News - Catalyst Physical Therapy & Wellness Mission Valley San Diego

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—THE TOP 3 THINGS EVERY YOUTH ATHLETE NEEDS —

Sports participation is on the rise with an all-time high of an estimated 45 million participants in youth programs in 2019 [1].This increase in participants has led to the formation of more and more leagues, and additional pressure on athletes to compete more frequently. Let’s face it, youth leagues are making good money and there’s very few central organizations controlling how they roll out their schedules and coordinate with neighboring groups. Year-round competition has quickly become the new normal for sports, and kids are being pressured at earlier ages to keep up. With no down time and poor skill development forced into the diet of these youth athletes, there is bound to be a higher injury rate and early burnout [2].

It’s staggering that roughly 8 million of the youth athletes will be seen by their physicians, or report to emergency rooms annually with sports-related injuries [3]. The incidence of ACL injuries has increased over the last 20 years with peak occurrence taking place in high school female athletes [4]. With the overuse injuries on the rise and sport specialization trending at a younger age, we must pay close attention to our kids’ developing bodies and minds. Not only has early sports specialization (playing one sport for an entire year) shown a direct link to overuse injuries, but it’s also leading to an early burnout and eventual drop from participating in organized sports.

Research conducted by the National Alliance of Sports has shown that 70% of children drop out of organized sports by the age of 13. 

This is scary considering a large number of parents are quick to up the training regimen for their children in hopes of forming the next superstar the second they show an ounce of talent or affinity for a specific sport. Don’t get me wrong, I completely understand how exciting it is to see your child naturally excel at riding a bike, kicking/throwing/hitting a ball or climbing a wall. If your child shows a natural talent for kicking a ball and wants to be the next soccer superstar at age 10, it’s natural to think you should enroll them into the elite organizations offering year-round competition. But at what price? Would you still do that if I told you they were much more likely to suffer from a knee injury at the age of 14 or 15 that could put their career in jeopardy?

There’s no arguing that children need to be protected from early damage to their bodies during their formative years and puberty. The wrong dose of running, jumping, cutting, hitting, throwing can injure your child for the season, and threaten their long-term development. Being on the front lines of the physical therapy field now for over a decade, I’ve seen ACL sprains, growth plate injuries, and strains/sprains showing up in younger and younger athletes. This has me nervous because according to research, this likely won’t be the last time the majority of these kids are seen in a clinic setting. Getting injured early in life has also been shown to cause a myriad of other problems, like decreased bone mineral density, skeletal deformities, higher re-injury rates, and even increased likelihood of chronic pain in adulthood [5].

— If it looks ugly, chances are it’s not a matter of if but when their body will break down —

Repetitive movement patterns with faulty mechanics will lead to overloading (too much stress) in the growth plates, ligaments, tendons, cartilage, bones, and muscles comprising our skeletal system. It’s the simple fact that when you tell 10 kids to kick a ball, they’re going to do it 10 different ways. No coach can conjure perfect form for all of their athletes, but they must be able to recognize when poor mechanics need correcting to prevent irreversible damage to their athletes’ bodies. For example, take a 10-year-old, tall girl that has excessive shoulder mobility but poor core stability and tight hips from growing too fast. If you ask her to go up in the air and deflect a ball over the goal, or block a shot, there is good chance she’s going to drive her knees excessively inward upon preparing to jump, arch her back to ensure her hand gets in front of the ball, and fail to slot her shoulder correctly when blocking the shot. This may not always be the case, but if not corrected, it will undoubtedly lead to increased stress across the ligaments or growth plates in her knees, excessive force across her lumbar spine, and possible rotator cuff or labral injuries in her shoulder down the road.

So, are coaches to blame? Absolutely not! It’s the system that needs revamping. Each organized league must be held accountable to take the child’s development seriously. That can’t happen without pressure from the parents and health care field. We all must strive to pick out ways to assist the kids with movement training and coordination development. 

So How Do We Fix The Broken System?

Here are three of the most important ways I’ve found to develop youth athletes:

  1. Get screened by professionals to assist with proper physical development
  2. Increased time with cross-training to overcome their weaknesses 
  3. Insert “down time” into the annual schedule to recover properly, and rebuild

I’ll go into detail on each one of these below:


ATHLETE PERFORMANCE SCREENING

Athletic performance screening can help identify the individual challenges each athlete faces throughout the different stages of development. Why is it that we see the dentist every 6 months to assess our oral health, but physical health takes a backseat? Truth is, we should be giving our body the same focus and attention that we give our mouths. Annual physicals are not designed to thoroughly look at a child’s physical development. Rather than waiting for a child to report pain, we can get ahead of injuries by performing detailed assessments or screenings more regularly to ensure the movements they routinely perform are done correctly. This screening must mimic the common actions in the sport they play, and assess the areas of the body that research shows are often injured.

The screening can be performed for each athlete individually in a controlled setting, like a gym or clinic, or out on the fields. The goal of these screenings should be to identify the body’s weak spots and determine a corrective exercise program to promote proper athletic development. When completed on the team level, athletes can be categorized into different groups based on their physical abilities and given corrective exercises, drill work, and appropriate sports performance guidelines to allow coaches and trainers to better prepare the teams for the rigors of competition.

CROSS TRAINING

Cross training is often thought of as choosing a lower impact activity to insert in place of your main sport. For example, a soccer player might choose cycling or swimming instead of running to keep up their endurance levels between their heavy periods of competition. While this is one form of cross-training, it’s also important to consider the benefits of what a solid gym or weight training program can do for a developing body. Resistance training is commonly thought of as bad for youth athletes. This simply isn’t true. While I don’t condone spending 5 days a week in the gym following a strict strength training regime, I do believe the right corrective exercises inserted into a routine for kids can make all the difference when it comes to preventing injury. The trick is to make these exercises challenging, well-rounded, and fun. This will allow our youth athletes to form healthy movement habits, and develop coordination and efficiency that will protect the commonly overused areas of their bodies. 

PROPER RECOVERY

Recovery is all too often an afterthought for developing athletes. While I’ll forgo the detailed description of how recovery affects our bodies both mechanically and metabolically, I will say that stress across muscles and joints must be monitored and controlled to avoid developing overuse injuries. Most professional organizations are aware of this theory now, and utilize different ways to monitor and alter training loads for their athletes based on the demands of the position they play and the competitive match/practice schedule. These organizations are taking note of how each athlete’s recovery for their body differs and charting ways to assist them in balancing their training bouts to allow for ample performance. Basically, they’re not just asking how the athlete feels anymore, but are now monitoring how their heart rates and body movement (e.g. range of motion, strength, blood chemistry) are adapting to the physiological stressors. This allows them to tailor the weekly workouts and guidelines for recovery for each athlete individually. This isn’t to say your 10-year-old athlete is also in need of this, but a simple rating of perceived exertion (RPE) and an awareness of down time each year (or directly after large amounts of competition) is warranted to ensure your child is not damaging their vulnerable areas and in risk of long-term injury. 

In closing, I hope you understand that not all athletes move the same, and the demands of each sport differ. It’s not the coaches job to identify the movement inadequacies and implement a corrective exercise program. Rather, it’s the organization and parents job to promote the health at all times of the youth athletes. This comes through education and strategic alliances with organizations that can help deliver proper warm ups, exercise guidelines, and physical screenings. By paying more attention to the quality of the movement early on in our kids’ development and creating healthy habits, we’re giving them the gift of longevity in becoming a life-long participant. Whether they go to the big leagues or not, having a young athlete learn the principles of healthy movement and balanced training loads will prove it’s worth over time, and cut down on the early drop-out rates that are trending in our current era. 

If you’re interested in learning more about ways to get our professionals involved with your athlete or organization, please fill out our questionnaire (athlete performance questionnaire) or check out the athlete performance section of our website to learn more (Read More). 

Brian Wilson, MPT

DOWNLOAD ATHLETE OVERUSE PDF

REFERENCES:

[1] State of Play 2019: Trends and Developments in Youth Sports. The Aspen Institute/Utah State 2019 National Youth Sport Survey. 2019 Sept; 3: 1-32.

[2] Difiori JP, Benjamin HJ, Brenner JS, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse Injuries and Burnout in Youth Sports: A Position Statement from the American Medical Society for Sports Medicine. British journal of sports medicine. 2014 Feb 1;48(4):287-8.

[3] Pinyao R, M.P.H., Ashman JJ, Ph.D., and Akintunde A, M.S.P.H. Emergency Department Visits for Injuries Sustained During Sports and Recreational Activities by Patients Aged 5–24 Years. National Health Statistics Report. 2019 Nov 15; (133) 1-15.

[4]  Beck NA, Lawrence TR, Nordin JD, DeFor TA, Tompkins M. ACL Tears in School-Aged Children and Adolescents Over 20 Years. American Academy of Pediatrics. 2017 Mar; 139 (3).

[5] Fulton J, Wright K,  Kelly M, Zebrosky B, Zanis M, Drvol C, Butler R. Injury Risk is Altered by Previous Injury: A Systematic Review of the Literature and Presentation of Causative Neuromuscular Factors. International Journal of Sports Physical Therapy. 2014 Oct; 583–595 (9).

 


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The Runner’s Rulebook: A Guide from Your Running Coach

 

What is the Runner’s Rulebook?  Well, it’s a guide from your running coach, that’s me, Coach BW, that teaches you how to keep running fun and pain-free year after year!

 

First, there’s no doubt that running is one of the world’s most popular sports.  Why?

  • No major equipment is needed to run
  • Running improves both your physical and mental health
  • Through running you build strength, and strong bones, as it’s a weight-bearing exercise
  • The attractiveness of a “high” euphoric feeling that you get running, especially outdoors, as you fall into a balance between your thoughts, effort, and your natural surroundings
  • During times of stress or long workdays, you can turn to running as an outlet.  It can provide you with a ‘reset’ that allows you to become a better version of yourself

 

A Guide Based on Experience

 

As a runner, an endurance coach, and a physical therapist for the past 14+ years, I created the Runner’s Rulebook based on my experience coaching running at all levels.  From beginners in the sport to professional runners. 

In addition, I also assess and treat running injuries on a weekly basis, and teach other physical therapists how to do the same.


Now then, the Running Rulebook does not contain hard lines drawn in the sand.  But, more of a template that can be revisited as your body evolves over time.  Let’s jump into my Top 5 Rules for Runners!

 

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1. Take time each year to understand your body

Taking the time to understand your body as a runner means taking a good look at your physiology and musculoskeletal makeup.  Therefore, a review of medical history, injuries, and, a true assessment of your flexibility and strength in all areas of your body pertinent to running.  

 

For example, have you taken a medication or been forced to wear dress shoes that have led to losing some of your ankle and toe mobility?  Well, we rely heavily on this mobility for running. 

So, a shortening of a person’s ankle dorsiflexion or change in toe extension can be directly linked to foot pain.  This pain typically does not improve unless you have a specialist identify what needs to be done.  Signing up for our run assessment is a great first step- literally! 

 

Running injuries are typically not acute.  But, they gradually evolve over time.  Therefore, the impact and stress applied to your joints needs to be balanced with the right exercise. 

For me, it may mean stretching a little more on one side versus the other.  For you, it could be activating a certain muscle set.  Moving through a strength routine.  Something to help you better control the forces applied when landing on one leg and absorbing shock. 

 

Catalyst run program

 

2. Manage your energy levels to become your best self

Next, proper energy management is essential when choosing what time of day you plan to run to keep it fun and pain-free.  Each run should complement your energy levels, allowing you to feel a sense of achievement and balance. 


As a runner and running coach, when I’ve gone for a run during a time when my energy levels were exhausted, it’s just junk miles.
  Wondering what I mean by this?  Well, there are mixed reviews on what junk miles actually are, and whether they worth having in your running training plan. 
As a running coach, I’d view junk miles as days when your running on empty.  Where each step feels heavier than the last.  Overall, you feel clunky and out of any sense of natural rhythm.


Therefore, understanding where and when you are naturally inclined to harness energy is extremely beneficial for the success of your run training plan.  How do you determine when and where to fit in your run?

Ask yourself these questions:

  • Do you wake up with energy and need to waste a bit to feel productive?
  • Do you get energized throughout the day interacting with people?
  • Are you someone that feels low on energy regardless of the time of day? Do you always need motivation to get outside and run?


running coast Carlsbad

 

3. Understand what style of runner you are

Did you know that your running form or technique matters?  Yes, there are direct links to the mechanics of how you run that influences how long your body will last in the sport.  A study published in Medicine and Science in Sports and Exercise provides robust evidence that technique explains a substantial proportion of the variance in your ‘running economy’ and performance. 

 

Do you know what type of runner you are?

Ask yourself, do you:

  • Land on the balls of your feet the majority of the time?
  • Have weak ankles or fallen arches?
  • Have a long stride?
  • Land on the heel of your foot every time despite whether you’re going uphill or downhill? 

 

By identifying and addressing some of these issues, you can actually change your running form.  And a change in your running form could actually save you a lot of time and money- helping to avoid medical expenses from injury and the purchase of unnessary equipment (shoes, braces, orthotics). 

 

Need help identifying what type of runner you are?  Make an appointment for a run assessment! One of our specialists will identify exactly what style of runner you are, and they can help you identify form issues that could lead to energy leaks costing you efficiency.

 

Why get a run assessment?  Well, having someone assess your natural style will prove extremely beneficial when it comes to becoming a more efficient runner.  What do I mean by that?  Efficiency equals faster speed, fewer impact forces on your body and less energy leaked that limits your performance.

 

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4. Set goals that make sense for what kind of runner you want to be

As a running coach, I see it all the time. Runners pick their races based on the training partners they’ve chosen. While I’m all about having people alongside you to motivate you towards your goal, don’t become a marathoner because your friends do.  Or, because it’s often seen as the pinnacle of the sport.

Think about why you enjoy running.  Then, set at least one or two races on your calendar that are your ‘A’ races.  These races should speak to the very reason you’ve taken up the sport! 

 

How do you determine what kind of runner you want to be?  Ask yourself if you:

  • Crave the hills?
  • Enjoy the environment found on trails or gravel roads?
  • Love pushing the pace on a track?
  • Need just 30 minutes of solitude to feel recharged?
  • Want to achieve a personal best in a 5k/10k? 

 

Based on your answers, you’ll be able to sprinkle in some of the motivating stuff you need each week while training and naturally increase your motivation towards your goal race.  This allows you to keep your eye on the prize!

As a running coach, I call these your soul-feeding workouts.  Fit one into each week to recharge. 

For me, this might be intervals on the track.  For you, it may be a walk/run combo in the woods to re-center and focus.

 

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5. Plan your workouts in advance and have someone hold you accountable

I’m not the most knowledgeable running coach in the world.  However, I see such success with my endurance athletes because I get to know them.  And, I help them to set realistic and fun goals that fuel them as human beings.

So, I love coaching and training runners of all ages and abilities.  In my experience, there are some of you who will need a 5-day adventure running race to feel fulfilled, while others only need a 5k.

 

How to Become Accountable

Bite-sized goal setting coupled with reality checks on performance is what allows a runner to progress.  Then, it all comes down to accountability. 

For you, accountability may come through writing in a journal or reporting progress over the phone to a running coach each week.  Or, it could be logging miles on Strava, GarminConnect, Suunto, or sharing via a social media post to allow friends and family to cheer you along. 

Either way, track what you do week-to-week.  Set goals for the year and constantly evaluate your progress towards meeting those goals.  This will lead to long-term success.

 

 

Final Thoughts from Your Run Coach

Running should never feel as though it’s a chore.  Something that you have to check off the list each day.  Therefore, pay attention to my top 5 rules.  This will allow you to feel fueled and avoid burnout year after year.

It’s a blessing to be able to run!  So, if you place emphasis each year on evolving your body alongside your goals in the sport, you’ll be able to look back with a smile and embrace the infinite amount of small steps it took to get you where you are.

Want to get started with me as your run coach?  Awesome!  The first step is to make an appointment for a run assessment. 


Personally, I want to run into my 90s, and I never lose the euphoria I get while trail running! 
I don’t need the distances to get longer and longer, I just need the views with each route I choose to be worth the challenge.

-Coach BW

 


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Top 5 Reasons to See a Massage Therapist in San Diego

During these uncertain times, self-care is more important than ever.  However, you may be wondering if you should see a massage therapist in San Diego right now.  So here are our Top 5 Reasons to not only see a massage therapist but what the benefits are of choosing Catalyst PT & Wellness for your massage therapy.

 

1.  We Are a Health Care Facility

As a healthcare facility, we are open and allowed to treat patients indoors.  This includes physical therapy, wellness, and massage.  In addition, we are taking the highest safety measures possible for our patient care.  Read our full update on the recent changes here at Catalyst to help beat COVID-19. 

Here are just a few of the new measures in place for our massage therapists in San Diego:

    • Both the patient and practitioner must wear a mask for the entire massage.
    • Health screenings are conducted prior to each person entering the clinic. 
    • There are no longer patients allowed to wait in the reception area.  At Catalyst, we ask that all clients wait in their cars to be called in by their therapist.
    • Strict cleaning protocol of massage rooms, massage table and linens and any other tools used for massage therapy

 

Catalyst Massage

 

2.  Stress Is At An All-time High

During the COVID-19 pandemic, have you been more stressed or anxious than usual?  If so, you are not alone.  Many of us are stressed about work, finances, family and friend’s health and wellness.  Read more from one of our own massage therapists, Kacey McCoig, on why massage is a great way to lower stress.

Therefore, with all this new stress in our lives, it’s been proven that therapeutic touch can help.  How?  Physical touch significantly reduces emotional and/or physical stress and anxiety.  Here’s a great piece from Harvard Medical School about The Healing Power of Touch. 

No need to read further and ready to book your massage therapy in San Diego?  Great!  Give us a call today, 619-501-2195, or email us.

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3.  New Hobby or Working From Home?

With gyms and fitness studios in San Diego shut-down, have you picked up a new hobby?  Perhaps running or biking to get your fitness on while still maintaining a safe distance from others?  Maybe you have mastered the garage home gym!

Either way, your new exercise routine may be creating pain in your muscles and joints.  Read more from the Cleveland Clinic on delayed onset muscle soreness or DOMS and how to tell if it’s a good pain or bad pain.

In addition, if you’re working from home now, you may be spending all day in your flip flops.  Read our last blog on why wearing flip flops all day is bad for your feet.  Coming into our San Diego location for massage therapy can help you relieve the pain.  Furthermore, our massage therapists can help you identify what specifically might be the cause, like wearing flip flops or being barefoot all day long.  See below for more on how our massage therapists work together with our PTs!

 

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4.  Back to Training?  


Now that sports are coming back online, are you training for an upcoming event?  Whether soccer, tennis, cycling, or a half-marathon, our massage therapists have guided both professional and amateur athletes towards health and wellness.  Read more on how Dr. Kristen Campbell, PT Manager and Director of Massage, worked with the U.S. Women’s Soccer Team to prepare them for competition.

Through proper timing, technique, and intent during every massage session, our skilled professionals take into consideration your WHOLE training and competition schedule.  We make sure we are helping you recover properly.  Therefore, we get your body ready to achieve your maximum potential in the pool, on the court, track, or trail.

 

Catalyst physical therapy

5.  Our massage therapy team works directly with our physical therapists

Our team of massage therapists in San Diego works closely with our physical therapists, facilitating a collaborative approach to your care.  This multidisciplinary team of specialists learns from each other.  In turn, this allows us to better address your specific needs and diagnose what’s causing your muscle aches and pains.

Constantly experiencing pain while walking or running?  Yes, we can help alleviate muscle soreness.  However, when we work together and combine our knowledge resources, we may discover that this constant pain is not from your workouts.  Sometimes is something more simple.  Perhaps the fact that you wear flip-flops all day.  Especially here in San Diego where flip-flops are the norm, we see this often.  Curious about how wearing flip-flops every day can cause harm?  Read our blog post on flip flops and how they can harm your feet!

 

Final Thoughts on Getting a Massage

So by now, we hope you have a better understanding of the steps we take here in the clinic to ensure your health and safety.  In addition, if you’re still wondering if you should see a massage therapist in San Diego right now, fill out our contact form.  Give us a call at 619-501-2195.  From our front desk to our massage therapists, everyone is highly trained to assist you in finding the best possible care.  At Catalyst, we excel in combining our services to give you the best experience and get you back to doing what you love.

 


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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.

 

yoga injuries

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. 

 

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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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Need a Proven Way to Lower Stress? I don’t know about you, but one of my favorite things to do is get a massage.  Yes, I know I’m a massage therapist, but I wasn’t always. I know what it feels like to sit long hours at a computer on a regular basis, and I know […]


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10 Minutes To An Improved Swing Speed

The Problem

Ok let’s take a snapshot of what Saturday morning looks like for us golfers. Tee time is at 8:00 am, we’ve been working all week sitting at our desks. We’ve rushed to the course to meet the crew, we’re stiff, tired and haven’t swung a club all week. Now, we have a few options. Should we just slam a few drivers and get out there? That sounds like…a plan. But what does this usually get us? A choppy front 9 until we’re ‘warmed up’ right?

Studies have shown that consistent warm up over a 5 week period before and after golf sessions can increase swing speed around 24%

What if I told you we only need an additional 10 mins at the course to get our bodies loose and our brain ready to fire those muscles properly? Studies have shown that golfers who spend at least 10 minutes warming up were less likely to report an injury than those who did not (Gosehger et al). When asked, 38% of golfers contribute a lack of warming up to their golf related injury (Azielah et al). 

The Explanation

Usually I meet people that would like to warm up before a round, but are at a loss about what exactly to do. This lack of preparation puts us at risk for injury while we’re trying to have fun with our friends out on the links. Getting your mobility and muscles firing before a round puts us at a huge advantage on the course! We’ll swing with better tempo, hit more consistently, and most of all reduce our risk of injury. 

The secret to having your best round of golf resides in not wasting energy when you swing. That means, all the energy you put into your backswing gets transferred into the golf ball allowing it to propel longer distances with better accuracy. If your muscles or joints are not properly ready to maintain alignment while swinging, then energy will leak into areas it’s not supposed to be. These leaks often lead to slices, hooks, strains/sprains and sore backs instead of a lower handicap. It has been found that a dynamic warm up resulted in straighter swings compared to no warm ups (Moran et al). Sorbie et al. also found that players were hitting greater distances with dynamic warm ups compared to static stretches. What does this all mean? Having a full body dynamic warm up is effective in reducing your risk of injury and performing better. The advantages to warming up for a short period of time are just too awesome to say no to!

The Solution

The big players in the golf swing are our mid back, hips, shoulders and our abdominal muscles. We want our hips, shoulders and mid-back loose along with an active core and rotator cuff to rip those drivers down the middle! Being a physical therapist that has treated countless avoidable golf injuries, I am making it my goal to change the way golfers treat their bodies before and after play.

Along with my colleagues, we at Catalyst have compiled our favorite warm up drills that do not require much equipment and can be done before any hitting takes place. Click here  to download Catalyst Golf Warm Up Guide that illustrates these drills and explains how to get the most important areas of your body ready for action. This warm-up with suggested reps and sets should take you around 10 minutes to complete. They are simple, and easily done with a bench at the course before you tee off. For entertainment purposes, I highly suggest you do these while watching the group ahead of you look for their ‘breakfast balls’ in the woods. That makes for some rewarding entertainment. 

All I ask in return for this free guide is that you provide us with feedback and share the love with anyone you want to remain your golf partner for the long haul. Of course this is just a starting point for most people and true golf success/longevity comes in understanding how your body is different from everyone else. If you would like to gain a better understanding of your weak spots that lead to energy leaks in the golf swing, I’d love to help. Our one hour full-body athlete performance screen (include link) can make all the difference when it comes to individualized corrective exercise prescription and dialed in biomechanics.  

Here’s to your longevity on the course, lower handicaps and future fun out playing the best sport ever invented! 

ANDREW WILSON DPT, CAFS
TPI CERTIFIED

 


References

Azeielah, A, Ajau D, Mohamed G, Khairil A. Prevalence of golf-related injuries among recreational golfers: a preliminary finding. Healthscope. 2021. Vol 4(1): 60-65

Ehlert A, Wilson P. A systematic review of golf warm-ups: Behaviours, injury and performance 

Fradkin A, Sherma C, Finch C Improving golf performance with a warm up conditioning programme. Br J Sports Med, 2004 38, 762-765. 

Fradkin AJ, Finch CF, Sherman CA. Warm-up attitudes and behaviours of amateur golfers. J Sci Med Sport 6: 210–215, 2003.

Gosheger G, Liem D, Ludwig K, Greshake O, Winkelmann W. Injuries and overuse syndromes in golf. Am J Sports Med 31: 438–443, 2003.

Moran KA, McGrath T, Marshall BM, Wallace ES. Dynamic stretching and golf swing performance. Int J Sports Med 30: 113–118, 2009.

Sorbie G, Baker J, Gu Y, Ugbolue C. The effect of dynamic and static stretching on golf driving performanceInt J Sports Exerc Med 2016, 2:035

 


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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.

runner at sunset

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.

 

running barefoot

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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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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Wondering How to Lower Your Blood Pressure? Before we dive into how physical touch can lower blood pressure, here’s something to ponder on: “Touch comes before sight, before speech. It is the first language, and the last, and it always tells the truth.” -Margaret Atwood   The Human Touch The human touch plays a crucial […]


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As a biomechanical specialist that has made endurance sports my life, I’m often asked the question by my clients, “Do I need orthotics?”

Let me disclose that I personally use custom orthotics, and have found them to be one of the BEST ways to rid myself of chronic shin and foot pain. I’ll explain why later in the post. To help you decide if orthotics are right for you, here are five questions to answer and discuss with your practitioner/orthotics fitter:

1. Are orthotics something you plan to use to improve performance?

Some people don’t have pain, but have poor foot foundation, causing their balance and proprioception to suffer. Perhaps you have diabetes or a heart condition that limits the amount of blood flow reaching your feet. Poor sensation can lead to poor balance and faulty mechanics. This population can benefit immensely from using custom orthotics regularly, in all of their footwear, to improve balance and reduce the risk of falling.Athletes can benefit from orthotics, too, by correcting faulty loading mechanics at the foot, ankle, knee, and pelvis. These mechanical deficits are oftentimes the result of improper foot positioning, and thus shock absorption, when the foots hits the ground.So what’s causing an improper foot position? The answer is feet that are too rigid, or too soft.Orthotics can help your feet achieve a more beneficial platform, allowing your body to disperse forces more evenly to the neighboring muscle and joint systems.

2. Do you have pain?

Consider this: Where is your pain? How long have you had it? Does anything make it better or worse?For example, do you feel that every time you buy a fresh pair of running shoes the pain decreases? This may be an indicator that your foot craves more stability and needs assistance from an orthotic.If your pain has only recently started, then I’d recommend getting more bodywork (massage), and being seen by a specialist that can assess your biomechanics, flexibility, strength, and tissue “feel” to determine if your pain can be reduced without an orthotic.If your pain is chronic and you’ve already tried seeing a specialist with no improvement in symptoms, then it’s possible a custom orthotic can be used to decrease your pain. That said, the orthotic should be prescribed ONLY after watching your mechanics and assessing your foot properly. This ensures you get the correct style of orthotic, as well as a good prescription for bodywork that will help correct any imbalances within your muscle structure.

3. What type of foot do you have in non-weight bearing, and weight bearing positions?

If you have extremely flat feet, but no pain, then I wouldn’t recommend an orthotic unless you’re involved in a high-risk sport like soccer that has a ton of cutting, and you can’t control how far your knee dives in or out.If you have regular arches while sitting (you can see a crescent shape in the arch) but they drop largely with full weight bearing, then you might have a high amount of pronation and require assistance with controlling the speed of collapse.If you have high arches in both seated and standing positions, then you might have a high degree of supination that limits your success with dispersing forces in the ankle, knee, and ultimately the hip and spine.Again, having a qualified practitioner that understands how to measure and assess these different foot types will be necessary. I’ve seen plenty of over-pronators and over-supinators for whom I didn’t recommend getting custom orthotics because they have effectively compensated for their foot structure. It’s the people with poor foot structure, plus recurring injuries or pain that often need custom orthotics.

4. Are you willing to perform exercises most days of the week to improve your foot structure?

If you’re one of the unlucky people that have poor foot mechanics, pain, and hobbies/work that involve heavy impact, you still may not have to get custom orthotics. However, in order to avoid them, you’ll need to put in the work to make your foot both strong and/or flexible.Perhaps you’ve been labeled an “over-pronator” and you rushed out to buy the “Born to Run” book along with a pair of the Vibram 5-Toed minimalist shoes with the intention of gaining strength. Well, the disclaimer that must be included is this: it doesn’t happen overnight, and you have to be very diligent with your strengthening as well as with your foot recovery techniques to regain an arch, and get rid of pain.On the other hand, if you’re one of those rigid-foot-supinators that needs mobility, you’ll have to commit time to regaining flexibility in the ankle, toes, and hips. Increased motion at these joints allows for the foot and arch to collapse in a manner necessary for absorbing shock in the ankle and leg muscles, without stressing bones.So, if you’re willing to put in the effort, you might be able to save yourself some money, though, I’ve seen most people struggle to do so, and end up purchasing a pair after a few months of non-compliance. Rest assured, I don’t blame them. After all, I’m in the same situation, not making the time to change my feet.

5. What are your job, or daily life demands?

If you have poor foot structure, but work at a desk and don’t find yourself walking or spending long amounts of time on your feet, then you might not require custom orthotics. Perhaps you only walk casually, and on fairly stable surfaces. People that have this style of living often just require supportive shoes for their daily walks that have more rigid lasts built into the sole of the shoe to decrease shock. There’s even a maximalist movement by shoe companies now to thicken the soft cushioning in a shoe (although keeping the material extremely light) in an effort to create decreased impact forces in the leg, and a larger sweet spot with landings.However, if you have poor feet and a job that demands a lot of standing, or hobbies with high amounts of impact, you might find a custom orthotic to be your saving grace. In my experience, it’s not a matter of if pain will eventually creep into your legs, but when it will force you to be sidelined in some manner.I’ve seen the arthritic build-up in knees, hips, and spines developed from years of overdoing on poor foot structure. These patients show up in the clinic with back pain resulting from years of bad mechanics that could’ve been prevented. While I don’t prescribe them orthotics on the first day, I do have a conversation with them about the compensations their body has undergone to adapt to the stresses that ultimately begin in their feet. These stresses, when discovered at a younger age, can ultimately be reduced, allowing for less degeneration, but early identification is the key. Most of these people will end up in some form of custom orthotics once pain has set in, which will hopefully prevent surgical repair to worn out areas!

The most important thing to consider when deciding on orthotics is: what type is necessary? There are a myriad of choices out there ranging from $25-50 on the cheap side to $200-800 on the expensive side. While the cheaper orthotics can serve as a nice temporary support for your foot, they use weaker materials and base their design off a common posting angle that may not benefit your particular foot mechanical problem. On the other hand, the custom-molded, more expensive orthotic may not be the right choice for you either. The actual making of the custom orthotic relies heavily on having the correct expert assess your foot both statically and dynamically under different loads, or ground reaction forces. Without an expert that understands how to assess your foot under different stressful situations, it’s nearly impossible to get the correct orthotic prescribed.

In the end, a custom orthotic is a big investment and shouldn’t be taken lightly by the practitioner responsible for getting you properly fit. I’ve seen way too many patients limp into my clinic carrying a bag of orthotics they have been “prescribed” through weight bearing scans, crush boxes, and treadmill video recordings. You can imagine the disgust they feel when I show them the reasons their $1000+ investment in foot care is really just a scam that has been played over and over to them by some of the best sales teams in the industry. I’m forced to try to use foam padding and tape to post and position their foot better with the orthotic they bring in, but this never serves as a long-term solution. They’re just a number to these sales teams, and no attention has been paid to their individual foot needs based off of their hobbies and work demands.

That’s why at Catalyst we’re expanding our foot care department to provide the best orthotic prescription in San Diego. We’ve partnered with Northwest Podiatric Laboratory and Smartcast Systems to get rid of the outdated plaster casting. This allows us to use 3d technology in printing and scanning in our orthotic prescriptions. We can now scan a patient’s foot to get an exact 3-D replica model. Taking it one step further, we use a foot positioning system at Catalyst that includes a laser alignment device to ensure each foot is positioned optimally when scanning and prescribing the perfect orthotic. With no time wasted, our patients will be back in action with the proper fit in a little over a week and their feet will send us “Thank You” cards.


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