintenance)

2.     Reduce risk for cardiovascular disease

3.     Reduce the risk of type 2 diabetes & metabolic syndrome

4.     Reduce the risk of certain types of cancers including but not limited to colon, breast, endometrial and lung

5.     Reduce the risks of contracting osteopenia and osteoporosis

6.     Reduce the risk of hip and pelvic fracture in the elderly

7.     Improve balance and coordination

8.     Decrease fall risk in the elderly

9.     Decrease pain and increase function in patients with osteoarthritis

10.   Maintain lean muscle mass and reduce body fat percentage

11.   Control chronic pain with conditions such as fibromyalgia and other autoimmune diseases

12.   Promote independence, confidence, and self-efficacy

13.   Improve mood

14.   Assist in the treatment of psychiatric disorders such as depression, anxiety, bipolar, mood disorders and other conditions

15.   Help in the treatment or prevention of substance abuse or other addictions

16.   Increase the length and quality of life

17.   Prevent or slow cognitive decline in conditions like dementia or Alzheimer’s

18.   Improve local or global mobility

19.   Improve local or global stability

20.   Improve circulation

21.   Improve respiratory capacity

22.   Improve body mass index (BMI)

23.   Improve measures of strength

24.   Improve power output

25.   Improve sports performance and functional capacity

26.   Improve sleep quality

27.   Increase sexual arousal

28.   Improve energy levels

29.   Reduce fatigue

30.   Improve mental alertness

 

If you need help getting started with fitness come see Dr. Steve!

 

https://www.cdc.gov/physicalactivity/basics/pa-healthy/index.htm

https://emedicine.medscape.com/article/324583-overview

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/

5.       https://onlinelibrary.wiley.com/doi/full/10.1111/sms.12581