After Christopher McDougall’s book “Born to Run” became a national bestseller in 2009, the running world was turned upside down by the notion that the current running shoe model may be one of the leading causes behind the high prevalence of injuries to runners. After reading the book, millions of runners around the world decided to ditch their expensive running shoes for the Vibram FiveFingers (the funny looking toe shoes) or something of the like. During their running shoe transition, many runners experienced lower leg injuries which eventually led to a class action lawsuit against the Vibram FiveFinger company in 2014 for making false health claims.

However, the question still remains: is barefoot or minimalist running beneficial to running athletes? The research published in some of the most respected physical therapy and sports journals in the world suggests that barefoot running may have significant advantages in improving running mechanics, performance, and decrease the risk of injury.

Barefoot running encourages a forefoot strike which has been shown to reduce the risk of injury compared to a rearfoot strike pattern. Have you ever tried going outside and running on your heel? I promise you won’t last long. That’s because a forefoot strike is more forgiving than the more common rearfoot strike pattern. Landing on the front of your foot allows for the small muscles in your feet, Achilles tendon, and calf muscles as well as the quadriceps to all work together to help dampen the impact during each stride. When you land on your heel, all of the force is immediately felt in the bony heel and transferred up the chain to the knees and hips. That might not be a big deal for one step, but when the process is repeated over an extended period of time, overuse injuries are inevitable. It’s probably not a coincidence that 95% of runners land on their heel and 80% of runners are injured in a given year.

In addition to the benefit of a forefoot strike, barefoot running increases sensory feedback when the foot hits the ground and increases the energy storage in the arch and Achilles tendon. This allows the Achilles to act similar to a spring, absorbing the shock and rebound, decrease the amount of effort required in the push off phase of the running cycle.

So if there are so many benefits to barefoot running, why was there an increase in the amount of injuries to the runners that tried it out? The answer likely lies in a flawed transition period. Making the transition to barefoot running takes a long time (conservatively, 1-2 years) for a number of reasons. Number 1, people have been living in a literal foot cast for most of their lives. When you put your leg in a cast after an injury, it doesn’t take long for the immobility to cause severe atrophy and weakening of the muscles in the leg. Likewise, the shoe acts as a cast for the small muscles in the bottom of the foot, not allowing them to work and causing them to become weak. It takes time to build up the strength of these muscles. Number 2, it also takes time to recreate the way you run. There is a significant biomechanical difference between rearfoot and forefoot striking. It takes time and effort to transition properly.

If you have a desire to run in a more efficient way and reduce your risk for injury, please contact one of our offices to get more information. Our physical therapists that we have on staff are well educated in the most up-to-date research regarding running rehabilitation. We will work with you in order to help you get over a current injury and even prevent a future injury.

Spring Cleaning:
I know all of you are hoping, just like I am, that spring is finally around the corner. For most of us, the change of season brings the "itch" for spring cleaning. With this in mind, I thought I would present everyone with some tips on lifting techniques to reduce the risk of serious injury.

1. Stand close to objects you are trying to lift.
   When you are trying to lift something whether it is from the floor or off a shelf get as close to the object as you can before picking it up. It is simple physics; the further away an object is from your body, the greater torque it will put on your shoulders, back, etc. Greater torque=Stronger muscle force needed to lift.



2. Bend your knees.
   Remember, when picking something off the floor, don't bend only at your back. You should have your back straight, head up, and knees bent. The muscles in your back are very small compared to your quadriceps and gluteal muscles in your legs. Smaller muscles are at greater risk of strain because they can't generate as much force, and they fatigue quicker.
3. Take breaks.
   All of your work doesn't have to be completed in one day. Just as Jules said last week, we are coming out of the "winter hibernation". Take some breaks. If you feel tired and try to push through, you are putting yourself at risk for injury. As you get tired, your lifting posture will deteriorate. The more it deteriorates, the higher your risk of injury.

If you follow these tips, you will have taken the steps needed to prevent back injury while performing your spring cleaning chores. Of course, we know that not everyone is perfect. If you tweak your back, or for that matter any part of your body, give us a call. As physical therapists, we are the experts at conservative management of musculo- skeletal issues.

The importance for dynamic warm-ups prior to exercise
Let's face it, we've had a long hard winter. Some of us fought those winter blues by remaining active; however, there are those of us who tend to go into hibernation and don't come out until the snow has melted. With spring coming, there are some of us who are getting ready to begin working on those New Year's resolutions and head outdoors for some running, jumping and playing.

Many times as the hibernators attempt to "jump" back into the swing of things full force without proper preparation; an injury may occur. Which brings us to today's topic: the Dynamic Warm-up. According to some research; performing a dynamic warm-up increases flexibility, improves core stabilization and balance in a safe manner.

• A TOTAL MOTION RELEASE WARM‐UP IMPROVES DOMINANT ARM SHOULDER INTERNAL AND EXTERNAL ROTATION IN BASEBALL PLAYERS
• COMPARISON OF THE IMMEDIATE EFFECT OF DIFFERENT TYPES OF TRUNK EXERCISE ON THE STAR EXCURSION BALANCE TEST IN MALE ADOLESCENT SOCCER PLAYERS/

Before any type of sporting event, whether it's a baseball game, volleyball practice or 5K race you've put on that resolution list, it is important to warm up your body and muscles properly to help avoid injury. The most efficient and effective way to do so is with a dynamic warm-up. A dynamic warm-up is comprised of a series of 8-15 movements that will increase your heart rate, improve muscle elasticity, open up your joints, and physically get your body warm in order to prepare for the demands of the activity you are about to participate in.

A good dynamic warm-up consists of movements that will incorporate your upper extremities, lower extremities, and core. The dynamic warm-up should incorporate all planes of the joints that will be used to help stretch and facilitate the muscles. Lastly, the dynamic warm-up should be done with focus and should not be "walked through" - think of this as preparing your body for the big game.

The following is an example of the flow and routine that athletes should perform:

• Walking Lunges
• Reverse Lunges With Torso Rotation
• Lateral Lunges
• Straight Leg March
• High Knees
• Butt Kicks
• A Skip
• Lateral Shuffle
• Inch Worms With Push-up (plank walk with straight legs to hands and back out)

Again, remember the purpose of these warm-ups is to prepare your body for activity to prevent injury and prepare the cardio-vascular system.

Should you need assistance wiping those proverbial "winter blues" away, contact Superior Physical Therapy and Sports Rehab (https://frederickpt.com/); we'd be happy to set a plan in motion to get you and your loved ones game ready for a lovely spring/summer season with injury prevention in mind!

We have either said this or heard this said. In fact, there is a 22 – 65% prevalence that individuals will experience low back pain this year. Wow! That is a significant population. So how do I avoid straining/spraining my back? Here are a few tips!

• First, never jump right out of bed! Actively pump you ankles, slowly move your knees and hips. Then when you are ready to get up, log roll onto your side (if not already there), bring your legs off of the bed as you push off your same side elbow and the opposite hand. When you go to stand make sure you are focus on something straight in front of you. This will keep you from bending your back.
• Second, a strong core and quadriceps muscles will help reduce your risk of back pain. Pilates and general exercise are good places to start.
• Next, one of your hamstring muscles tenses a ligament in the Sacroiliac region. So having strong flexible hamstrings may reduce your risk.
• Finally, know what your body mass index is (BMI). Every 5 extra pounds of additional mass increases the strain on your back by 100%.
• Again, these are just a few tips. As always eat right, exercise, stay hydrated and get enough sleep. Avoid heavy, repetitive lifting.
• If you do experience back (and/or leg) pain that does not subside in a week, consult your friendly neighborhood physical therapist.
• Good luck and stay tune for our weekly “health and fitness” blogs!