Ankle and Foot Pain from Summer's Flip Flops

Flip-Flop Flaws
According to a new study, the ubiquitous summer shoe may be bad for your ankles and feet.

Summer is when the rubber hits the road. We're talking about flip-flops, the ubiquitous sandals that consist of little more than a sole held onto the foot by a Y-shaped thong. Flip-flops used to be relegated to the beach or the locker room, but in the last few years they seem to have become the footwear of choice for a whole generation. Back in 2005 some members of the Northwestern University national champion women's lacrosse team drew flack for wearing flip-flops when they met with President Bush at the White House.

Questions of etiquette aside, flip-flops may not be the best choice for health reasons. In a study presented last week at the annual meeting of the American College of Sports Medicine, researchers at Auburn University found that flip-flops actually alter the way wearers walk. That change in gait can cause persistent foot and ankle pain—the kinds of problems usually associated with a fondness for Manolos and Jimmy Choos.

Justin Shroyer, a doctoral student in biomechanics at Auburn, and Dr. Wendi Weimar, the director of Auburn's biomechanics laboratory, were tossing around ideas for a research project when they hit upon a subject that seemed ripe for exploration. "We're biomechanists," explains Shroyer. "We can't go anywhere without analyzing the way someone walks." They noticed that when students came back from summer vacation they often complained of pain in their feet, ankles and lower legs. The same students were also likely to be flip-flop fans (as is Shroyer, as a matter of fact). Could there be a connection?

To find out, Shroyer solicited 39 college-age female and male volunteers. The participants wore thong-style, flat-soled flip-flops and then regular athletic shoes while walking on a platform that measured the force they exerted when their feet struck the ground. Shroyer also filmed them as they walked so he could study differences in the movements of their hips, legs, knees, ankles, feet and toes.

After digitizing all these images and analyzing the data, Shroyer came up with some disturbing conclusions for those of us who treasure the freedom of flip-flops. He found that flip-flop wearers take shorter steps. The result is more stress on the body because you have to move more to go the same distance as people wearing other kinds of shoes. That could mean a higher risk of muscle and joint pain in the legs.

Toes are another problem area. "When you wear flip-flops, you kind of scrunch your toes to keep the flip-flop on your foot," Shroyer says. That constant pressure often adds up to throbbing and tenderness in the toes. "The body is an amazing machine," Shroyer explains. "When you do one thing, other things turn off and on. By engaging the muscles that scrunch your toes, you are turning off the muscles that would bring your toes up." That also means that you can't lift your foot up as much when you walk—hence the characteristic flip-flop shuffle.

Shroyer's analysis of the mechanics of flip-flop wearing isn't the first warning about their dangers. The American College of Foot and Ankle Surgeons has reported an increase in heel pain among flip-flop wearers, especially in the spring, when they make the switch from sturdier winter shoes. The problem is exacerbated when people who are overweight or sedentary wear flip-flops. One of the most common sources of heel pain is plantar fasciitis, an inflammation of the connective tissue that links the toes to the heel bone. Being overweight and wearing ill-fitting shoes make it much more likely that you will suffer from plantar fasciitis. Thin-soled flip-flops without arch support aggravate the effects of any existing sources of strain on the legs and feet (such as too much weight or weak muscle tone).

Does this mean that you should throw out your beloved flip-flops or walk barefoot? Not necessarily. Like all good things, flip-flops are probably fine in moderation. Wear them at the beach or even for short jaunts to the mall. But don't make them your everyday footwear. You can get much the same look from sandals that have a little more arch support or another strap that keeps them on (and gives your scrunched up toes a rest). Shroyer also suggests replacing flip-flops more often. "Usually people break their shoes in so they become more comfortable," he says. With flip-flops, he says, "that is probably the point where you need to get rid of them."

If you're already experiencing pain, kick those flip-flops to the back of your closet and slip on footwear with more support until you feel better. If you have flat fleet, arch supports may help; you can find relatively inexpensive ones at the drugstore. If the pain doesn't go away, see your doctor. In a few cases foot and heel pain could signal more serious medical conditions like arthritis or even a stress fracture.

May is Posture Month

Stand taller for posture month

May is National Correct Posture Month, and it seems mom was even right about standing up straight. Improving your posture is not just about looking good. Studies show people with better posture really are healthier and actually live longer.

From kids with backpacks or cane-carrying seniors — studies show poor posture is a major cause of back and neck pain for all ages, and over time often contributes to digestive and cardio-pulmonary problems.

Here's three things to help keep you standing tall:

1. Take an annual posture picture to set the benchmark for your body. Ask a friend to take your picture from the front, back and side. Print them out, one to a sheet, and look at your body symmetry.

Just comparing posture pictures from year to year can be eye-opening. You can assess your alignment by putting a dot between your feet on the front and back view, and at your ankle on the side view. Then, fold each paper in half neatly at the dot.

Front and back view: The two halves of your body should be the same. If your head and/or torso is off to one side, or your arms are hanging differently, your posture is not symmetrical.

Side view: The line from your ankle should pass thru your shoulder and ear. If your head is way forward of that line, you may have a posture distortion called forward head posture (FHP).

File your posture picture and compare it to a new one next year.

2. Do posture strengthening exercises to maximize the benefit of any workout, or as a beginning exercise to get in shape. Yoga, Tai-Chi, and Pilates are all great for building body awareness and control.

Best posture stork: Train yourself to Vertical wall stand: Back up to a wall so your heels, buttocks, shoulders, and head all lightly touch the wall while you keep everything level, relaxed and aligned — and take three slow breaths, feeling your body’s best posture. Note: If you feel any areas of stress, get your posture checked by a professional.stand tall while building good posture by balancing on one foot. First, stand tall with your best posture and then focus on staying tall and straight as you lift your thigh so your knee is at hip height. Keep standing tall for 30 seconds on each side, focusing on keeping your body well aligned.

3. Choose smart posture habits, Get a good chair, and change it's position during the day. If you're going to play videogames, exercise more than your thumbs with games with one that makes you move such as the motion sensing videogame consoles.

Invest in quality shoes, and consider using a shoe insert or orthotic, especially if you've had foot problems.

If you have back pain, neck soreness, or other posture problem — or want to find out how strengthening your posture can improve sports performance (ie golf, tennis, baseball) and wellness — help is available. Consult a certified posture exercise professional or other chiropractor, PT, or massage therapists trained to analyze posture pictures and teach individualized posture exercise routines for pain management and wellness.

Your posture is how the world sees you, and a bit of effort at strengthening your posture is an anti-aging habit to make you look and feel better, avoid injury and exercise effectively to stay active and age well.

Cold Laser Therapy For Back Pain

Erchonia Laser Healthcare

In January of 2002, after groundbreaking studies in laser therapies the U.S. granted F.D.A. clearance for the treatment of chronic neck and shoulder pain. Their commitment to forms of laser therapy has led them to research laser treatment for back pain, with very successful findings.

Laser therapy for back pain utilizes many similar techniques of biostimulation as other low-level laser therapies, and can greatly increase a patient’s quality of life as an alternative pain solution.

Rather than turning to heavy doses of pain medications, patients are able to achieve relief through non-invasive and painless cold laser therapy for back pain. Cold lasers work much differently from other lasers in that they do not utilize heat whatsoever. The beams are able to penetrate the skin and biostimulate on the cellular level; the pain relief comes without the cost of scars or nerve damage.

Back Pain

Common treatments for back pain include pain medication, physical therapy, chiropractic, and in some cases, surgery. Pain medication leaves patients feeling groggy, and they can easily build up a tolerance to them, while surgery always opens the door to the risks of complications and infections.

Back pain laser treatments utilize biostimulation, which means that after each session, patients will feel considerably better for longer periods of time. Low-level laser therapy for back pain is an effective alternative solution to the temporary and potentially dangerous options that are mostly commonly prescribed and utilized. Once patients are able to experience the relief of cold laser therapy, they will never choose habit-forming pain medications again.

Golf and Chiropractic

Common golf injuries treated by chiropractors

There are a number of ways a golf chiropractor can treat the golfer and enhance his golf experience. Spinal and shoulder adjustments, preventative swing advice, rehabilitation exercises, electric muscle stimulation, chiropractic massage or Graston, deep heat therapy, laser therapy and anti-inflammatory nutrition are just some of the ways that golf chiropractors can treat golfers who are injured and who are trying to prevent injury. Basically, a golf chiropractor will treat the golfer who wants to play the game pain-free.

"Seeing a chiropractor on a regular basis has made me a better golfer. I've been going to chiropractors for as long as I can remember. It's as important to my training as practicing my swing"

-Tiger Woods, 14 time PGA Championship golfer

Golfer's Elbow

People that suffer from golfer’s elbow are often involved with racquet sports or golf. As with tennis elbow, they may overuse the forearm, traumatize the elbow by hitting several “fat” golf shots, or have poor swing technique.

Pain at the inner aspect of the elbow and reproduction of symptoms with resisted wrist flexion are common.

Shoulder Pain

Rotator cuff and general shoulder problems can occur from golf for the same reasons as shown above for golfer's elbow.

Wrist Tendonitis

Wrist tendonitis can set in even of you have good swing technique. This is often called "golf wrist" by golfers.

Patellar Tendonitis

Knee injuries like Infrapatellar Tendonitis (jumpers knee) are very common in golf for a multitude of reasons.

Achilles Tendonitis

Injuries to the achilles tendon are a common problem for golfers.

Low Back Pain

Last but not least, the most common injuries suffered by golfers are to the lower back and the sciatic nerve or "sciatica" as it is commonly called.

Go to a Chiropractor for Tennis Injuries

TENNIS, ANYONE?

The sport of tennis is often saddled with a reputation for being a rather "dainty" game, thanks to the well-mannered fans who frequently grace the stands at professional tennis matches-not to mention the elite country clubs that typically provide tennis facilities. According to the American Chiropractic Association (ACA), however, the game of tennis can be not only an extremely physical challenge, but also a tremendously healthy endeavor.

"Tennis is a game that-if you start playing early and continue to play it-can actually reduce your risk of heart attacks because of the cardiovascular workout it provides," says Dr. Scott Bautch of the ACA's Occupational Health Council.

BENEFITS
One of the great things about playing tennis is that you only need to find one other person to play with in order to play a match. In fact, if you can find a tennis facility that has a tennis wall-or a wall with a horizontal line that simulates a tennis net-you can get a great tennis workout all by yourself.

"The combination of both high and low exertion levels that tennis offers can provide a unique exercise experience, as well as tremendous health benefits," says Dr. Bautch. In addition to helping to reduce your risk of heart attacks, playing tennis can also tone the muscles of your upper and lower body, burn calories, and improve your balance, hand-eye coordination and agility.

EQUIPMENT
Perhaps the most important element to beginning a tennis regimen is selecting the right equipment. Basic equipment includes proper tennis shoes, socks, appropriate attire and a good tennis racket. Dr. Bautch offers the following recommendations:

SHOES & SOCKS
Because of the constant pounding your feet will endure, it is critical to select a true tennis shoe. Don't purchase a shoe that is designed for basketball, running or cross-training. The shoe should be built low to the ground yet designed to be shock-absorbent to minimize stress on your feet.

"Socks are extremely important too," says Dr. Bautch. "Perspiration is a concern for tennis players, so look for socks that will help keep your feet dry." Some new synthetic fibers used in making socks are scientifically engineered to move sweat away from the body. The more traditional acrylic socks also work well in preventing perspiration buildup on the feet. Avoid cotton socks, as they tend to trap perspiration and hold it close to the skin. According to Dr. Bautch, "you should also consider a foot powder to help keep your feet dry. If your feet are wet, you have a greater chance of developing painful blisters."

ATTIRE
While some professional tennis players may be able to get away with wearing tight-fitted clothing on the court, most of us need to exercise a bit more caution. Avoid wearing sports attire that pinches any part of your body. These "pinch points" can inhibit circulation, causing you to tire more quickly than normal. They can also cause uncomfortable blister marks and rashes. And just as with socks, skip the cotton apparel in favor of synthetic fibers that will absorb sweat and move it away from your body.

RACKET
"Two important considerations when selecting a tennis racket are the size of the racket and your hand comfort when gripping the racket," explains Dr. Bautch. "Beginning tennis players often try to pick out an oversized racket to give them a better chance at hitting the ball. But with an oversized racket, you tend to catch the ball on the extreme edges of the racket, which can twist your hands and wrists beyond their normal range of motion. Look for a normal-sized racket instead."

The grip of your racket should be comfortably cushioned to absorb the shock that comes from hitting a tennis ball. The grip should also be thick enough so that your hand fits around it without having your thumb and fingers overlap one another.

HYDRATION
"Do not underestimate the importance of drinking water," urges Dr. Bautch. "When playing tennis, you lose a lot more fluids than you realize because a lot of your perspiration simply evaporates." According to Dr. Bautch, "water is your best choice for hydration. Whatever you do, don't drink sodas, because they actually take more water from your body to push them out of your system than they put into your body."

To determine the optimal amount of water to drink in a given day, take your bodyweight and cut it in half. That figure represents the number of ounces of water you should drink. For example, if you weigh 100 pounds, you should try to drink 50 ounces of water per day.

SURFACES
Selecting a tennis court with a safe playing surface is another important step in starting your tennis program. Because your knees, hips and feet will take a pounding, surfaces that have some give-such as cushioned surfaces or even grass surfaces-are a better option than those made of concrete. Once you've selected an appropriate court, check it for trash, sand or other foreign objects. These unwelcome articles make it easy for you to lose your footing when practicing or playing.

LESSONS
Dr. Bautch recommends that beginning tennis players take tennis lessons, because lessons "teach good tennis habits and proper form, which will help take pressure off your wrists, spine and hips. It's important to learn to play the game correctly." If taking lessons is impossible because of financial concerns, scheduling conflicts or other reasons, there are many instructional aids available such as books, videos or DVDs. These products can be very helpful in familiarizing your body with the game of tennis.

AVOIDING INJURIES
In order to help prevent injury, it is critical to warm-up before practicing or playing. Dr. Bautch recommends that you "mimic the moves that you will make while playing, but do them more slowly and deliberately. Perform these moves through a full range of motion." You should also spend a few minutes rotating each of your legs, shoulders, hands and elbows in a slow, circular motion. Finally, move forward and back, then left and right, across your end of the tennis court, simulating the movements you would make when actually playing.

PAIN AND INJURY
Even when the best preventive measures are exercised, pain and injury can be an unfortunate fact of life with any sport-and tennis is no exception. Common tennis injuries include tennis elbow, shoulder injuries, low back injuries and turned ankles and knees. If you experience pain or injury beyond simple muscle soreness, make a doctor of chiropractic your first choice.

- Having treated collegiate and professional tennis players, I quickly learned that tennis puts a tremendous beating on the body. It is very rare to meet a competitive tennis player that doesn't have pain somewhere in the body. In grueling 3 or 5 set matches with constant repetitive and dynamic motions, these athletes are prone to injuries. The torque on the low back and pelvis that comes with lateral movements and hitting a tennis ball can be brutal to the joints. Chiropractic adjustments and stretching will help to not only alleviate pain, but restore the motion and function of that particular motion segment. Soft tissue massage and Graston to hypertonic musculature are also very beneficial techniques when treating tennis players. Whether you play for fun or compete at a high level, here at Rosa Family Chiropractic of Alexandria we treat you like a pro!

How to give your knees some TLC

Surgeon: How to give your knees some TLC

Knees help us stand, sit, walk, dance, kick a field goal and escape a predator. They bend, bounce, straighten and lift. Is it any wonder that at some point in life, knees may just wear out?

But, there are a few things you can do in order to keep your knees in the best possible working condition throughout life.

Athletes in any sport, professional or leisure, should take time to learn how to protect the knees from injury. Athletic trainers can provide assistance in learning those techniques.

Varying workouts and putting limitations on the number of hours in practice can also be helpful in protecting the knees from overuse and injury. Always be certain to take 5-10 minutes to warm up and cool down.

Wear appropriate footwear for your profession. Beware of spiked heels. Wearing spiked heels causes alignment problems, putting strain on the knees, as well as the back. Studies have shown that spiked heels put stress on the part of the knee where osteoarthritis usually develops.

Very flat soles can also present a problem with alignment. Comfortable and practical shoes do not have to be expensive. Choose carefully.

Keep your weight in check. Extra pounds put extra pressure on the knees. Every extra pound you carry can add up to three pounds of pressure to your knee joints when you walk, and even more when you run.

Exercise regularly. Choose low-impact activities you enjoy that build strength and flexibility such as yoga, walking, swimming or weight lifting. When exercise is done properly and consistently, it can help with range of motion and circulation as well as building muscle.

Practice good posture. Just like mama said –shoulders up, abs tight, head centered, knees slightly bent and don’t rest on one hip. Be aware of your posture whether standing or sitting.

Do not ignore pain. Stop the activity that is causing you discomfort and do something else. If the pain persists for a couple of weeks after you have discontinued the activity, check with your doctor.

We consider the knee to have three compartments, the medial or inner part of the joint, the lateral or outer part of the joint, and the patellofemoral or front part of the joint.

Acute pain in the medial or lateral parts of the joint should especially be reported to your physician.

Some frontal knee pain or soreness is not uncommon with new and strenuous activity. Of course if pain persists in the front of the knee, this too should be reported to your physician. Chronic pain may be a sign of plain ‘ol wear-and-tear. X-rays and other imaging will reveal the severity of the process.