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Why I Don’t Train Barefoot

Barefoot training and the use of minimalist footwear has become a widely discussed topic in sports physical therapy and the running community. Many folks in the fields of sports medicine, injury rehabilitation, and performance training are all-in on the idea of training in bare feet.

Training barefoot provides great benefits.

The absence of shoes gives the body a direct connection to the ground for quicker and more accurate feedback which helps to improve balance.

Barefoot training also strengthens the feet themselves. When the feet do not have assistance from footwear for support, they must do the entirety of that job for themselves. Muscles, tendons, and ligaments in the feet work to support the arch, the heel, and the forefoot which strengthens them over time. For this reason we often prescribe barefoot training for our physical therapy patients.

However barefoot training is not appropriate for all people.

Most of us walk on hard surfaces like concrete and unlike grass or dirt, concrete is not a forgiving surface. We are unable to manipulate concrete and we have less shock absorption as we step onto harder surfaces.

In addition to an external environment that may not be conducive for barefoot training, many people have unique foot structures or previous injuries that make barefoot training unrealistic. In these situations, a shoe may help their foot function better.

An appropriate shoe allows for the foot to find the ground optimally and properly transition through the different phases of the gait cycle. This allows the body to properly alternate from one leg to the other.

A proper shoe must provide optimal heel control, allow for the arch of the foot to contact the shoe properly (and at the correct time in the gait cycle) and bend only where the toes bend.

The correct shoe can have an incredibly powerful effect on a variety of different ailments and can make a huge difference in the effectiveness of someone’s rehabilitation and training program.

Are you eager to find out if barefoot training is right for you? Contact us today to learn more!

Try this to improve your hip and trunk mobility

Who doesn’t want to loosen up their hips and trunk while building strong hamstrings and glutes?!

It is common to encounter youth athletes and active adults in athletic physical therapy and injury rehabilitation settings who have tight posterior hips and stiff rib cages. This limits the amount of rotation that they available through the trunk and reduces mobility in a variety of different directions within the hips.

As a result, more stress is placed onto the lower back, knees, and other areas of the body. Overuse injuries often follow that send people to physical therapy, including general lower back pain, lumbar disc injuries, knee arthritis, meniscus injuries, etc.

The good news is that the root causes of these kinds of injuries can be addressed and often do not require a boring home exercise program.

The Single Leg RDL (Romanian Deadlift) is a fantastic drill that you can implement into your workout routine to improve your hip/trunk mobility and strengthen your glutes/hamstrings.

This drill is particularly powerful for rotational athletes like golfers, tennis players, lacrosse players, and hockey players.

We typically start our patients and training clients with the kickstand version of the Single Leg RDL before progressing to the more advanced versions below.

Kickstand RDL (front leg emphasis)

Kickstand RDL with Foot on Wall

The key with these activities is to ensure that you feel the back of your hip, glute, and hamstring working (on the working leg), while also feeling your abs working. You should not be feeling your lower back at any point during the drill.

Are you interested in learning more ways that you can adjust your exercise program to correct old injuries, improve your performance and/or stay pain free? If so, simply contact us!

Speed Up Your Recovery From Back Pain

As anyone who has thrown their back out and needed physical therapy will tell you, bending over feels rough for several days after.

Putting on socks and even sitting down is uncomfortable as the body attempts to prevent the lower back from moving, especially into flexion.

Flexion of the spine is commonly the most aggravating movement for anyone experiencing an acute episode of back pain. In physical therapy we test this by asking our patients to touch their toes. Once the acute episode subsides, the next step is training and learning to tolerate slow, controlled movements of the spine.

When tolerated well, the reverse crunch is great drill to teach this quality and can be used effectively as a warmup in the gym.

Oftentimes this is where the injury rehabilitation process stops. At this point the body can tolerate all normal daily activities however it has not learned to manage rapid movements of the spine, such as those that occur in sport or in the gym.

The Med Ball slam is a great drill to train the spine to tolerate movements that involve rapid spinal flexion. This drill should be pain free before attempting any heavy Olympic lifts like a clean or a snatch.

Also, remember to avoid using a ball that bounces as we don’t want any broken noses from this drill!

Physical Therapy Didn’t Work…

I tried physical therapy and it didn’t work.

Many of our patients in Bethesda have seen other physical therapists prior to seeing us. In their previous physical therapy experiences, they did not achieve the results that they were looking for and are coming to us for answers.

Personally, I love working with these people because they continue to believe that our profession can help them. However, negative experiences in physical therapy often cause many others to lose faith in the profession.

Perhaps you are one of these people. If so, I don’t blame you as I once was in your shoes!

When I was in High School, I experienced a quadricep injury that was impacting my ability to play football.

I went to my local physical therapy practice searching for help in overcoming this injury and play in my junior season. It was going to be my first season starting on both offense and defense causing this injury to constantly remain in the front of my mind.

My introduction to physical therapy was not what I had hoped for, and I now realize that my physical therapists were not taking great care of me (to learn more about how you can determine if this is the case, see my latest blog here).

Luckily, I was still able to play in my season and was back to 100% by the middle of the year. However, I can’t help but wonder if I would have been fully healthy to start the season if I saw a different physical therapist.

Like all other professions, the physical therapy industry has great professionals and poor ones. Furthermore, some physical therapists specialize with athletes, some with cardiac patients and others with people living in nursing homes.

As a result, my hope is that instead of saying “I tried physical therapy and it didn’t work”, you say “This physical therapist or physical therapy practice didn’t provide the results that I was looking for and I need to find someone that is a better fit for what I need.” 

Where You May Be Cheating Your Pushups (Video Included)

Let’s stop cheating our pushups and making the injury rehabilitation process more challenging! 

There is a simple way to make our pushups easier. Allow for your shoulder blades to pinch together and limit the motion’s range of motion . Less distance required for the push up=less effort. 

However, is this better for you?

Allowing your shoulder blades to pinch together excessively when performing a pushup places more strain onto the shoulder joint and may lead you to a physical therapy clinic like ours. Because the shoulder blades are pinched together, they are no longer able to move effectively and contribute to the exercise. More strain is placed onto the shoulder joint as it is forced to pick up the slack. 

Correcting this common compensation may prevent you from “repping out” the same number of pushups however you will get more out of the exercise. In addition, your shoulders will be healthier in long run!

The video below helps to illustrate this difference.

Video 1: The shoulder blades immediately come together.

Video 2: Begins by reaching away from the floor thus helping the shoulder blades to start in a more protracted (spread apart) position. From there they move slowly together as the body descends to the floor and spread apart again on the way back to the starting position.

A Shoulder Friendly Chin-Up

As we referenced in a recent article (found here), our ability (or lack thereof) to breath effectively will impact the function of our shoulders and is something we often address in sports physical therapy or performance training (as well as with many runners). This can affect our posture or shoulder mobility, and even result in clicking/popping or reductions in strength.

Of all these factors, reduced shoulder mobility is often the most obvious characteristic.

In most situations, a slight reduction in shoulder mobility is not an issue unless you are performing exercises that require a great deal of shoulder mobility.

One of these exercises is the pull-up or chin-up. Proper performance of these exercises requires a great deal of shoulder flexion and overhead pulling strength. The body is then forced to compensate when these qualities are lacking.

It is common to see an individual lean back and puff out their chest up when initiating the movement from the hanging position. As this occurs, the anterior ribs will flare out and impact the position of the shoulder, which reduces overall function.

So how do we ensure that we are properly performing our vertical pulling movements such as pullups and chin-ups?

Simply perform these movements in a tucked position! This position flexes the hips which stacks the pelvis underneath the body. It is very difficult to puff the chest out excessively when the pelvis is in this position.

However, be warned because this position makes chin-ups and pull-ups much harder!

In addition to increasing the amount of work required from the abdominals, any time a position takes away your compensations, the movement becomes much more challenging.

When first performing this movement have your legs or feet supported. After mastering this step, attempt to hold them up yourself.

Check out this video of Dr. Cohen performing these in his training routine.

Be prepared for the tucked position to challenge your vertical pulling ability!


Image Credit

“Pullup” by U.S. Army Europe is licensed under CC PDM 1.0