Do Functional Foot Orthotics Work? Yes!

Dear RunDoc: I read in the NY Times that orthotics often don’t work and I should try running barefoot to strengthen my feet. I tried and my feet got a lot worse. I know you wear orthotics and make a lot of them for your patients. Why do you think custom foot orthotics work in your hands?

RunDoc answers: Hmmm….Good question! I read the article in the New York Times and laughed then cried. They are so biased against orthotics that this is bout the tenth time in the last few years they are trying to make them voodoo. Fortunately, they are wrong and there is science behind it.

Many tens of millions of patients have been helped by custom-made foot orthotics over the past 50 years.

There are many studies published in peer reviewed medical journals showing the effectiveness of orthotics in reducing injury and relieving pain.

One of the most important factors creating the need for orthotics is that we usually walk on essentially hard, flat surfaces that do not exist in nature.

Walking or running barefoot does not change the above.

The science of biomechanics relating to orthotics is complicated and requires years of study. This is why you should have your orthotics made by a well-trained podiatrist in biomechanics and even better, one who has an understanding of your specific sport.

The process of getting an orthotic to be most effective is iterative, often requiring serial adjustments. This is because everybody is different and may not tolerate “perfect” biomechanics.

The conditions for which orthotics are prescribed often take years to develop. They are not going to disappear overnight with the use of orthotics.

Orthotics should not be chosen by how comfortable they feel. Often, they are uncomfortable at the beginning because they are “correcting” your biomechanics with an external device and you have to get used to them.

The reason foot impressions (casts) are taken off-weight-bearing is so the foot can be positioned in an optimal shape that will allow it to naturally bear weight on its own. A three dimensional scanner can also be used to get a “true” picture of the foot without a cast.

Orthotics are not arch supports. They guide the foot through a proper gait cycle, allowing the foot to achieve various optimal positions at the correct time and creating a means for shock absorption, weight bearing, and propulsion.

A flat foot by itself is not good or bad. A high arch by itself is not good or bad. How the patient functions with those features is the issue.

If you have been told you need orthotics and you’re in doubt, get a second opinion. If you have orthotics and they are not working, get them adjusted.

Correctly made functional foot orthotics work! I have built my reputation with them.

Run Happy! And in orthotics if you need them!

Acheive Your Fitness Goals!

The most common New Year’s resolution in the United States is to lose weight or improve your fitness. Let’s face it, even for the veteran marathoner or triathlete, the New Year gives us an excuse to refocus or give us just a little kick in the butt we need. We all need a plan to achieve our fitness goals or race success. I woke up on January first and realized it was 21 weeks until Ironman Texas. Wow! That crept up on me! Janet has been blogging for months about the road to Ironman Texas. I’ve been so busy working my butt off and being Mom, it crept up on me. Now it is time to refocus on my fitness goals, so I don’t perish on the streets of Houston on May 21st.

Maybe you are like me, a race is creeping up on you, or maybe you have just gained a few extra pounds from the holidays, or maybe you are like some of my friends who realized running up their stairs they get out of breath. This is a great time of year to refocus on your fitness goals. We all have obstacles; time, energy, financial, and our own self-defeating voice in our heads! Here are some tips that will help you focus and reach your fitness goals in 2011!

1. Know your goals: You need to start with the end in mind. What are your goals? Lose weight? Get faster? Get fitter? Get stronger? Body sculpting? Finish your first marathon? Finish your first Ironman? Whatever they are, start with small focused goals and build to larger ones.
2. Start Simple: Begin with a basic program. Make it a habit, and then you can build from it. Maybe you run for 30 minutes every morning at 5:30 am. Maybe you add a strength work out twice a week. Maybe it is as simple as adding a tempo run once a week. By starting simple, after 21 days you have now made a new habit to build on.
3. Write it Down: A goal not written down is a mere wish. Also, logging your workouts make them more real. It also makes any blank spots much more glaring! There are lots of logs or even phone apps to log your workouts and your nutrition. Use one! Include your goals at the top of each page of your log. I also find it helpful to leave myself sticky notes around the house. When you find a note that says “20 weeks to Ironman” on your bathroom mirror when you get up in the morning that is powerful motivation!
4. Enable Yourself: Make sure your equipment is working well. Time to get that new pair of running shoes. Time to tune up the treadmill and work on your bike. Buy yourself a new toy like a chin up bar or power meter for your bike. New toys make fitness goals even more fun!
5. Make it Fun: Find some workout peeps. Make sure you are having fun even when your muscles are screaming at you to stop. I find a weekly group run or ride, coupled with a weekly mostly social weight workout at the gym, makes the many solitary miles on my bike, treadmill or road a lot more tolerable.
6. Confuse your body: Mix up your workouts. Your body gets stronger and faster with small incremental increases in stress. This means changing speeds, changing routines and scenery to confuse you muscles to get stronger. Throw in a crazy yoga workout, a new routine or just a bunch of hills when you usually avid them. Change your energy levels for better success.
7. Be Committed and Consistent: Every year I see a whole gaggle of new people at the gym in the first week of January, and then they are gone by Valentine’s Day. Fitness goal cannot be reached in a month or two. You have to commit to your goals and work towards them. It may take a year to reach your goals. I started working towards my first Ironman two years ago. Now I am less than 5 months away. Rome was not built in a day. When you feel like quitting, pull out your goals and read them again. Start a mantra, “Pain is temporary and quitting is forever” is the one I use with my middle school cross country running daughter. I personally like, “It’s all about the finish line”. Find one that works for you. It really is true that the hardest part of a marathon is the first three steps out of bed in the morning! You will find that once you get up, the rest is easy!

If you follow these few tips, I promise you will reach your fitness goals in 2011! You will thank me! And I will live though Ironman Texas this year! Run happy and towards your goals!

Carroll Middle School First Cross Country Meet For Alex

This week my 12-year-old daughter, Alex, had her first cross-country meet. Wow! 7th grade. Where did the time go? The States of Texas is so weird with their sports timing. Middle school cross country is December to February. Very strange and I figure we will be freezing for many of the meets, so it will feel just like Rhode Island in November! All joking aside, when she put on her uniform, I almost cried. My heart was so full of joy that my daughter would hopefully experience the same positive affect that competitive running had on my teen years. Most of my happy times as a teen revolved around running and running is so much a part of my life still today.

As for Alex’s first meet, true to form, she found the only gopher hole in the first 100 yards of the race and fell flat on her face (all my Facebook friends that ran with me are laughing, my nickname was “Crash Crane” because I fell so much!), but got right back up and proceeded to pass about a hundred people. She finished 83rd (out of about 300) and did her best time to date. She was very excited and happy. Energized to do it again after the holidays!

So here is a shout out to all Moms who infect their kids with the running bug. Keep it up!
It is a great way to occupy them as teens and positively influence their health choices for a lifetime!

Why Is The Ability To Be Truly Thankful and Happy Elusive To So Many?

This Thanksgiving weekend I sit back and reflect on how thankful I am for all the blessings I have in my life. I have a wonderful family with three healthy and happy girls. My oldest two even did their first triathlon this fall with me. I am blessed with healthy and happy 70+ year old parents who support me and my girls in all our crazy endeavors. I have siblings, who think I’m nuts, but would cross the globe to help me. I have amazing and creative friends who have circled the wagons every time I needed them. I am blessed to be loved by a caring, thoughtful and selfless man who treats me like a princess. I have an unbelievably rewarding and fulfilling career in a profession that not only supports my family, but fulfills my need to be needed and useful in other people’s lives. And I enjoy the ability to run, jump and play (as well as swim and bike) with all my friends and the rest of the crazy marathon running, triathlon trying community. I am truly blessed and remember that daily.

Why is that peace so elusive to so many? I think Blake Mycoskie, the founder of TOM’s shoes and one of my personal heroes, hit the nail on the head in his Thanksgiving blog post, “This Thanksgiving, try to really stop. Sit still. Hold a loved one's hand, and simply be thankful. No matter what your situation, positive or negative, sad or joyful, take the opportunity to truly experience this moment. The stillness. The mystery of this life. For this, and no other reason, I'm thankful.” If you are not familiar with TOM’s shoes, take a look at their website. He gives a pair of shoes away to a needy child every time they sell a pair of shoes. They have given out more than a million pairs of shoes already! Changing lives one pair at a time. Not bad for a 30-something guy from Arlington, Texas!

Happiness and peace of mind does not need to be elusive. Enjoy a still moment. Revel in the people and places around you. No matter what is going on in the circus that is your life, we all have something to be thankful for; even if it is just breathing another day. And for all the runners and triathlete’s who follow my blog, we should all be thankful for the ability to enjoy our sports activities. Always answer the question, “Why do you run?” with the answer, “Because I am blessed that I can!”

Happy Thanksgiving to all! Run happy!

Losing Your Motivation to Run?

Let’s face it. The alarm goes off at 5:30am and there are many days I don’t want to get up and run or bike. My bed is warm and the air is cold. My pillows are so comfortable and missing one work out won’t matter that much. I’m in great shape! STOP! The negative self talk is waxing away at your motivation and suddenly those fitness goals are sliding away.

It’s not hard to stay motivated during the season. There is always a 5K or sprint triathlon every weekend and they fill your calendar. Your “A” and “B” big races are in red on the schedule and that motivates you to get out of bed and even do two-a-days. But now it’s off season for triathlon, and even the fall marathon season is slipping away. The days are getting shorter and colder; and in some areas the snow has begun to fall. Even in North Texas, the mornings are dark and the winter running gear is coming out of the moth balls. Motivation is hard to come by. I’m tired and cold and my morning run has lost its appeal.

What’s an athlete to do? Well, the winter off-season is a great time to mix it up a little. Training has to change from time to time to be effective. We all get stuck in ruts, so the off-season is a great time to try out some new tools. This is the time to build some strength, allow other muscle groups to become more balances and especially allow for recovery from a hard season. It’s the time to build on the hard work of the season and prepare for even greater success in the future! Motivated yet? Me neither, but I find two great tools do help me shake the winter doldrums and get motivated to work towards the next season: goal setting and visualization.

Everyone yawns now; it’s the goal setting lecture…..Wake up! Most of us have goals in our head, but very few have written concise, realistic, timely goals for the next year. A goal not written down is a mere wish! Teaching yourself to write realistic, yet challenging personal performance-oriented goals will allow you to do the work necessary to achieve those goals, allow you to see improved performance, lead to increased confidence, and ultimately lead to greater success as an athlete.

Goal Setting 101
1. Define what you want to accomplish in 2011. It is important to begin with the end in mind. My goal for 2011 is the finish the Texas Ironman and not perish. Good goal! Time goals or a new distance should be realistic. I once had a patient that told me her goal was to finish a marathon a month in the next year. I asked how many marathons she did last year. None. Not a realistic goal!
2. Know where you are right now. How strong are you? Do you have any nagging injuries?
3. Be honest about what you need to develop. I need to get stringer on the bike. What are your weaknesses? Be objective and painfully honest with yourself. Put your ego aside. This is an important step.
4. Set sub goals and segment them. Perhaps you have a time goal, but you also probably have a weight goal, a nutrition goal and a mental goal.
5. Write performance goal for all the sub categories. Be specific and measurable. Don’t say, “I’m going to stop drinking so much beer,” a better goal is to say, “I’m only going to have one beer a night and only on days that start with S.”
6. Commit yourself completely. A goal should be something that leaves you with a burning desire to reach it! I post my goals on a sticky note on my bathroom mirror so I look at it daily. This motivates me. Have a goal card in your pocket and look at it. Keep a training log and make interim goals. This helps you stay focused.
7. Monitor your progress. Listen to your body and do not become obsessed with your goals. Your body will tell you if you need more rest! Injuries happen when we push ourselves too hard. This does not help us meet our goals.
8. Visualize yourself meeting your ultimate goal. I have watched myself cross the finish line of a full Ironman many times in my head. Close your eyes and visualize the starting line and you are feeling great and in the best shape of your life. Go through the race in your head, feeling confident and relaxed. Watch yourself finish strong and feel the rush of achieving you goal. Practice this weekly and your brain will be mentally prepared for success.

Motivation and drive come from constant focus on the destination and then seeing you move through the process to get there. Having a purpose is important or it is really hard to consistently train during the off season. Take some time and work on your goals. Visualize success, and then get out of bed!

‘Tis the Season to Have a Bunionectomy Fa-la-la-la-la-la-la-la-la!

Seriously! The holidays are upon us and it seems like everyone in Grapevine, Texas, is on my operating schedule or is having some kind of elective surgery with one of my surgeon friends. My family always wonders why my schedule gets completely crazy just when the rest of the world is taking a vacation? Why is it that we do more bunionectomies in November and December than the first two quarters on the year? You may think it is because they have family around to help them, but that’s really not the main reason. It is a little invention of the insurance companies called the deductible.

It used to be that no one wanted surgery over the holiday season. That was when deductibles didn’t exist. Now, policies are written with high deductibles and co-pays. Imagine that if you have met your deductible and your out-of-pocket for your health insurance, any elective procedure is free until the end of the year. January 1, you have to pay again! This has caused the mad rush to the podiatric surgeon as well as any other surgeon in town. Even the plastic surgeons are affected, because people have money in their flex spending or health savings accounts that they lose if they don’t use it before the end of the calendar year. Crazy!

So, you decide to join the masses and have your foot fixed that has been annoying you or out-right crippling you for years. What should you do to survive the holidays and not end up with a bad outcome?

Listen to your doctor. Non-weight bearing or partial-weight bearing means just that. Stay off your foot! A short trip to the mall or football game is not a good idea.

Ice, ice and more ice! Ice and elevation are your friends. They will decrease your swelling and ultimately keep your pain under control.

Limit holiday parties. Just because you are invited to a billion parties does not mean you have to go. Pick one or two small parties and send regrets to the rest. People will understand, even your boss!

Shop before surgery or embrace the internet. I did all of my holiday shopping in one night on the internet last year. A quick side tip is that if you do binge shop, don’t be surprised if you get a call from your credit card company. They just want to make sure it’s not fraud. Using Pay-pal will avoid this.

Order a catered holiday meal or teach your children to cook. Almost every nice grocery store can cater a meal your family will love. As for cooking classes, do it from the couch and turn off the smoke alarm!

Don’t over eat! You are resting, so your portions should be smaller. Most people gain 2-5 pounds over the holidays. Inactivity makes this worse, so be diligent about what goes in your mouth!

Rest and relax. You have taken care of your family for years. Pull out the tiara and a little bell. It’s time some one waited on you. If you live alone, invite a friend to stay for a few days after surgery so you have some help.

And last tip, listen to you doctor! Patients who follow their post-operative instructions are much more likely to have good to excellent outcomes!

‘Tis the season to have a bunionectomy or an arthroscopy or a rhinoplasty….Fa-la-la-la-la-la-la-la-la!

Celebrate the Holidays Without Gaining Weight

It’s that time of year again. Whether you celebrate Thanksgiving, Hanukkah, Quanza or Christmas; all of these holidays have one thing in common: Lots and lots of food! The average American gains between two and five pounds during the holiday season. Why? Fork to mouth problem! Here are some tips to keep from gaining that extra poundage and start the New Year off without having to make a resolution to lose weight.

Don’t Skip Meals. During the holiday season, a lot of people will skip lunch in anticipation of a holiday party or get so caught up in the festivities that they don’t take time to eat. When you go to a party really hungry, you tend to eat quickly and overeat.

Slow Down. Take breaks while you are eating to give your stomach a little time to discus with your brain how full it is. Amazingly, those that ate slowly and joined in the holiday conversation tend to eat less.

Watch your portions. We all know that holiday portions can border on enough to feed a small African nation. Use a smaller plate or just take one scoop of your favorites. That way you enjoy them all but eat less.

Pack up your leftovers right away. Especially if you are one of the cooks, grazing the leftovers in the kitchen can be a social over eating fest! Send leftovers home with your guests so you won’t be tempted to have a midnight snack.

Limit alcohol. Face it, the more you drink the more you eat! Save the calories for that sliver of pie you are craving.

Exercise as part of the holidays! If you can’t convince the family to run the Turkey Trot, take the clan for a walk after dinner. Enjoy the day and work off a few calories. If the weather is bad, Wii bowling as a family can be hilarious and help burn some calories.

Be Realistic. Starting a diet plan during the holidays is setting yourself up for failure. Try to maintain your current weight and plan for a weight loss goal in January.

Shop ‘til you drop. Not only will you be stimulating the economy and helping the recession, but you will be exercising! Have a healthy snack before or carry some granola bars so you won’t be tempted to visit the food court.

Fight the holiday blues. Many people get depressed around the holidays and tend to use food as an anti-depressant. Spend time with friends and count your blessings. Writing them down can help you realize even in down years, you have a lot to be thankful for.

Think of how happy you will be in January if you navigate the holidays without all those excessive pounds! Follow these tips and be diligent. You will thank me later!