Uncategorized Archives - Catalyst Physical Therapy & Wellness Mission Valley San Diego

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How To Select The Best Running Shoes

You may be wondering how to select the best running shoes to fit your running style.  Other questions you may be asking yourself:

  • Which brand of running shoes are best? 
  • Do I need minimalist shoes?
  • What about arch support?  What about custom orthotics? 
  • How about maximum cushioning? 
  • Do I need a run assessment to determine what kind of runner I am?


These are just a few of the questions our Run Specialist Dr. Ellie Nevarez gets asked each week.  In addition, these are undoubtedly some of the most common questions she gets asked by new runners. 
A veteran runner, by comparison, most likely has “their shoe” that works great for them.

However, if you are a new runner that’s training for an upcoming half-marathon, how are you supposed to know what shoe to buy?  So before we go to the research, let’s check in with Dr. Ellie.

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Minimalist vs. Supportive Running Shoes

The first question I hear often?  Do I need a more “minimalist” shoe versus a “supportive” shoe?  To start, running shoes follow a spectrum based on the amount of cushion or thickness of the sole of the shoe.  In addition, there’s also arch support and “drop” or the ratio of sole thickness under the heel compared to sole thickness under the toe.

A minimalist shoe has very little cushion.  Therefore, very little arch support and a “zero drop” sole.  An example of this would be a Nike Free

However, a supportive shoe will have a thick cushion, high arch support, and a relatively big drop.  One of the most common max support shoes are the Hoka One One.

Are you looking for something supportive, but more lightweight for racing?  Well, a carbon-plated running shoe, like Nike’s Vaporfly Next% might be it.  In addition, these have been so popular that they sell out as soon as they launch a new pair!

 

Catalyst Run Program group run

How Your Unique Running Form Comes Into Play

As a physical therapist and a run specialist, I know that one size does not fit all.  You are unique in your running style and your current or past running injuries will influence this. Furthermore, you might make additional compensations for aches and pains, or based on the course or trails you’ll be running!  Want to come in for a comprehensive run assessment so I can take a better look at your form?  Let’s get you in!

Here’s what else comes into play when we talk about your running form:

  • Your foot posture, so flat feet vs. high arches
  • Toe strike vs. heel strike
  • Wide feet vs. Narrow feet
  • Forward lean
  • Stride length
  • Leg/core strength
  • Balance

In addition to all these things that make your running form unique, there may be certain shoe styles you find more comfortable.  Furthermore, you may hear, “humans have run for thousands of years without shoes.”  This statement supports that minimalist shoes are the best.  However, the counterpoint to that argument is that most individuals have worn shoes their entire life.  Therefore, going from a supportive shoe to a shoe with little to no support will increase the chance for injury. 

Then, add in an increase in mileage or running on new terrain, and this further increases your risk!  Not only are you removing support, but you are also significantly increasing stress in the feet from each foot strike on the ground.  In fact, the vertical force distributed through each foot with running is 2-3x your body weight compared to 1.5x your body weight with walking.

 

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Back to Maximum vs. Minimalist Running Shoes

So are maximum support shoes the best?  Well, many of my patients are runners who wear Hoka’s and swear by them.  Clients often tell me they feel as though they are “running on clouds.”  In addition, maximum support running shoes have helped many of my runners who suffer from knee pain.

However, having all of this support of a maximum support running shoe, the foot no longer has to work as hard and can get lazy.  When this happens, I often see problems further up the chain in the hips, knees, IT band, and lower back.

 

So What Does The Research Say on the Best Running Shoes?

Let’s look at the science behind running.  Here are a few resources that have helped us debunk the myths:

 

Therefore, after reviewing all the research, and combining that with what we’re seeing in the clinic, we can conclude that your running form matters more than the type of running shoe you are wearing.

 

Words of Caution When Opting for a Minimalist Running Shoes

So, if you’ve decided you’d like to wear a minimalist running shoe, a slow evolution is absolutely necessary when transitioning.  As an example, running in Vibram’s Five Fingers leads to a greater risk of injury. 

Furthermore, we can assume that your foot and ankle strength isn’t there initially. Slowly develop this over time.  And, through a proper training program with support from a physical therapist. In addition, if you’re prone to injuries or foot pain, the minimalist running shoe route is one you want to use with extreme caution. 

Finally, if you’re in it for the cool factor of progressing like our ancient ancestors, get on the minimalist’s running shoe wagon.  However, remember to build up that ankle/foot strength, slow down your speed, and focus on landing more forefoot!

 

Things to Keep in Mind with a Maximum Support Running Shoe

As the research shows, a maximum support running shoe does not necessarily protect you from injury either. 

Although there is not a lot of research done on it just yet, some preliminary findings suggest that when runners are given an extra cushion to support their feet, they tend to rely on it more than using their foot/ankle strength.  In addition, maximalist running shoes are being shown to actually increase the vertical loading forces in the body.  This could be good news initially for those of you prone to foot and ankle injuries.  However, redistributing these larger forces to the knees and hips could lead you down another path of destruction.  Therefore, you’re not necessarily decreasing your risk of injury, but rather choosing a different style of injury. 
 
A better investment might be identifying some running form changes that will allow you success in the new shoe you choose.  In addition, since research shows that a majority of runners may not accurately identify their running form, coming in for an assessment is a great next step.

 

Ultimately, the goal is to find a running shoe that is comfortable for you and your running style.  This is why I’ve focused on running here at Catalyst PT & Wellness.  Got a quick question for me?  Drop me a message and let’s get you back to doing what you love! 

If you are having pain, or have a history of injuries, come in for a PT appointment, or schedule your run assessment and I will give you a full evaluation of your running form plus tweaks to make running more fun and pain-free!

 

Catalyst Run Program group run

 

Final Thoughts

Remember, you are unique!  So googling ‘what are the best running shoes’ will give you results, but perhaps not for your unique running style.  Although some high end running shoe stores might be able to do a run assessment, most have not been educated on proper running mechanics.  In addition, most store clerks have not managed patient care specifically for runners over the years.

My suggestion for the best running shoes?  Find a running shoe that is comfortable to run in.  If you’re new to running, start small.  30 minutes max.  Build up the miles slowly, and change up the terrain. 


Remember, running should not be painful.  Especially not in your joints!  Do you have a history of injuries or are significantly increasing your training to prep for a race?  Then I recommend coming in for a run assessment before logging those big miles. 

 

Need more running tips?  Read our Runner’s Rulebook, a guide from a running coach on how to create a well-rounded training program that will keep running enjoyable and help prevent injuries.

 

Thanks for reading and hope to see you out there on the road or trails!

 

Dr. Ellie


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Are you a yoga teacher, or a teacher in training and searching for common yoga injuries and how to avoid them?  Both for yourself and your students?  Well, you’ve come to the right place!  We’ve been instructing yoga teachers for a few years now on how to teach so that you help to reduce the potential for injuries in your practice.  

 

Common Yoga Injuries

First, let’s talk about the most common injuries we see at the clinic from yogis and long-time yoga teachers.  Here’s a quick list:

  • Lower back pain
  • Ongoing wrist soreness
  • Tight hips flexors
  • Shoulder strains/rotator cuff injuries
  • Hamstring issues

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Top 5 Reasons Yoga Teachers Develop Injuries

Second, let’s tackle why we see these injuries in the clinic.  Most are not acute injuries by the way. They develop over time from repeating the same postures or poses.

 

1. Lack of Anatomy Knowledge

Anatomy is one of the most important pillars of any movement professional’s journey into teaching.  Now, it’s not necessary to memorize all 650 muscles, 360 joints, and 206 bones.  However, it is important to have a good grasp of the relationships the muscles form when interacting with each other.  And specifically in this context, from one pose to another, to avoid common yoga injuries. 

This interaction needs to happen in a way that allows for healthy movement not overrun with compensation. Meaning, the big guys win and the stabilizers, or the smaller muscle groups, are overpowered. 

Achieving balance within the musculoskeletal system will require an understanding of the common signs of tightness, weakness, and even pain, and how they limit normal fluid movement.

 

Yoga teacher training

2. Focusing on aesthetics instead of function

What yoga teachers need to always ask themselves is, “What is the purpose of this pose, and how will my class achieve it?”  Far too often, we see yoga teachers disregard function.  Instead, they replace it with beautiful, but challenging poses.  Do they want to show off their uber-flexible selves by bouncing from one difficult pose to the next?  Perhaps ending the sequence with a graceful inversion or arm balance? 

If so, this creates a risk for both the instructor and the student.  You are asking the body to perform difficult transitions and this can lead to the common yoga injuries mentioned above. 


Understanding that the body faces its largest amount of stress in these transitions means that you as the teacher must strive for proper alignment and control.  Especially through the changeover from an eccentric to concentric motion.  More on this principle down below. 

Ignoring the challenging portions of a flow to simply make things look cooler will ultimately lead to injury.  Instead, yoga teachers should pay special attention to developing their ability to provide “bite-sized” cues that allow for safety and success while flowing from one pose to another.   

 

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3. Not Enough Self-Care in Between Teaching Yoga

As a yoga teacher or a teacher-in-training, we bet you have a huge heart and want to give back to people to help them live longer, healthier lives.  However, you also face the pressure of balancing that giving of yourself with the need to make a living. 

As an example, early on in your career, you may be placed in one type of class.  This forces you to flow through the same sequence over and over again.  Every single day, sometimes twice a day!  

Not having the experience or control to vary up your sequences can lead to a beat-up body through repetitive overuse of certain areas.  In particular, we see common yoga injuries in the wrists, shoulders, lower back, and neck.  Although you may want to grind it out, and push yourself to achieve a higher level of performance, these rigorous practice sessions can have long-term negative effects on your body. 

In addition, you may be coming from an athletic background in dance, gymnastics, or acrobatics.  Therefore, you may already be prone to rarely slow down enough to allow for the body to repair.  Pushing yourself year-round, practicing until near perfection is achieved, often does more harm than good.  Self-care baby!

Thus, take the time to unload your body between practices to avoid common yoga injuries.  Yes, we realize you may think yoga is low-impact.  Especially if you also participate in more intense sports like running, cycling, or rock climbing.  However, lack of recovery, coupled with the fact that not all teachers have been shown self-repair techniques, increases the risk of overuse injuries even more.

While stretching and self-massage might not be your main concern, find proper corrective exercise to strengthen weaker areas.  Concentrate bodywork or self-massage on the spots being overused.

 

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4. Flow Speed is Too Quick

The timing established for a flow must match the intention you have for the workout planned.  The goal should always be to provide just enough cues to allow people to draw attention to their breath, balanced with a speed slow enough to allow for safety and controlled motion. 

Controlled motion is achieved when muscle recruitment is at its peak, and the reliance on passive connective tissue, like ligaments, is low.  This keeps the joints and bones from feeling the stresses that ultimately lead to breaking down.  In addition, it allows for coordinated movement.

When it comes to coordination, the different types of muscle actions must achieve synergy.  Muscles are known to face their largest amount of forces as they go from an eccentric (lengthening) position to a concentric (shortening) position. 

So, gaining control of the momentum imposed by gravity during these transitions will never be easy.  Especially for your students in your yoga class.  Or a teacher struggling to race the clock to finish class on time. 

If the speed of the flow increases based on your feelings that you need to perform for your higher-skilled students, then timing becomes the catalyst for some of these yoga injuries. 

 

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5. Unbalanced Sequencing

Do you often struggle when thinking about what poses to demonstrate in a sequence?  Well, think about introducing variation into your “teaching moments”.  By creating variation, you will achieve balance among your muscle groups. 

As an example, you may get used to showing a few key poses in each class.  However, you’re forgetting to include variation in your own sequence throughout the day.  This leads to an imbalance in pressures across your body.  Then, over the course of weeks and months, you’ll see deterioration at the joint level.

In addition, consider that mental and physical stamina levels are generally lower towards the end of a long day of teaching.  So you know it becomes especially difficult to maintain quality and choose a pose that’s healthy for your body over the pose that is simply easy to show.

To combat this, it’s important to plan out YOUR teaching week for YOUR body’s needs, as well as your students.  While the scope of this article is not to teach you how to design a flow that balances out the different muscle groups, it is important to understand where your injury-prone areas are located.

Having a good understanding of your postural needs, movement impairments, general flexibility, and strength will help you to select the smartest, most effective poses to demonstrate throughout your teaching week. 

 

yoga teacher training

 

More Tips to Avoid Common Yoga Injuries

The key to creating a great yoga practice lies in planning ahead.  Use this time to remind yourself what poses you need to demonstrate more and insert them into your practice.  Then, work on walking the room.  Cueing and adjusting the poses you don’t need as much to avoid dangerous repetitive overuse.

Need more help?  Well, then book a Wellness appointment where a physical therapist can identify your postural needs to assess flexibility/strength.  With this information, we can help you build a foundational practice tailored to you

 

Best Practices for Yoga Teachers

The best yoga teachers that go the distance in the profession have all taken time to develop a strong foundation of anatomy, and the proper verbal cueing required for fluid movement.  In addition, the secret to remaining injury-free as a yoga teacher requires a strong understanding of the above 5 principles. 

Furthermore, they understand when to increase the speed of their flows based on the coordination and challenges presented during class.  Finally, they have a good understanding of their own body’s limitations.  So, take the time to put into practice the necessary repair work and corrective exercise required for longevity as a yoga teacher.

It’s our mission to encourage all people, healthy and injured, to develop a clearer picture of their body, and the needs they should address when striving for better physical health.  If you’re interested in learning more about your body, or find yourself battling any of the topics listed above, we strongly encourage you to meet with a physical therapist soon!

 

 


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Are Flip Flops Bad For Your Feet?

Are you searching for bunion pain relief from wearing flip-flops all day?  If so, you are not alone.  Millions of Americans suffer from foot and ankle related issues because of the shoes they’re wearing.  Especially here in San Diego where flip-flops are the norm, we see this often.  Not only can wearing flip flops cause pain, but they can eventually lead to a lack of proper mobility of your feet.


So is wearing flip flops everyday bad for your feet?  The answer is yes, and one of the most common problems we see at Catalyst is bunion growth due to daily flip flop wearing.  In addition, while some of these problems from wearing flip flops all day long require surgery or drugs, many of them can be addressed with less invasive care.  Below we’ll break down the science behind it all, along with at-home tips for how to get your feet back in shape!

 

What Problems Do Flip Flips Create

First, what exactly is a bunion and why does wearing flip flops create one?  A bunion is a condition that is caused by the big toe angling away from your body towards the 2nd toe. The fancy medical term we use for a bunion is hallux valgus, which translates to an “increased toe angle.”

Once the toe starts to angle away from your body, your body enters a protection phase by increasing the production of bone and soft tissue around the joint.  In the early stages, this leads to a purely cosmetic issue around the toe knuckle without pain. In the later stages, patients can complain that the area is painful to touch and even hurts while walking.

 

Bunion Pain Relief

 

What Causes Bunions? 

While the bunion manifests itself in your toe, the actual root of the problem could be higher up in your body.  Wearing flip flops as your daily shoe can create dysfunction in your ankles, knees, and hips.  Therefore, as a result of these dysfunctions, the body compensates for every step you take. 

In the physical therapy world, our fancy term for how you walk is “gait pattern.”  During optimal walking, your big toe is the last part of your foot to leave the ground.  With a perfect gait pattern, your big toe is like a bowstring during these final moments.  Fully taught ready to spring you forward.


However, in people with bunions, the midfoot begins to collapse due to weak hip muscles.  These weak muscles are unable to control the motion of the leg below.  Instead, you push off the inside of your foot like an ice skate, rather than letting your big toe spring you forward.  By taking the recommended 10,000 steps each day, and in shoes that offer little to no support, like flip flops, you can quickly see how your foot structure will change to compensate.

 

Flip Flops and Foot Pain

Still not quite certain that flip-flops could be causing these bunions?  Here’s more research to prove it:

 

Six Steps To Prevent Foot Pain and Provide Pain Relief

Here are a few quick things you can change right now to help prevent a bunion from occurring or for bunion pain relief:

 

1.  Stop Wearing Flip flops All Day Long! 

Instead of flip flops, buy some fun slip-on sneakers. The wider toe box allows your foot to splay on the ground the way it was meant to.  If you’re still not certain if flip flops are bad to wear all day, even after reading the research, try swapping them out for sneakers on your walks.  Heading to the beach?  Wear sneakers and toss your flip flops in your bag!

 

2.  Maintain a healthy weight

Staying in that healthy weight range for your age not only helps you with bunion pain relief, it also reduces your risk of heart attack and high blood pressure.  Plus, it will make you feel good and give you more energy!

 

3.  Exercise regularly

Get into the habit of exercising and adding more movement to your daily routine.  Even if its just 30 minutes a day of brisk walking.  Remember, walk in your sneakers and not your flip flops.

 

4.  Get fitted for orthotics

Orthotics can be helpful to not only support your feet properly but also keep them in the proper alignment when running, walking, or hiking.  In addition, our foot care department at Catalyst PT & Wellness can provide custom orthotic prescriptions!

Fill out our request form now, or call us at 619-501-2195 for an appointment.

 

5.  Massage Therapy

Massage therapy is one of the oldest medical practices still around today.  We’ve adapted this Eastern medicine into our routine care and offer several types of massage- sports, deep tissue, neuromuscular, prenatal, and even chair massages.  In addition, many of our massage therapists see patients that suffer from foot pain due to wearing flip flops all day.

Read more on the styles of massages we offer, what the additional benefits of massage are, and how to become one of our Monthly Massage Members!

 

6.  Rest, Ice, Compression, and Elevation

As with most common injuries, the tried and true method of R.I.C.E. (rest, ice, compression, and elevation) will help alleviate foot and ankle pain due to wearing flip flops.  As an example, a warm soak with Epsom salts or an ice pack in the evening will bring foot pain relief.

 

Bunion Pain Relief

Additional Treatments For Flip Flop Wearers

Bunion Surgery

The quick fix for a bunion as a result of wearing flip flops is a surgery known as a bunionectomy.  During the surgical procedure, the bone and soft tissue on the big toe is cut out and the big toe is reset into position.  Besides dealing with post-surgical pain, recovery can last anywhere from 6 weeks to 6 months.

Unfortunately, the success rate of these surgeries is mixed.  The bunion is not the actual problem, but rather the area in the body that is compensating for the problem.  If you’re still wearing flip flops post-surgery, your feet will continue to work in the same way.  Therefore, we have seen bunions re-develop after surgery.   The cause of the foot pain or bunion is never addressed and you end up back where you started.

 

Physical Therapy

Physical Therapy treatment involves assessing your walking mechanics.  First, we identify the contributors altering your foot and ankle mechanics.  We watch you walk in your shoes or flip flops.  Often we find imbalances in muscles and joints of your hip, knees, ankles, and even your core muscles! 

Second, we teach you about strengthening and stretching techniques.  Third, we have you move in functional patterns.  This allows your body to incorporate your new strength and range of motion into daily life.

 

Not sure if flip flops are causing your injury? Or if your foot pain can be treated with physical therapy?  This is why we offer free injury screenings.  An injury screen is a quick, 15-minute video or in-person chat that can allow a doctor of physical therapy to assess your signs/symptoms.   

If your therapist determines your symptoms stem from an orthopedic issue like wearing those flip flops all day, together you can discuss which course of action will work best for you.  Whether it’s telehealth or in-person PT appointments, we can help you get your body back in action.  Fill out our request form, or call us at 619-501-2195 to book an appointment.

 

Bunion Pain Relief

Summary

If we haven’t convinced you yet, wearing flip flops all day long is bad for your feet.  The constant pain you develop as a result is not only uncomfortable, but it can also make it harder to do the things you love- run, jump, play with your little ones.  Spend a little time taking care of your feet now, and you’ll be pain-free for years to come.

 

Looking for more information about foot and ankle health?  Check out our Foot and Ankle Guide. 

 


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Moms have taken on many new roles these past few weeks.  From homeschooling to chief playtime officer.  So we’ve created a way to say thank you with a digital gift card! 

These can be used towards any service at Catalyst PT & Wellness:

    • Massage
    • Physical Therapy
    • Personal Training
    • Acupuncture

Digital gift cards are available in $25, $50 and $100 increments and do not expire.

Therefore, you can pick one up today and share with your favorite mom, aunt, sister, or friend that has gone above and beyond these past few weeks.

Thank you to Moms everywhere.  We hope their day is filled with love…and major pampering!


CATALYST GIFT CARD

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