Clinical Predictive Rules for Management of Plantar Heel Pain

Medical professionals rely on clinical practice guidelines to have better outcomes, lower utilization of care, and lower costs. These guidelines have limited value since they often fail to keep up with new research findings or recently available diagnostic or therapeutic interventions. For example:  clinical practice guidelines are available for plantar heel pain (plantar fasciitis) from…

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Gait Deviation – Excessive Inward Rotation of Hip Joint

Excessive inward rotation of the hip joint can be a contributing factor to development of repetitive use injuries of: Lateral hip pain (gluteal muscle tendinopathy) Buttock pain (piriformis syndrome) Anterior knee pain (patella femoral arthralgia) Lateral knee pain (IT band syndrome Shin pain (posterior tibial tendinopathy) Plantar heel pain This video first illustrates the gait…

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That’s a Stretch: Why Stretching May Not Always be the Solution

It’s good to stretch a dollar. It’s bad to stretch the truth. But what about stretching your calves? That might depend on whether you believe Dr. Google every time a search result says to stretch sore calves. Calf stretching aims to increase the range of motion (ROM) for ankle dorsiflexion. “Dorsi” is a prefix meaning…

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Shoes too big for foot contributes to injury

A majority of all people are in shoes that are incorrect shoe size according to Fawn Evenson director of the Footwear Industries of America. There are two potential errors when selecting what size shoes to wear. Either the shoe will be too small for the foot or too large for the foot. In my experience…

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Cuing to Alter Gait Deviation of Too Long a Step

Cuing to Alter Gait Deviation of Too Long a Step Mathematics helps explain walking or running faster. Step length X steps per minute = speed. In order to move faster there are 3 opportunities take longer steps or strides, increase the steps/minute (cadence), or do both longer steps and a faster cadence. Taking longer steps/stride…

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Shoe Soles: Stiff Rocker Bottom Sole versus Flexible Sole “Barefoot”

There are many things to consider when selecting shoes, including comfort, injury and energy expenditure. Arnie Davis a Certified Pedorthotist has coined the term shoes with rocker bottom soles are the proverbial “aspirin” for chronic foot problems. A rocker sole shoe is recommended to help manage a number of painful injuries including: low back pain;…

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Pain on Bottom of Heel: Too Much Big Toe Motion

 Pain on the bottom of the heel (Plantar Heel Pain) is a complex problem with variable diagnoses and explanations. And with variable diagnoses there should be variations in treatment. Unfortunately, the common treatment recommendations do not recognize such variability. For example, the universal suggested treatment for plantar heel pain is calf stretching and stretching of…

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Strengthening Exercises for Intrinsic Foot Muscles

Exercises to strengthen the foot are frequently used to treat injuries to foot, ankle, knee, hip and low back.  Toe curl or toe scrunching exercises is not appropriate for strengthening the muscles intrinsic to the feet. Muscles about the foot and ankle are described as either extrinsic muscles or intrinsic muscles.  Extrinsic foot muscles have…

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Stiffness – Resistance to Change: Good or Bad?

In the realm of health and fitness, the term stiffness often has a bad connotation. In reality, being stiff can have positive benefits.   When something is stiff, it is difficult to change. When the range of motion of a joint is limited, it is also described as stiff. There is an optimal range of motion…

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Shock – Injury – Cadence – Quiet

How hard a walker or runner impacts the ground can be described with several biomechanical terms, including vertical impact loading rate, braking impulse force, and shock. Scientists have determined it is not the magnitude of force, but the rate at which the force is transmitted from the ground to the foot and leg that is…

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