Armstrong Podiatry & Sports Health's Blog

Information that promotes wellness

Changes

Just wanted to give notice about new changes happening at Armstrong Podiatry & Sports Health.

First, the office has focused on preventative healthcare and overall wellness.  This theme has been continued by becoming a supplier of “Correct Toes“, a great device that redistribute the weight on the feet by correct positioning of the toes. In fact, it could be a solution for people suffering from plantar fasciitis and painful hammertoes deformities FOR THE RIGHT INDIVIDUAL.  Created by Dr. Ray McClanahan (see my interview with him here),  it has great potential to increase the movement and strength of your feet.

Correct Toes

Correct Toes

Second, I have accepted an assistant track and field coaching position with Guilford College. My functions include working with the sprinters/hurdlers and being the primary strength and conditioning coach.  Using my years of coaching experience, along with my biomechanical knowledge, I am hoping to help these young student-athletes achieve with their full potential.

 

2008-09_Guilford_College_Quakers

Guilford Quakers!

Last, but not least, there is a new member in the Armstrong Podiatry & Sports Health family!  Deni McKenzie Armstrong was born on 09/15/2012.  Her role in the office is yet to be determined. 

One big happy family!

One big happy family!

Stay tuned for future developments at our office, who truly believes that keeping feet in motion is critical for an individual’s healthcare.

Health and happiness!

 

January 19, 2013 Posted by | Annoucements, track and field | , , | Leave a comment

“Helping You Keep Your Feet in Motion”

Armstrong Podiatry & Sports Health, PLLC  is proud to present a monthly series of information sessions about the foot and ankle.  You will not see the topics you typically find by most podiatrists;  in fact, these sessions are made to enpower the listener and keep them out of physicians’ offices!

Topics include: “Barefoot/Minimalist Running”, “Prevention of Foot Pain”, “Flat Feet: Real or Fantasy?” and “Orthotics: The Truth Behind Them”.  All sessions are thirty minutes in length, which includes a question and answer portion. 

The dates for 2012 are: July 21st, August 18th, September 15th, October 20th, November 17th and December 15th, all at 12:30 pm in the office (2206 Page Road Suite 101 Durham, NC 27703).

Space is limited, so please either call (919-806-3668) or e-mail (ap4feet@gmail.com) to RSVP!

Health and happiness!

 

June 19, 2012 Posted by | Uncategorized | , , | Leave a comment

“Let Kids Be Kids”

Building Health

  

Destroying Health

My son has now started taking karate classes.  For his age (four years old), the classes involve lots of games and fun ways to incorporate karate moves into a thirty minute time span.  Most of the stuff initially seemed to have little fitness value, until I thought about some of the drills they are doing, i.e., army crawls, frog jumps, bear walks.  These drills mirror a lot of the drills I do with my athletes which helps reinforce and build basic movement patterns.  These drills help build stability in the joints, flexibility in the muscles and a coordinated effort of tendons, nerves and muscles. 

These basic movement patterns become the precursor for such activities as standing, walking and running.  If these patterns are not properly established by mastering these preceding drills, problems arise in the neuromuscular system, for example, a muscle does not work when it is supposed to when running. When I looked at the children performing these drills at my son’s karate class, I can see that there were several that had great difficulty in performing these simple drills.  Dan Pfaff, arguably the greatest and smartest track and field coach ever, offers an explanation for this lack of function:

It is my belief that general activities that enhance posture,

joint strength, muscle and joint coordination and all aspect of mobility

are in short supply with today’s youth.  A highly sedentary lifestyle

exhibited by today’s society has precluded the acquisition of

these general qualities once found in abundance several generations ago.

(“Alternative Methods for Developing Strength, Power and Mobility”, p.2)

I wholeheartedly agree with this assessment.  Our sedentary society has trickled down from the adult to the children with devastating results. When basic movement patterns should be developed by crawling and  jumping, they are being delayed or blunted by sitting while watching television or playing video games.  This leads to a lack of function when it comes to doing higher levels of activity such as walking and running and a higher incidence of injury.

If you look at things in this perspective, you will understand the importance of recess in school and general outdoor play for children.

 

Health and happiness!

May 8, 2012 Posted by | Uncategorized | , | 1 Comment

Running shoes ARE useful!

Evil?

The barefoot/minimalist running debate rages on (I am completing an article for footanklehealth.com) and there are benefits to both sides.  The most obvious one is that running shoes increases the weight of the runner, therefore increasing metabolic cost. This increase in metabolic cost is where the real debate should be focused on.  This metabolic increase gives you increase efficiency during running, that barefoot/minimalist running can not provide.  So the question for any runner should be, “Do  you want to risk injury with barefoot/minimalist running due to inefficient running patterns or do you want to run with more efficiency, but more effort?”.  Barefoot/minimalist running can be more efficient, but it requires a complete biomechanical examination with a corresponding stretching and strengthening protcol.  My previous post would be good way to start with that.  Here is an article that talks about this:   http://t.co/GEIlrXtD   

Health and happiness!

March 21, 2012 Posted by | Uncategorized | , , , , , | 3 Comments

Restoring Proper Body Alignment and Function

Potential injury waiting to happen....

  

  In my never-ending search in trying to help my patients, I have long thought about how to make my patients better long-term.  I have had some success in treating patients’ injuries and getting them functional again.  But what I can do in the office is only a small fraction of what patients goes through during a day or even a lifetime.  Patients are forced to wear shoegear with a heel lift, shortening the calf muscles and possibly leading to lower back pain.  Patients have to sit down for long hours at the job, causing tightness of the hip flexor muscles.

     To combat these external influences, I have a designed a protocol that helps restore proper body alignment and function.  If it used daily, it should help with prevention of overuse injuries due to faulty mechanics of the body.  Of course, each individual is unique and may require additional treatment, but I feel this to be an adequate starting point.

     If you are interested in this protocol, email me at: ap4feet@gmail.com and I will send you a copy.  I plan to make a YouTube video of it soon, along with some other things.

Health and happiness!

 

You can live healthy and happy!

February 6, 2012 Posted by | Uncategorized | , , , | 1 Comment

Exercise Prescription for Healthy Living

I came across a great blog post from Bret Contreras, which gives reasons for exercising and gives you a blueprint for it!  This is a great guide for anybody who wants to start exercising or maintain their fitness levels.

  http://bretcontreras.com/2012/01/ten-minute-a-day-keeps-the-doctor-away-a-5-set-full-bodyprogram/

No excuses!  Just do it!

Health and happiness

January 5, 2012 Posted by | Uncategorized | Leave a comment

Lift for Flexibility!

Staying healthy by lifting

As you probably have read some of my previous blogs and twitter posts extolling the virtues of resistance training, i.e., dumbbells, barbells, resistance bands, etc.. But one more advantage of a good resistance training program would be its ability to increase flexibility.  I have found this out personally throughout my years of weight training when I feel much more loose and flexible after a weightroom workout.  Various studies have shown this, especially in nonathletic, middle-aged individuals (Monteiro et al., 2008, Santos et al, 2010).

Keep in mind in order for this flexibility to be achieved, the resistance exercises should be performed in the full range of motion, and there should be a hindrance to the full range.  Both requirements should be able to be assessed by a good personal trainer/strength coach and sent to the appropriate health professional if full range of motion can not be achieved.

Full range of motion?

I have recently started to prescribe more robust exercise routines for my patient for a dual purpose of strengthening and gaining flexibility.  I still prescribe stretching protocols as I also do them personally, but I feel resistance training gives busy patients a bigger “bang for their buck”!

Please contact me if you have any questions!
Health and happiness!

December 20, 2011 Posted by | Uncategorized | , , , | Leave a comment

Interview with Dr. Jeff McBride

Jeffrey M. McBride, Ph.D.

I have had the pleasure of listening to Dr. McBride lecture at Appalachian State University in Boone, North Carolina twice now and I have always come away more informed and enlightened enough to change my practicing and coaching ideas. His journal articles are always fascinating and defend/refute old ideas about how the body works.  So it was only natural that I did a blog interview with Dr. McBride.

Dr. Jeffrey McBride is a Professor in Biomechanics at Appalachian State University in the Department of Health, Leisure & Exercise Science, along with the Director of the Neuromuscular & Biomechanics Laboratory and Director of Graduate Studies in Exercise Science.  He has published 65 research studies in scientific journals and has 100 conference abstracts presentations.

(Q): What led you to become a scientist specializing in biomechanics?

(A): I have always participated in sports and exercise.  So my undergraduate major in exercise science was a perfect fit.  During my undergraduate degree, I started to become interested in resistance training research.  I was a competitive powerlifter for many years and started to focus on athletic performance, in particular the stretch-shortening cycle.  I met a scientist, Dr. Robert Newton, from Australia when I was at Penn State, completing my Masters Degree with Dr. William Kraemer.  Dr. Newton had similar interests in studying strength and power training.  I decided to go to Australia to complete my Ph.D. with him in the Biomechanics Laboratory at Southern Cross University.  There we were examining power output with different loads in the jump squat.  This involved biomechanical measurement techniques using a force plate, videography and EMG.

(Q): Your Neuromuscular & Biomechanics Laboratory always seem to turn out impressive work.  Tell us about your lab.

(A):  It has taken a long time and a lot of hard work to develop my laboratory.  Since we are always trying to do measurements and study topics in a new and unique way, we have pretty much had to make everything ourselves, from platforms to pulley systems, electrical systems, etc.. My father was a drag racer, so I was always working on engines and building various things by hand when I was younger.  I love to build new devices for making different kinds of measurements in the lab.  A very important component of my research is the assistance I receive from my graduate students.  They run the day-to-day operation of the lab and I could not perform my research without them.

(Q): You also do some track and field coaching.  Do you find your knowledge a hindrance (“paralysis by analysis”) or helpful when working with an athlete?

(A):  Because of my busy schedule with research, I really have very little time to work with specific athletes.  I recently, though, have had the opportunity to work with a very gifted weightlifter from Japan and also a great 800 meter runner here at ASU.  I find it interesting that a lot of practitioners actually have this problem (“paralysis by analysis”) and make training athletes much more complicated than necessary. My workouts are relatively simple, by some people’s standards, in that I simply use a couple of simple exercises like squats, power cleans and plyometric exercises like drop jumps.  Strength and conditioning is simply a supplement to an athlete’s overall training program.  Most of their training takes place on the field.  The most difficult part of training is regulating volume and intensity of training, not picking which exercises they will use.  When I do train an athlete, I have spreadsheets mapping out volume and intensity variation over time.  If you are not monitoring volume and intensity very closely, then you are missing the whole point of training.  I hate to say this, but training to improve athletic performance is not really rocket science.  When the athlete is tired, they rest, when they feel good, you train.

(Q): Do you believe that everyone should get stronger?  If so, what would be the best exercises to elicit overall strength gains?

(A):  The most important factor as a strength and conditioning coach is to make the athlete stronger, that’s why it’s called strength and conditioning.  Strength training takes place in the weight room and most conditioning actually takes place on the field.  The exercise that you use are mostly irrelevant.  The reason you use a squat to strength train the legs is that it is an easy exercise to use to get the needed loading to cause adaptation, meaning placing a lot of weight on your back. The concept of trying to mimic any on-field movement patterns in the weight room seems like an odd concept to me. From a biomechanical research standpoint, nothing you do in the weight room is anything like what an athlete does on the field.  Weight room training requires high levels of loading which causes adaptation of the neuromuscular system.  By that I mean muscles hypertrophy and the peripheral nervous system changes firing rates and neuromuscular junction capabilities.  Neither of these things are movement pattern specific.  If a muscle gets bigger or the peripheral nervous system activating this muscle can fire at a higher rate than the muscle can generate more force; it seems like some people are saying that these systems have a brain and know when they are performing a contracting during a golf swing versus a tennis serve versus the shot put, etc.

(Q): I have long held the belief that “core training” does little for the core musculature and it is refreshing to see that proven in scientific studies.  Does “core training”, i.e., stability ball, BOSU balls, have any place in a training program?

(A):  “Core training” is just a layman’s term. The term “core” is not used in the discipline of anatomy.  What I think they mean is “trunk” or “torso”.  The trunk is divided into the thorax, abdomen and pelvic region.  These muscles are a component of overall physical performance, but to indicate that they play some major role in athletic performance more than any other body part, I think seems a little odd.  The trunk has been a major area of focus in rehabilitation settings because of low back pain issues in patients, which is the number one reason for missed days at work in the country.  Most of the concepts in training the trunk have come from rehabilitation-related professions. I am not dismissing the very important aspect of trunk function.  Low pain back is a very difficult disability to deal with and can lead to a very low quality of life.  Unfortunately in rehabilitation, a lot of research has shown very few programs with long-term effectiveness for recovery from this debilitating condition.  Acute recovery has been achieved, but in the long-term, people with this condition continue to have lasting problems, even the rest of their life.  Permanent and continued focus on strengthening all parts of the body (legs, thorax, abdomen, pelvic region, etc.), I believe is the key to success.  The best way to do this is with structural exercises, not isolating one region or the other.  This is not my opinion, it is based on data.  A general exercise program (sit and stand [squats], push ups, medicine ball lifts, jogging on a bouncer, skipping rope) has been shown to be just as effective as motor control exercises (instruction and training by recruiting deep muscles of the spine and reduce activity of other muscles) and spinal manipulative therapy (joint mobilization or manipulation) in improving patient-specific functional scores and global perceived effect scores (typical measurements used in low back pain studies) after a 6 to 12 month time frame (Ferreira et al., 2007).

(Q): I recently heard you talk about FMS (Functional Movement Screening) and its usefulness in sports performance.  Tell us what studies have shown about this.

(A): There are many studies I could mention, but one in particular, showed no or actually an inverse relationship between FMS scores and athletic performance (Okada et al., 2011).  Our recent study just coming out in the Journal of Strength & Conditioning Research showed the same thing.  Absolutely no relationship between FMS score and jumping, running, etc.. I think the primary factor is that FMS does not have a measure of strength or power.

(Q): What exciting new projects are you are working on?

(A):  Our most recent studies have been focusing on mechanical efficiency in jumping and running.  This comes back to my interest in stretch-shortening cycle function.  This is of importance to especially repeated event athletes.  Like repeated jumping (basketball, volleyball, etc.) or long distance runners (1500m, 3000m,  marathon, etc.).  We have been attempting to use ultrasound to visualize muscle length changes and optic fibers to perform in vivo measurement of patellar tendon forces.  These are very difficult techniques and I have actually been working on them for the past 10 years trying to get them to work.  This information would show us how and why plyometric exercise improve performance by allowing athletes to maintain muscle length and maximize tendon length changes during jumping, thus improving jump height and mechanical efficiency during repeated jumping.  We have also had the opportunity to work with NASCAR pit crews in terms of testing them for strength and power capabilities for the development of training programs.  Next year we will be back to working on determining what loads maximize power output during human movements using loading and unloading.  The last topic is something I have been working on for quite some time.  This has implications for training loads for power training programs.  We also are working some more on examining instability training in the weight room and its effect on athletic performance.  I wanted to finish up by saying that I have “no dog in this race”.  I don’t want to sound indifferent but I actually care very little about what training programs practitioners use, it’s up to them.  My goal is simply to publish data concerning the findings of our studies on these topics. I would be happy to accept one form of training over any other.  It doesn’t matter to me what type of training works and what type of training doesn’t work. That’s not my job.  I just come up with scientific experiments to address hypotheses of interest of us.  But of course I always hope that the date eventually assists practitioners in making decisions about their training programs. Practitioners have the difficult job in trying to determine how they are actually going to train their athletes.  Thanks.

An incredible amount of information with implications for not only the athlete, but the active individual.  Please fee free to contact me if there is any questions.

Health and happiness!

November 1, 2011 Posted by | Uncategorized | , , , , , , | Leave a comment

Cute and Comfortable

Shoe party at Armstrong Podiatry & Sports Health, PLLC

I am proud to present our office’s first shoe party/information session. Aerosoles will be at the office on Friday November 11th from 6-8 pm to present their fall line of shoegear. You will only see shoes with some support and adequate for everyday usage (not the best, mind you!). Take this opportunity to buy some quality shoes with direction from a podiatrist! E-mail the office at ap4feet@gmail.com if you are interested.

Health and happiness!

October 22, 2011 Posted by | Annoucements, Uncategorized | , , | Leave a comment

Strong hips=Healthy life

Work those hip muscles!

I came across a cutting-edge, top-notch facility located in Calgary, Canada called the Running Injury Clinic (http://www.runninginjuryclinic.com/).   They have truly grasped the concept of the entire body contributing to health or injury of the individual.  They offer a lot of hip strengthening exercises, in which their studies reveals helps with knee pain. Furthermore, strong hip muscles direct the entire lower extremity and limit excessive motion which could cause injury, i.e., ankle or foot motion.  These types of exercises can be done by anyone, young and old, athletic or nonathletic. I am starting to incorporate these exercises as part of my protocol for anyone with stability issues or running-related overuse injuries.  Check them out at: http://www.runninginjuryclinic.com/Resources/hip-muscle-strengthening.html

Health and happiness!

September 7, 2011 Posted by | Uncategorized | , | Leave a comment