Plus: Biometrics in Pro Sports, Epigenetics and How Exercise changes our DNA, Hip Dysplasia„ Pavlik harnesses.
We hope you find today’s show helpful. Remember, we don‘t know everything, and we do not expect everyone else to know everything either. We are just bringing our logic and knowledge and hopefully truth to the web … . . Please, Correct us when we are sharing inaccuracies, as we try to do the same. There is alot of misguided info on the web and in the wrong hands, people can get hurt … . we feel we are doing our part to carve a safe path. But, when we go astray, please our dear brethren……call us out on it ! We insist. -Shawn and Ivo
Journal of Pediatric Orthopaedics: January 2015 – Volume 35 – Issue 1 – p 57-61 Back-carrying Infants to Prevent Developmental Hip Dysplasia and its Sequelae: Is a New Public Health Initiative Needed? Graham, Simon M.
Just a simple reminder. Most shoes have EVA foam between the hard outsole rubber. EVA foam compresses but it also has memory. If you have a running form issue or a foot type that drives abnormal biomechanics into the shoe then over time the shoe’s EVA foam will break down into that pattern. Not only does this then support the problem, but it enables you to engrain the pattern (which means you are not engraining a cleaner pattern) meaining that every other joint and muscle then assumes that this is the norm and begins to alter their function based on the premise. A sign issue can drive many issues and many other complaints. This client had a rigid rear foot varus , obviously as you can see by the wear pattern (yes, we gently and lovingly flogged this running for wearing the shoes this long into this pattern) but it was made worse by letting the shoe entrench this pattern so deeply. You see, their rear foot varus was no where nearly as bad as the wear into this shoe. But they continued to wear it and the foam continued to break down further and deeper into this varus wedged pattern. They came into see us for lateral knee pain and a tight IT band that was not responding to foam rolling (we immediately began to whimper and then proceeded to thump our forehead into our desk, repeatedly). Some things should be obvious, but even we are far from perfect or wise at times.
Key point, you have heard this here over and over again from us, have 2 or 3 pairs of shoes. Introduce the new shoe into your running repertoire at the 200 mile mark. At that point start rotating your shoes so that you are only a day away from a newer shoe that his not broken down into a faulty pattern and thus deformed EVA foam. Even by the time the one shoe is dead and done, you have not been in it every run. You should never kill a shoe to the 500 mile mark and then buy a new shoe. The pattern you have worn into your shoe will suddenly disappear when you put on the new shoe. Injuries occur from repeated events or sudden changes. Reduce your risk and rotated at least 2 pairs of shoes, one newer and one older.
We talk about alot of these issues, and so much more, in the National Shoe Fit Certification Program. Email us if you think you might be interested. firstname.lastname@example.org
And ……when it comes to your feet and shoes, use your head.
What does sustained rearfoot and forefoot inversion look like in terms of shoe wear ?
This is a client who came to us with a history of several months of big toe pain (specifically 1st metatarsophalangeal joint pain). The pain was dorsally located (ie. top of the big toe joint). It was clear that on examination the pain was being caused by osseous and soft tissue dorsal impingement due to a progressing hallux rigidus/limitus.
This painful status obviously is creating both a conscious medial toe off pattern during the propulsive phase of late stance phases. The client is more than obviously steering push off laterally as can be seen in this photo. The grey lateral pods are almost obliterated. This means the foot is perpetually supinated during the entire stance phase of gait and this means that pronation shock absorption is not present.
Remember, a perpetually supinated foot means the talus and arch never descend as part of the pronation/shock absorption cycle and so the same side limb will always remain longer than the other limb which is seeing the internal rotation/pronation effects which functionally shorten the leg during stance phase. So in this case, we have a pelvic unlevelling and a frontal plane shift to the functionally shorter leg during its stance phase. It should not surprise you that this client has hip pain contralateral to this abnormal shoe wear/hallux limitus side.
There are plenty of other issues here to be discussed, like eccentric weakness of the same side g.maximus, patellar tracking issues, lack of hip extension and thus weakening of the glutes and thus resultant shortness of the quadriceps group which will all often be found in this clinical picture. But we will save that all for another time.
Remember, the longer this client stays in this shoe, the easier it is mechanically on them because the eVA foam and the shoe are broken down into their compensatory avoidance behaviour. But, this is where the pattern becomes subconsciously embedded and thus when the pattern drives many of the other compensatory patterns off of this one since it is the new norm. The faster you address this problem, the sooner you stop the compensatory cascade. And on that note, if you read our blog post re-run of the Arm Swing last week you will understand why these folks will begin altering the opposite arm swing phase.