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 deviations are considered risk factors and/or causative drivers for musculoskeletal pain syndromes. There is a growing body of research showing a relationship between gait deviations and musculoskeletal pain syndromes injuries: shin pain (here, & here,) ; patella-femoral arthralgia (here); IT band syndrome; Achilles pain; plantar heel pain (here, & here). There is growing consensus…

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High body mass index (BMI) is significant factor in low back pain, osteoarthritis; hip osteoarthritis; knee osteoarthritis, plantar heel pain. Weight loss intervention for pain reduction Decreasing body weight is an effective intervention to decrease musculoskeletal pain. Research by Stephen Messier at Wake Forest U, looking at individuals with painful osteoarthritis of the knee who…

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Anyone who has had tendon pain will tell you it is a frustrating problem to resolve.  Common repetitive use tendon problems include: plantar heel pain; Achilles; patellar (knee) tendon; hamstring tendon; gluteal (buttock pain) tendon; rotator cuff (shoulder) syndrome; and tennis elbow. Tendon problems take a long time to heal. Understanding the continuum of tendon…

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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 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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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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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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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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The term shin splints refer to a painful condition that develops in the lower leg, usually along the tibia bone, in response to exercise or activity. Shin splints are a common problem for novice runners, dancers, field hockey, basketball, baseball and tennis players, and even walkers. Shin splints can be classified into different problems including: tendonitis,…

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