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Six Simple Exercise to Stronger Strides

Posted by: Dr. Marybeth Crane Posted Date: 04/06/2011

Part one talked about why shold you embrace minimalism?

 

A better approach to minimalism is to realize that your feet are weak in their current state and you need to add a foot and leg strengthening program to your current regimen. A strong core is imperative for good, efficient running form. The stronger the core, the longer you can hold good posture as you run down the road in search of your zen.

 

Six Simple Exercise to Stronger Strides

 

Here are six simple exercises you can do daily to improve your intrinsic foot strength. I recommend you walk around your house barefoot for five minutes to warm up your feet. Then really warm up your foot muscles by pretending your big toe is a marker and writing the alphabet with your foot. Do this twice. Now you are ready to begin strengthening your feet.

 
  1. Towel crunches. Your foot has tiny intrinsic muscles that stabilize your toes called the interossei and lumbricals. A great way to strengthen them is to put your foot on a towel and crunch your toes. Do this ten times, then take a 30 second break and repeat to complete three sets of ten. When you get good at this, replace the towel with a pen or marker and grab it with your toes.
  2. Heel walking. Heel striking is what we are avoiding, but heel walking is a great way to strengthen your anterior lower leg muscles (muscles in your shin). Roll back on your heels and walk forward balancing yourself on your heels for about 30 seconds, then take a 30 second break and repeat two more times.
  3. Deep squats on your forefoot. Roll up onto your forefoot then squat down into an almost sitting position, trying to keep your balance and avoid shifting back onto your heels. Hold this pose for 30 seconds then stand up for 10 seconds and repeat 5 more times. When you get good at this, try holding a weighted bar at you shoulder level and then squat.
  4. Inner foot strengthening with a resistance band. (This targets the medial muscles; the posterior tibial muscle and abductor hallucis) Tie the resistance band on a chair leg then use your medial muscles to pull the band toward the center of your body. Other option is to hook the band around your foot, then use the other foot to stabilize it. Pull your foot toward the midline of your body. Hold for 10 seconds then relax for 10 seconds. Repeat 10 times. (An alternative is to balance on the inside of your foot and walk for 30 seconds, following the pattern of heel walking)
  5. Outer foot strengthening with a resistance band. (This targets the lateral muscles; the peroneals) Tie the resistance band on a chair leg then use your lateral muscles to pull the band toward the outside of your body. Other option is to hook the band around your foot, then use the other foot to stabilize. Then move your foot towards the outside of your body. Hold for 10 seconds then relax for 10 seconds. Repeat 10 times. (An alternative is to balance on the outside of your foot and walk for 30 seconds, following the pattern of heel walking)
  6. Proprioceptive/Balance Training. Balance on one foot with other leg bent. Hold for 30 seconds. Repeat 5 times. When you get good, then roll up onto your forefoot. If you are a pro, then put a 5 pound weight in the opposite hand and touch your toes while balancing on your forefoot. (An alternative progression is to go from one leg on forefoot on level ground, to a foam mat then a Bosu ball or wobble board) 

These six simple exercises can help you strengthen the intrinsic muscles of your feet and lower legs to help you transition to a minimalist running style. Remember to also stretch your quads, hip flexors, hamstrings, and calf (gastrocnemius and soleus) as well as your plantar fascia after these exercises to warm down.

 

Small incremental increases in stress make us stronger. Large incremental increases in stress lead to overuse injuries! Achieve your natural stride slowly and carefully to stay injury free.

 

Watch the video if you need help with the exercises!

Which is Better? Ice, Heat, or Beer for Injury Rehabilitation?

Posted by: Dr. Marybeth Crane Posted Date: 05/12/2010

Ice, Heat or Beer? That is the Question.....

 

Seriously, I crawl over the finish line and the first thing I want is a beer (or twenty)! I think that beer is a great adjunctive therapy for injury rehabilitation. Think about the benefits of beer:

1. It relaxes you.

2. It is a great pain reliever.
3. It makes the end of a race much more enjoyable.
4. It can precipitate post-race amnesia making you want to do another one.
5. It tastes much better than Gatorade.
6. I think I even read a study that showed beer helps flush out all that lactic acid!
7. It promotes social activity after a race when you feel like you just got run over by a truck
8. It’s a great carbohydrate replacement recovery drink.

9. It makes the ride home so much more comfortable……….and the next morning if you don’t have to go to work 

 

All right, all funny aside, how about the ice versus heat question?
 

Ice versus heat? This is a common question a lot of athletes, coming into my Grapevine, Texas office, ask. Most understand that ice immediately after injury is very important. The questions usually revolve around when to use heat.  There are some basic guidelines that every athlete can use to reduce confusion.

 

Immediately ice the “fall down, go boom injuries.” Ice works well for reducing redness, swelling and internal bleeding in acute injuries.  It also is a great pain reliever. Acute injuries and post surgical pain and swelling usually respond well to 10 to 15 minutes of ice every few hours. This should be done for up to several weeks after an injury or surgery. Ice can be in the form of an ice pack (ice wrapped in a protective towel) or ice massage (massaging with a frozen water bottle or block of ice). 

 

Ice can also be helpful in reducing swelling in a chronic injury like runner’s knee or plantar fasciitis. Icing immediately after activity can prevent further inflammation of an already annoyed area and help in recovery.

 

So where does heat come in? Heat can be used in several different ways. Contrast baths with ice/heat/ice can be helpful in chronic injuries. Especially those joints or tendons that still have just a little inflammation or edema. Heat should never be used alone in these cases. Moist heat is best for chronic stiffness and old injuries with scar tissue. It can also help in the rehabilitation process. For example, when plantar fasciitis becomes plantar fasciosis after four to six months (which is a chronic degeneration of the plantar fascia), deep heat therapy with ultrasound or moist heat packs can help increase range of motion of the area and increase the effectiveness of physical therapy. Heat actually temporarily increases inflammation in an area, but this is often helpful in kick starting the healing process.  Heat can also be used to calm muscle spasms and relax a tight muscle. 

 

Heat causes an increase in circulation to an area, so it should never be used in acute injuries or chronic injuries with a lot of swelling. It can actually make an injury worse if there is still a little internal bleeding going on. A great way to heat a joint or tendon is to use a reusable heating pack or an electric heating pad for about 20 minutes before stretching, massage or other therapy. Heating an old injury before exercise can also be helpful in warming up the area to ready it for increased activity.

 

The simple rule of thumb is that ice is used for acute, swollen injuries and heat is used for stiff, chronic injuries. This subject is debated continuously, but I hope this discussion clears up the mystery of ice versus heat!

 

Run Happy!

RunDoc at DFW Sports Medicine Symposium

Posted by: Dr. Marybeth Crane Posted Date: 03/28/2010

 

This morning I spoke at the DFW Sports Medicine Symposium in Arlington, TX. What a great crowd! Over 300 physical therapists, athletic trainers and sports medicine physicians from all over Texas gathered to discuss advances in the medicine of sports.

 
 I spoke on running injuries and more specifically the need for a complete biomechanical exam to not only diagnoses, but to guide your treatment plans. This way the runner can return to running in much better shape than they walked into your office. I feel it is a missing link in a lot of offices due to the time involved. Dynamic gait analysis can actually help the clinician diagnose the root cause of an injury instead of just treating the symptoms. This will decrease the chance of a repetitive injury.
 
 I also talked about the current barefoot running phenomenon and the fact that the average runner will most likely not benefit from barefoot running due to poor biomechanics and muscle imbalances. There is much more of a chance that they will actually hurt themselves. Those runners with fairly good biomechanics and patience can benefit from some barefoot running in a controlled environment. Lots and lots of questions still exist and more biomechanics research needs to be done in this arena.
 
The need for functional foot orthotics was also discussed. No! Every runner does not need orthotics, but almost 80% need some kind of biomechanical help. Most can be accommodated with shoes, stretching and strengthening programs. You would be amazed how much impact a core strengthening program can have on your running biomechanics. Recurrent, nagging injuries often require orthotic control to alleviate recalcitrant pain.
 
The last thing I discussed was the need for a gradual return to sport so there will be no more of the too much, too soon, too fast phenomenon that plagues so many runners!
 
A great question and answer session followed. I gave away a few copies of my book, If Your Running Feet Could Talk. I think we all learned something this morning. A good time was had by all and all the athletes in the Dallas-Fort Worth area and all over the State of Texas will benefit!

Physical Education in Schools Found Lacking!

Posted by: Dr. Marybeth Crane Posted Date: 03/29/2009

Childhood Obesity In the News

 

I was watching ESPN this morning while I was eating my breakfast. Yes, this is my usual morning routine as a sports junkie! A story came on that I felt compelled to share with my readers. It highlighted a cause that is near and dear to my heart: Childhood obesity. So many of my adult patients are obese and if we curb this trend in our children, they are much more likely to be healthier adults. As a parent, I make sure my children are as active and healthy as they can be. Obese parents tend to have obese children. We need to break the cycle.

 

Here are the highlights of this story:

 

There's a childhood obesity crisis in the country, virtually any expert will tell you, and there is no shortage of reasons: increasingly sedentary lifestyles driven by video games, television and computers; a fast-food society in which soda machines and greasy cafeteria food are ubiquitous in kids' lives; and dwindling opportunities for exercise, particularly during the school day.

 

Put simply, at a time when every penny is being pinched by every school in every district in every county in every state, physical education is taking a beating. The experts and educators say there is no doubt that the erosion of P.E. has been a major contributor to the skyrocketing obesity rates.

 

And, of course, the more kids are unhealthy, the less they can exercise. This is their circle of life.

 

The National Association for Sport & Physical Education -- a non-profit organization made up of P.E. teachers, coaches, athletic directors and other professionals advocating for physical activity -- says students should receive 150 minutes of P.E. per week.

 

How many schools actually meet this standard….almost none!

 

Take home message: we cannot rely on our schools to provide physical activity for our children. As parents, we need to turn off the TV, video games, and computers. Make our children go outside and play. Make healthy play a family tradition. On cold, rainy days teach your children stretching, yoga, or get small dumbbells and do a strength workout with them. Make it fun and most of all…share it with them! This will make family time a healthy time! Memories are made of this and your child will thank you when they are a healthy adult sharing the same kind of family time with their children!

 

Achilles Tendon Woes

Posted by: Dr. Marybeth Crane Posted Date: 04/05/2008

Achilles Tendon Woes

 

This week a very good runner from Wichita Falls came in with an Achilles tendon problem. He gave a horrible story of a primary care physician who injected his Achilles bursae TWICE with cortisone. He was looking for better answers and was willing to drive almost 2 hours south to find them.

 

I was almost apoplectic! Injected his tendon or even around his tendon?! In my world, that’s almost borderline malpractice; but I can’t fault the physician, she obviously didn’t know any better and was trying to treat the patient. Bottom line: Go to a sports medicine physician. We would all tell you the same thing: injecting the Achilles tendon can lead to spontaneous rupture which would basically end his running days. Look at poor Dan Marino…a ruptured Achilles tendon ended his Hall of Fame career!

 

Let’s talk about Achilles tendon injuries. They are very common especially in runners with high arched feet or very flat feet. Both of these foot types put way too much torque on the tendon and will cause a wear and tear tendonitis that eventually becomes tendonosis without proper treatment.

 

Tendonitis results from overuse. Long-standing tendonitis becomes tendonosis (degeneration of the tendon) which is much harder to treat. This overuse can happen over a period of time or can happen over a weekend.  Those of you who exercise regularly or are in training for an athletic event, as strong as the Achilles tendon is, this work horse could use a break every once in a while!  With chronic, long term, sustained use, this tendon becomes strained.  It also can become just as strained with whom we fondly refer to as the “weekend warriors”.  You know who you are!  You are the ones who think it perfectly o.k. to hike the Appalachian Trail or take the steep way down the Grand Canyon over a three day weekend because “it was there”! Marathon runners who decide they can run the Western States 100 without the proper training….you can't hide for long....I will find you....


The simplest form of treatment can involve rest, heel lifts, icing, inserts, night splints, custom orthotics and anti-inflammatories.  More complex forms Achilles tendonitis can include immobilization through a boot or cast, physical therapy, and in the most resistant cases, surgery. Active release myofascial release is very helpful. Thank God for David Bloom at Restoration Physical Therapy and Dr. Darryl Laney at Laney Chiropractic in Keller! Most of my long-standing Achilles tendon injuries are successfully treated with aggressive PT and manipulation on top of orthotic control. The longer you have it, the worse it gets.  Do not let it get that far. Tendonosis is a chronic degeneration that can lead to splitting of the tendon and long term disability!


Thinking of waiting to see if it works itself out or are trying to work through the pain?  Let us help you reconsider. Chronic Achilles tendonitis (tendonosis) results in degeneration and breakdown within the tendon and this, in turn, can lead to a partial tear or full rupture.  Now that will put you out for more than a couple months!    If you are experiencing a nagging pain or swelling to the Achilles tendon or the back of the heel, call or contact the office to have it evaluated.  It is that simple!

 

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