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Dr. Carla Cupido: Newsletter



  





Hello

One minute researchers are telling us to wear motion control shoes and the next they are telling us that free motion shoes are the key to injury-free running.  What is the truth?  Which shoe is best for me?

Sorry to be the bearer of bad news, but I wish I knew exact answers to these questions!  There is so much conflicting research out there that it makes even my head spin!  There are convincing arguments for many of the existing theories on running shoes as well as running gait, but the problem is that the research is not yet harmonizing.

Let's just pin down some points that we can all agree on that we can benefit from:

  1. The stronger the muscles are that stabilize your pelvis, the less knee and lower leg injuries you will have.  Such muscles include the gluteal muscles (minimus, medius & maximus) and the abdominal muscles.
  2. Strong intrinsic foot muscles help to support the three main arches of the foot, subsequently supporting the base on which our body rests.  If we fail at any point in the chain of connected body parts, other areas are at risk.  I have sang this before: "The knee bone's connected to the leg bone."
  3. If you are a pronator, strong foot arches and tibialis posterior muscles are very important in preventing severe pronation.
  4. If you are a supinator, loose / flexible calf muscles, plantar fascias and Achilles tendons will absorb some of the shock that your rigid foot refuses to. 
  5. Proprioception3 is CRUCIAL to injury avoidance.  Training proprioceptively not only decreases our risk of injury, but also improves our ability to perform optimally due to improved efficiency.  Better balance equals better body!
  6. Orthotic prescriptions can be great and can be awful.  My goal is to try to keep people out of orthotics by strengthening muscles instead of making people reliant on an insole. However, there are times when they are ideal for a particular patient's case. 

1. Pronation is when your foot rolls inwards.  In other words, pronation is when the arch of your foot collapses towards the ground.

2. Supination is when your foot rolls outwards.  In other words, supination is when the arch of your foot remains rigid and high.

3. Proprioception is the sense that allows us to tell where our body parts are in relation to other body parts.  Close your eyes.  Now flex and extend your finger for a while.  STOP!  Can you tell if your finger is flexed or extended?  Of course you can, this is proprioception.  Our ability to accomplish this is due to sensory organs in our muscles and tendons. Amazing!

Tendinosis

Take Home Points

Tendinosis

Until we have better research supporting our shoe decisions, a good preventative muscular and gait assessment and shoe journal may be your best bet.  Keep learning about your body and you will need doctors like me much less! 

Listen to your body! You are the one wearing the shoes, not the person selling you the shoes and not your medical professional.  Keep a shoe journal that logs how you felt in your shoes, if anything hurt during or after wearing them, or even the next day. Paying attention to your body not only gives you valuable information to play Sherlock Holmes, but it provides your clinician with all of the information for an accurate diagnosis and plan of management.

Regular Health Information Updates

If you are keen to follow my health advice, follow me at "@drcarlacupido" on Twitter or on Facebook.  You may also sign up for my blog via an RSS feed or email.  Please feel free to share my health tips with your friends and family via Twitter, Facebook, Linkedin and email.

Dr. Carla Cupido

   
   
   

Visit Carla on the web at www.drcarlacupido.com
Questions or comments? carla@drcarlacupido.com