Reposting - Physician Told Her Give Up, Fitness Fixer Made Her Able
Monday, August 24, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Last week, several Fitness Fixer posts did not become viewable after writing and posting them. One reappears here (hopefully) with the rest to follow this week. Photos will not load at all, so I have included links to view them at another page. May all life's troubles continue to be this small :-) enjoy the posts:
Another reader named Lisa wrote in with a success story. This Lisa had not been active for many years. Her doctor had told her the way to stop injuries from running was to give up running. She is now successfully doing marathons, changing to healthy movement, and working as a professional photographer.
Lisa P writes:
"I had done some running in college and wound up with a stress fracture on the ball of one of my feet. I remember the doctor telling me to stay away from running in the future.
"I have enjoyed visiting your site for many months (more than a year for sure) and find your practical, everyday life approaches to body movement and exercise right on. The idea of walking a marathon was a "no-brainer" once I found out that walking was allowed.
"As someone who grew up in a home where shoes were always worn, I never got the chance to let my feet walk around barefoot for any extended periods (or distances). My feet couldn't handle "feeling" everything as they had been encased for so long in any number of supportive shoes.
"I remember reading a post of yours about hiking in flip flops and tried to imagine myself doing anything in flip flops or another simple shoe without a lot of cushy padding and support in "all the correct places." I am using my muscles to adjust to uneven surfaces while walking barefoot or with minimal padding between my feet and the ground. I think this has improved my body mechanics. Doing it myself helps in a way that wearing special shoes to do it for me does not. Time will tell of course.
Walking may take more time than running, but I've become a faster walker with training and will surely realize my goal of completing a marathon in under 6 hours this fall.
"I've made an effort to reduce and or eliminate certain things from my diet such as refined sugars, hydrogenated oils, and processed foods. This most certainly has contributed to the results I get in training. As I near the actual marathon, I will be walking upwards of 30 miles a week. It is amazing how my stamina improves as the miles add up.
"Attached is a photo of me at mile 25 of The Nike Women's Marathon, the first marathon I completed.
"Oh, one other thing that I have you to thank for is my regular routine of push ups. After every training walk, I do push ups and am currently doing 36. Won't be long before I get to 40!
Going barefoot by itself, or wearing special shoes will not automatically put your foot in healthy position or increase balance skills. You can walk in healthy or unhealthy ways when barefoot, and in healthy or unhealthy ways even in an expensive corrective shoe. You can easily change how you move to healthy ways without needing devices, and save time and money. You can change to healthier eating and reduce a grocery bill greatly, by no longer buying unhealthful food. Click the labels under this post for all Fitness Fixer articles with ideas on each topic.
--- I make posts from fun mail and success stories. 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. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. 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.
Physician Told Her Give Up, Fitness Fixer Made Her Able
Thursday, August 20, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Another reader named Lisa wrote in with a success story. This Lisa had not been active for many years. Her doctor had told her the way to stop injuries from running was to give up running. She is now successfully doing marathons, changing to healthy movement, and working as a professional photographer. Lisa P writes:
"I had done some running in college and wound up with a stress fracture on the ball of one of my feet. I remember the doctor telling me to stay away from running in the future.
"I have enjoyed visiting your site for many months (more than a year for sure) and find your practical, everyday life approaches to body movement and exercise right on. The idea of walking a marathon was a "no-brainer" once I found out that walking was allowed.
"As someone who grew up in a home where shoes were always worn, I never got the chance to let my feet walk around barefoot for any extended periods (or distances). My feet couldn't handle "feeling" everything as they had been encased for so long in any number of supportive shoes.
"I remember reading a post of yours about hiking in flip flops and tried to imagine myself doing anything in flip flops or another simple shoe without a lot of cushy padding and support in "all the correct places." I am using my muscles to adjust to uneven surfaces while walking barefoot or with minimal padding between my feet and the ground. I think this has improved my body mechanics. Doing it myself helps in a way that wearing special shoes to do it for me does not. Time will tell of course.
Walking may take more time than running, but I've become a faster walker with training and will surely realize my goal of completing a marathon in under 6 hours this fall.
"I've made an effort to reduce and or eliminate certain things from my diet such as refined sugars, hydrogenated oils, and processed foods. This most certainly has contributed to the results I get in training. As I near the actual marathon, I will be walking upwards of 30 miles a week. It is amazing how my stamina improves as the miles add up.
"Attached is a photo of me at mile 25 of The Nike Women's Marathon, the first marathon I completed.
"Oh, one other thing that I have you to thank for is my regular routine of push ups. After every training walk, I do push ups and am currently doing 36. Won't be long before I get to 40!
Going barefoot by itself, or wearing special shoes will not automatically put your foot in healthy position or increase balance skills. You can walk in healthy or unhealthy ways when barefoot, and in healthy or unhealthy ways even in an expensive corrective shoe. You can easily change how you move to healthy ways without needing devices, and save time and money. You can change to healthier eating and reduce a grocery bill greatly, by no longer buying unhealthful food. Click the labels under this post for all Fitness Fixer articles with ideas on each topic.
I make posts from fun mail and success stories. 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. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. 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.
This is fun - this article is the 600th Fitness Fixer post.
Yesterday's post started a series on Triathlons. Triathlon races of different names, organizing bodies, and distances are held year-round. The Ironman is a trademarked name of one particular triathlon and its qualifying races.
The Ironman Triathlon is a long-distance race of a 2.4 mile swim (3.86 km), 112 mile (180.25 km) bike, and a marathon run of 26 miles 385 yards (42.195 km), continuously, in that order.
Fifteen men competed in the first Ironman triathlon in 1978. Then, it was a known "Fitness Fact" that women could not do hard athletics. Several sports of the time banned women. Magazine articles appeared regularly that women had special problems that made doing athletics more dangerous and less possible. Scuba magazines printed (and reprinted) bizarre myths by reporters, that women were physically predisposed to injury from heat, cold, exercise, and decompression. Even chapters in medical books had separate "woman sports" chapters with "proofs" such as shorter legs and less testosterone and blood volume. Currently, teen Asian girls are beating the times of big Western men from that era. Injury rates are shown to be not from gender as much as training. I am a former anatomy and physiology professor. Don't try to snow an anatomy professor about joint angles and limb length as proof of athletic prowess or injury. Future posts will dissect these myths from a physiology basis.
The name "Ironman" and related "Iron" labels are official property of the World Triathlon Corporation (WTC). The WTC hosts other triathlons around the world that are called Ironman. Who owns what name seems to change, and can get confusing. Several events formerly called Ironman no longer use the word due to aggressive trademark protection. Readers can comment to keep us current.
The Hawaii Ironman Triathlon (various alternate names) hosts the Ironman world championship and owns the race held each fall in Hawai'i. Last year's 2008 Hawai'i Ironman drew over 1700 athletes. The 2009 Hawaii Ironman will be held October 10, 2009. Qualifying races required for eligibility are held throughout the year. Several qualifiers are going on right now, this June and July.
Next - Ironman Qualifiers.
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Read success stories of Fitness Fixer methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking 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. See class schedules, get certified - DrBookspan.com/Academy.
This week - a fun series with a post each day about triathlons.
A triathlon is usually a race, where each competitor swims, bikes, and runs one continuous effort. The first person to finish all three is considered the course time-winner. The order is often swim first, then bike, then run, although order can change depending on the length and kind of course, and opinions of the officiating body.
Some triathlons are relays. One person enters each part, for example the first person swims, then their teammate continues the run. A race consisting of a run, bike, then run again is considered a duathlon, even though the competitors do three parts. "Run-bike" and other duathlons will be covered in future posts, as will summer and winter biathlons.
The first modern triathlon was possibly a race in 1920 or so, in France, called "Les Trois Sports" (the three sports). Within that decade, several more three-event races of various distances and names followed.
In the 1980s, different big triathlons became more popular - including the several Ironman distance races and comparable races, called full triathlon and long distance, by other organizations. The "Ironman" brand and name is highly protected and can't be used by anyone else, a topic for another post. These are usually 3800 m swim (2.4 miles), 180 km bike (112 mi), and 42.2 km run (26.2 mi). In 2005, the World Triathlon Corporation started the Ironman 70.3, also known as a Half Ironman.
Triathlon became an Olympic event at the Sydney Games in 2000. Olympic Distance is considered a short triathlon - 1500 m swim (0.93 mi), 40 km bike, (24.8 mi), 10 km run (6.2 mi). The Olympic Triathlon is about half the bike and run distance, and a slightly shorter swim, of what is usually called a half-triathlon.
The many other triathlon events can vary in length and level of organization, depending what is available to the organizers. Distances may conform to standardized organizational rules, or vary with whatever length the available course allows. A kids' summer camp may use their pool or lake and a dirt road, track, or field nearby. A town may organize their waterways or harbor and roads. Sometimes the world comes together to host international events.
In some smaller-scale races, participants can show up on race day, sign up, and go. Larger races require registration and briefings before race day. Big triathlons require qualifying times in previous races and large entrance fees.
Read success stories of Fitness Fixer methods and readers, and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. See class schedules, get certified - DrBookspan.com/Academy.
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Photo 1 - Emma Snowsill wins in Beijing, image by Getty Images via Daylife Photo 2 of winner at Southeast Asian Games 2005 via Wikipedia
Weak Hips on Purpose? Running Injury and Hip Strengthening
Wednesday, June 03, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Who works their hips? Fitness Fixer success story Robert Davis wrote me several
notes that the weightlifters he knew didn't want to exercise their hip because they thought it would take away from the "V shape" they worked for.
Mr. Davis said that using my daily good bending and other functional exercise worked his hip greatly. He was pleased with reduction of stiffness and pain and increase in strength and mobility. No decrease in "V-shape."
The May/June 2009 issue of Sports Health: A Multidisciplinary Approach, published a study based on a literature review, concluding that running injuries to the lower leg may have more to do with weak hip muscles than how many miles run. Lead author Reed Ferber, Assistant Professor and Director of the Running Injury Clinic from the University of Calgary stated ”Hip muscle weakness especially appears to lead to atypical lower extremity mechanics and increases forces on knees and feet while running.” He also stated, "Based on a literature review, it appears that foot pronation (turning the arch and ankle flatter to the ground, and/or the knee inward) and inadequate hip muscle stabilization are the top categories for injury.”
From my own work in this area, I found that strengthening alone won't make you run with good mechanics, prevent pronating, or other injurious habits, you need to retrain them too. Not hard. Stopping your life to do rehab exercises then returning to bad daily movement also isn't so helpful. My work builds-in both strengthening and mechanics to daily life - functional exercise. Robert Davis has been sending in his successes fixing back and other injury using functional fitness.
Robert Davis writes:
"I had made a slight error in my story! I just wanted to let you know.. I had not ordered fix your own pain till only about 4 weeks ago cause I was looking at my expenses and the Amazon one came up!
"So to see how rapidly things change when you take up these habits is even more encouraging.
"Some things I noticed along the way (I did have some slight questions on this!). My hip muscles for one, started to get "sore". I believe this is because of over tightness and overall lack of use. My guess is like every other gym rat they avoid things to make obliques and lower back "too" big because it takes away from the V shape they are after. Everyone seems to fall for this but it is an un-healthy trap I now realize.
"Anyhow I had started to get really sore over the last few weeks in hip muscle areas and even upper buttocks from stretching these areas and working them (using your stuff). When I practiced going into full squats, this really seemed to stretch out areas that began to show signs of weakness/tightness. So it was like working out muscles and getting that "soreness" when your muscles start to adapt. I kinda figure it is as it is just as normal to workout a bicep and for it to "be sore" the next few days.
"The soreness goes away and with each passing week, it becomes more mild - kinda like the body getting used to biceps being sore and you don't get sore anymore.. They do not get sore like they did when I first started your stuff. I was just curious if you had seen this. I am sure it is normal, especially for a group of muscles not used to being used or stretched out.!
"Jeez I do not think most people realize just how tight and weak they can be in areas, mostly because they are never used or people are used to being tight there. People do not believe in the squat (I showed a few people to prove them wrong lol) because they are too tight. I realize how much I am glad I found this out early in life. I get stronger every day in the areas that were weak. I know I will have a much better core, lower back, complete back, and body then before I hurt myself :)
"I put together my "planche/pull up" setup for pictures and to start working on a full planche! That is difficult to do like you do it! Any suggestions? Just keeping trying? Heheh
"Thank you again! Thank you for posting my story."
Mr. Davis, thank you. You are well ahead of the fancy researchers :-)
Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
The RSS feed may still be down. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
Grace didn't have a lifetime of track and field experience. She lived a life of real movement, called functional exercise, raising 11 children and doing chores. She decided to run a race. One month later, she ran the race and broke a world record.
A video should appear below of Grace Foster. Click the small, right-pointing arrow at bottom-left of the video box to watch her straight body positioning, the race, and her happy family.
Grace exercises daily, stretches, eats healthful food. Other racing record holders over age 90 will be featured in future articles.
Get moving, stay moving, be happy. It keeps you vital, more with each year.
Click the labels, aging, running, and spirit under this post. Labels give all Fitness Fixer posts about that topic. The label video-movie shows all Fitness Fixer posts containing a video to watch and enjoy learning how to be happy and fit.
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Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking, 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, free. Click "updates via e-mail"(under trumpet) upper right. SeeDr. Bookspan's books.
When I was in the military, we ran. A lot. Every day. I love to run fast. When we ran, we sang. What did we sing? What they told us to sing - How much we loved to run. How much we loved everything about the military. Why? It kept us from saying what we were thinking. Military cadences have long been used for physical training. These are the Jody Calls.
The origin of the Jody Calls is usually given around World War II, but chanting, sea shanties, group mantras and hymns, and others have been known for centuries. It is generally thought that group unison music reduces perceived exertion, allowing greater effort toward the common goal.
I am a career physiology researcher in extreme environments. That means I spend much time directly testing humans to see what they can do, then how to make them better at it. Doing experimental and research work personally, makes it easier to know if what you hear about fitness is true, or just another of countless repeated myths. Even doctors learn from books that are often not primary sources, just repeated by someone else who learned it in school, repeated from a non-primary source.
In the military, and since then, the Jody Calls interested me. I wanted to know if chanting and singing really make the work of running easier, or just make it seem easier, or perhaps even use more oxygen and is actually more work than running without singing. I did many laboratory experiments on Jody calls.
Some of the experiments I conducted involved running troops on treadmills at different speeds, with specially fitted masks, so that they could chant into the mask, or just breathe regularly for control tests. I collected their expired air (what they breathed out) and analyzed it for oxygen usage and carbon dioxide production, a measure of the work of running. I compared oxygen usage with chanting and without.
Why are U.S. military chants called Jody Calls? There are many stories, usually involving a civilian character named Jody or Jodie, who stayed home when you left… you left… you left… right… left….
Below, hopefully sound file will appear. Turn your computer sound on, and click the arrow to listen to one stereotype call of the U.S. Marine Corps:
Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
A debate in fad fitness is if you need aerobic activity to lose weight, or if weightlifting is sufficient. The larger issue is that you need to use your cardiovascular system for health.
A 21 year long study from the Stanford University School of Medicine found that older runners live longer and suffer fewer disabilities than healthy non-runners.
All 440 study participants were 50 years old or over at the beginning of the study. All ran an average of four hours a week. By the end of the study, all were in their 70s, 80s, and older, running an average of 76 minutes a week.
At the 19 year mark in the study, 34 percent of the non-runners had died, compared with 15 percent of the runners. Onset of disability was delayed in runners by an average of 16 years.
Lead study author, Dr. James Fries, is almost 70, runs 20 miles a week and plays tennis. He stated the positive numbers for runners was not even as high as compared to average populations, because "the control group was pretty darn healthy." The "health gap" between runners and non-runners increased with age. Fries said, "I always thought that the two curves would start to parallel each other and that eventually aging would overpower exercise. We can't find even a little twitch toward that gap narrowing in the present time."
Study authors also stated that, "The findings probably apply to a variety of aerobic exercises, including walking."
Study was published in the Aug. 11 2008 issue of the Archives of Internal Medicine.
Conventional medical texts originally stressed that exercise would harm elders. That viewpoint led to disastrous decades of needless infirmities among people who could have retained mobility and independence.
In 1980, Dr. Fries wrote a landmark paper of his "compression of morbidity" hypothesis, that "regular exercise would compress, or reduce, the amount of time near the end of life when a person was disabled or unable to carry out the activities of daily living, such as walking, dressing and getting out of a chair."
Stay active, keep moving whatever your age. It is the most important medicine you have.
--- 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. ---
A study in the American Journal of Preventive Medicine found no evidence of accelerated rates of osteoarthritis among long-distance runners.
Further, weight-bearing exercise like running helps stave off osteoporosis by maintaining bone mineral density.
Study source: American Journal of Preventive Medicine August 2008; 35(2):133-8.
With good movement mechanics, running will not cause early wear on your bones and joints. With injurious poor movement habits, of course, you can wear and injure the joints.
Posts showing good movement mechanics during exercise and daily life:
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
The Shinobi no Mono, or the Ninja of old Japan, were renowned for their running speed and endurance.
Running drills called "ashi" (foot or feet) were an important part of Ninjutsu physical training. Try this basic Ninja ashi, or running drill:
Put a straw hat on your chest.
Run without holding the hat with your hands or other fastening.
Run so fast that the hat does not fall - this requires keeping a minimum speed for the duration of the ashi drill.
Where is the photo? He (or she - there were female Ninjas) must have run by so fast you didn't see. We are still working on the problem of photos not uploading. Healthline staffer Jerry has been helping to upload several photos for posts to come. Thankyou Jerry.
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Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives, and labels under posts. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
Exercise and Aging - Don't Limit the Patient to Limit the Pain
Wednesday, June 04, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
A Reuters news item last week reports that "baby boomers" are accumulating wear and tear injuries, and they should consider cutting back on amount and type of exercise they get.
The article points out that contributors to injuries are biomechanics, poor flexibility, and "pounding" or stomping down unnecessarily hard when running, jumping, walking, etc. Even with that knowledge, the news report goes on to say the answer to reduce injuries is to cut back activity. In Sunday's Fitness Fixer post, Forearm, Upper Body and Hand Exercise, I wrote that it is not a healthful or useful solution to "limit the patient to limit the pain."
The Reuters article quoted a foot and ankle podiatrist saying, "It is really important that people continue to be physically active, but they need to think logically about how to remain active as they age… Probably when you start getting into your 40s and 50s, the half marathon is a great alternative (to full marathons). Or, if you did two or three marathons a year, cut it back to one a year or opt for 10K or 5K runs." The podiatrist himself is a marathoner. He stated, "Having run 25 marathons, it was hard for me to cut back."
I would suggest looking at biomechanics, poor flexibility, and "pounding" first, before telling someone to stop doing what they love:
I have some exciting developments about getting you information on Exercise and Aging. Will announce soon.
--- 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. ---
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.
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 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 posts to come.
The post Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It? showed the common and painful bad posture of standing with too much inward curve in the lower back, called swayback and hyperlordosis. A reader mailed me an article about gluteal muscles and asked what gluteal muscles have to do with it. The article shows one kind of hyperlordosis, with the hip pushed forward. The drawing at right shows that hip-forward hyperlordosis position (right figure) compared to neutral spine (left figure). The article stated that the hip-forward posture was due to weak gluteal muscles, and that strengthening the muscles would fix the bad posture. The article gave a strengthening exercise of lying on your back and squeezing the "cheeks" of the backside together as if squeezing a coin between them.
Knowing muscle action will help you know why it doesn't work that way:
Your gluteal muscles are muscles of your backside. One function is to pull your upper leg backward, for example, when walking, to pull each leg behind you. The distance between the back of your hip and the back of your upper leg shortens.
If you use your gluteal muscles while standing (not tighten them, just use them to bring about movement) your hip will push forward. That is the opposite of correcting a hip that is forward in bad posture.
Squeezing the "cheeks" of the gluteal muscles together is training a different movement direction than either pushing your hip and leg forward or back.
Another fallacy is that tight gluteal muscles pull the hip so that it pushes forward into bad posture. It is true that tight hip muscles in front will change the tilt of your hip. People with anterior tightness cannot easily bring the leg behind them, which hurts stance and gait. Gluteal muscles cannot get that tight unless you have tetanus. Gluteal tight enough to push the hip forward a few inches would be so tight that you would not be able to sit down. You would tear your backside like splitting your pants.
The key point is that strengthening a muscle does not make it move your body or change your position. If you strengthen your arm, for example, your arm does not automatically wave around or raise over your head. Your arm only moves when you make it move. Strengthening your gluteal muscles will not move your hip for you. Even if strengthening did make any body part move on its own, gluteal muscles would cause a forward hip, not correct it.
Think of asking a dog to shake hands with you. If you want the dog to move his paw up to shake your hand, you do not strengthen his leg and paw. You train the movement and the voluntary desire to bring about the action.
Standing, walking, and running in hyperlordosis is a major cause of lower back pain. Some people stick the backside out in back and others tilt the upper body back with the hip thrust forward. Both increase the inward curve of the lower back and painfully pinch the lower back structures. Although some fitness information and advertisements represent overarching as attractive, even something to deliberately do, it is an unhealthy and weak posture, making it unattractive and undesirable.
Strengthening muscles is good and helpful and fun and healthy, and so on. Strengthening gluteal muscles or any other muscles will not automatically make you stand in healthful position. Stronger muscles do not make you move. You can change to healthful position right now without strengthening. These posts show how:
When you hear that you need various strengthening exercises to correct posture, think of shaking a dog's paw.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
Thursday, March 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
The post Innovation in Abdominal Muscles showed one of the most common, yet most overlooked cause of lower back pain during long standing walking, and running.
Readers sent excited letters stating they could finally see and feel why they had back pain, and could immediately feel the difference when they stopped standing with too much inward curve in the lower spine, and began standing and moving in neutral spine.
Neutral spine at left. The line from the top of the leg up to the middle of the hip is vertical. The beltline (line from front to back through the crest of the hipbone) is horizontal.
Middle drawing shows tilting the hip forward in front and out in back.
Right drawing shows tilting the hip forward, and also leaning the upper body backward.
Readers asked for more photos so that they can see the difference between overarching (hyperlordosis) and neutral spine (normal lordosis) during running and walking. They wanted to see the overarch in action and what running in neutral spine looked like.
The two photos above show allowing hyperlordosis, or too much inward curve (arch) in the lower spine. It is not a normal curve. The angle increases where the back of the vertebrae come together. It does not look fit or healthy.
In both photos, the hip tilts forward in front (and out in back) instead of holding vertical. The abdomen rounds outward.
Note the red stripe on the runner's pants in the photo at left. The stripe tilts forward from the top of the leg to the middle of the hip. Compare to the red vertical line in the middle and right-hand drawing. The beltline tips downward in front. Compare to the red lines tilting downward in the drawings.
The walker in the photo at right tilts the hip forward in front (and out in back), beltline tips downward. The upper body leans and sags backward.
Neutral spine.
The muscles that shorten to prevent the upper body tilting back and the hip tilting forward are your abdominal muscles. The abdominal muscles are too long when you allow overarching. Keep this in mind when you hear about exercise programs that claim to lengthen your abs.
Moving your spine to neutral spine for all daily life is how abdominal muscles help prevent back pain. It is not strengthening them that does this, and it is not tightening. Crunches and other forward bending exercises do not train you how to use your abs to hold neutral spine and they increase herniating pressure on your discs - click Good Life Works Better Than Bad Ab Exercise. Use your abdominal muscles, without tightening them, to position your lower spine during all you do, just like using any other muscles to move any other part the way you want. It is a free ab workout all day, and you will stop a major cause of back pain during standing, walking, and running.
Click Prevent Back Surgery to see why overarching can be so damaging to the joints of the vertebrae.
Click my web site books page www.DrBookspan.com/books to see the training manual The Ab Revolution™. It shows several techniques to learn neutral spine as a normal habit, and how to use it to stop back pain from hyperlordosis, even if you don't exercise (Part 1) and how to use it for better core training if you want to incorporate it into exercises (Part 2), from simple to the hardest you can get.
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.
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.
Photo by Jolie taken at a Malaysian backpackers hostel
Here is Friday Fast Fitness - fixing painful swayback to neutral spine.
If you have lower back pain after standing, walking, or running, or feel that you need to bend forward or lift one leg to relieve lower back pain, you may stand with too large an inward curve in your lower back (hyperlordosis).
Stand with hands on hips, thumbs in back
Roll hip under so that thumbs and the back of the hip come downward (not forward)
Use the neutral spine position for normal posture.
Reader David from Belgium made us this short video of correcting overarching (hyperlordosis). At first he is standing with the front of the hip tilted forward and the upper body leaning backward. Both actions increase the lower back curve. Then he tucks the bottom of the hip under to neutral position, correcting the hyperlordosis.
Don't tighten your abs to do this. Just use them to move your lower spine out of unhealthful arching to neutral spine. Breathe.
Studies first started to report the benefit of exercise to reduce incidence of colds when looking at recreational exercisers, who reported fewer colds once they began regular running. Later research on exercise, intensity, and the number of colds, found that people who exercised moderate on most days averaged one cold, while the less active group reported over four colds in the year. Related work shows that being a regular exerciser is also associated with quicker recovery from colds.
Moderate exercise also enhances immune function during the exercise and for a few hours following it. Specific research into mechanisms has found that moderate exercise speeds various immune-function cells through the body, and increases levels of the type of white blood cell called leukocytes that work to fight infection.
A 2006 randomized clinical trial found that "postmenopausal women who exercised regularly for a year had about half the risk of colds compared to those who did not work out routinely." The women in the exercise group also reduced body weight, body fat, and intra-abdominal fat from increasing their exercise level.
Too much intense exercise may lower immune function and predispose to some infectious illness shortly after the time of the exercise. The decrease seems to be temporary, similar to the increase seen around the time of moderate exercise. There is some concern that continual, intense exercise lowers immune function for longer periods. An example often offered for this is that during the Winter and Summer Olympic Games, clinicians report that "upper respiratory infections abound" and that "the most irksome troubles with athletes are infections." The situation may be more that high numbers of young people are concentrated in close quarters. Their high general health may mean that they are unlikely have other health disorders during the short period of the Games.
It is more likely that poor nutrition and insufficient rest, added to harsh, ongoing, strenuous work or exercise, decreases immune function, not just strenuous exercise alone.
Although cold and flu germs are reported to live better in the cool dry weather of fall and winter, if you are cold, caught in the rain or snow, or out in a draft, that does not make you more likely to fall prey to them. Immunology is not my field so I can only repeat what I've read. My understanding is that these germs are all around us most of the time. They are on surfaces all over our home, and workplace. Your immune system keeps them out or eats them if they try to invade (pictured to my level of understanding at right). They don't cause problems unless their number is too high and your immune system cannot deter them. I call germs the jerks of the world - they are always there and are harmless unless conditions let them under your skin with your defenses down.
Much attention is given to disinfecting yoga mats. Give attention to cleaning up your own strength against disease:
We need to start a new trend that Health is Contagious - Make Health Catching! Stand up and stretch. Do good deeds. Go now.
--- For more, click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute. Read success stories of these methods and send your own. 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. ---
Photo of cold microbe toy by dantc Photo of AntiViral cat by surekat
This is the first part of a great reader story. Mike has been fixing many things. Pain started with a local radiating pain, then became much other pain. Mike looked for something to fix the first area, then ably used other techniques.
Mike writes,
"I'm sorry it's taken so long to write back. Along with teaching and family time I've been taking a graduate class and I've just finish my final project for the class. Now I have time. Here goes.
"Back in 1983 I developed a deep pain and spasms in my right buttock along with radiating pain down my leg. I had been running 40-90 miles per week as a high school and college cross-country/track/road runner. For the past 20+ years this pain has come and gone every week while lying down, walking, and mostly sitting, making it very difficult to work at a desk, sit at a class, and drive. I've assumed it was a type of sciatica and read and tried everything I could for relief.
"The only temporary relief I found was in cycling, which stopped the pain for up to 48 hrs after rides, so I ended up cycling for 20 years, including racing for a team for 2 years. All that cycling caused other problems including a slumped, impinged shoulder from a separated collarbone in a crash, tight hip flexors, allergies from all the car exhaust and desert riding, and too many close calls from SUVs with drivers calling, texting etc. in heavy traffic. I was eating far too many simple carbs for energy on these intense rides. I stopped cycling to improve my health, decrease my risks of collisions, and to save money on all that equipment.
"The pain and spasms in my rear and down my leg increased in frequency and duration. My shoulder was not improving despite a month of visits to a physical therapist. Through searching in the internet I came across Dr. Bookspan's Fitness Fixer and books in early 2007. The logical stretches and strengthening moves worked much better than anything I had tried before. One time during a long class my rear and leg were killing me, so I applied a stretch (I learned from one of the books) while sitting in the chair without anyone knowing. The pain went away for the rest of the class. (Since applying Dr. Bookspan's shoulder retraining) my shoulder rarely bothers me and I've gone months without any pain in my rear and down my leg.
"I've also been enjoying Jolie's books for the sections on nutrition, spirituality, mental focus and general health and exercise advice. Working on all the parts at once seems to help the individual parts even more. I'm now working on walking comfortably without orthotics (it's getting better) and figuring out why my left knee and right hip pop so much. I'm very fortunate that I'm without pain now though, thanks to Dr. Bookspan's advice.
"I've attached some photos of the (hip) moves and stretches that work for me. Thank you! Mike "
Just as I was uploading this post today, Mike wrote me:
"Just wanted to let you know that my wife had a lot of pain and tightness in her hip yesterday from squats without warming up enough and possibly poor technique. She was very uncomfortable in any position, even lying down. I showed her how to do the hip stretch that worked for me, from your book, and it IMMEDIATELY, stopped the pain and tightness and she still feels great the next day! Mike"
I asked Mike about his statement, "I stopped cycling to improve my health." His story will continue, I hope next week.
Prevent Main Factor in Back Pain After Running and Walking
Thursday, October 11, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
One of our readers, Nick, wrote me that he had had slowly increasing lower back pain despite exercising regularly. He ran, he stretched, he did abdominal exercises. Nick's doctor told Nick to give up running and take up low impact activity. Giving up running made Nick miserable but he did it. The pain came and went, but overall did not change. One day during a walk, his pain had spread into the back of his hip and was unendurable. He didn't feel able to make it back home, and wound up in the emergency room.
His x-rays were inconclusive and he was sent home with anti-inflammatory medicines, instructions to stretch his hamstrings, and rest or try other non-impact activity. This is a common story that readers mail me. It is unfortunate because:
The real cause of the pain was missed.
You do not need to give up running.
This kind of back pain is not inflammatory so does not benefit by anti-inflammatory medicine, which often causes its own problems.
Impact is not the problem. With a little common sense you can see if you clomp instead of walking or running lightly. Use leg muscles to step lightly instead of bashing down with no control. You should be able to run and jump with little impact. Many people walk with higher impact than a good runner lands during running. Future posts will cover this.
Most important was the missed cause - lower back pain during and following running, walking, lifting, and other upright activity is usually from allowing the lower spine to over arch. This hyperlordosis is not caused by an anatomic problem "condition." It is a bad posture, which is easily correctable. Hyperlordosis is one of the most commonly missed causes of lower back pain. Left drawing shows neutral spine. Right drawing shows one kind of hyperlordosis.
In the left neutral spine figure, the hip is level and horizontal from front (ASIS) to back (PSIS). The hip is also vertical from the top of the leg (greater trochanter) to the center crest of the hip. The right drawing shows allowing the front of the hip (pelvis) to tilt forward, which increases the lower spine angle. A small inward curve in the lower back is necessary for disc health and shock absorption. A high angle is as painful as any other pinching and pressuring of an area.
This is what I had Nick do. You can try it too. Check yourself these two ways to see if you stand in hyperlordosis:
Stand up and look sideways in a mirror. Your belt should be level-green line in left neutral drawing. The side seam in dress or trousers should be vertical from leg to waist - black arrow in left drawing, not tilted forward at the hip
Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first it is usually a good indicator that you lean the upper body backward, which increases a second kind of hyperlordosis. See Neutral Spine or Not? for more.
Here is how to reduce an overly large arch:
Stand with your back against a wall, with heels, hips, upper back and back of your head touching.
Put your hands on your hips, thumbs facing the back.
Roll your hip under so that your thumbs come downward in back.
Feel the large space between lower back and the wall become a smaller space.
Keep your heels, hips, upper back and the back of your head touching the wall and stand tall and straight. Lower back pain that is caused by hyperlordosis should ease right away.
Keep the good new neutral spine when you walkaway from the wall, and all the time.
More step-by-step instructions and photos in the Ab Revolution manual.
Check back often. I am working on the next part of this post: Another Common Cause of Back Pain With Running.
Nick was quickly able to return to running by stopping hyperlordosis. So was Ted - Back Pain From Running. Recognize hyperlordosis. It will save office visits, even emergency room visits, tests, time, money, stress, and worry. Reduce hyperlordosis to neutral spine with a simple repositioning technique to stop and prevent much pain.
--- Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here in the several replies to questions already here under this post. Get all posts on this topic by licking labels under posts and links in posts. Also check archives at right, the Fitness Fixer Index, and all the success stories of Fitness Fixer methods.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. See class schedules, get certified - DrBookspan.com/Academy. ---
One of my areas of injury research for both Army and Navy aeromedical systems was preventing back pain from running. Disease Non-Battle Injuries (DNBI) from exercising in the gym and doing PT is a huge military issue - grounding far more personnel than combat casualty.
I ran several studies and found that overarching (hyperlordosis) is a major overlooked cause of lower back pain - some examples are shown in the post Prevent Back Surgery.
I developed a simple method for people with this kind of back pain to understand and reverse the cause of pain themselves, with simple repositioning to neutral spine instead of overarching. It was unexpected news to some groups who have been taught to overarch, and who deliberately tilt the backside far out in back for exercise. But it was welcome relief for my guys who liked to joke that they were my STRACguys - combat slang for 'stupid troops running around in circles.'
I wrote a little training manual that went through several improvements to become the book, The Ab Revolution™ No More Crunches No More Back Pain. The book has two parts. The first shows how to stop back pain during various standing activity in daily life, both non-active and active, including running. The second part gives ways to exercise core muscles in healthier ways.
Reader Ted found the book and put it to immediate use to stop years of disabling back pain and return to running. Ted wrote:
"I am 57 years old and have weighed 175-lbs for the last 10-years (which drives my doctor nuts). I discovered running in 1969, after gaining weight when I entered college. The track at the University was fenced in, so we'd slide under the fence to run it. I jogged for six years, then raced for another ten years. I wasn't a fast runner, but I hit the legendary ''Second Wind'' on many occasions - you feel like you could Run Forever.......No Time....No Distance.....Just You and the Road.........it is a Mystical Experience....
"I tore out my ankle ligaments in 1980, and had to rehab for a year 'til I could start running again. I have run carrying 2 1/2-lb hand weights for the last 22 years. In 1989, I tore my back. It hurt, then the pain subsided, but flared up every so often."
The only way Ted had then to "cure the pain" was to stop running. Ted continued:
"In 2005 I REALLY hurt it, went into spasms (my wife had taken me shopping for eight hours, and I still blame this on being taken shopping), and the pain made me look back fondly on the Ligament Tear of 1980. After that, it was an All the Time Thing. Running dropped to twice a week (if that) and the slightest thing would trigger a back spasm. I accidentally came upon Dr Bookspan's ''Ab Revolution'' and 'mistakenly' bought it as an exercise book. It's more of a Way of Life, just like running.
"I have been pain-free (amazing) for 12-weeks and counting. I have increased my running to 4-5 days a week. Not having my back killing me is more than I could have hoped for. I thought my running days were over, and I would have missed them.......A LOT.
"The funny part was, I had gotten so used to the pain, it took about three DAYS for me to realize it WASN'T hurting. I cannot recommend the techniques in this book enough to other runners, If you can do The Thing You Love, why WOULDN'T you try this?"
What specifically did Ted do to fix the pain? He writes:
"The two techniques (in the book) I got the results from were the Standing Beginning Crunch with the hands facing each other, and the Where is My Belt Pointing? technique."
I will ask Ted what's going on with his knee in the photo he sent for this post, and what we can do to fix that up next. I will cover more on back pain after running, and also hope to post some other interesting work I did on the military running chants called jody calls or jodies, and their effect on perceived exertion during running. Click the label military fitness, below, to see my work on this. Check back often for more.
--- 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.
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