I had an opportunity to contribute to a friend’s webmagazine (hurdlesfirstbeta.com) the other day in regards to “groin” strains. There are many ways that people look at it, but it is a reminder of how each body part works in unison with each other.
The “groin” is a catch-all term, referring to five muscles in the inside of the thigh. Their major function is to bring the leg towards the midline of the body (adduction). Injuries to these muscles are usually due to these muscles doing more than they can handle, as a large component of their activity is postural in nature (keep the body upright). This excessive activity is due to muscular imbalances and faulty body positioning elsewhere in the body.
Tight hip flexor musculature (lifting the leg and thigh up at the hip) is something I find all too common with patients, specifically the iliopsoas muscle group). This can be created by prolonged sitting, bad postural (forward lean) when walking and of course, the dreaded high heel shoegear. These can all make for an overworked iliopsoas group, which causes it to become tight.
Two muscles that make up the “groin” have a lesser function in hip flexion also. If the iliopsoas is not able to perform its usual function, these muscles become the primary hip flexors. This increases its muscular activity, making it more prone to strain/injury.
Another result of an overworked/tight iliopsoas muscle group would be its effect on the pelvic bone. Because of their attachment to the pelvis, its tightness causes the pelvis to tilt, lengthening some other muscles attached to the bone, i.e., the hamstrings (muscles at the back of your thigh). The hamstrings changes from a primarily postural muscle to a hip extender (bringing your hip and thigh down), as the gluteal muscles (“butt” muscles) loses this role and its resultant strength via pelvic positioning. In addition to the hamstrings, three other muscles of the “groin” become hip extenders. These muscles are prone to become overworked, due to their increased activity.
Treatment of “groin” injuries involve the usual rest, compression and elevation. But the emphasis should be on not forcing these muscles to be overworked. Hip flexor stretching, along with soft tissue release can help with the tight iliopsoas muscles, in addition to flatter shoes, more erect posture when walking and lesser sitting. Abdominal exercises will help tilt the pelvis properly; variety is the key (the regular crunches do not work the right muscles and are not recommended). Lastly, exercises that focus on the gluteal muscles will help it regain some of its strength, i.e., Deadlifts, Romanian Deadlifts, Hip thrusts.
Please feel free to contact me if any questions at firstname.lastname@example.org
Health and happiness!
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 email@example.com if you are interested.
Health and happiness!
The toe spring can be defined as the upward slant of the toebox of a shoe. If you look at any shoe from the side, you will notice that the tip of the shoe does not touch the ground; it is more pronounced in running shoes. The necessity of the toe spring is due to the stiffness of the sole of shoegear. Since the sole is difficult to bend and flex, shoes artificially create a “bend” in the toe area to allow proper motion of the foot throughout a normal walking cycle. The concept is similar to the “rocker bottom” shoes which are so popular today, i.e., “Shape Ups” and MBT.
The resultant position of the toes by the toe spring negates their natural activity of grasping the surface when weightbearing. The toes are placed in one position with limited ability and need to provide motion. And following classic maxim, “If you don’t use it, you use it.”, the joints respond by becoming stiff, leading to the surrounding tendons and ligaments to also become stiff and tight. This could lead to such things as hammertoes and clawtoes, and most importantly, limited big toe range of motion (hallux limitus).
Another consequence of the toe spring is the increased pressure on the ball of the foot. Since the toes are minimally weightbearing, the ball of the foot (capsule) assumes the major weightbearing responsibility, leading to capsulitis. The previous blog article about the heel lift also talked about this capsular pressure, so it seems like both of these shoegear characteristics direct pressure on this area. A common treatment I have used for pain caused by this capsular pressure involved decreasing the heel height and causing a straightening of toes to increase their weightbearing status. This is done by insole modification and has been effective in most of my patients in my attempt to make shoegear more “natural”.
Perhaps the most devastating aspect of the toe spring could be the formation of limited big toe range of motion (hallux limitus). The big toe provides a major force during walking/running and any disruption of its motion will cause compensation throughout the body, i.e., ball of foot calluses, capsular symptoms, increased knee bending, increased hip bending with lower back pain.
The destructive nature of the toe spring has multiple consequences which overlaps with the consequences of the heel lift. In the next installment, the curved last shoe will add the final piece of the nature of shoegear. Please feel free to contact me if any questions.
Happiness and good health!
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