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Case Study #1: How a 34-year-old physiotherapist overcame his foot, back, hip & knee issues

I get asked by my clients all the time: ‘what made you want to be a physio?’ So I figured I would make myself Case Study #1 in a series that I am writing to help you relate to pain, injury and rehabilitation in a realistic and practical way.  My short answer to clients is usually ‘I’ve been an active athlete my whole life and have always been very good at hurting myself so I spent my fair share of time in physio.  I was quite familiar with it and always had a fascination with the human body so it was a natural progression for me after my Human Kinetics degree to go into Physiotherapy.

This article will summarize the lessons I have learned from both hurting myself repeatedly and working with people in pain every day.  I will outline the path I took to overcome some chronic issues that are very common to people of all ages and the things I try to teach to both my parents and my kids.

Brief Background …

I tend to refer to your teens and twenties as your invincible years.  You can punish your body without experiencing that much consequence because the pain, stiffness and soreness doesn’t last long enough to deter you from doing the activity again, or to change your behaviour significantly.  I was a long, lanky kid that played a lot of soccer, rugby, baseball, track & field, water-skiing, wake-boarding, basketball and volleyball.  I sprained ankles, broke my wrist, and dislocated my shoulder many times, but I kept on going.  Now at 34, after being a physiotherapist for ten years, starting a business and having three kids in three years, I have come to realize that I am the cumulative product of everything I have done up to this point and that I better take care of my body because it’s the only one I’ve got for the next 60 years (Click here for related article). Read More

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Plantar Fasciitis: an illustrated explanation of why your foot hurts

171/365:
photo: who am i today

Plantar fasciitis is a very common form of foot pain and one that I find really interesting because it manifests in both really active runners and relatively sedentary people.  How can a person that is training for their third marathon develop the same pain as someone that doesn’t exercise much more than walking from their desk to their car?  You can’t purely blame it on over or under-use if the desk jockey and the super athlete are getting the same thing.  So what is causing the bottom of people’s feet to hurt so much and for so long?

The short answer: (a combination of the following factors)

  1. The shoes you wear all day (not just while running)
  2. Your posture & movement patterns (how you sit, stand, walk and breathe all day)
  3. A nerve irritation in your low back
  4. Weakness in your feet and tightness in your calves
  5. Fascial restrictions in your visceral system affecting the blood and nerve flow to your feet

The long answer:
It is typically a series of on-going events that leads to you developing that burning, pulling, aching pain on the bottom of your foot.  You may have one or all five of the above issues.  If your pain has lasted a long time, it is worth exploring all of them.  Read on for details…

1. The shoes you wear all day…

It is hard to talk about foot pain and not mention shoes.  I have written a number of articles on this blog already about feet.  If you are convinced that your shoes are the culprit please read these articles too:

All too often, plantar fasciitis gets blamed on a ‘lack of support’ and this bothers me. 

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How to strengthen your feet: advice and tools to get you started

You may go to the gym to strengthen your chest, back, legs or core, but what about your feet?  Your feet end up being held hostage in a stinky pair of shoes, unable to move or breathe all day and then you expect them to hold you up while you walk, run or play sports.  They are pretty durable, but will eventually begin to break down, hurt and even deform if you don’t give them a chance to work properly with the rest of your body.  Your feet are your body’s suspension; they act as both shock absorbers and rigid levers to help propel you when walking and running.  Losing awareness of your feet leads to poor movement patterns, poor posture and inevitably pain.

Imagine you have a job that requires you to wear tight leather socks on your hands all day.  Now imagine the palm side of the sock has a firm plank on it so you can’t flex your hand to properly grab anything, but you still have to use your hands all day.  What do you think would happen to your hands over time?  They would turn into deformed, weak clubs like most people’s feet end up looking like.  You would lose the dexterity in your fingers while your forearms, wrists and shoulders would get all tight from compensating all day; this is what effectively happens to most peoples toes, ankles and hips from wearing stiff shoes all day, but your feet have much more of an impact on your posture than your hands ever would.

Four facts about your feet that are hard to argue with:

  1. You were not born with shoes on…evolution designed your feet to function barefoot
  2. Your feet’s arches are designed to be held up by the muscular tension holding your foot bones together, not by external “arch supports” pushing them up from the bottom
  3. You likely wear shoes most of the time and walk mainly on very flat surfaces
  4. You are unlikely to stop wearing shoes, but would like to keep your feet warm, healthy, strong and protected

 

So you will probably agree that your feet would be happiest and strongest if you were barefoot all day walking around an uneven meadow, but practically that is not going to happen, so what do you do to keep your feet strong, living in reality? Read More

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Barefoot Running vs Barefoot Lifestyle: a fad leading to a revolution

Barefoot running has got a lot of press since Christopher McDougall released his book Born to Run: A Hidden Tribe, Super Athletes and the Greatest Race the World Has Never Seen.

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(click the above picture for details)
A great book and amazing story that is worth the read even if you’re not a runner.  This book has lead to a paradigm shift in the running shoe world and is slowly creeping it’s way into the normal shoe world.  If you are not familiar with my stance on shoes, have a look at my articles:
Shoes: Good support or coffins for your feet?
Why Feet Hurt

Movement in general is a set of skills that you acquire through trial, error and practice throughout your life.  Walking and running are fundamental movement skills that we develop from a young age, but the thing that most people don’t understand is that just because you can walk and run, doesn’t mean you are doing it very well.  The most important tools our bodies have, that gives us the unique ability to walk and run upright, is our feet; covering them up with heavy, clunky, confining shoes most of your life will almost guarantee that you walk and run poorly and inevitably develop pain and deformity.

Although I think the barefoot running movement is great, what really needs to happen is a barefoot lifestyle movement.  You need to walk before you can run and stand before you can walk.  What you choose to put on your feet will affect all three of these skills.  You spend far more time in a day standing and walking than you do running so the best cross training you can do for running is to keep your feet active and in tune with the ground when ever you are vertical. 

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