Getting More From a Hip Stretch

This post tells the Hip Stretch story started with Inspirational Ivy in August. In that post, Ivy tells how she used healthful body mechanics to fix a serious and extended attack of sciatica and foot drop the year before. Several posts since, have given fun updates. Here is the fun that the Hip Stretch started:

Feb 2006, Ivy from New Zealand wrote to me,

"My hips are tight, particularly the right side that being the side I had the severe attack of sciatica. I have worked so hard on my hamstrings and my "dropped" foot, the bonus being that I am winning. Now it is time to put the same amount of work into my hips."

I figured Ivy would start with the Better Posterior Hip and Piriform Stretch and a few of the other hip stretches in my books, then apply them for daily life by crossing one ankle over the other knee for putting on shoes, shown at right, described in Ancient Shoe Exercise for Hip Stretch and Balance, and that would be that.

In August 2007, she wrote,

"I am jumping for joy. No, I haven't won a million dollars.

"After having been doing the posterior hip stretch lying down for the past 21 months twice a day, I can now do the same stretch sitting. My hips have always been so tight and there was no way that I could get my ankle across the knee - this has been my goal and I have done it. I have to be honest, I have not got it to perfection, that being my next goal. I wonder if that will take another 21 months. It just shows that a little persistence pays off in the end. I trust that all is well with you."

Twenty-one months - what a dedicated learner. It was a joy to work with enthusiastic Ivy. I wrote back saying it should not take so long, and asked if she did the stretch standing up to put on shoes and socks to make it real life, not an artificial stretch. Ivy wrote back,

"I have tried standing to put my sox on and cannot quite make it YET (note the yet), that will come. I do, however, ensure that I always stand to remove my sox, and the like. Also to put them on except for the sox. I also stand when I moisturize my legs and feet - I do this so as to improve my balance."

I wrote back encouraging putting socks and shoes on and off while standing. The point of stretching is healthy function, not to "do a stretch" just to have a greater range. The benefit is from applying the stretch to ability to stand steadily on one foot and have muscle stretch and length to put on shoes standing .

Four hours later Ivy wrote back:

"Wow, I did it. I have just returned from a 30 minute walk, did some lunges as a further warm up and thought I would give it a try. I cheated, instead of shoes, I used slippers - I thought it would be easier. Tomorrow I will try shoes.

"Dr Jolie, you are my inspiration, you asked if I could do it and that set me a challenge. I must NEVER SAY CAN'T. As you are probably aware, I am a very motivated woman, however, there is no one to spur me along - you have done that and again, I can only say a huge thank you."

The next day this arrived,

"I am very pleased with myself. I just needed that push. As I said yesterday, I must never say can't again.

"Again, all I can say is a huge thank you. A huge hug from me."

Readers, stand with safe balance to dress. Send me your fun photos, mpegs (short computer video) and stories of using healthful range of motion for daily life.

Original story and updates:

• Inspirational Ivy
• Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier
• Good Life Works Better Than Bad Ab Exercise
• Farm Work, Lifestyle Exercise, and Preventing Overuse Pain

Ivy is a great-grandmother! (and a pretty great person too). She says,

"I guess I am very much like my late father who was a quiet achiever who used to tell me to 'stand tall and be proud of who you are' - I pass this advice on to my kids all the time."

Labels: balance, hip strength, leg stretch, readers inspiring story, sciatica, shoes, spirit, stress, stretch

Permalink | 1 Comments| Email Post

Post your comment

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

Permalink | 2 Comments| Email Post

Post your comment

Fixing Fitness Myths

"The public has an insatiable curiosity to know everything, except which is worth knowing." - Oscar Wild

April 1 seems to be a day to notice, more than usual, if things in the news are not facts but April Fool. On other days, urban legends and other stories are still popular, sometimes more popular than what is really going on.

The observation that the Earth is flat seemed obviously true at one time until we had more information. It used to be a taught as a medical fact that the cause of epilepsy was masturbation. When I was in school, one of my medical books stated that you don't need to eat calcium since you can "get all you need from your bones." It is true that you pull calcium from your bones when you don't eat enough, although with unhealthy results.

The post Forensic Science told of two crime-science myths, often still taught in forensic books and popularized in television shows, which were never true. Following are more posts hoping to replace myth with information, so that you can get stronger and do more, without the injuries or restrictions in activity that are part of many fitness or injury rehab practices.

Feet and Ankles

Myth - You need tight shoes for support. Fact - tight shoes can deform toes and prevent healthy muscle use:
Are Your Shoes Too Tight?
and Healthy Toe Stretches.

Myth - All ankle stretches prevent sprains. Fact - Some may enhance predisposition to ankle sprains:
Unhealthy Yoga Ankles.

Myth - Following an ankle sprain, bracing must be continuous since no exercise can restore the area. Here is another way -
How To Treat Ankle Sprains and Prevent Them
and
No More Ankle Sprains Part II.

Dispelling Myths of Orthotics Use:

Myth - Only orthotics can place your arches in neutral position. Fact - your own muscles can often do the same:
Arch Support Is Not From Shoes
and
Which Shoes Help Exercise, Fall Prevention, and Ankles?

Dispelling Aging Myths - That respiratory function only declines with age:

Do Breathing Exercises Work?

Dispelling Aging Myths - That you only get weaker with aging:

Getting Stronger is for Everyone
What I Learned at the Aging Conference
Better Balance by Christmas
Conference on Aging Dec 2, 2006 in Midtown New York.

Dispelling Nutrition for Exercise Myths:

That weight gain with aging is primarily lower metabolism: Metabolism - How to Lose Weight and Save Money

or that Healthy eating is difficult or expensive:
What Medical Students Told Me About Nutrition.

Myth that you must eat much protein to get muscles:
Get Muscles for Christmas

Myth that acid prevention drugs are harmless:
Stomach Acid Drugs May Increase Osteoporosis and Hip Fractures

Myth that food marked "Health Food" means it has to be healthy:
Is Your Health Food Unhealthy
and Exercise Common Sense Discipline - Turn Down Halloween Junk Food

and the myth that it's healthy for children to eat junk food:
A Little Good Exercise, a Lot of Bad Food - Overweight Still No Mystery.

Myths that only gyms and weights can improve your strength:

How to get natural exercise is in Rocky IV and Healthier Exercise,
Getting Stronger Without a Gym
Exercising With A Friend - Partner Leg Press
Don't Confuse Exercise With Real Fitness
Healthy Toe Stretches
Quick and Fun Arm and Body Strengthener
and Quick and Easy Strength and Balance Exercise.

More to come for smart, fun, healthier ways to get exercise.

Labels: aging, ankle, arches, arm, balance, breathing, feet, fix pain, forensic, holiday, leg stretch, myths, nutrition, osteoporosis, partner exercise, shoes, sprain, strength, toes, yoga

Permalink | 0 Comments| Email Post

Post your comment

Why You Need Toe Stretches

When you take your shoes off and stand up, do your toes turn upward by themselves, as in the photo at right? That is usually from tightness in the top of the foot. You can often see the tight, string-like tendons on the top of the foot pulling the toes back. Do your toes face outward (toward the little toes) when your foot is facing straight forward (same photo). A sideways -shift is common, not only from tight shoes, but can be produced from how you walk, step after step, year after year.

Toes deform into unhealthful positions in common ways:

• Shoes: Tight shoes fold and shift toes out of place. Heeled shoes push toes upward. When toes are held in one position too much, the muscles tighten and don't go back to normal length.
• How You Use Foot Muscles: Many people do not use muscles in their feet or toes when they walk. They just clomp. The muscles that normally work to pull toes and forefoot downward during the weight-bearing phase never engage properly. The toes stretch upward during push-off, but not downward.
• Positioning: If you walk with feet facing outward, the "push-off" phase is on the side of the big toe instead of the bottom of the foot. After years of being pushed toward the other toes, the big toe eventually tightens into the new shifted position.

Good reasons to stretch toes:

• Healthy spacing avoids fungus like Athlete's foot, calluses and other injuries from rubbing, and improves needed movement.
• Toes need to move through a full range up and down, and independently from each other, for balance, preventing several causes of foot pain, and for quicker, healthier movement ability. Feet are not just blocks to clomp around on.
• You can avoid toes that curl, hook, hammer, face different directions, or push sideways into bunions.

Try these easy stretches:

• Take your toes in your hands and bend them all downward, to stretch the top of your foot.
• Take your toes in your hands and bend them all upward, enough to feel a nice stretch in the bottom of your foot, not just the toes.
• Pull each toe apart from the next.
• Pull the little and big toes away from each other at once, restoring healthy width to the front of the foot.
• Pull any toes that are bent-up until they are back downward. Pull bent-down areas gently straight, and pull curled toes straight out to restore straight length.
• See the post Healthy Toe Stretches for fun foot stretches.

Stretch deformed, squashed toes with your hands several times every day, or at least at night and in the morning, or when exercising or stretching. Reduce the need to stretch them back to health in the first place. Walk with feet (and knees) facing straight ahead. Wear shoes with room in the toes. Tight shoes are not healthy. Unhealthy shoes are not beautiful.

Labels: feet, fix pain, gait, posture, shoes, stretch, toes

Permalink | 0 Comments| Email Post

Post your comment

Are Your Shoes Too Tight?

It is often taught that tight or snug shoes are needed for "support." However, tight shoes are not healthy for many reasons, or even needed. The posts Arch Support Is Not From Shoes and Which Shoes Help Exercise, Fall Prevention, and Ankles? explain more about the myth that support is from shoes.

Shoes worn snugly "for support" cause frequent problems. If your toes fit together like puzzle pieces or do not face straight ahead, as in the photo at left, it is likely that you frequently wear shoes that are too tight.

There should be space between each toe, and each toe should face straight forward, not turned toward either side (photo below right).



If you need toe separators (a soft foam device for separating toes) to paint your toenails, your toes are too tight and bunched together. Toes that are bunched together need regular stretching to separate them. Take your toes in your hands and gently pull them apart. Some of my patients use those toe separators to wear to bed. That is all right to start, but instead of only treating the result of a tightness problem, it is best to correct the problem with simple stretching before deformity progresses to the point where it is difficult to fix:

• Pull your toes away from each other with your hands.
• Straighten each toe gently.
• Make sure all toes separate and can wiggle.
• Practice wiggling your toes.
• Don't wear shoes that push your toes together or keep them from moving.
• Avoid tight socks and stockings - "tight" is anything that presses your toes together.
• When standing, don't tighten or clench your toes against the floor or each other. Don't press toes into the ground to balance so much that they buckle and bend. Keep your weight distributed over your entire foot, including your heel. Notice if you rock forward to the ball of your foot when standing.
• Take off shoes and all hosiery every day and let toes get sunlight and air.
• When you exercise and walk, make sure you do not walk "toe-out." Turning the feet outward, sometimes called "duck-foot" used to be thought the normal direction of the fibers and muscles. Now it is known that both feet should be able to comfortably face straight ahead.

Toes do many wonderful things for balance, walking, ability to jump and move quickly, for the shock absorption important to your hip, and more. See the post Healthy Toe Stretches for foot stretches. The next post will give fun stretches specifically for tight toes.

Labels: feet, fix pain, gait, injury, shoes, stretch, toes

Permalink | 2 Comments| Email Post

Post your comment

Why So Many Aerobics Injuries?

A recent New York Times article quotes aerobics teachers and devotees saying they now have painful, chronic injuries from years of aerobics classes. Why did this happen?

I receive frequent e-mails from aerobics instructors, many only in their 20s and 30s, saying they are too old to continue teaching because of pain and injuries from teaching. I am older than their parents. At the schools and clubs where I teach classes, teachers and trainers are often absent, or replaced, because of herniated discs.

The Times article quotes major aerobics spokespeople, attributing the injuries to jumping on "concrete floors in bad tennis shoes," and related how former well-known-names in the aerobics industry now teach low impact classes. The article continued, "A lot of people doing aerobics back then can no longer do any jumping whatsoever. They have problems with their backs, feet and hips."

In the years I spent in the lab studying injuries, seeing patients, and teaching students, I have found that the problem is not that impact must be avoided. I see patients who are instructors of Pilates, stretch, yoga, rowing, martial arts, and Alexander technique for degenerating joints. It is simple misuse. It is not that people are doing the exercises "wrong" but the movements themselves. If you saw someone bend over at the waist or hips to hoist a suitcase or child, you know it is bad bending and it hurts the back. The same people will bend over the same way to lift weights in a gym or do yoga stretches. It is the same disc-injuring bending in all cases. The post Common Exercises Teach Bad Bending gives interesting examples from a class that is "low-impact." Wear occurs on the lower back and neck discs regardless of how expensive and engineered the aerobics shoes. The post Are You Making Your Exercise Unhealthy? shows you how to put the knowledge of bad positioning together in your mind with how people are exercising, to realize it is not rocket science when people have pain, even though they "do their exercises."

Impact activities are not the problem. Many people walk with higher impact than a good martial artist will kickbox. Many people are unnecessarily restricted from favorite sports and told to walk instead, based on the fallacy that running or tennis is necessarily higher impact, instead of looking at how heavily they clomp around letting spine, hips, knees, and ankles sag and grind. One story with helpful links is told in You Can Fix Your Own Knees.

Many of my obese patients with knee pain stand and walk with their knees in sagging positions. This is not a consequence of their body weight. When I show them to simply hold their knee from knocking inward (or outward) by using their own muscles to hold straight, the pain quickly goes away. They say that they can then, for the first time, *do* any real exercise to lose weight.

The post When Did Health Become Thinking Out of The Box? explains more of why you don't have to have pain from exercising or even long sitting while studying (or watching TV). I don't take people away from their favorite activities when injured. I even use their sport as rehab, showing them how to do it in healthier ways so that they can do more, lift more, and run more than before, not less. Health care should not be "Limit to the patient to limit the pain."

Read Inspiring Patient Stories on my web site - how patients fixed their own pain and could do more than before.

Labels: ankle, disc, fix pain, hip, injury, knee, martial arts, planter fasciitis, shoes, yoga

Permalink | 4 Comments| Email Post

Post your comment

Arch Support Is Not From Shoes

The previous post showed how the best ankle support comes from your own ankle, leg, and foot muscles. Pronation (flat, sagging arches) is rarely just the way your feet are made or something you can't prevent. You may allow ankles to bend inward and sag, or you can prevent sagging and easily hold your ankles in healthy position, no differently than not letting your posture sag anywhere else.

It is commonly taught in gyms, medical schools, aerobics certification programs, and footwear stores all over the US, that shoes or orthotics are necessary to hold up your arches. That is a fallacy. The needed support should come from your own foot muscles. How do you do this?

• Stand up with both feet parallel, pointing straight ahead.
• Allow your body weight to slump downward, pressing your arches against the floor (left hand photo). You will notice that your arches flatten, reducing the arch, not because there is something wrong with your arches, but simply because you allowed it.
• Next, use the muscles on the outsides of your ankles and legs to gently shift your weight more to the soles of your feet and off your arch (right hand photo). Don't tilt completely to the side or stand on the sides of your feet, just shift enough to lift your arches from the floor.
• Now you can see that having arch support is the same as having neck support by using your upper body muscles to stop slouching. Pull your chin inward gently right now to remind yourself of this.

Support your feet by holding position using your own muscles, not a shoe 'straight jacket' that lets ankles atrophy and doesn't let toes move, stretch, and straighten.

See fun posts on foot and ankle health:
Healthy Toe Stretches and Unhealthy Yoga Ankles and my web site page Inspiring Patient Stories for a first-hand account of someone who fixed a lifetime of pain and pronation by simply stopping the cause - letting ankles and feet sag. By simply holding healthy positions during your normal day, you can get free built in exercise for your feet and ankles, and better health. See the book, "Fix Your Own Pain Without Drugs or Surgery" for how to have healthy arches and foot support.

Labels: ankle, arches, feet, fix pain, myths, orthotics, pronation, shoes

Permalink | 3 Comments| Email Post

Post your comment

Which Shoes Help Exercise, Fall Prevention, and Ankles?

We are in the cold, damp Tennessee mountains for the rest of the week, teaching at a medical school program of wilderness medicine. It should be warmer than home in the Northeast US where it's snowing, and the Schuylkill River, and water bottle on my bicycle are frozen. I won't have Internet or phone access at the wilderness camp. Unflagging Healthline staffer Carrie Locke is posting the blogs for me all week. Thank you Carrie, once again.

For wilderness treks and hikes, and everyday walking, you need to walk on uneven surfaces without stumbling or spraining your ankles. Expensive shoes, inserts, arch supports, braces, ankle supports, and orthotics are sold on the belief that they are needed to hold your foot and ankle in position. However, this is an expensive fallacy.

You are the one who can hold your ankles in straight position or let them sag into foot pronation. You don't need, or even want, shoes that hold your ankles straight for you. Without use, your ankle muscles weaken. With shoe support, your ankle doesn't have to work to hold itself. It gets weaker. It forgets how. It is the opposite of what is needed.

It is not high top shoes or ace bandages or taping or orthotics that prevent falls and ankle sprains, or prevent ankles from sagging inward or "pronation." The most important thing you can do for healthy ankles and preventing sprains is to use your own leg muscles, and simply hold your ankles without sagging, the same as any other posture. Think of a beginning skater. At first, they let their ankles bend and sag inward. They do not know how to hold their legs using their own muscles. Eventually, they learn to hold straight, healthful positioning.

Letting your ankles sag inward can press the joints of your arches, ankles, knees, even hips. In most instances, supportive shoes and inserts are no more needed than putting your mouth in a sling to keep it from falling open when you walk around. Thinking that you need supportive shoes to brace uninjured ankles for hiking and walking is a common myth that perpetuates weak, unstable ankles. Many people who use arch supports never learn how to use their own muscles, and are told to never go barefoot. This is an unfortunate and unnecessary restriction to their health.

The post Healthy Knees shows what inward-sagging knee positioning looks like and how to fix it. It is easy to do and makes an immediate and important improvement to your joint health.

Often in wilderness settings, I see hikers in expensive boots. The native mountain guides and pack-bearers are wearing flip-flops. This is not just a salary inequality. It is not that the guides don't know ankle health. They know something crucial - the health of your ankles comes from your own muscles. You will save much money on footwear and products that prevent your foot and ankle muscles from working, and you will get free, built-in leg and foot exercise with every step.

Read more how to have healthy ankles and ankle support in the book Fix Your Own Pain Without Drugs or Surgery.

Labels: ankle, arches, feet, hip, orthotics, pronation, shoes

Permalink | 10 Comments| Email Post

Post your comment

Healthy Toe Stretches

Don't forget to stretch your toes. You need mobile toes for balance, healthy walking mechanics, and foot health.

Every day, take your feet in your hands and stretch your toes apart side to side, easily and comfortably. Make sure all your toes can move apart from each other, and that each one moves up and down. It is not healthy for your toes to remain stuck together and not moving.

Sitting in various ways can be a built-in stretch for the toes. If you sit on your heels, as in the photo at left, or kneel on your hands and knees with toes curled under you, or when you are sitting in your chair right now, see if you can bend your foot behind you and still touch all your toes to the floor - even your little toes. Don't force toes to bend, just gently see if they all reach the floor. After stretching your toes back (toward the top of your foot) bend them all down toward the bottom of your foot. Many people, particularly people who wear heeled shoes wind up with toes that are bent upward all the time. The tendons on the top of the foot can shorten from keeping the toes bent up, and the toes can get stuck in a pulled-up position. Future posts will cover more on stretching your feet for mobility, pain control, and health.

When you sit, as in the photo above, see if you can rise to a stand without pushing off the floor with your hands or bracing your hands against your leg or knee. Just use your leg muscles and get a strength and balance exercise while you get a nice stretch on the bottom of your feet.

The photo was taken when I studied a medicine course in Cambodia. Before and after classes you practice respect, concentration, and self-discipline. While you do this, you get a lot of physical exercise - it is commonplace for people of any age to kneel without using hands for anything except to hold the candles, flowers, and incense, and to rise the same way. The photo was taken in the middle of bowing, so I am not fully straightened yet. The nun is laughing. My Cambodian is so bad that I made her laugh. I think that is good exercise and good medicine too.

Photo by Paul

Labels: ankle, arches, balance, feet, fix pain, gait, leg strength, orthotics, pronation, shoes, spirit, squat, strength, stretch, toes

Permalink | 0 Comments| Email Post

Post your comment