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West Point, NY. September 2015.

Sports medicine specialists from around the world convened at West Point Military Academy to discuss best practices and what is new in the field of sports medicine.

While some things stayed the same, such as attempting to help our athletes recover without surgery, other things changed substantially when compared to our previous approach to athletic injuries.

A significant example of one such recent change is that we will no longer suggest that pronation is a primary cause of athletic injuries. Rather, pronation is a normal physiological movement that varies from athlete to athlete and should not be treated as a dysfunctional movement. Further, the idea that athletic shoes favorably alter pronation, and thus reduce injury, has been abandoned. This is a huge paradigm shift in the world of sports medicine, and fortunately this shift is supported by the available medical literature that was reviewed.

Another powerful step forward (this pun is intended) is the realization that teaching an athlete how to run better can alter their body mechanics in such a way as to reduce certain types of injuries. Heel striking as the favored method of running has been replaced with the need to get the athlete’s foot under their body, by teaching and focusing on a midfoot strike. Again, thankfully, the medical literature supports this as an injury reducer.

Dr. Mark Cucuzzella gave a great talk on how we all need to play, and that movement is medicine for all of us, for our entire lives.  Unfortunately, he had to condense what he ordinarily teaches in a 2-day course into a 30-minute talk. Nevertheless, his wisdom was appreciated.

Golden Harper, designer of Altra footwear, was present and tirelessly taught many sports medicine doctors the merits of natural foot positioning, and the importance of allowing the athlete’s feet to function as nature intended with the least amount of interference coming from the footwear.

Jonathon Beverly, editor of Running Times and Runner’s World magazines, was there to capture it all.

Many relationships were formed, and a renewed passion for helping our athletes was deeply palpable.

Perhaps the highlight, of many high points for me personally, was the invitation to speak to the group next year regarding the natural foot health program we offer at NWFA/Correct Toes. Could it get any better? Yes! Next year’s meeting will be held in Portland, Oregon, and I have been asked to help organize and lead the meeting.

If you are a sport medicine provider, we hope to see you in Portland next year.

Until then, have fun, be well, and don’t forget to play each day, no matter your age!

– Dr. Ray McClanahan, DPM
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In Top Photo: Dr. Ana, Dr. Ray McClanahan, Dr. Mark Cucuzzella

In Bottom Photo: Golden Harper (Altra Running Shoes), Dr. Ray McClanahan, Dr. Mark Cucuzzella

Damian Stoy- Correct Toes Sponsored Runner

Correct Toes has recently started sponsoring Damian Stoy, an ultramarathon runner.  We wanted to congratulate both Damian and his girlfriend, Lindsey, on a great run at the Spokane River Run a few weeks- see what they had to say about the race and Correct Toes below!

spokane

The Spokane River Run race went well.  I finished in 5th place in the 50k, 10 minutes faster than my two previous times.  My girlfriend Lindsey Hintz won the 25k and almost beat all the men.  She rocked it!

Lindsey says, “My feet feel much stronger and aligned because of Correct Toes. They are definitely helping my running performance.

For me, my feet don’t ever get sore even after ultramarathon races because I use Correct Toes.  My feet are stronger and more flexible.  We both love them!

 

Meet Running Wild

Running Wild
Running Wild
is a fantastic shoe store in Pensacola, FL that carries Correct Toes. We recently reached out to our friends at Running Wild to see how their customers are responding to Correct Toes. What follows is our Q&A with Running Wild:

CT: What are some of the most common foot complaints you hear from customers?

RW: Plantar Fasciitis is definitely #1. But most often customers just complain of heel and/or arch pain rather than identifying their condition as PF. Others tend to be: pain in their big toe area from a bunion or burning/pain in one of several of their metatarsals.

CT: What are customers’ reactions to Correct Toes once they see a visual demonstration of how it works?

RW: We have yet to have someone not buy them once we put them on a customers feet. It’s amazing when they try on the Correct Toes they say: “Wow I’ve never had anything on feet feel this good.”

CT: What are some of the most common questions you receive about Correct Toes from your customers?

RW: Usually before a customer tries them on, they ask about comfort, but as soon as they try them on they ask if they can buy them.

CT: What are the advantages of offering a product to your customers that addresses so many foot and toe ailments?

RW: Well the advantage is that the Correct Toes are seemingly so simple and non-invasive. The response that we’ve had is overwhelming. We started carrying them just a few weeks ago and we’re ready to place our third re-order.

CT: Can you share with us your personal experience with Correct Toes and how this device has helped you or people you know?

RW: As soon as we received our first order I snagged a pair and have not taken them off. OK, maybe a few times. They have definitely made my feet feel more stable and running more comfortable. I wanted a pair for my 11 year old daughter because she has a slight bunion on one foot, but we sold out of her size the second day after we received our order. I finally got her size in and once I put the Correct Toes on her feet, she had instant relief. She’d previously complained of her toes cramping and arch pain, but not any longer.

Thanks, Running Wild, for sharing your experience and for helping Pensacola’s runners to… run wild!

Dr. Sanatan Golden’s New Practice

Dr Sanatan GoldenAfter three great years practicing physical therapy at Therapeutic Associates-Downtown Portland, Dr. Golden has decided to become an independent practitioner. An expert and instructor in the field of functional natural foot health, his innovative practice is now in the heart of Downtown Portland, at: Optimal Results Physical Therapy.

Sanatan (as most of his patients call him) is very excited about his new venture, which will allow him to not only give more time and attention to each of his patients, but also spend more time with his young family. Over a long working relationship with Dr. Ray McClanahan, Sanatan has developed many complementary treatments to help accelerate the process of healing lower extremity injuries, including:

  • Total body evaluation and assessment to find root-causes of pain and treatment.
  • Building you a personalized, and laser-targeted, home exercise program to address your specific needs
  • Targeted manual therapy:  A hands-on method of restoring proper motion and function.
  • The Astym System: A manual treatment the stimulates the body’s own healing response.
  • Real-time running technique video analysis and specific training drills to immediately improve technique.
  • RESTORE: The natural foot function restoration program.
  • Full access to the only AlterG Antigravity Treadmill in Portland, outside of OHSU. Click the link to see an amazing short video of one of the most revolutionary pieces of rehab equipment around. From the Olympic track stars, the Portland Timbers, to weekend warrior trying to run their first half-marathon, to a patient the day after a hip replacement, the AlterG can help folks get back on their feet sooner, and go for longer, than ever before.

Special Offer For Correct Toes Newsletter Recipients: As a token of appreciation for his ongoing partnership with Dr. McClanahan and Northwest Foot & Ankle, Dr. Golden would like to extend the offer for a complimentary injury examination and consultation or AlterG trial for all those looking accelerate their healing process. Between now and December 1st, contact Optimal Results and mention the Correct Toes Newsletter to get your complimentary appointment.

Optimal Results Physical Therapy
Portland, Oregon
Phone: 503-294-7463
Fax: 503-294-7405
Email: sanatan@optimalresultspt.com

If you would like to see Dr. Golden’s Specialties and Professional Profile, click here.
If you would like to read more about Dr. Golden’s practice and relationship with Dr. McClanahan, click here to read Natural Feet Unite!

Transitioning From Conventional to Minimalist Shoes

It's important to transition to minimalist shoes slowly, over time.Many people are aware that a transition period is required when switching from conventional, PECH-style (Pronation control Elevated Cushioned Heel) shoes to minimalist shoes. In fact, this is one of the most common topics we hear about from patients and customers. Most people want to know the proper protocol for transitioning to foot-healthy footwear—shoes, boots, or sandals that are widest at the ends of the toes, have flexible soles, and possess no heel elevation or toe spring. Though every individual is different and has unique factors or circumstances to consider, we’ve come up with eight general suggestions to heed that are important for everyone making this transition. And here they are:

1. Take a Slow, Progressive Approach

It’s perfectly normal to be excited about this new approach to foot health and function. After all, countless people have already benefited from true minimalist shoes and natural foot health approaches. But it is possible to be overzealous in the adoption of this new footwear, and failing to transition slowly from conventional-style shoes to minimalist shoes might lead to problems.

Consider wearing your new minimalist shoes for a very short period at first, such as 30 minutes per day, and then gradually increasing wear time by 30 minutes per day as your feet and body adapt to the changes. If you’re a runner, consider wearing your conventional shoes for the first part of your run, then switching to your minimalist shoes toward the end. As your feet and toes get stronger, you can begin wearing your minimalist shoes for longer periods during your run, eventually phasing out entirely your conventional running shoes.

2. Proceed in a Stepwise Fashion

Many people benefit from a stepwise approach to minimalist shoes that involves a gradual transition from a built-up conventional shoe to a transitional type of shoe to a true minimalist shoe. There are two main considerations as it concerns this stepwise approach: the sole of the foot and the Achilles tendon.

The sole of the foot is extremely sensitive (which is great for sensing the ground and making appropriate micro-adjustments during gait). But after a lifetime of wearing thick-soled shoes, the sole of the foot (skin, muscles, nerves) is not properly adapted to the ground, and being barefoot or using thin-soled shoes can be uncomfortable. The best way to build up your foot’s sole is to start with thicker-soled footwear, such as Altras and Lunas, and then move to thinner-soled options over time. Note that your thicker-soled footwear selection should still possess all the other foot-healthy characteristics that we recommend, specifically, a flat platform (no heel elevation, no toe spring, no arch-propping inserts), a wide toe box (widest at the ends of the toes), flexibility, and light weight.

Having worn conventional shoes with heel elevation for years (decades, in many cases), the Achilles tendon often becomes contracted, or shortened (sometimes up to three-quarters of an inch!). A shortened Achilles tendon will return to its normal length after conventional footwear is abandoned, but this process takes time. Heat, ice, physical therapy modalities, and warming or cooling gels can help with this transition and rehabilitation. Shifting from a shoe with heel elevation to a “zero drop” shoe can place a tremendous amount of strain on your Achilles tendon, and overdoing it, especially at first, can cause damage and pain in this structure. Again, a slow, stepwise shift to transitional footwear (e.g., Altra shoes, Luna sandals, etc.) can make the leap to ultra-minimalist shoes (e.g., Lems Primal 2 shoes, Vibram FiveFingers shoes, Xero Shoes, etc.) a much lower risk.

3. Allow Time for Adjustments to Occur

The changes and deformities that happen in feet and toes exposed to conventional footwear take many years to occur. It’s no surprise, then, that positive, healthy changes and true foot and toe rehabilitation will also take some time to occur. Some people who transition to minimalist shoes do not allow enough time for the soles and muscles (in the feet and the rest of the lower body) to strengthen. Transitioning to minimalist shoes will, in most cases, work your foot and lower body in a very new and unique way, leading to initial soreness and fatigue in many before the longer-term strength gains and other favorable adaptations occur. Be patient, monitor your body’s response to this transition, and take it slowly! Changes are afoot.

4. Address Gait Changes

It’s extremely common for gait changes to occur when switching from conventional shoes to minimalist models. Most people who wear conventional shoes are heel-strikers (thick, elevated heels make it almost impossible to be anything else). People who wear minimalist shoes, on the other hand, often first contact the ground with the mid-foot or forefoot—a very different gait pattern that has wide-ranging effects throughout the body. This change in gait pattern tends to happen naturally upon moving to footwear with a completely flat (and thin) support platform. But sometimes there is a lag in gait changes that occurs during this transition, such that some individuals still continue to heel strike even after shifting to minimalist footwear.

Heel striking in minimalist shoes may cause some heel discomfort, as there is no longer the same level of cushioning in place to absorb the shock. Using heel cups (please see the next section for further details about heel cups) can be helpful in reducing or preventing this discomfort. Another helpful approach is to pay a lot of attention to how your feet and body feel during the transition phase. Consider paying extra attention to your feet during this time, and walk in a way that feels right to you (avoid “pushing through the pain” or limping in order to avoid pain). Forcing a forefoot strike is not ideal either. Basically, just feel and listen to your body and avoid distractions (chatting with friends, listening to music, etc.) while you’re walking or running during this transition period.

5. Use Met Pads and Heel Cups, if Necessary

Metatarsal pads are a fairly unobtrusive way to restore muscle or tendon balance in your feet and restore the position of your forefoot fat pad to a place that supports your metatarsal heads in the ball of your foot (a common pain point in many people with foot problems). Metatarsal pads, if placed properly, can also help spread your transverse foot arch, which helps take pressure off the structures that run through the ball of your foot, such as nerves and blood vessels.

Heel cups are another helpful (and unobtrusive) natural foot product that alleviates point tenderness in the heel that may develop in minimalist shoe adopters. This point tenderness can happen early in the transition phase or later on, after you’ve been wearing minimalist shoes for a period of time. Point tenderness in the heel is relatively rare in minimalist shoe adopters, but it can be uncomfortable and, in some cases, lead to abandonment of natural foot health approaches. A simple heel cup is often enough to address this discomfort and keep a person in footwear that lets his or her foot function the way nature intended. Setbacks may happen from time to time, but in most cases, there is a simple solution or tweak possible that can help you stay on the path to natural foot health.

6. Use Correct Toes Toe Spacers

Using Correct Toes is one of the most powerful ways to support the transition from conventional footwear to minimalist shoes. Correct Toes naturally curbs overpronation and enables proper weight distribution. This extremely helpful product also encourages a natural strengthening of the muscles and tendons that act on your feet and toes. Correct Toes toe spacers work well in minimalist shoes with anatomically appropriate toe boxes (i.e., toe boxes that are widest at the ends of the toes, not the ball of the foot as in conventional—and many minimalist—shoes).

7. Add Barefoot Time to Your Regimen

Adding some barefoot time to your foot health and minimalist shoe transition regimen can be extremely helpful in ensuring a smooth (and injury-free) shift. Spending at least some time barefoot, even if only around the house, can help condition the soles of your feet and strengthen your foot and toe muscles, accelerating the foot adaptations that occur with minimalist shoe wearing in a safe and constructive manner. If appropriate, you may also consider walking outdoors in your bare feet, weather permitting, starting with as little as one block.

8. Perform Key Home Care Exercises

Performing certain exercises at home (or work) can help with your transition from conventional to minimalist shoes. The most helpful exercises you can perform include the Toe Extensor Stretch, the Bunion Stretch, and the Ball Rolling Exercise. These exercises, when performed in series, help relax tight muscles and tendons and build foot strength. For the best possible outcome, perform these exercises at least several times each day.

Conclusion

Using true minimalist shoes—shoes that are widest at the ends of the toes, have a flexible sole, and possess a completely flat support platform—offers the possibility of profound and enduring foot health benefits. Like most aspects of health, it’s always best to exercise caution and restraint in transitioning to a new and natural approach. Your feet and body are amazingly adaptable and will indeed strengthen if treated appropriately. But this remarkable adaptation process only works well with time, patience, diligence, and a progressive approach. It is an investment well worth making, as it will pay foot health dividends for an entire lifetime. If you have any questions about any aspect of transitioning from conventional shoes to minimalist footwear, please consider meeting with your natural healthcare provider. And now: onward, to excellent foot health!

About the Authors:

Dr. Robyn Hughes is a naturopathic physician; the Director of Medical Education for Correct Toes; a foot health educator in Asheville, North Carolina; and the co-founder of NaturalFootgear.com. She is an avid cyclist, trail runner, and yoga student.

Dr. Ray McClanahan is a sports podiatrist; the founder and physician of Northwest Foot & Ankle in Portland, Oregon; and inventor of Correct Toes. He’s a former elite cross-country racer and regular participant in various running events throughout the Pacific Northwest.

It’s National Yoga Month!

Correct Toes and NWFA would like to acknowledge the contribution of yoga teachers to our society. We’d also like to acknowledge yoga students, who have been quick to embrace Correct Toes and natural foot health principles.

Correct Toes’ own Liesa Steiner is our in-house Certified Yoga Instructor, and we’d like to thank Liesa for her dedication to yoga as both a health tool and way of life (and for sharing her expertise with us!).

Correct Toes use is very complementary to a yoga practice. We encourage any yoga practitioner reading this newsletter to submit a testimonial or story about Correct Toes and how it has helped your practice. Post your comments below!

Meet Jay Dicharry, PT.

Jay works as a physical therapist at Rebound PT in Bend, Oregon. He is a well-known author who has penned the books Anatomy for Runners (2012) and Run Like an Athlete (2013). We recently asked Jay a few questions. Here are his responses:

Please tell us a bit about yourself and your physical therapy practice.
I’m a physical therapist, researcher, author, and coach. I guess I come at injury prevention, treatment, and performance training at a bit different perspective than a lot of others. My years of working in the UVA Motion Analysis Lab, and my current REP Biomechanics Lab @ Rebound Physical Therapy in Bend, have really taught me to stop looking at symptoms, and starting identifying and fixing problems. Sometimes these problems require improving mobility, sometime they require improving stability, and sometimes they require improving strength and power. And it’s quite typical that the lines are blurred between “patients” and “optimizing athletes.” If you really understand the biomechanics of the sports they play, and keep your focus revolving on the end goal – which is always helping athletes achieve their goals in sport – you harness their motivation and combine it with cutting edge intervention to produce the best results.

How were you introduced to Correct Toes?
From Dr. Ray himself – he presented them at a conference I was a part of years ago. I was intrigued…..

How do you use Correct Toes in your practice?
In my experience, Correct Toes serve 2 critical roles. When they are worn, they improve the alignment of the toes and directly improve the individual’s dynamic stability. This produces a better training environment to work on closed chain stability and better dynamic stability in gait. But the great thing about Correct Toes is that they also produce benefits when you aren’t wearing them. Since they “cue” your foot to work better when wearing them, and you take thousands of steps daily, they help you “learn,” or even “train” your foot to work better over time.

What results have you seen in your clients using Correct Toes? Which types of people have benefited the most?
Improved recruitment of the muscles in the foot, improved foot strength, and improved passive mobilization of the plantar fascia. In short – a mobile and strong foot just works better.

What feedback have you received from your clients about the natural foot health approach?
Most patients say the same thing when they put [Correct Toes] on and stand on one leg – “wow – I feel 2x’s as stable”  – better alignment improves foot control.

An increasing number of healthcare professionals, fitness educators, and coaches/trainers throughout the world are incorporating Correct Toes into their practices. Do you see a role for Correct Toes and and its associated natural foot health principles in running, athletics, coaching, and physical therapy?
Yes – you train your heart and lungs, you train your strength in the weight room……why do so many folks forget about their feet? It’s your foundation! Train your feet! If people paid more attention to building a better athlete from the ground up, they’d spend a whole lot more time doing what they love.

Please feel free to share a client or personal testimonial, or a client’s story about recovery from a foot problem.
To be 100% honest – I lost count. I use [Correct Toes] a ton – from folks just out of a period of immobilization for an acute injury to tweaking that last bit of performance. They are a very unique product.

Thank you, Jay, for sharing your experience, and for helping keep Central Oregon’s athletes pain-free and strong!