Fast Fitness - Children as Leg Weights

Here is Friday Fast Fitness - Train children's balance and grip strength, use your legs, and have family fun.

1. 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.
2. 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.
3. 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.

Labels: children, endurance, fast fitness, feet, hand, leg strength, partner exercise, performance enhancing modality

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Runner Fixes More Pain With Straighter Push-Off

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"

"Ps. I got your new book (Health & Fitness THIRD edition). VERY good info, I'm trying to use it everyday."

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:

• Back Pain From Running - Ted's story
• Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
• Walk Lightly - Shock Absorption for Happier Joints
• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Plantar Fasciitis Part I
• Health & Fitness Third Edition at Last

Labels: feet, fix pain, impact, knee, readers inspiring story, running

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Plantar Fasciitis Part I

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. Over years, your foot can get strained. 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.

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 pronate (arches flatten) is another fascial strain. Keep your body weight evenly around the sole of your foot, not sagging inward on your arches, pressing them downward. Reader David from Belgium has 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, therefore stopping the pain from the stretch, giving the false impression that the injury is lessening. It is a negative cycle 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. Use good body movement for all movement to allow it to heal and be functional.

Helpful links to move in healthy ways to stop plantar fasciitis:

• Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches
• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Arch Support Is Not From Shoes
• Better Achilles Tendon Stretch
• 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.

Labels: achilles stretch, feet, fix pain, injury, plantar fasciitis, pronation, running, walking

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Fast Fitness - Sprain Prevention and Rehab Training

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:

1. Stand with feet parallel and look in a mirror where you can see your feet, or just look down.
2. Rise to toe and hold
3. 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.

Labels: ankle, balance, fast fitness, feet, fix pain, injury, sprain, toes, video/movie

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Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches

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:

1. Stand with feet parallel and look in a mirror where you can see your feet, or just look down.
2. Pull outward until your arches rise and restore, and your ankles are straight
3. Use this as your new natural position, gaining 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. Then 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 simply restores and holds a healthy arch from second 13 onward.

You can have healthful arch position too. 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.

Labels: ankle, arches, fast fitness, feet, fix pain, posture, pronation, video/movie

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Walking Softly Benefits Olympic Wrestler

Reader Dennis is an Olympic Medalist in wrestling. He is the student who asked me how to walk without shocking his joints in the post Walk Lightly - Shock Absorption for Happier Joints.

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. He said he 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.

Landing without jarring reduced pain. Dennis also did several things to stop injuring his joints during movement:

• Stopped keeping a large inward curve in the lower back while running. Changing to neutral spine decreased the compressive pinching and loading of the vertebral joints and soft tissue - Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?

• 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.
  
  
• Held upright head and neck position instead of jutting the chin forward - Common Exercises Teach Upper Back and Neck Pain.

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 posts to come.

Labels: feet, fix pain, impact, readers inspiring story, running, walking

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Fast Fitness - Leap for Balance on Leap Year

Here is Friday Fast Fitness for the intercalary year (Leap Year) - Leap to develop ankle and knee stability, leg power, and balance.

1. Leap forward, landing on the other foot with soft shock absorption. Don't land hard, which jars joints.
2. "Stick" your landing, without wobbling or setting the first foot down.
3. 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.

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.

Labels: ankle, balance, fast fitness, feet, hip, holiday, impact, knee, leg strength, sprain

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Walk Lightly - Shock Absorption for Happier Joints

"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.

Banging down with each step is not good for your body. It increases risk of joint pain and plantar fasciitis.

I tell my students to stop banging and stomping 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 walking, try not to make noise. It doesn't mean to tip-toe, but to walk 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.

Labels: arthritis, feet, impact, knee, leg strength, martial arts, plantar fasciitis, running, walking

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Prevent Knee Pain When Rowing

Rowing can be fun, and good functional exercise.


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.






Use the same heel-down push off to prevent knee pain while ascending stairs - Better Exercise on the Stairs, and when doing leg press exercise and half squats for weight lifting and daily bending .

Labels: feet, leg press, planter fasciitis, rowing

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Top Diabetes Treatment is Exercise

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.
• For better nutritional mindset, click A Little Good Exercise, a Lot of Bad Food - Overweight Still No Mystery. Then for specific recipes and methods click the nutrition label under this and related posts.
  
• 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.

Labels: aging, children, diabetes, endurance, feet, injury, nutrition, strength, weight loss

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Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier

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.

We changed that:

1. 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.
2. 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
3. The post How Often Should You Be Healthy? explains when and how to apply it.

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."

What about Ivy's e-mail that I mentioned in the last post about the new hip stretch? I'm out of room again. Watch for the next post.

Labels: disc, facet joints, feet, fix pain, iliotibial band, injury, knee, lunge, nutrition, readers inspiring story, sciatica, shoes, spirit, squat

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Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life

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:

• Foot stretch - Healthy Toe Stretches
• Achilles stretch - Better Achilles Tendon Stretch
• Achilles stretch built into daily bending with half-squats - Bending Right is Fitness as a Lifestyle and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Happy knees during stair climbing - Better Exercise on the Stairs
• Plantar fasciitis - see the comments in Why So Many Aerobics Injuries?
  
• Lunges - Strengthen Legs Without Knee Pain - Standing Lunge and Strengthen and Retrain Function With The Lunge
• All posts helping knees

To stop pain and regain your life, you don't have to "do exercises" - use movement for healthy life. Have fun. Shine!

Labels: achilles stretch, celiac, feet, fix pain, knee, lunge, planter fasciitis, readers inspiring story, squat

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Strengthen Legs Without Knee Pain - Standing Lunge

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:

1. Stand with one foot far in front of the other. Both feet face forward. (Left photo.)
2. Feet remain normal width from side-to-side, not directly in line front-to-back.
   
3. Lift your back heel. Don't turn the back toes outward. Look at your back foot and check.
4. Tuck your hip under (click "neutral spine" label for posts explaining how). You will feel a far better stretch and strengthener.
5. 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.)
6. Don't let your front knee sway inward.
   
7. Keep upper body upright and straight. (Right photo.)
8. 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.

Fitness as a Lifestyle:

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.

Labels: achilles stretch, feet, knee, leg strength, leg stretch, lunge, neutral spine, squat, strength

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The Coming Two Weeks

We leave in a few hours for Colorado and the Wilderness Medical Society Meeting.

For the next two weeks, I'll have uncertain access to Internet, mail, or messages, to read or answer comments. I stored some fun posts for you. New Healthline staffer Leigh is scheduled to put them online while we make our way 'out West' during the week before the meeting. Thank you Leigh.

With each trip out to this part of the US, we work to document and preserve various martial arts systems of Native American Indians, as much as they want us to have. Will also make our way through the Rocky Mountains.

For going off-trail, we don't carry a tent or sleeping bag, let alone a computer. Simpler. There are still things to carry. The post Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain explained the role of using abdominal muscles to prevent one kind of back pain from carrying backpacks. It is not by tightening the ab muscles, but using them to position the lower spine forward enough to reduce an overly large lower back arch, and stand with neutral spine. Strengthening exercises, whether for abdominal or back muscles do not make the spine attain neutral position in place of overarching. That is why strengthening core muscles does not stop this kind of pain. You get better and more functional core exercise by preventing overarching when carrying loads than by doing crunches or exercises for any specific back muscles. When you hold neutral spine, a small inward curve remains, just not the large one with the "backside-stuck-out-in-back" tilt that damages the lower back.

The post Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique gives a quick effective way to feel how to move your hip and lower spine using your abs away from arching to neutral. This Friday's post should cover preventing upper back and neck pain when carrying backpacks.

In pretty much any terrain, we don't wear hiking boots or fancy cross-training shoes. I wear roomy, cheap (ten or fifteen dollar range), discount store sneakers (usually in tatters). A shoe should not be what holds your foot in position - it is better when your own ankle, leg, and foot muscles do that. For me, shoes are more to avoid hookworm, other parasites, tetanus, and bites. The posts
Arch Support Is Not From Shoes
and
Which Shoes Help Exercise, Fall Prevention, and Ankles?
show how to hold healthy foot and arch position, and give ideas for better gait and balance. In technical climbs, tight shoes are often worn. I'm not much of a climber, but decline tight climbing shoes for bare feet, and enjoy feeling the rocks. For daily wear, tight shoes are not healthful: See, Are Your Shoes Too Tight? My near-seven-foot-tall husband Paul does the same, in his size 17 sneakers or flip-flops (approx size 52+ European).

We don't bring "sports food," commercial hydration drinks, or energy bars and drinks. Refined sugar is not health food. Unfermented soy in many of these products is increasingly documented to promote unhealthy over-estrogenic effects for both men and women. The post Is Your Health Food Unhealthful tells hidden dangers to avoid. The posts Healthy Mother's Day and Independence Day for Fitness give a few quick, good-tasting, healthy foods and drinks to try instead. If you don't have a blender, mash ingredients by hand for arm exercise. Dehydration is important to prevent, and can be done with healthy food and drink.

We hope to arrive in Snowmass by Saturday for the toxicology symposium before the meeting. Then interesting lectures, my two workshops (come take them) and other workshops. The WMS will present the first Fellows of the Academy of Wilderness Medicine. I have been advanced to Fellow, along with Wilderness expert and Medicine for the Outdoors blogger Paul Auerbach, and others in the field. Dr. Auerbach could have easily been "grandfathered" to Fellow status for his stack of achievements, but he went through the exacting point system along with the rest of us. You set the bar high Boss, wow, thank you.

I will try to get to the conference Internet café during the meeting. For the week after, will again be outback without access. If you comment or e-mail, I may not have access to reply. Check existing replies to posts for answers already there. Look for fun posts until then. Hope to see you at the meeting.

"Utility is when you have one telephone; luxury is when you have two, and paradise is when you have none."

Labels: ankle, education, feet, lower back, martial arts, nutrition, orthotics

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Hyperbarics for Diabetic Foot Injury

It is estimated that every 30 seconds someone in the world has their foot amputated because of a diabetic foot ulcer. Reduced blood supply to the feet and lower legs in people with diabetes delays wound healing and increases infection and chance of gangrene. Foot infection worsens the situation of inadequate blood supply by increasing the area's need for oxygen but decreasing blood supply. Poor blood supply further decreases ability to fight infection. Diabetic ulcers treated with antibiotics can become colonized with drug-resistant bugs.

I am at the annual meeting of the Undersea and Hyperbaric Medical Society (UHMS). Several interesting studies are being presented on diabetic wound healing. Enhancement of healing in selected problem wounds is one of the 13 approved indications for use of hyperbaric oxygen therapy as defined by the Hyperbaric Oxygen Therapy Committee. Hyperbaric treatments are done by putting the entire person in a small room or chamber and increasing the pressure inside so that the person breathes oxygen at higher pressure than what you are breathing now. The post Does Hyperbaric Oxygen Help Exercise Ability? explains more of how it works.

One of the studies presented here looked at 50 patients with severe diabetic foot ulcers. Half were treated with hyperbaric oxygen therapy (age and gender matched with the half who did not). Diabetic patients treated with hyperbaric oxygen had 56% chance of healing and 16% chance of amputation. Diabetic patients not receiving hyperbaric oxygen therapy had a 32% chance of healing and a 32% chance of amputation. Supplying oxygen to compromised areas, such as diabetic wounds, is important to restoring health. Hyperbaric oxygen is established to help that.

From the President's Competition came another study on hyperbaric oxygen therapy and stem cell mobilization in people with diabetes. This study was by researchers at the University of Pennsylvania's Institute for Environmental Medicine, where I did nine years of my research in diving medicine. Hyperbaric oxygen is already known to mobilize bone marrow stem cells in animals, healthy humans, and in patients with a history of radiation exposure. This study looked at diabetic patients with refractory foot ulcers or radiation necrosis who were receiving hyperbaric oxygen treatments. The study was small and results varied more than in previous trials. However, the researchers reported that overall, hyperbaric oxygen therapy increased circulating CD34+ stem cells three-fold in the patients with diabetics, and was shown to play a role in wound healing. Three patients of twelve in the study group did not increase stem cells. The researchers said that the reason for no increase should be investigated.

In the exhibit hall of the hyperbaric conference, various companies display their fun oximetry units. There are several kinds of oximeters. The most common ones painlessly assess oxygen levels through the skin. Oximetry is used to assess oxygen available to the injured and surrounding tissue, and to tell how well hyperbaric oxygen treatments are working to improve oxygenation and new blood vessel growth. I like to try them all on, on different parts of my body. I experiment with different exercises to see the different effects on oxygenating different areas. Movement makes rapid, effective increases in oxygen levels.

In the past, people with diabetes were cautioned not to exercise because it was felt that they would injure themselves. Now it's known that exercise is an important part of preventing injuries from diabetes, and preventing or curbing diabetes itself. Regular exercise:

• Helps your body burn more sugar.
• Increases the number of insulin receptors on your cells and increases the sensitivity of your body to insulin.
• Helps your body grow new blood vessels and improve circulation.
• Improves oxygen levels to areas to help them heal.
  
• Reduces high blood fat levels (cholesterol and triglycerides) which leads to early aging of blood vessels.
  
• Increases blood flow to the feet, which helps prevent diabetic foot problems.

Keep moving for many aspects of preventing disease, secondary effects from disease, and to improve your health.


Here is the next post from the conference Exercise and Fitness in Decompression Sickness Risk.

Labels: circulation, diabetes, feet, fix pain, hyperbaric, scuba

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Forensic Anthropology and Bone Density

A few weeks ago, I attended a lecture on forensic anthropology. In general, this is the study of things you can tell from human bones in a crime setting. How old was the person? Were they male or female? How big were they? What was their probable race or ancestry?

Why was I there when my work is with the living? Two main reasons. I am the science officer for the Vidocq Society, an international forensic society. I might evaluate data, for example in an aviation disaster, whether someone might have been conscious at each point when undergoing G-forces or different temperatures and amounts of oxygen after a depressurization at various altitudes. In a scuba death, I might advise on physical changes that occur with different situations. The second reason was to learn more about bones. Bones are remarkable. Your bones know a lot about you. What was your health like? Were you active? What kind of activity did you do? When I was small, I read about an archaeological dig in ancient Rome. The bones of a girl were recovered. The account stated they could tell she carried loads too heavy for her, and was therefore (in conjunction with other evidence) probably a servant or slave. I was riveted. How could they know that? I spent years after that learning more about telling how someone moved from looking at their bones.

Throughout your entire life, when you exercise you stimulate growth of new bone cells. The physical pull of muscles thickens your bones where the muscles attach. Using your arm muscles thickens arm bones. Using your legs strengthens leg bones, and so on. This is a main mechanism of how exercise prevents osteoporosis. Without exercise, you don't stimulate enough new cells to counter the normal loss as old ones break down. Your bones thin no matter how much calcium you eat. The post Exercise is More Important Than Calcium Supplements for Bones tells more about this. Bone demineralization is rapid and serious in astronauts in microgravity (Collapsing Astronaut Gives Healthy Reminder).

How you use your muscles causes them to pull differently, giving evidence about the kind of habitual motion. More interesting is that when you are active, your bones grow and shape themselves to facilitate your motion. An example of interest to readers following the posts on squatting is that people who habitually sit for normal daily life in full squat grow "squatting facets" on their lower leg bones. These are small areas on the bone that quickly grow to make squatting more comfortable. At one point, it was a debate in anthropology that squatting facets were a marker of someone of Asian ancestry, until it was found that others who squat also grow them, and that squatting facets disappear when the person adopts a Western sitting habit of chairs and no longer squats. Babies of all races can have them.

Someone who habitually slouches can change the shape of their bones, eventually deforming them. This can occur in the spine, knees, hips, ankles, shoulders, feet, toes - everywhere you pressure your bones. Changing positioning habits to healthier ones can, in many cases, reshape the bones back to healthier shape. Think of braces on your teeth. It's human bonsai. In cases of extreme dystrophies of the muscles, someone who sits without function of their trunk muscles to hold the spine upright, can eventually deform their spine until their ribs sit on their hip bones. How are you sitting right now? The recent post What Does Stretching Do? explained a bit of why stretching isn't reducing injuries. People are stretching, then exercising and going about daily life in bent over positions that rub and grind the joints and soft tissue.

You literally shape your own health. Use the posts throughout this Fitness Fixer blog to do healthy exercise in healthful positioning so that your bones will only tell good tales about you.

Labels: achilles stretch, aerospace, ankle, arm, feet, forensic, injury, leg stretch, osteoporosis, posture, scuba, sitting, squat, toes

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Doorway Hamstring Stretch

Here is a hamstring stretch that is relaxing to do, more effective than bending over to touch toes, and doesn't pressure the lower back or neck discs. The doorway hamstring stretch trains healthful positioning that makes straighter posture feel natural in daily life when standing up and gives a better stretch while lying down. Reader Ivy from New Zealand sent in the photo at right of doing this stretch so well. Thank you Ivy.

• Lie face up in a doorway.
• Lift one leg up to rest against the wall or doorjamb.
• Keep your body, shoulders, head, and other leg relaxed comfortably flat on the floor.
• Keep both hips flat on the floor. Don't let your hips round under you. Don't let the leg on the floor get lifted upward along with the leg you are stretching. If it raises, that often indicates a tight hip. Gently keeping the leg down on the floor stretches the hip, giving additional benefit.
• Relax and breathe. Smile. Hold for a few seconds, then switch legs using the other side of the door or wall.
• For more stretch, move your whole body further into the doorway.
• To add stretch for the back of your calf and bottom of your foot, pull your toes back and downward, using your shin muscles, a towel, or your hand if you can reach.

It is not the case that you must bend the other knee to protect your back or prevent muscle strain. It is not harmful to keep the leg on the floor comfortably straight and stretched flat against the floor. Keeping the leg down makes the stretch more functional and transferable to daily life movement. Future posts will cover why. Until then, relax and enjoy this stretch. Readers, send your photos and stories showing healthy movement during real life. Don't be shy.

Read more from Ivy to get inspired about fitness as a lifestyle

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