Flip Flop are Feet Flops

As a Sports Chiropractor in San Diego in the summertime, I find myself repeatedly doling out the same unheeded disclaimer to my clients, friends, and family. It’s not a fun message, it’s not a welcomed form of advice, and it kinda sucks to have to break the news. It’s like being a professional “Santa Clause isn’t real” messenger. Who wants to be that guy?
santaflipflop

So here it is. Flip Flop style sandals are terrible for your feet (Yes even ones with arch support), ankles, knees, hips and back.

I said it, go ahead and roll your eyes. Wearing flip flops for foot protection and support is like Brushing your teeth with cake icing and maple syrup (classic Dr. Todd analogy). I see more and more feet, ankle, knee, and hip pain mysteriously kick in during the warmer months. There is silent attack on foot and lower leg biomechanics, so lets discuss it and discuss the science.

It goes without saying that flip flops have their own charm. Something about the open and free nature of this particular design of footwear makes it one of the most popular in the world. They usually flood the streets during the summer or on any other casual sunny day but it is not entirely unheard of to find someone who wears then day in day out. For the longest time now, there has been a debate on the safety of flip flops. Those in support of the casual trend argue that they are open and comfortable allowing much needed aeration and sun exposure. Those against them point out major cons of the design including exposure to penetrating parasites as well as musculoskeletal injuries due to inadequate support among many other reasons. So, are flip flops a good idea?

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Flip flop dangers

Flip flops may be comfortable and all that but they are actually not very good for you. This is the case when you regularly walk for long distances in them. Below are a few joint and soft tissue injuries you put yourself at risk of wearing flip flops.

1. Blisters and bruises

The constant contact and friction between the straps and your skin will eventually lead to bruising and formation of blisters. This usually occurs when you wear ill-fitted flip flops and could have further effects on your walking style and posture. The overall effect is pain and staining on only on the affected area but also on other parts of the foot and the leg when the blisters lead to change in gait.

2. They increase the risk of developing heel spurs

Heel spurs are calcium deposits on the heel bone as a result of consistent stress. This is usually associated with long periods of walking or standing on shoes without proper support such as Flip flops.

3. Increases risk of plantar strain leading to fasciitis

Plantar fasciitis is as painful as it sounds. It usually presents as sharp pains on the middle region of the sole of your foot as your foot pushes of the ground. This is an effect of lack of proper support while walking which flip flops are notorious for. A study in Journal of the American Podiatric Medical Association additionally claims that compared with athletic shoes, they increase peak plantar pressures, placing the foot at greater risk for pathologic abnormalities

4. Unnecessary strain on toes and the tarsal-metatarsal joint

Flop flops lack support at the back and people usually have to compensate by gripping the front of the shoe with their toes. This will eventually lead to toe pains and when worn consistently could damage the existing joints making mobility an absolute nightmare. According to a study in Journal of Foot and Ankle Research, (1) flip-flop footwear conditions altered gait parameters when compared to barefoot. Maximum ankle dorsiflexion in swing was greater in the flip-flop. Significantly higher tibialis anterior activation and a faster heel velocity toward the floor was evident in the flip-flop. (2).

5. Tendonitis at the Achilles tendon

This is also as a result of the lack of support from flip flops that forces the wearer to compensate using other muscles and tendons. Calf muscles are among those involved in the process and strain is usually experienced at their point of intersection through the Achilles tendon. When worn and walked on for a long period of time and on a regular basis, they could lead to inflation of this tendon.

6. Foot muscle straining especially in the flat-footed

Flat footed people have foot arches that are considerably lower than those of normal footed people. This means that they need properly supporting shoes more than anyone else. Wearing flip flops leaves them inadequately supported leading to muscle strains and foot pain.

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7. Increased risk of tripping

Finally, flip flops significantly increase your chances of filling and getting injured. Something that you are likely to have experienced in flip flops is stumbling when someone steps on the back of your flip flop. It actually happens a lot and is pretty much an occupational hazard for flip flop diehards.

Bottom line

After all is said and done, there is no denying that flip flop dangers are real. If you can, do your best to avoid wearing them for too long or even at all. If you are unwilling to compromise on the comfort of open shoes, you could always go for safer alternatives including peep toe shoes and back strapped sandals. But the bottom line is that you flip flops are actually not a good idea. Wear the on occasion, for short bits of time. It’s not an all day shoe, it’s convenient wear.

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For more information:

Heel Spurs

https://m.huffpost.com/us/entry/3569222.html

www.cosmopolitan.com/health-fitness/news/a39188/flip-flops-are-bad-for-you/

The prescription and the dose most doctors aren’t prescribing correctly!

What if your Doctor prescribed you a therapy that would decrease your chance of dying by 70% and your chance of cardiovascular disease by 60%, would you be interested?

Studies have claimed that between 75-85 percent of death and disease can be related to lifestyle. You do not need a doctorate to understand that proper exercise, healthy diet, and mindfulness are they key ingredients to allow your genetics to present the best “you” that you can. There was a great study that tackled part of the equation above in terms of how much exercise in the form of running (one of our more organic and natural forms) is beneficial for health purposes.

woman runner

Here is the summary and take-aways from the study, attached is the link below for a full copy of the study.
“what’s the proper dose of running?”
-Maximal benefits of running occur at low levels, around 40 minutes or less.
Optimal frequency of jogging was 2-3 time per week, a combined 1 to 2.4 hours per week.

“What does running help protect you against?”
-People who ran at the dose listed above had a 68% reduction in mortality (less chance in dying)
-Runners had a reduction in all-cause and Cardiovascular disease mortality of 30% and 45% compared to non-runners
-People who ran a combined 1-2.4 hours per week was associated with the lowest mortality (71% reduction in death)
-Running and walking, but not other exercise, produces and equal “reduction” in Osteoarthritis and hip replacement risk
running heart

“Is it better to walk or run?”
Running vs. Walking: You have to walk 3 to 4 times as much as running for the same health benefit. 5 min running = 15 min walking, 25 minutes of running = 105 minutes of walking

For references and the full Proceedings from the Mayo Clinic, click here for the journal

“If I wanted to start running, what should I do to avoid injury?”

In my opinion, there are 5 components of running injuries and several training components that help minimize your risk for injury

1) Biomechanics, most running injuries stem from restricted range of motion in the feet or hips/pelvis. Professionally we help with treatment of the feet with our Functional Hallux Rehabilitation work, and chiropractic approach to the pelvis. Self care, you can work on mobility protocols for ankles and pelvis

2) Soft Tissue – Asymmetry (one side stronger than the other), trauma, and overuse can cause a thickening of the fascia, causing a restriction of the muscle, and friction between muscles, tendons, and joints. Professionally we use cutting edge techniques to restore and normalize tissue like Fascial Distortion Model, Active Release Technique, and Rapid Release Technology. Self care, you should employ mysofascial release tools like the foam roller, mobility bands, and tools like lacrosse balls and tigertails/sticks to keep the fasical system free

3) Neuromuscular Balance – Tight hamstrings and shortened hip flexors is a great example. Activities such as sitting or driving may alter our neuromuscular system which can affect performance. Chronic tight hamstrings, weak and sore lower back, sore shins may be a result of movement patterns of the muscles, not necessarily the muscles or joints. We employ neuro activation with several tools and approaches, self care is best done through cross training and body weight movements to address the imbalances

4) Footwear- There are many opinions and a lot of marketing in footwear. Find a good running shoe store and get fit correctly. If you go the minimalist route (barefoot) please slowly scale your distance and intensity. If you go the stability shoe and orthotic route, please don’t neglect to strengthen your feet with exercises and sensory input so you don’t become dependent on the support as much.

5) Running Form and Training-
Most beginners just run, and never consider there form. Although their is not one ideal form, there are techniques that can help minimize the impact on your body, and make you more efficient. Here are some tips and links below to help with form.

-Don’t run consecutive days, give your body a chance to rebuild and repair. maximum 4 days a week, with days in between.

-Don’t Increase your mileage or time too fast, experts say between 10-20% per week increase.

-Running speed and running down hills increases the pounding on your body

-Read the books or watch the videos on Chi-Running or Pose Method, great resource on posture and running.

-Attend a running clinic or get a running coach. We have some gems in San Diego, one of my favorites is a wizard of running, Ozzie Gontang…checkout his clinic on Sundays at mission bay, I’ve sent over 50+ runners and they have all had amazing results.

-Experienced runners should find a good coach locally, and even get online or phone training schedules. Below are a few friends and clients I’d highly recommend:

Bernie Sydney- Both One on One Running, triathlon, and pilates. Online and phone programs. Click for contact

Sheri Mathews- One on One running Sessions, Spin, womens group run, and training programs. -Sheri Mathews Fitness Wellness Health” target=”_blank”>Click for Contact

Speed Training Coaching by James Sheremeta- Great coach for new and experienced runners. contact here

Get out there and move, have fun and stay healthy

Dr. Todd’s Top 5 Health App’s

Technology is growing at a faster rate and programs and applications that used to cost thousands of dollars in the healthcare field are now easily accessible, accurate, and inexpensive (sometimes even free). Now you have free access to formerly fancy expensive exercise and nutrition software & programs that were only accessible by Nutritionist and Exercise Scientist. Simple programs now replace high priced GPS watches would calculate your pace, and fancy timers and stop watches would assist your workouts. Below are my favorite applications (mostly iphone/ipod users….I’m an apple guy, but some can be found online and for android apps too).

So be smart with your smart phone, be more healthy!

My FitnessPal Calorie Counter
-Awesome application that allows you to count and track calories. Studies showed that people that kept a food journal lost more weight and kept it off. This tool is great, and its free. My favorite features is the bar-code scanner, saving meals, and tracking exercises. You can also connect with friends to help hold each other accountable.

Nike+Running Application
Turn your phone into a gps watch. Track your pace, distance, and workouts on this great app. Very cool interactive website that goes with it. Also plays music to help with pace.

Fooducate App
This application track calories, but offers a more education tool to help you make smart healthy decisions shopping and ordering.

Map My Run GPS
-This is a great application to not only track your runs or hikes, but to discover others. If you are traveling and wanted to find a 4 miler run near your location, search for routes that other users have submitted and published and learn their routes, terrain, distance, etc. Fun to track, log, and share.

Tabata Timer
-High Intensity Interval Training (HIIT) is a great way to get in shape, get more bang for your buck with cardiovascular training. Make a 12 minute cardio session feel and act like a 60 minute. The Tabata method has clinical studies showing the benefit of this specific interval training of cycles of 20 seconds of intense exercise followed by 10 seconds of rest. Turn boring eliptical or recumbent bicycle sessions into intense heart pounding intervals. Can be used with burpees, pushups, running in place, stairs, jogging, and all of the cardio equipment. I prefer spin bikes.

Post Race Recovery Foods

Recovery is as important as training when it comes to performance. During a long endurance event, you break your body down and deplete your body of nutrients and reserves. To avoid deficits, and sub-optimal performance, follow the following recovery food list to help rebuild your body, detox from oxidation, boost your immunity, lubricate your joints, and extinguish inflammation.

    POST RACE RECOVERY FOODS

Increase Protein
Greek Yogurt
Grass Fed Beef
Omega-3 Eggs

Increase Fats
Almond Butter
Fish Oil (Omega-3) Flax if your vegetarian
Macadamia Nuts

Increase Anti-oxidants
Frozen Berries-Blueberries
Greens Supplements, Tart Cherry Juice, and Non Alcoholic Beer???
Kale & Chard
Sweet Potatoes & Yams
Dark Chocolate

Increase Electrolytes
Coconut Water
Electrolyte Drinks

Increase Immune System
Pro-biotics (Whole Foods/Henrys) **Multiple strains
Whey Protein

Muscle Soreness
Magnesium Supplement (Calm is a good one)
Arnica
Tumeric Capsule or Yellow Curry

Dr. Todd’s Recovery Drink
Coconut Water-Whey Protein-Blueberry-Banana-Flax-Dark Chocolate-Ice-Greek Yogurt

PNF/Fascilitated Stretching – Simple Solution to Chronic Tight Hamstrings!

Proprioceptive neuromuscular facilitation (PNF) stretching techniques are commonly used in the athletic and clinical environments to enhance both active and passive range of motion (ROM) with a view to optimizing motor performance and rehabilitation. PNF stretching is positioned in the literature as the most effective stretching technique when the aim is to increase ROM, particularly in respect to short-term changes in ROM.
McCarthy et al.[39] demonstrated that ROM gains last for approximately 7 days after 1 week of twice-daily stretching
12-week period in the direction of long-lever hip flexion when conducting one repetition of PNF stretching 2 times per week


Video of PNF Stretch on your own!

The terms ‘contract relax’, ‘hold relax’ and ‘con- tract relax agonist contract’ are commonly referred to in PNF stretching literature

For more info, or a book, checkout the website at The Stretching Institute.

Chi Running

If you were to spend 4 hours a week golfing, you would probably take a lesson or a tip or two to learn to golf. If you were to fish 4 hours a week, you may ask the Bait shop which rod to use and what the fish were biting on. If you were to start sailing, entering tennis tournament, or skydive…you might want to learn how to do it before investing your time and health.

For some reason people begin to run and assume they do everything naturally. There is a huge gap in human movement in our society. If you are an elite super athlete, then you get instruction and training. If you are injured and in Rehab or Physical Therapy, you get instruction and training. If you are not an super athlete, or not injured, many people still need and Movement Instruction due to improper posture, poor coordination, or old injuries.

Chi Running is great for people looking to learn a system of running form. Pose method is also a similar and very good technique and form.

Chi Running blends the powerful movement principles from T’ai Chi, with running, to create a revolutionary approach to effortless and injury-free running.

The cornerstones of Chi Running are postural alignment and relaxation because the combination of the two is the best way to run faster, farther and injury-free. Chi Running includes: landing with a midfoot strike, using a “gravity-assisted” forward lean and engaging core strength for propulsion rather than leg strength. This approach makes your running easier and healthier for your whole body.

Below are some great videos