Cheating on your workouts

When it comes to weightlifting, are “cheat” reps worth it? Dr. Linsay Way shares some insight:  The long answer is that not all cheating is created equal. Some of the world’s best physiques, such as Ronnie Coleman’s, were built utilizing momentum to help lift progressively heavier weights. On the other hand, bodybuilder Dorian Yates is religious about using perfect form on just about every exercise he does. Who’s right?

Biomechanical Considerations

Biomechanically, several factors need to be considered. First let’s differentiate between the two types of cheating in weightlifting. The more allowable of the two is the extended-set cheat, in which reps are performed with as perfect form as possible before using momentum or additional muscle groups to push past the point of failure for one or two reps.

weight traingin - Copyright – Stock Photo / Register Mark If you’ve been training hard consistently for years and your progress has stalled, this is the type of cheating that can help push past a plateau. For everyone else, however, it’s not necessary. Beginning and even moderately experienced weightlifters will build muscle without going to failure. They should be focused on perfecting form, not looking for ways to undermine it.

The other variety is the heavy cheat, in which a “looser” form is used through the entire set to lift heavier weight than normally possible. This is the type of cheating that should be discouraged for all lifters, no matter what their experience level or which exercises they’re doing. The benefit gained is minimal compared to potential risk of injury.

The second consideration is injury history, as most cheating involves movements that are risky for joints, muscles and ligaments. For example, if you have a history of lumbopelvic injuries, it’s not wise to be bouncing the bar off the pins while deadlifting. Even a slight slip in form can result in a serious injury if you’re working with compromised joint and ligament function. The 6-8 months of lost time and lost progress spent recovering from an injury isn’t worth the minimal extra muscle fiber activation.

The final consideration is the type of lift being performed, as certain exercises lend themselves to cheating reps better than others.

Allowable Cheat Exercises

  • Lateral deltoid raises: Performing strict reps to failure and then swinging the weights slightly will hit your deltoids hard with little chance of injury.
  • Dumbbell curls: Using some knee-bend and body English can extend the set past failure relatively safely.
  • Triceps pushdowns: Use the lats and pecs to push past failure one or two reps.
  • Seated leg press: Put your hands on your legs to get a few extra reps.
  • Dumbbell / cable rows: Utilizing proper form until failure and then using momentum to keep going can be done with minimal injury risk.
  • Lat pulldowns: It’s difficult to injure yourself performing these, so cheating at the end of a set isn’t usually a problem.

Asking for Injury: Cheat Exercises to Avoid

  • Deadlifts
  • Barbell rows
  • Shoulder shrugs
  • Bench presses
  • Chest flyes
  • Squats
  • Leg curls
  • Preacher curls
  • Calf raises
  • Upright rows
  • Parallel bar dips
  • Lying triceps extensions
  • Chin-ups

Better Options to Maximize Gain

It’s a shame that cheating is so overused, as there are better techniques for getting the maximum benefit out of a set. Drop sets, for example, are a great option for lifters looking for significant gains in mass. Drop sets are done by performing a lift to failure or just short of failure, then dropping the weight or resistance by about 15 percent and continuing repetitions. Once failure is reached again, an additional 15 percent of resistance is dropped, and so on. The idea behind forced sets, in which a spotter assists progressively more as your muscles fatigue, is similar.

If you’re going to utilize extended-set cheaters, don’t go overboard. Use strict form on the majority of sets and avoid cheating on any more than one or two sets per muscle group. Most weightlifters can make significant, consistent gains by using textbook form 100 percent of the time. As discussed above, there are some situations in which some extra “oomph” is needed to push through a plateau, but these are the exception, not the rule.

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Plantar Fascitis

Plantar fasciitis affects approximately 2 million people in the United States each year. It can come on gradually as the result of a degenerative process or sudden foot trauma. It can appear in one heel or both. It is generally worse on taking the first few steps in the morning or after prolonged sitting or non-weight-bearing movement. Symptoms can be aggravated by activity and prolonged weight bearing. Obesity is also hard on the feet—it can cause plantar pain or it can make that pain worse.

The plantar fascia connects the heel to the forefoot with five slips directed to each toe respectively. One cause of plantar faxcitis is improper footwear. Some footwear may allow improper foot function, as well as impaired shock absorption. In normal gait (walking), the ankle rolls slightly inward after heel strike. Then, the ankle rolls outward as you toe-off from that step.

Compensation is a problem with plantar fasciitis. We are “compensating” when we get into the habit of moving the body in a new way to avoid pain. On the other hand, persistent pain from plantar fasciitis itself may get you to shift your weight to the outside of the affected foot, or you may try to land on the toes. Any of these pain-avoiding strategies throw the body out of alignment—and can lead to stressed joints and new pain in other parts of the body. Symptoms may increase to the point where you are no longer able to bear weight on the affected foot.


Many types of treatment have been used to combat plantar fasciitis, including chiropractic adjustments, stretching, injections, anti-inflammatory medications, orthotics, taping, and night splinting. Stretches should be performed several times per day, with the calf in the stretched position. Therapeutic modalities such as low-level laser, ultrasound, and electrical muscular stimulation may be effective in the reduction of pain and inflammation.

Chiropractic Treatment

Manipulative treatment may be beneficial to restore normal joint mechanics to reduce tension across the plantar fascia. Chiropractic treatment may include a rehabilitation program. Progressive resistance exercises should begin with isometric toe curls. You hold the contraction for 10 seconds, repeat that 6 to 10 times, and do it one to three times a day. Initially, some muscular cramping may occur, at which point the active contraction should be stopped. Reintroduction to the exercise should be limited to cramping tolerance. Strengthening exercises of the calf muscle group must be performed over a progressively increasing range of motion.
Final-stage rehabilitation exercises may include proprioceptive exercises such as single-leg stands with the eyes closed for 30 to 60 seconds. These can be introduced with limited pain upon weight bearing. Exercises that include jumping rope or other hopping exercises can be introduced in the final stages of rehabilitation.

A brief self-massage of the plantar fascia before getting out of bed in the morning can be helpful—before any weight bearing or stretching. Try rolling a golf ball from the middle of the affected foot on the sole toward the toes. Do not roll it over bones; keep it in the soft-tissue part of the underfoot. This brief massage takes 20 to 60 seconds. You can also try rolling a frozen water bottle back and forth along the fascia.

Surgery may be a consideration only after all conservative measure have been adequately exhausted.


Recovery from plantar fasciitis can be a slow process. Most people recover within a few months with conservative therapy. Approximately 90 percent will respond to conservative measures.
The key to effective treatment of plantar fasciitis is aggressive conservative therapy and dedicated patient compliance. No single treatment has been shown to be effective for all cases. Multiple modes of therapy may be required for this difficult condition.

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Independent proof that Chiropractic reduces costs to employers and insurance companies

Chiropractic care not just cost effective for individuals.  From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP). The authors analyzed databases belonging to a large, self-insured company over the course of nine years to evaluate the direct and indirect costs of LBP for the company’s employees (EEs). You can find the entire article, which is a quick read, here:

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Aging Too Quickly?

For years we have been hearing the mantra of baby boomers who refuse to grow old gracefully: “50 is the new 40”and “60 is the new 50.” But researchers in the Netherlands have discovered that in young adults this axiom is not true. Conversely, the current generation of young adults is actually biologically older than their parents and grandparents at the same age. Today’s young adults are so unhealthy that they appear to be 15 years older than their parents appeared at the same age. The study published in the European Journal of Preventive Cardiology followed 6,000 adults over a 25-year period. This study found that young adults suffered an alarming increase in conditions attributed to metabolic syndrome: increased rates of diabetes, hypertension, cardiovascular disease, obesity and other conditions.

According to this study, men in their 30s were 20 percent more likely to be obese than previous generations, and women in their 20s were twice as likely to be obese as previous generations.

“The more recently born adult generations are doing far worse than their predecessors,” said Gerben Hulsegge of the Dutch National Institute for Public Health and the Environment, who authored the study.

“For example, the prevalence of obesity in our youngest generation of men and women at the mean age of 40 is similar to that of our oldest generation at the mean age of 55,” Hulsegge says. “This means that this younger generation is ‘15 years ahead’ of the older generation and will be exposed to their obesity for a longer time.”

Silent Pandemic
This study exposes a silent pandemic that is sweeping the developed world; the growing epidemic of ill health brought on by unhealthy eating, obesity and sedentary lifestyles. In spite of a reduction in risky behaviors, such as smoking, and medical advancements, life expectancies may plateau and actually recede in coming decades. Certainly the cost of health care can expect to rise, possibly to the point that health care costs could bankrupt the developed world. Consider some of these chilling statistics:

• $62 billion is the yearly amount spent by Medicare and Medicaid on obesity-related conditions (Robert Wood Johnson Foundation).

• $580 billion is the projected economic productivity loss due to obesity that could occur by 2030 if the current trend continues (Robert Wood Johnson Foundation).

• $1 billion is spent per year in additional airline costs (350 million gallons of fuel) to cover the cost to fly obese passengers (Aircraft Interiors International).

• $14.3 billion is spent on the cost of childhood obesity in the United States each year (Brookings Institution).

• $164 billion is lost in productivity to U.S. employers due to obesity-related problems (Society of Actuaries).

• One in four young adults is precluded from U.S. military service due to obesity.

More Medicine or More Motion?
Medicine is passive. The chemicals in drugs may slow the inevitable decline of health suffering from metabolic disease and obesity, but they do not address its foundational causes: sedentary lifestyles, unhealthful eating, sleep deprivation and obesity. More medical doctors means more pills but not necessarily a change in the fundamental way we manage health care.

Motion is life. Chiropractic restores motion and promotes an activated lifestyle. More chiropractors means more motion.

Mahatma Gandhi: “Be the change that you wish to see in the world.” Treat your patients with chiropractic, and encourage them to participate in a chiropractic lifestyle of activity, healthful eating, sleeping, temperance and healthy relationships. You may also choose to become a local champion in your community to promote an active, fit lifestyle and to encourage schools to expand physical education programs. Finally, I would challenge you to live your life in such a way as to inspire all those around you to greater health and fitness.

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Army Study Highlights Benefits of Chiropractic Care for Soldiers

A Beaumont Medical Center study recently showed that chiropractic care adds a “significant advantage” to their medical care. This study compared standard medical care to standard medical care plus chiropractic manipulative therapy. The study, which can be found at, made the following conclusions:

– Disability scores were significantly better in the group of patients that received chiropractic care.

– Pain scores were also significantly better in the chiropractic group.

– Seventy-three percent of participants in the chiropractic group rated their global improvement as pain completely gone, much better, or moderately better, compared with 17% in the standard care group.

– The average satisfaction-with-care score was nearly twice as high in the chiropractic care group compared to the standard care group.

This study reflects why medical doctors are increasingly embracing chiropractic care as a viable referral for musculo-skeletal (pain) conditions. At Urbandale Chiropractic, we frequently work with the medical profession for the ultimate benefit of our clients. Give us a call at 278-4594 to see how we can help you!

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Clearing up some of the major questions about Obamacare

Here are some details.

The Patient Protection and Affordable Care Act (PPACA), more commonly known as Obamacare, is more than 2,700 pages long, which means you probably haven’t read much of it – and certainly don’t know when and in what fashion certain provisions of the act will take effect. It’s time for a brief review, because key provisions of the act are scheduled to take effect in a few short months.

In this article, Matt Minnetta clears up some of the pressing questions surrounding Obamacare, highlighting provisions taking effect in 2014 that are pertinent to you as a consumer of health insurance plans.

Health Insurance Exchanges

All states must have an operational health insurance exchange taking open enrollments by Oct. 1 2013, for plans that will begin coverage Jan. 1, 2014. Each state can run its own exchange, partner with the federal government or let the federal government run an exchange in the state. The exchanges will be online marketplaces where consumers can compare and purchase health insurance plans.

There are rules that govern what plans can be sold on the exchanges. Each state can choose the “benchmark” plan that is to be sold on its state exchange, regardless of whether the state or the federal government is operating the exchange.


The federal government has defined a set of essential health benefits (EHB) that must be included in all health insurance plans going forward. A state can choose a benchmark plan that exceeds the EHB requirements. If a state does not choose a benchmark plan, then the default will be the largest small-group plan in that state, determined by enrollment.

There will be one uniform aspect to all plans sold on the exchanges: All plans will be labeled as either a bronze, silver, gold or platinum plan. The purpose of this is to make comparisons of the plans easier for consumers. Each level of plan equates to a different amount of costs covered by that plan. Bronze plans cover 60 percent, on average; silver 70 percent; gold 80 percent; and platinum 90 percent.

Plan deductibles cannot exceed $2,000 for an individual or $4,000 for a family. The out-of-pocket(OOP) maximum allowed for plans sold on the exchanges is not to be higher than the OOP limits on HSA plans. For 2013, the OOP limits are $6,250 for an individual and $12,500 for a family.

There will be subsidies to cover the premiums and out-of-pocket expenses based on the consumer’s income relative to the federal poverty level (FPL). If someone earns less than 133 percent of the FPL, they would be directed to Medicaid. There is a sliding scale of subsidies on premiums for households making 133-400 percent of the FPL. For reference, the 2013 FPL is $11,490 for an individual and $23,550 for a family of four; 400 percent of the FPL for a family of four is $94,200.

Medicaid Expansion

Next year is when the expansion of Medicaid will take effect. Prior to this expansion, eligibility for Medicaid has varied greatly from state to state. Most commonly, Medicaid / CHIP has been offered to children, pregnant women and parents with very low incomes. Among these groups, eligibility was determined by the individual’s income as a percentage of FPL. States’ eligibility threshold varied from as low as 17 percent of FPL to as high as 215 percent. The Medicaid expansion will make a uniform eligibility level of 133 percent of the FPL.

States do not have to accept this expansion, as ruled by the U.S. Supreme Court. If they do, the federal government will cover 100 percent of the cost of the newly eligible participants for 2014-2016. The percentage covered will gradually decrease to 90 percent in 2020. The percentage is not defined beyond 2020.

If all 50 states accept the Medicaid expansion and all eligible citizens enroll, this would add 15 million participants to Medicaid nationwide. But there are concerns as to whether eligible individuals will enroll. A Kaiser Family Foundation survey found that two-thirds of uninsured and low-income Americans do not understand the health reform laws and how the laws will affect them.

Individual Coverage Mandate

Jan. 1, 2014 is the date when all U.S. citizens (barring a very small group of exceptions) are required to have at least minimum essential health insurance coverage. Individuals who do not obtain such coverage will be subject to a tax penalty. This rule is pivotal to many of the other provisions of Obamacare.

The many demands imposed on health insurance carriers in terms of broader coverage are supposed to be made up for financially by the influx of new insurance consumers due to the individual mandate. There are reasons to believe this will not work out as planned.

The penalty for an individual who does not obtain coverage is the greater of either $95 or 1 percent of their income for that year. By 2016, the dollar amount rises to $695, the percentage of income to 2.5 percent, and is adjusted upward based on inflation going forward.

The national average health insurance premium on the individual market for single coverage was $2,580 in 2010. The state with the highest average premium was Massachusetts at $5,244, while the lowest was Alabama at $1,632. Based on either the dollar amount penalty or the percentage of the national per-capita income ($27,915) or median household income ($52,762), it is still significantly less expensive for uninsured individuals to stay uninsured.

Regardless of income, the penalty for not carrying health insurance will under no circumstances exceed the national average cost of a bronze (lowest)-level health insurance plan certified to be sold through the state health exchanges. That exact dollar amount cannot be determined until the plans and prices are in effect on the exchanges throughout the nation. Also, the IRS has been restricted in its means to obtain this tax penalty. No criminal penalties, liens or property seizures are allowed for failure to pay the individual mandate tax penalty.

It seems the main process the IRS will use to collect the penalty is to offset the offending individual’s income tax return. The low cost of the penalty relative to the cost of insurance and the weak enforcement options have led many to believe that Obamacare will not inspire nearly as many Americans to obtain coverage as the law’s authors suggested and intended.

No Annual or Lifetime Limits on Coverage

Under Obamacare, carriers will not be permitted to impose any dollar-value annual or lifetime limits on what the law deems to be essential health benefits. This provision has been in the process of being phased in for a number of years but will take full effect and apply to all health insurance policies as of Jan. 1 2014. This could certainly be seen as a positive for both consumers and providers. Carriers are no longer allowed to apply an arbitrary cap to a patient’s treatment that otherwise could have cut off care before they reached maximum therapeutic improvement.

However, there are potential negative, unintended consequences to this rule. First, not allowing a carrier to build in a maximum payout on a particular service will apply upward pressure on its actuarial calculations. This is one of many reasons why there is a belief that Obamacare will actually lead to higher insurance premiums.

Second, this could affect utilization review procedures. For example, right now, there are a few large carriers / plans in New Jersey that do not impose utilization management of any kind. Instead, they simply allow the insured a pre-set number of chiropractic visits under their plan. If the carriers are not allowed to follow this protocol going forward, they would essentially be forced to perform some form of utilization management, since they cannot impose an annual or lifetime cap. It seems likely that if a carrier had to direct a department or vendor to review care, treatment could be cut off earlier than the previous annual allowance would have.

Guaranteed Availability of Insurance

There are two main components here. First, health insurers will no longer be able to deny coverage to anyone based on a pre-existing condition. Second, there are very specific reasons why carriers can charge different amounts for coverage. Carriers can only charge an individual higher premium based on age, geographic area, tobacco use and family composition.

Carriers can only charge up to three times more for premiums based on a consumer’s age. Carriers can only charge up to 1.5 times more based on tobacco use. They can charge more based on region, and the family composition rule leaves the states to decide who in a household can be included on a family plan and at what cost.

It is believed that this rule will lower premiums for older Americans and women. Older insurance consumers are usually charged more because they require more care. Women are usually charged more because they also statistically require more medical expenditures. This is usually attributed to the medical costs of childbirth.

While it can certainly be seen as a positive for society to mandate that care be offered to those with pre-existing conditions and to not discriminate financially against women or older consumers, these changes will add significant cost to carriers. This cost will be passed on to someone. That someone will likely be younger to middle-aged males. Several independent analyses expect premiums for certain demographics to increase by over 100 percent from 2013 to 2014 because of these changes in regulations.


Starting in 2014, the PPACA will insist on broader coverage included in each health insurance plan (essential health benefits). It will not allow carriers to bar or charge more to consumers who have pre-existing conditions. It will restrict the level at which smokers and older consumer can be charged for health insurance relative to younger or non-smoking consumers. It will not allow annual or lifetime maximums to be placed on essential health benefits.

These factors will require greater payouts by carriers and hence necessitate more premium dollars. The theory of Obamacare is that these additional costs will be made up for by the newly insured. This is not necessarily the case. First, many of the new insureds under the law will be covered by Medicaid, which will not contribute anything to the premiums carriers take in. Second, many are skeptical that uninsured Americans will acquire coverage despite the mandate and penalty, as mentioned earlier.

In short, premiums will likely go down for older consumers, those with pre-existing conditions will be able to obtain coverage, and families making 400 percent or less of the federal poverty line will receive subsidies to purchase coverage and pay out-of-pocket expenses. However, those in the middle – both by age and economic class – will see significant increases in their medical expenses beginning in 2014.

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Selecting a Bed/Mattress

Mattresses used to be made primarily of cotton padding and springs. But after 1950 and the invention of plastics and foams, the modern mattress has gone through many evolutions. From water beds to recent memory foam offerings, this evolution has been quite spectacular. But during this time, sleep issues have risen to almost epidemic proportion making us question “is the modern mattress a wellness product or not?”

Sleep and Wellness

The ideal mattress should: support the spine properly; reduce pressure and encourage deep, healing sleep; be made of safe, non-toxic materials and wear properly. When we evaluate the modern mattress on these guidelines we find the following problems. Alignment support: the hip and lower torso weigh more than the shoulder area. To provide proper support the mattress must push the hips up into alignment (or level) with the shoulders. The use of new foamed materials like memory foam and latex to replace steel springs do not do this. Neither does air or water. The fastest growing segment of the modern mattress market is memory foam beds which will soften with use further diminishing alignment support as they become worn. Hence, the movement in the modern mattress away from steel springs presents a threat to proper back support.

The modern mattress is composed of two basic parts:

  • The foundation which is usually a box spring, but can also be a platform or adjustable base.
  • The top mattress which has a support layer and a comfort layer.

The support layers’ job is to provide support for the skeletal system. It can be an innerspring unit, air or a foam core. The comfort layers’ role is to provide pressure relief. Synthetic foams like viscoelastic (memory), latex (rubber derivative), soy and polyurethane foams (and combinations thereof) are used to provide these comfort layers. Additionally the Federal Government passed a law requiring all mattresses to also contain a fire blocker that self extinguishes open flames should a mattress be set on fire. Over the years these modern materials, primarily synthetic foams, have replaced cotton and steel springs as the primary materials used in a mattress. This is due to cost and the availability of cotton. New learning shows that in the case of a mattress, this broad scale move to newer materials might be causing unintended consequences when it comes to health, wellness and sleep.

Pressure Relief

Synthetic foams wear with use at a much faster rate than cotton. This has given rise to the phenomenon “body impressions” which occur with use reflecting a foams inability to rebound over time. Independent testing of mattress foams show they can be expected to wear out in 3-8 years depending on the amount and type of foam used. Buyers, however, expect the modern mattress to last for the warranty period of 20 plus years like their old cotton mattress did. The fine print limits the warranty coverage to the normal wear pattern of the foam however. This results in many people continuing to sleep on a mattress that is “worn out”, but not replaced because of budgetary considerations. The period of time spent trying to sleep on a “worn out too soon” mattress will certainly contribute to poor sleep and mis-alignment.


Synthetic foams emit noxious fumes as they wear which is called off-gassing. The fastest growing segment of the modern mattress market, memory foam, is made from polyurethane foam and an additive to make it rebound slowly. Almost every modern mattress uses polyurethane foam which is proven to contain carcinogens. New research is linking PCB’s like polyurethane to the rise in childhood cancer, ADD, asthma and autism. Many adults report severe allergic or immune related reactions after sleeping on new mattresses made with synthetic foams. See for more information on this topic.

Fire Blockers

Many of the materials used to retard fire also contain known carcinogens. By federal law, mattress manufacturers are required to prove to the government that their products will extinguish an open flame, but don’t have to reveal to the consumer what materials they are using to do it. The least expensive way is to use a chemical spray containing PCB’s like asbestos and boric acid. Since most mattresses are sold on price/value this results in even more toxic materials being added to the polyurethane foam used in almost every modern mattress.

This is not to say that your mattress will kill you tonight. The synthetic materials it is made from and the fire blockers used are present in many other areas of everyday life including the home. It is to say, however, that for some people the affects are quite serious and it is also clear that the mattress in its modern evolution as compared to its previous form has moved further away from being a safe, reliable product upon which to sleep.

What Can You Do?

Sleep is important. It is the third leg of the wellness stool along with exercise and nutrition. Recent studies linking the absence of deep, healing sleep to increased risk of stroke, diabetes and obesity (not to mention overall performance levels) are increasing your patients interest level in this mostly misunderstood topic. A new category of wellness quality mattress and sleep products is beginning to emerge as a result. As patients become more aware of the issues surrounding sleep and wellness, the doctor of chiropractic is in a perfect position to advise patients in this area. If you take the time to become familiar with the research regarding the materials used in todays’ retail mattresses and some of the new products that are available it’s possible to add the properties of deep, healing sleep to your wellness plan.

Contributing Source: Shawn Clark via Dynamic Chiropractic


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Going Shoeless: The Pros & Cons of Barefoot Running

With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.  The feet are some of the body’s most beautifully efficient mechanisms, so changing the way they’re used every day shouldn’t be done haphazardly.

Most of the hype put forward by barefoot-running advocates is anecdotal and based on questionable knowledge of biomechanics at best. They point out that humans ran and walked without shoes for millions of years, arguing that going barefoot is natural for humans and can reverse injuries caused by modern running techniques while preventing future problems. But “going Paleo”  for the sake of going Paleo isn’t a very strong argument on which to base any patient recommendation. This argument also fails to take into account the fact that asphalt and concrete didn’t exist, as well as the fact that there were very few 50- or 60-year-olds still running around millions of years ago.

Nevertheless, there are compelling arguments for going shoeless or at least wearing the minimal amount of shoe possible. A 2010 study led by Harvard professor of human biology Daniel Lieberman, published in the journal Nature, suggests that runners who don’t wear shoes have a significantly different foot strike that minimizes structural impact compared to those who wear shoes. Lieberman, et al., analyzed the running styles of adult U.S. athletes who had always worn shoes; adult U.S. runners who had grown up wearing shoes, but now run barefoot; Kenyan athletes who had never worn shoes; and Kenyan athletes who had grown up running barefoot, but had switched to running with shoes. They found that the barefoot runners tended to point their toes when landing, putting the impact at the middle or front of the foot instead of on the heel and making the runners less prone to repetitive-stress injuries.

Other research out of Harvard has demonstrated that the foot-strike pattern associated with barefoot runners is significantly more economical for running, meaning runners use less energy to run the same distances as runners wearing traditional shoes and striking with the heel.

On the other hand, a trial published earlier this year in the journal Medicine & Science in Sports & Exercise raises questions about whether barefoot running is really advantageous or simply contributes to the development of a different set of running injuries. Thirty-six recreational, experienced runners participated in the study. Each participant had, until the beginning of the trial, run between 15 and 30 miles a week wearing normal running shoes. Both groups received a pre-participation MRI of their feet to ensure no pre-existing injuries were present.

Half of the participants were used as a control and told to continue their running routine using the same mileage in the same shoes for the duration of the study. The other runners were given barefoot-style shoes and told to incorporate them into their runs according to the recommendations provided at the time by the manufacturer: a single short 1-2-mile run in the shoes the first week and two 1-2-mile runs in the shoes the second and third weeks. After the third week participants were encouraged to add miles as they felt comfortable. (The manufacturer has since changed its recommendations to include strengthening and proprioceptive exercises, and suggests barefoot-style running be introduced more gradually.)

Following 10 weeks of training, both groups received follow-up MRI studies. Neither group showed injuries or tissue changes to any of the structures in the lower leg, but over half of the participants wearing barefoot-style shoes had developed increased bone-marrow edema in the tarsals and metatarsal bones.

The radiologists rated the severity of the edema on a scale of 0 to 4, with 0 indicating no edema and 1 indicating the slight edema of a normal response to training. The control group showed average level 1 edema levels in the bones of their feet, while the majority of the barefoot-running group had developed edema levels of at least 2. Three of the barefoot runners had extensive level 3 edema and two displayed full stress fractures of their calcaneus or metatarsals with associated level 4 edema. By the end of the test period, almost all of the barefoot-style runners were running fewer miles due to pain and soreness.

Not everyone who chooses to make the switch to barefoot or minimal footwear will end up with injuries. However, anyone planning on doing so needs to be extremely cautious during the transition period. People who are dead set on ditching their shoes for barefoot running should transition slower than they think is necessary to allow their foot and calf muscles to adapt; start on a cushioned track surface if possible; and consider using a barefoot-style minimalist shoe at first. Distance running without shoes might have been natural for our human ancestors, but for most of us, it’s something our bodies have never experienced.

In a press release detailing the Medicine & Science in Sports & Exercise study, one of the study co-authors stated, “People need to remember they’ve grown up their whole life wearing a certain type of running shoe and they need to give their muscles and bones time to make the change. If you want to wear minimalist shoes, make sure you transition slowly.”

What’s the clinical takeaway from these studies? When it comes to injury prevention and running efficiency, it’s much more important how you run than what you run in. Heel strikers, regardless of shoe, will sustain more impact injuries than those who land on their mid or forefoot and allow their arches to act as natural shock-absorbers. The most efficient and least-injury-prone runners shorten their stride, land on the forefoot, and keep the running motion smooth, light and flowing.

courtesey: Lisa Way, DC, via Dynamic Chiropractic

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Sciatica – More Than Leg Pain

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.  Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica? The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report a pins-and-needles sensation (most often in the toes or foot), or numbness or muscle weakness in the affected leg or foot.

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

How is sciatica diagnosed? Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs; you may be asked to lie on an examination table and lift your legs straight in the air, one at a time, along with other tests.

In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, or may be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

What are my treatment options? For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.

Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.

An Ounce of Prevention Is Worth a Pound of Cure While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.
• Maintain a healthy diet and weight
• Exercise regularly • Maintain proper posture • Avoid prolonged inactivity or bed rest • If you smoke, seek help to quit •Use good body mechanics when lifting


Information povided by the ACA.

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How to Select Athletic Shoes

Because footwear plays such an important role in the function of bones and joints—especially for runners and other athletes—choosing the right shoe can help prevent pain in your back, hips, knees, and feet.  Read on for tips from the ACA.

Unfortunately, there is no such thing as the very best athletic shoe—every pair of feet is different, every shoe has different features, and overall comfort is a very personal decision. For this reason, it is recommended that you first determine your foot type: normal, flat, or high-arched.

The Normal Foot Normal feet have a normal-sized arch and will leave a wet footprint that has a flare, but shows the forefoot and heel connected by a broad band. A normal foot lands on the outside of the heel and rolls slightly inward to absorb shock.

Best shoes: Stability shoes with a slightly curved shape.

The Flat Foot This type of foot has a low arch and leaves a print that looks like the whole sole of the foot. It usually indicates an over-pronated foot—one that strikes on the outside of the heel and rolls excessively inward (pronates). Over time, this can cause overuse injuries.

Best shoes: Motion-control shoes or high-stability shoes with firm midsoles. These shoes should be fairly resistant to twisting or bending. Stay away from highly cushioned, highly curved shoes, which lack stability features.

The High-Arched Foot The high-arched foot leaves a print showing a very narrow band—or no band at all—between the forefoot and the heel. A curved, highly arched foot is generally supinated or under-pronated. Because the foot doesn’t pronate enough, usually it’s not an effective shock absorber.

Best shoes: Cushioned shoes with plenty of flexibility to encourage foot motion. Stay away from motion-control or stability shoes, which reduce foot mobility.

When determining your foot type, consult with your doctor of chiropractic. He or she can help determine your specific foot type, assess your gait, and then suggest the best shoe match.

Shoe Purchasing Tips Consider the following tips before you purchase your next pair of athletic shoes:
• Match the shoe to the activity. Select a shoe specific for the sport in which you will participate. Running shoes are primarily made to absorb shock as the heel strikes the ground. In contrast, tennis shoes provide more side-to-side stability. Walking shoes allow the foot to roll and push off naturally during walking, and they usually have a fairly rigid arch, a well-cushioned sole, and a stiff heel support for stability. • If possible, shop at a specialty store. It’s best to shop at a store that specializes in athletic shoes. Employees at these stores are often trained to recommend a shoe that best matches your foot type (shown above) and stride pattern. • Shop late in the day. If possible, shop for shoes at the end of the day or after a workout when your feet are generally at their largest. Wear the type of socks you usually wear during exercise, and if you use orthotic devices for postural support, make sure you wear them when trying on shoes. • Have your feet measured every time. It’s important to have the length and width of both feet measured every time you shop for shoes, since foot size often changes with age and most people have 1 foot that is larger than the other. Also, many podiatrists suggest that you measure your foot while standing in a weight bearing position because the foot elongates and flattens when you stand, affecting the measurement and the fit of the shoe. • Make sure the shoe fits correctly. Choose shoes for their fit, not by the size you’ve worn in the past. The shoe should fit with an index finger’s width between the end of the shoe and the longest toe. The toe box should have adequate room and not feel tight. The heel of your foot should fit snugly against the back of the shoe without sliding up or down as you walk or run. If possible, keep the shoe on for 10 minutes to make sure it remains comfortable.

How Long Do Shoes Last? Once you have purchased a pair of athletic shoes, don’t run them into the ground. While estimates vary as to when the best time to replace old shoes is, most experts agree that between 300 and 500 miles is optimal. In fact, most shoes should be replaced even before they begin to show signs of moderate wear. Once shoes show wear, especially in the cushioning layer called the midsole, they also begin to lose their shock absorption. Failure to replace worn shoes is a common cause of injuries like shin splints, heel spurs, and plantar fasciitis.

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