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!

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.”

Can Hiking Make You A Better Runner?

If you’re running is starting to feel stale or boring, it might be time to switch things up. Officially known as “cross-training” in sports physical therapy, hiking can be an effective training strategy to help prepare for running. From both a physical and mental standpoint, there are several benefits that hiking will have on your running performance.

Aerobic gains with less chance of injury

Hiking is the perfect low-impact cardio alternative to running that vastly decreases the impact on the joints and muscles. Doing this low-intensity activity over long periods can help improve your aerobic engine, which helps new runners.

Engage different muscle groups

In our experience with performance physical therapy in Bethesda and Chevy Chase, we’ve noticed that runners can sometimes rely heavily on certain muscle groups while ignoring other important ones. The uneven terrain of hiking requires lunging and squatting movements, which help activate different muscle groups. Adding hiking to your training can help to utilize less-utilized muscles.

Improves balance and leg strength

Hiking, specifically on uphill climbs, requires you to use your glutes and quads to get over hills. This motion is similar to the act of running and gives the body a chance to exert itself without the added stress of actually running. Maintaining a steady pace while hiking also engages the core and stabilization muscles, improving balance and running form.

Stress relief

Let’s be honest — most runners choose time-saving routes in the neighborhood or treadmill rather than getting out on a trail. Though this is great in a pinch, being in nature can help alleviate stress and anxiety, improve productivity, and increase creativity. By cross-training with a hike, you’ll not only improve your performance but your mental health as well.

Make the most of your visit: 3 questions to ask your physical therapist

Whether you’re attending in-person or virtual physical therapy, your success largely depends on how engaged and involved you are in the process. A physical therapist’s role is to identify issues, develop a personalized treatment plan, and guide you toward recovery. However, as the patient, your active participation is just as crucial. Asking the right questions during your sessions can empower you to take control of your health and recovery journey.

Here are three essential questions to ask your physical therapist to ensure you get the most out of your sessions in McLean or Bethesda.

1. Why Did This Happen, and How Can We Prevent It from Happening Again?

One of the key goals of physical therapy is not just to treat the symptoms but to address the root cause of your pain or injury. Whether it’s a recurring injury, chronic pain, or post-surgery rehabilitation, understanding *why* the issue occurred in the first place is crucial to preventing it from becoming a long-term or recurring problem.

By asking your physical therapist about the underlying cause, you’ll gain insights into the factors that contributed to the issue—whether it’s poor posture, repetitive strain, muscle imbalances, or even lifestyle habits. With this knowledge, you and your PT can develop a plan to not only treat the current problem but also take proactive steps to ensure it doesn’t happen again. This might include correcting your movement patterns, strengthening weak areas, or making adjustments to your daily activities.

2. What Should I Be Doing at Home to Support My Recovery?

Physical therapy sessions are often limited to a few hours per week, but your recovery continues long after you leave the clinic. The majority of your time will be spent outside of the physical therapist’s office, which is why it’s critical to know what exercises, stretches, or adjustments you should be doing at home.

Ask your physical therapist for a clear and detailed home exercise program that complements your in-person treatment. This plan should be tailored to your specific needs and capabilities, ensuring you’re doing the right movements to support your progress. A good physical therapist will not only show you the exercises but also explain why they are important, how to perform them correctly, and how often you should do them.

On the flip side, it’s equally important to know what not to do. Certain activities or movements could slow down your recovery or even worsen your condition. By clarifying both the “dos” and “don’ts,” you’ll feel more confident in managing your rehabilitation at home.

3. How Can You Measure and Ensure I’ll Make Progress?

The ultimate goal of physical therapy is to make meaningful progress toward your recovery goals, whether that’s reducing pain, improving mobility, or returning to your favorite activities. However, many healthcare systems focus on generic benchmarks, such as returning to basic activities of daily living (ADLs) or reaching a general “baseline.”

While these objectives are important, physical therapy should go beyond just meeting minimum standards—it should be about helping you achieve your personal goals. By asking how your progress will be tracked and measured, you set the expectation that the focus is on your individual needs, not just generalized outcomes set by insurance companies.

Your physical therapist should provide a clear roadmap for your recovery, outlining the specific milestones and indicators they’ll use to track your progress. This could include improved range of motion, increased strength, reduced pain levels, or functional abilities tied to your lifestyle. Regular check-ins and reassessments will ensure that your treatment stays on track and is adjusted as needed.

Physical therapy is a partnership, and the more actively engaged you are, the better your results will be. By asking thoughtful questions and staying informed, you’ll not only deepen your understanding of your treatment plan but also enhance your ability to manage your health outside of therapy sessions.

Athletic injury rates are on the rise

As the weather warms up, COVID-19 cases decline, and spring sports resume, many young athletes are eager to return to their favorite activities. While the excitement to get back on the field is high, it’s crucial to prepare your body properly to avoid injuries and maintain good health. In the Bethesda and Chevy Chase areas, proper performance training can make all the difference between a dream season and being sidelined.

After a long break from sports, the risk of injury is elevated because the body isn’t accustomed to the demands of sport-specific activities. That’s why it’s essential to spend time before the season starts preparing both mentally and physically for peak performance.

Research shows that strength and conditioning training can reduce sports injuries by 33% and overuse injuries by nearly 50%. Therefore, it’s important to begin with simple, manageable exercises to get back in shape and stay injury-free.

A smart approach to preseason training starts with individual sport-specific drills focused on conditioning. From there, athletes can gradually progress to drills with a partner or opponent. Eventually, they can increase their activity level to include team drills, scrimmages, and full game play. This gradual increase in activity, similar to what is seen in professional and collegiate sports, allows the body to adapt and handle the cumulative stress.

The best way to develop a sport-specific training program that meets an athlete’s individual needs is to consult a professional who can tailor the program to their unique strengths and weaknesses. If you’re looking to optimize your performance after a long offseason or recovery from injury, consider seeking performance training in Bethesda or Chevy Chase to kickstart your dream season.

Here’s to a fantastic new season—don’t forget to enjoy it!

An Essential Part of Athletic Physical Therapy: Strength Training for Runners

Many of the runners that we work with at CHP supplement their running with strength training. Strength training is a large component of athletic physical therapy and provides a host of benefits including, but not limited to; reduced injury risk, increased muscular endurance, and faster running times. Research shows that regular strength training improves a runner’s speed and VO2 max. VO2 max is a measure of the maximal amount of oxygen that a person can use during exercise.

However, there is one important caveat to all of these great benefits. A runner’s strength training program must be designed and executed appropriately, and according to the runner’s goals and individual characteristics.

Luckily, most runners have similar goals. They wish to run faster and/or farther, and avoid injury.

Strength training programs for runners should consist of exercises that improve qualities specific to running.

When running, there is never a time when both feet are touching the ground simultaneously. The arms and legs are constantly moving in opposite and alternating directions as the body transitions from one foot to the other.

Therefore, we commonly advocate for runners to include more single leg exercises into their training.

These exercises include, but are not limited to: lunges, single leg squats, split squats, and single leg RDLs (Romanian deadlifts). Simply adding one of these activities into each of your strength training sessions can have a large impact. Take a look at the videos below for examples of these activities.

https://www.youtube.com/watch?v=aazACzyUR-Q

https://www.youtube.com/watch?v=KK05iugeIDE

https://www.youtube.com/watch?v=EjDtPek261c

Furthermore, runners should not neglect upper body training. Arm drive is an essential component of running and helps to drive leg action. An effective runner cannot have one without the other!

A thoughtful and more scientific approach to strength training, specifically designed for runners, may be all that is needed to drastically improve your running performance.