I have flat feet but I didn’t realize it until I started running 8 years ago. I was told to invest in custom orthotics and I trusted the experts, so I had a pair made. The orthotics helped at first, but 2 years in I ended up with a stress fracture. Perhaps other factors were to blame, but since I started wearing my orthotics I’ve had one injury after the other. This past year I was recommended by a physiotherapist to get a new pair since my old ones were clearly inadequate. So, a new plaster was made, another $500 paid, and I started running with new orthotics. Less than 5 months in a new debilitating injury appeared. It felt like I was going to be stuck in a vicious cycle of injuries, rehab, new orthotics and new running shoes. Lots of money spent, but no long-term solution on the horizon. If this story is starting to sound familiar, you might be interested to hear what I have to say.
I decided to go minimalist; not barefoot, just minimalist. I have an arch in my foot but it collapses when I’m standing or weight bearing. This means that strengthening/stretching the associated muscles and tendons could rectify the problem, at least partially. Yet, in all the years of going to rehab specialists, not one recommended exercises for my feet or ankles. Not one!
I did some research and found some appropriate exercises. I also got rid of my painful orthotics and started wearing running shoes with no arch support. I stopped running for a couple of weeks and through a friend of a friend I learned about Barefoot Science Insoles (http://www.barefoot-science.com). As a scientist I rarely buy something without seeing the evidence first but with no research trials available on the product and two extremely positive anecdotal reports, I decided to give them a try anyway.
WEEK 1: Last week, with a sample size of just one (n=1, literally) I began my research on the Barefoot Science Insoles. I put them in my running shoes and decided to pound the pavement. I mapped out a 5K, but it was a gorgeous day, so I ran just over 8K. It felt great. With the exception of a little IT band pain while running up the final hill and the smallest start of a blister, it went well. For the first time in months I was able to run more than 6K without ankle pain, knee pain or complete discomfort in my feet. Now obviously, it was day one, and I might have been a bit euphoric on hope.
Over the course of the week I have used the insoles in all of my shoes for workouts and work. My calves were easily fatigued and occasionally I experienced discomfort in my foot (primarily when on the elliptical), but all in all, things have been good. My ankle is feeling better; likely a combination of a decrease in running over the past couple of weeks and hopefully because of the new insoles.
Stay tuned for weekly updates on the insoles (it is a 7 week program). I will be sharing the good, the bad and the ugly. I also hope to hear from others that have used them or products similar to them.
There are three main components of health related fitness: aerobic fitness, musculoskeletal strength and endurance, and flexibility. While the link between aerobic and musculoskeletal fitness with health and independence is clear and consistent, there is limited evidence to show any relationship between flexibility and long term functional health outcomes.
So, is flexibility important? It is important to note that I am not asking if stretching is important. Of course, at the end of a long run or strenuous workout, one should stretch as there is evidence to suggest that this prevents injury and maintains flexibility. But does it matter if I am a flexible person? Do measures of flexibility actually determine whether I will be healthy and remain independent when I am older? A recent review published in the Journal of Aging Research attempted to answer just this question. In a paper entitled “Flexibility Training and Functional Ability in Older Adults: A Systematic Review” Dr. Stathokostas and her colleagues reviewed 22 research studies and found that flexibility training (i.e. stretching of the appropriate intensity, frequency and duration) leads to an increase in range of motion of a joint, but does not necessarily lead to an increase in functional abilities. The average age of participants in the papers reviewed was 74 years. The main outcomes assessed were range of motion about a joint (flexibility), assessments of gait and walking speed as well as a variety of functional tests such as how long one takes to stand from a chair and walk 8 meters. According to the results of the review, gait and walking speed were positively affected by flexibility training, but this was not consistent. Further, many studies did not demonstrated a significant improvement in functionality with flexibility training. In a subgroup of older old participants (aged 80 and older) results were a bit more promising, but still not consistent.
The flexibility training used in the studies ranged in intensity, type, duration and frequency. Some studies used whole body training i.e. joints all over the body were trained while others only used lower body/lower back stretches. The studies ranged in duration from 4 weeks to one year and the frequency was approximately 4 sessions per week. Stretches were held anywhere from 30-85 seconds. Despite scientifically devised flexibility training sessions, the review showed that there is not much benefit on overall functional ability. So, why is there such an emphasis on stretching? Well, as I mentioned above, for those of us who are active we need to stretch to ensure we prevent injury and to ensure we are able to maximize our athletic performance. Also, for those who have sedentary jobs, stretching can help ease muscle tension. Of course, an inflexible lower back leads to significant problems as well. It seems then that maintaining “normal” flexibility is important, but increasing flexibility may offer no additional health benefit.
Take Home Message: Maintaining “normal” flexibility is important for general health however, it is apparent from this review that flexibility training is not strongly associated with functional ability, particularly among older adults. Thus, while we should spend some time stretching after a workout or a long day at the office, there may be no point in spending additional time stretching. I would suggest that you use that extra stretching time to do some aerobic activity (eg. walking) as aerobic fitness is STRONGLY associated with health and wellness. Whatever you do, stay active so that you can maintain your HALF!
It is thought that 80% of the population will experience low back pain at some point in their lifetime. Whether this is chronic (lasts for a long period of time, 3 months or more) or whether acute (short period of time) will depend on the cause of the back pain. One of the most common reasons for low back pain is weak abdominal muscles and tight low back muscles. This is often a result of having a large waist. Thus, any physical activity will help with back pain of this nature because it will help with weight loss and will also help strengthen and stretch the appropriate muscles. Of course, there are many other causes of low back pain, such as an injury sustained at work or in a car accident. In these cases, more specific exercises targeting the cause of injury may be required. These are generally prescribed by a health care professional such as a physiotherapist. Nevertheless, even for such injury related low back pain, general physically active has been found to be beneficial.
Supervised exercise sessions for chronic low back pain can be expensive and may not be enough to counter the pain. In recent years, exercises such as yoga and Pilates have been investigated as exercise options for those with low back pain. In a recent study published in the peer-reviewed journal Medicine and Science in Sports and Exercise Wajswelner and colleagues investigated the benefits of Pilates compared to a general exercise program for those with low back pain. Participants were adults who reported symptoms of pain or stiffness in the lower back with or without lower limb symptoms (no leg pain or numbness) on most days of the week for 3 months or more. They also had to report significant pain to participate in the study. For 6 weeks, twice per week (60 minutes each), participants attended group sessions of either Pilates or general exercise with a physiotherapist. At the end of the 6 weeks all participants showed significant improvements in pain and disability scores; the improvement was the same between groups. In other words, Pilates led to similar improvements in low back pain symptoms as did general exercise.
This is great news for those with low back pain. It seems that you can safely and effectively use Pilates to improve pain in your lower back. If you don’t have access to a health care professional, then an instructor led Pilates class might be a good alternative. If you do have access, then you could add Pilates to your program for some variety!
TAKE HOME MESSAGE: If you have low back pain, adding physical activity to your daily schedule is essential! There is no doubt in the scientific community that physical activity is good for your back health, but be cautious in choosing the type of activity you do. It would be ideal to consult with a health care practitioner prior to beginning an exercise program, but if you can’t, choose a safe and effective physical activity like walking or Pilates. Don’t let low back pain control your life.
Remember, you have control of your HALF!!!