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In our last blog we discussed rocker bottom/toning shoes.  In this blog we will discuss toe shoes or five finger running shoes.  I’m sure you have seen these shoes worn by various people both for walking and running.  Some people hate them, while others won’t stop ranting about them.  So what’s the full scoop?

These toe shoes are designed to provide minimal support to the foot in order to simulate barefoot walking and running with less risk to the individual wearing them than having completely bare feet.  The shoe promotes pressure being place toward the ball of the foot versus the heel during running activities.  With all of that being said, is this form of shoe actually good for you?

The argument for “barefoot” style running is that our bodies were initially designed for running barefoot versus in a ridged shoe.  On the flip side, our bodies were also designed for running on dirt and grass versus asphalt and concrete.  The impact that these harder surfaces provide can be damaging to the foot and can cause ligament strains or even stress fractures in the feet.  Despite the fact that our bodies may have initially evolved to walk/run without footwear, not everyone is exactly the same and individuals may have foot problems right from the start.  People with various foot conditions may need the extra support that more rigid footwear can provide while others may receive benefit from the minimal support that the toe shoe provides. 

The other important component of the minimalist toe shoe is that it promotes forefoot strike during running.  In other words, the shoe makes you land on the ball of your foot while you run.  There are several minimalist styles of shoe that also promote this forefoot strike, but is that a good thing?  Forefoot strike actually increases the amount of tension that is places on the Achilles’ tendon and calf musculature which may lead to more injuries in the area.  Research has also shown that using a heel strike (landing toward the heel of the foot) during running is more energy efficient.  This means that people who use a heel strike during running have the potential to use less energy and oxygen while running at the same intensity as a person using a forefoot strike.

The minimalist toe shoe is much like any other type of shoe.  It may work for some people and be harmful for others.  The ideal candidate for toe shoes/five finger running shoes would be an individual who already uses forefoot strike while running, lands softly, and has a relatively flexible arch that does not overly pronate (position that causes a dropping of the arch of the foot).

Just because a certain type of shoe is trending at the moment does not mean that it is the healthiest option or the best one for your body.  Do your homework and find what fits you best.  If you have concerns about what shoe may be the best fit for you, talk to your physical therapist. 

Resources:

http://regressing.deadspin.com/the-scientific-case-against-vibrams-fivefinger-running-1575132888

http://www.washingtonpost.com/news/to-your-health/wp/2014/05/08/say-it-aint-so-vibram-say-it-aint-so/

http://observer.com/2013/06/science-says-your-disgusting-toe-shoes-arent-doing-anything-but-grossing-people-out/

http://www.runnersworld.com/barefoot-running/are-you-ready-to-go-minimal

http://kdvr.com/2014/05/13/refunds-for-toe-shoes-owners-after-maker-settles-false-advertising-suit/

 

 

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I am sure that you have heard about the various shoe trends that have come out over the years, from the rocker bottom shoes to the minimalist and toe shoes.  But are these different fads good for you or are they harming your body?

Let me start by saying that every person is different.  People are built and conditioned in different ways throughout their lives.  As I’m sure you have noticed, some of the most amazing runners in the world are from Kenya, but if you look at the form used by some of these athletes, it is not necessarily the textbook definition of efficient or “perfect”.  So why does it work for them?  Their form works because they are built and conditioned for it to work.  If you grew up in Kenya with a completely different physical environment and job tasks, then you may be conditioned the same as those athletes.  If, however, you grew up in “big city USA” with the constant force of concrete to run and work on, then you likely will have very different body mechanics than the Kenyan athlete.  With that being said, even individuals who grew up in the same environment can have different foot mechanics.  One person may have a very rigid foot while another person has a very mobile foot or even a flat foot.  These differences can also effect which shoe choice is the best for you.

Obviously, not everyone is looking for a “running shoe.”  Some of you may just be looking for a fitness shoe or simply a shoe for daily use.  A variety of shoes have been manufactured for these reasons.  Let’s start by discussing rocker bottom shoes, also referred to as “toning shoes”.

These shoes were initially intended as a specialty shoe that podiatrists would prescribe for various ankle and foot problems, issues with walking, diabetes, or deformities.  Now they have been mass produced for all to use.  The big marketing campaign for these shoes is based on the claim that they help to tone the body and improve calorie burning simply by wearing them regularly.  So is this claim accurate?  The unstable nature of this footwear does cause the wearer to activate muscle that may not have regularly been activated by simple stance positions.  They can also assist with training balance stability by challenging balance due to their unstable base, thus causing the wearer to have to balance more efficiently in order to stay steady.  Posture may also be assisted due to the wearer staying more upright in order to maintain balance.

If all of this is true, then what’s the down side?  One down side is that the claim that these shoes improve muscle tone and burn calories may not be accurate.  More research is needed to substantiate these claims, but currently conflicting evidence is present; meaning that there are studies that show positive benefits and others that show no difference than other footwear.  Another negative is that these shoes cause greater instability.  Yes, they could cause the wearers to challenge and improve their balance; but if a person does not have good balance to start with, then that person will be more prone to fall in an unstable shoe.

The moral of the story is that rocker bottom shoe may be beneficial for some, but not for all.  Our next blog will discuss toe shoes. 

Resources:

http://www.aapsm.org/toningshoes.html

http://www.webmd.com/fitness-exercise/guide/truth-about-toning-shoes

 

 

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I have heard plenty of people complaining recently about how expensive health care costs are especially after a hospital stay or surgery.  So what if you could avoid an expensive surgery?  

What if you could see a healthcare professional, receive exercises that help to decrease your symptoms, and then utilize the knowledge you learned to manage your symptoms without having to continue to pay for treatment and without having to pay toward a ridiculously high hospital bill?  Well the research shows that physical therapy can be just that remedy versus surgery for spinal stenosis.  If cost is not your concern, then perhaps time is.  When properly managed, patients that undergo back surgery should then be treated with physical therapy for improving function, strength, and stability in the back. 

For those of you who don’t understand what spinal stenosis is, it occurs when there is a narrowing of the spaces between your vertebrae (bones that make up the neck and back) resulting in pressure on the spinal cord or nerves.  This pressure can result in pain, numbness, tingling, or weakness in the arms or legs.  Occasionally, it can also affect bowel and bladder function. 

According to a study recently published in the Annals of Internal Medicine, physical therapy was shown to be just as effective as decompression surgery in terms of relieving symptoms and improving function in individuals with lumbar spinal stenosis.  This means that if you skip the back surgery and attend physical therapy, then your overall outcomes are nearly the same.

In this particular study, the physical therapy regimen that was used followed an evidence-based, standardized program.  Patients were treated with instruction on lumbar flexion (bending forward at the waist) exercises, conditioning exercises (ex. stationary biking or treadmill walking), leg strengthening exercises, and education on avoiding aggravating postures like excessive extension (bending backward).

The most important thing to note is that physical therapy can be used as a cost effective and less risky treatment for low back pain like stenosis.  Before going under the knife, an episode of physical therapy is worth considering.

Resources:

http://www.apta.org/Media/Releases/Consumer/2015/4/8/

http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=5e4daaa0-cb21-4eee-8484-e728617397aa#.VZLqA_lViko

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