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Chondromalacia Patella / Cracking Knees or Runners Knee, Treatment and Prevention Tips from The Barefoot Running Doctor

Chondromalacia Patella ICD-9 733.92 Chondromalacia Patella / Cracking Knees or Runners Knee, Knee Cap Pain! Treatment and Prevention Tips from The Barefoot Running Doctor Tips For Better Health Ask the doctor, Dr James Stoxen DC Do you experience knee pain when running? Do you have knee pain when bending? Does your knees crack when going up the […]

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Chondromalacia Patella ICD-9 733.92

Chondromalacia Patella / Cracking Knees or Runners Knee, Knee Cap Pain! Treatment and Prevention Tips from The Barefoot Running Doctor

Tips For Better Health

Ask the doctor, Dr James Stoxen DC

Do you experience knee pain when running?

Do you have knee pain when bending?

Does your knees crack when going up the stairs?

You may have what athletes call Runners Knee, what non-athletes call Cracking Knees and what doctors call, Chondromalacia Patella.

I have found the usual cause of this infra patellar pain is an abnormal foot plant.

To view the original post, click here

Question:

I haven’t run in weeks and i decided to go out for a jog. Ended up doing 5k and giving up before my knee gave out.
Should I be running that much? Maybe i should be doing 1k a day and start building up?
What do you think is the best way to recover from this? And to eventually raise mileage to marathon training. (in long future of course)

Dr. Stoxen’s Answer:

patella pulley example

I’m assuming you are talking about pain under, below or around the knee cap. This can be called chondromalacia patella or cracking knee. You may hear it crack or click more often when you go up the stairs.

As you know, the patella is a pulley mechanism (see picture to the right). The trochlear groove is the concave surface where the patella (kneecap) makes contact with the femur (thighbone). Also called the ‘trochlea’.The foot adjusts for the impacts of running with two main spring mechanisms:

1. The Arch Leaf Spring – There have been studies on the arch with all muscles removed leaving just the bones and ligaments. These were extracted from               cadavers. What the study showed was that the arch complex itself has the ability to spring back forces without the aid of the muscles.

“If any of these 33 joints are locked then the foot cannot absorb the impact force smoothly. The foot will either roll into over supination or over pronation to compensate to roll around these locked joints.”,  Dr. James Stoxen DC

2. The Spring Suspension System Muscles – I coined these muscles as the spring suspension system muscles, the landing muscles or the pronation-supination cuff muscles. When this happens the impact is received as a “negative” by the tendons of the landing muscles.

“If any of these muscles and tendons are too weak to handle the impact force, the foot can roll into over supination or over pronation.”, Dr. James Stoxen DC

In my model the body moves as a lever and a spring

The foot rolls from supination to pronation. Have you ever heard of over pronation? That is when the foot rolls too far inward. When this happens, the limb internally rotates on impact. For more information read this article:  What Is Foot Pronation And Foot Supination? Is It Good Or Bad?

Safe and Unsafe Range

That does not put the patella in a good position to allow for stress and strain free motion.

Therefore, if the foot rolls outside the safe range (green-black-green) then the limb rolls in or outside the safe range this causes the knee to be in a position where the knee cap will grind against the pulley mechanism gro0ve (trochlear gro0ve) This can cause irritation to the cartilage, inflammation and pain.

Over Pronated Foot

Not only that but this misalignment of the limb can cause spasms of the muscles from toe to head. The reason is because the body senses the abnormal movement of the limb and reacts with a spasm called a “tonic protective spasm”.

This can lead to various changes in the knee and other joints that make runners uncomfortable and unhappy…..

  1. When muscles spasm on many sides of a joint it cause inhibition of others opposite them called reflexive inhibition. That is a fancy term for shutting down muscles. Sometimes we feel our leg go out from under us in a split second.
  2. Since the abnormal movement pattern starts at the foot and goes to the head it can compress every joint from foot to head. This can cause abnormal internal compressive forces on not only the knee but the arch, ankle, knee, hip and spinal discs.

Internal External Forces Conditions

What we do is a gait evaluation to check how your foot is landing and how it interacts with earth

How does it land…

  1. Does it land with the second toe towards the target, pointing inward or pointing outward?
  2. Does the foot bang when it lands and twist when its lifting off or does it spring down and up?

The intricacies or nuances of how your foot lands during walking or running can be difficult to see when you are moving so quickly. Also, if you have never studied walking or running forms and technique it’s difficult to pick up the details. I still urge you to study your walk and running form and technique so you can get a better feel for how your body is interacting or impacting the earth and how to improve it.

The reason is because your body will impact with the earth 270,000,000 or so times in a lifetime.

  • what shoes you wear outside running training – a poorly constructed shoe can be used for 6 months adding up to 1,850,000 abnormal movements burning the pattern into your brain for a poor landing in running.
  • a stressful time in your life – stress causes people to tense up the entire body leading to more of a bang and twist running impact rather than a spring and roll running impact

How to do your own gait evaluation:

  1. Get a $140 HD flip video camera.
  2. Video yourself walking barefoot 10 steps toward the camera and back. Do this while walking, fast walking, and running.
  3. Download it
  4. Watch the video frame by frame to see how the foot lands and you will see why the patella is not in the groove. It is obvious and enlightening.

Here is a blog post you may like that talks about “foot lock”, which is when joints of the foot are locked causing abnormal movement patterns (compensations) which effect patella position and a lot more! click here to view

Next, I developed a 3 step self-help approach to helping align the foot on impact and improve the spring loading capacity of the limb. The three steps to my human spring approach are:

  1. Release the stiffness or locking of the joints of the spring mechanism so the muscles can pull through full range of motion to maximize development.
  2. Strengthen the pronation supination cuff, landing muscles AKA spring suspension muscles with lever resistance exercises.
  3. Strengthen the pronation supination cuff, landing muscles AKA spring suspension muscles with spring impact exercises.

This three step approach will help you expand the force loading capacity of your human spring to better spring off from impacts, to have maximum performance and reduce risk of injury.

In running as you know there is simplistically the “take off” and the “landing”

When you run with braces (shoes), your body has an artificial support and an artificial landing gear that most think will keep the foot centered. You know that the muscles to do that.

This is what is unique and cool about barefoot running training is:

  1. When you are barefoot running you aren’t copping out on strengthening by putting a brace on your foot to try to hold it in the safe range like a motion control shoe or an orthotic like the doctors who can’t get their runners out of their braces recommend. You really have no choice but to strengthen the landing gear so that the muscles will maintain your foot in the safe range.
  2. When you are barefoot running you don’t have the artificial spring (cushioned sole) to absorb the impact like the doctors who recommend more cushion so you really have to have a springy foot. While it might seem like heavily-cushioned shoes would be the answer, they are in fact, likely doing more damage as they dramatically affect the arch spring’s ability to appropriately absorb, store, then release the energy from each step.
  3. When you train in multiple direction movements you can get your foot in many other landing configurations which stimulate more muscle development through adaptation to create a stronger landing gear.

Rather than strapping five-inch ‘pillows’ to your feet, the best solution is to repair the spring mechanism in the arches by following the procedures and exercises in this article.

Most runners strengthen the take off muscles thinking the artificial support and think that their artificial landing gear (shoe cushion) will do the trick. We all know the majority of injuries occur in the landings

The key is to strengthen the muscles that resist the over rolling of the foot outside the “safe range between supination to pronation (rolling from the outside to the inside) during impacts. If the foot rolls to an unsafe position then the knee rolls to an unsafe position.

 

Logical so far?

 

I call these muscles the landing muscles, the spring suspension system muscles or the pronation supination cuff muscles

 

Introducing…  The Pronation Supination Cuff Training

 

The muscles that prevent over pronation and over supination of the foot consist of the tibialis posterior, tibialis anterior, peroneus longus, and peroneus brevis.

 

The strength of these muscles, supination and pronation as well as the spring suspension system are not covered much in bodybuilding, fitness magazines, training routines etc., but of all the muscles, in fact these are THE most important muscles in the body to work.

Why?

  • These muscles suspend your foot as a leaf spring so it can bounce your body off the ground instead of bang your body into the ground.
  • They store FREE elastic energy when your mass impacts the ground when they stretch. This storage of energy is what allows your body to move more efficiently as a spring mechanism rather than an inefficient lever mechanism.
  • These muscles, which I also refer to the pronator supinator cuff muscles, maintain the foot and lower limb in the safe range between supination and pronation

Below are my last two articles you might find helpful to release the tension on the spring and strengthen the landing gear muscles so that your limb will land straight, spring off the ground with the knee cap and other joints in good alignment with little to no abnormal compressive forces as the goal.

How Does The Body Spring Back Safely From Impacts Of Running and Walking?, click here to view

Self-Tests & Exercises To Reduce Over Pronation and Over Supination From Impacts During Walking and Running, click here to view

I recommend you do the Human Spring release exercises, video tutorials #77 – 89 on my before every run and when you take off your shoes at night, see below:

Video Tutorial #78 Dr James Stoxen DC Demonstrates Self-Help, Deep Tissue Treatment Of The Knee Popliteus Muscle

Video Tutorial #79 Dr James Stoxen DC Demonstrates Self-Help, Deep Tissue Treatment Of The Gluteus Medius Muscle of the Hip

Video Tutorial #80 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Subtalar Joint Of The Ankle On The Inside

Video Tutorial #81 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Ankle (Subtalar Joint Outside) 

Video Tutorial #82 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Treatment Under The Big Toe And Second Toe

Video Tutorial #83 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Treatment Above The Big Toe And Second Toe 

Video Tutorial #84 Dr James Stoxen DC Demonstrates Scissor Stretching Of The Feet

Video Tutorial #85 Dr James Stoxen DC Demonstrates Stretching Great For Mortons Neuromas And Narrow Heels

Video Tutorial #86 Dr James Stoxen DC Recommends The Best Shoes To Prevent The Foot From Deforming

Video Tutorial #87 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Of The Ankle Mortise

Video Tutorial #88 Dr James Stoxen DC Demonstrates Stretching Of The Foot While Sitting At Your Chair

Video Tutorial #89 Dr James Stoxen DC Demonstrates A Stretch To Increase The Flexibility Of The Arch Of Your Foot

The key training I do to strengthen my landing gear is run the entire training session in zig zag patterns

Watch this video below to see two time Taekwondo National Champion Christian Medina and Dr. Stoxen run barefoot in zig zag patterns.

I also suggest you read Anthony Field’s book, How I My Wiggle Back.  He is an entertainer who followed my approach and it helped him change his life. The book has over 200 tips for you in the 100 pages of content that are on the Human Spring Approach.

Be sure to check out The Barfoot Runners Society to learn more about barefoot running and find a chapter near you., click here


 

Disclaimer

All content on teamdoctorsblog.com, including without limitation text, graphics, images, advertisements, videos, and links (“Content”) are for informational purposes only. The Content is not intended to be a substitute for professional medical treatment, advice, or diagnosis. Please remember to always seek the advice of a qualified physician or health professional with any questions you may have regarding any medical concerns. Dr James Stoxen DC and Team Doctors does not recommend or endorse any specific treatments, physicians, products, opinions, research, tests, or other information it mentions. Said Content is also not intended to be a substitute for professional legal or financial advice. Reliance on any information provided by Team Doctors is solely at your own risk.

 

  • Fever: When you have a fever, your body is trying to isolate and expel an invader of some kind. Massage increases overall circulation and could therefore work against your body’s natural defenses.
  • Inflammation: Massage can further irritate an area of inflammation, so you should not administer it. Inflamed conditions include anything that ends in itis, such as phlebitis (inflammation of a vein), dermatitis (inflammation of the skin), arthritis(inflammation of the joints), and so on. In the case of localized problems, you can still massage around them, however, avoiding the inflammation itself.
  • High blood pressure: High blood pressure means excessive pressure against blood vessel walls. Massage affects the blood vessels, and so people with high blood pressure or a heart condition should receive light, sedating massages, if at all.
  • Infectious diseases: Massage is not a good idea for someone coming down with the flu or diphtheria, for example, and to make matters worse, you expose yourself to the virus as well.
  • Hernia: Hernias are protrusions of part of an organ (such as the intestines) through a muscular wall. It’s not a good idea to try to push these organs back inside. Surgery works better.
  • Osteoporosis: Elderly people with a severe stoop to the shoulders often have this condition, in which bones become porous, brittle, and fragile. Massage may be too intense for this condition.
  • Varicose veins: Massage directly over varicose veins can worsen the problem. However, if you apply a very light massage next to the problem, always in a direction toward the heart, it can be very beneficial.
  • Broken bones: Stay away from an area of mending bones. A little light massage to the surrounding areas, though, can improve circulation and be quite helpful.
  • Skin problems: You should avoid anything that looks like it shouldn’t be there, such as rashes, wounds, bruises, burns, boils, and blisters, for example. Usually these problems are local, so you can still massage in other areas.
  • Cancer: Cancer can spread through the lymphatic system, and because massage increases lymphatic circulation, it may potentially spread the disease as well. Simple, caring touch is fine, but massage strokes that stimulate circulation are not.Always check with a doctor first.
  • Other conditions and diseases: Diabetes, asthma, and other serious conditions each has its own precautions, seek a doctor’s opinion before administering massage.
  • Pregnancy: No deep tissue work. Be aware: danger of triggering a miscarriage by strong myofascial work is greatest during the first 3 months (especially through work around the pelvis, abdomen, adductors, medial legs, or feet)

Dr. James Stoxen’s Radio Interview On Mornings With Nick Rheinberger ABC 97.3 Illawarra

  Dr. James Stoxen’s Radio Interview On Mornings With Nick Rheinberger ABC 97.3 Illawarra 8/15/2012 Rheinberger mentions an interview last year with the blue Wiggle Anthony Field about his physical problems which was eventually diagnosed by Dr. James Stoxen from Chicago as a broken spring. Rheinberger is joined by Dr. Stoxen who is also known […]

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Dr. James Stoxen’s Radio Interview
On Mornings With Nick Rheinberger
ABC 97.3 Illawarra
8/15/2012

Rheinberger mentions an interview last year with the blue Wiggle Anthony Field about his physical problems which was eventually diagnosed by Dr. James Stoxen from Chicago as a broken spring. Rheinberger is joined by Dr. Stoxen who is also known as ‘The Barefoot Doctor’ given one of his treatments advocating barefoot walking. Dr. Stoxen talks about what can be determined by looking at how people walk and contact the ground. Dr. Stoxen talks about the trend of padding in running shoes and why this isn’t necessarily a good thing.

 

Listen To Dr. James Stoxen DC Interview with Bernadette Young ABC Gold Coast Radio 91.7 Sydney Australia

  Dr. James Stoxen DC Radio Interview with Bernadette Young ABC Gold Coast Radio 91.7 Sydney, Australia Friday August 17, 2012     To hear the interview click the arrow above Young plays an interview where she is talking to Dr. James Stoxen DC who thinks people should do more exercise bare foot. Stoxen says […]

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Dr. James Stoxen DC Radio Interview
with Bernadette Young
ABC Gold Coast Radio 91.7
Sydney, Australia
Friday August 17, 2012

 

 

To hear the interview click the arrow above

Young plays an interview where she is talking to Dr. James Stoxen DC who thinks people should do more exercise bare foot. Stoxen says people have called him the anti-shoe doctor. Stoxen says that people should not exercise with binding devices on your body. Stoxen says that instead of controlling the movement of the foot we should try and restore it to the way it was before so we can live a  normal life. Stoxen talks about Anthony Field from The Wiggles who he helped. Stoxen says that he saw of Field’s Facebook that he was playing basketball bare foot. Stoxen says that some people are afraid of running bare foot but you have to get over the fear.

Listen to other radio interviews Dr. Stoxen has been on below:

Listen To Dr. Stoxen’s Interview On Afternoons With Richard Stubbs 774 ABC Radio Melbourne, Australia

Listen To Dr. Stoxen’s Interview On Luke Grant Afternoons show 873 AM 2GB Radio, Sydney, Australia

Video Tutorial #205 Barefoot-Arch Stretches in Malaysia

Dr. James Stoxen DC of Chicago IL and Dr. Amir Majidi Dc of Ontario Canada  April 29, 2012 at a park Kuala Lumpur, Malaysia Disclaimer

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Dr. James Stoxen DC of Chicago IL and Dr. Amir Majidi Dc of Ontario Canada 
April 29, 2012 at a park
Kuala Lumpur, Malaysia

Barefoot-Arch Stretch

Disclaimer

Video Tutorial #203 The Foot Supination To Pronation Roll-Press Exercise

Dr. James Stoxen DC of Chicago IL and Dr. John Petrozzi Dc of Leichhardt NSW Australia April 29, 2012 at a park Kuala Lumpur, Malaysia The Foot Supination to Pronation Roll-Press Exercise is A great exercise for those who stand a lot. It can also help with the prevention of  foot injuries, foot cramps, ball […]

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Dr. James Stoxen DC of Chicago IL and Dr. John Petrozzi Dc of Leichhardt NSW Australia
April 29, 2012 at a park
Kuala Lumpur, Malaysia

The Foot Supination to Pronation Roll-Press Exercise is A great exercise for those who stand a lot. It can also help with the prevention of  foot injuries, foot cramps, ball of toe pain, plantar fasciitis and  foot arch pain as well.  Doing this exercise might also help with preventing a sprained foot, twisted ankle and/or a broken ankle.

This ankle exercise is similar to the foot exercise you do for the recovery and rehabilitation of a sprained ankle.  Therefore it will help speed up ankle sprain recovery as well as prevention.

Weather you have ankle pain from running, foot pain from standing or  recovering from an ankle sprain, this foot and ankle exercise in this post will increase the health of your foot.

If you are like me and forced to stand a lot at work then I recommend you do this foot and ankle supination to pronation roll press exercise for many reasons:

  • It will help keep the 33 joints of your feet moving
  • It will help strengthen your pronation-supination cuff, AKA landing muscles or spring suspension system muscles.
  • It will help stimulate circulation in the calf area which will stimulate circulation in the entire body

To Strengthen your unlocked spring mechanism we are going to initially focus on creating resistance through using your body weight to generate relatively low levels of force.

One exercise I use to be able to accomplish this is called the Foot and Ankle Roll.

movement training

This drill concentrates on moving the foot in multiple directions. (see above)

It also helps to keep your muscles contracting and not stagnating into fatigue.

The long tendons of the spring suspension system medial and lateral

The Foot and Ankle roll as well as the other strengthening exercises (listed on the bottom of this post) do a really great job in developing elastic tendon strength in movements outside of the normal straight ahead running movements. What this will do for you is develop more elastic capacity in the tendons or the elastic structures because in reality running relies on elastic recoil or spring mechanisms and less on muscular contractions.

Foot and Ankle Roll

The most efficient energy comes from the tendon stretch and elastic, spring-like structures. However the muscles must be strong to provide a base of support for the tendon springs.

Spring Suspension System Muscles

When the muscles that suspend the spring suspension system of the foot are no longer able to support the spring, then the spring suspension system drops or collapses, stiffens or locks.

When the spring locks

  • your ambulation is not as efficient due to a reduction of free spring energy
  • your spring mechanism can no longer protect you as well from the impacts
  • your spring mechanism cannot conform as closely to the terrain changes

Where we have breakdowns in the spring suspension system is with the weakness of the mechanism.

This weakness happens many ways:

  • Atrophy or weakness from inactivity
  • Overload of the mechanism (overweight or obese)
  • Injury
  • Surgery
  • Binding of the mechanism (shoes that bind the joints)
  • Alterations of natural motion (shoes or footwear that alter natural motion)
  • Sustained Contraction Fatigue

The way you get sustained contraction fatigue is simple.

You are standing in one place too long.

We were meant to keep moving.  That is because we had to find our next meal from the earth.  Also, if we did not keep moving we would be eaten or killed.

In todays society, we get our next meal by walking straight paths down the aisle of a grocery store, from the seat of our car in a drive through or sitting while someone brings it to us in a restaurant.

Our spring suspension system does not get enough rocking side to side motion to maintain the strength of the muscles that suspend the feet from the sides, the spring suspension system.

I realized I was a prime candidate for this kind of fatigue.   I’m on my feet sometimes 12 – 16 hours a day when i’m treating patients.

One day I put my computer on a podium so I could do my medical records between patients without sitting down.  After a week or two my spring suspension system muscles fatigued and my spring suspension system dropped, locked and I developed chronic ankle and foot pain, chronic fatigue and swelling of the ankles.

Because I am a barefoot runner, that evening after work, I would be taking up 6000 + impact forces of 550 – 600 pounds into my bare feet running barefoot on the concrete path by the lake.

If my spring was locked I could get injured.

This was a valuable lesson I learned from that which I am passing on to you.

This is when I invented this important little exercise.

Directions:

  1. Stand with your feet about hip-width apart
  2. make sure your toes are pointing straght. Your’re going to massage the ground alternately with the outside edge of the feet.
  3. Use your body weight to bear down on one side. Working your ankle muscles.
  4. make sure you are not rolling your knees are your hips.
  5. Shift your weight toward your left so that your right foot rolls toward the arch and your left foot shifts toward the outer part of the left foot. Then shift your weight in a smooth manner toward your heels, and shift toward your right so that your right foot rolls onto the outer right foot and your left foot rolls toward the left arch. Shift your weight toward your toes and continue to roll counterclockwise for 10 rotations.
  6. Then rotate your feet and ankles in the opposite direction. Keep your knees slightly bent as you move.

1.  This exercise gets your  33 joints moving

Your arch and foot is designed with 33 movable joints.  The reason for so many joints is so the impact forces of walking, running, dance or sport can be spread across many joints.  By allowing the forces to spread across many joints it provides for a smoother landing and spring off.

Safe and Unsafe Range

What this exercise does is it gets the feet and ankles moving in the directions of supination and pronation so you can actively mobilize the joints of the feet.

2.  This Exercise Actively Develops your Spring Suspension Muscles as a Lever Mechanism

Your foot is designed as a spring suspension system.  That means the arch mechanism is essentially suspended by special muscles that attach on the back of the calf.

These muscles have a specialized design with shorter muscle bellies and longer stretchy tendons.  The greater the percentage of tendon the more efficient it is.

When you push actively roll from supination to pronation and push against the ground,

This exercise stimulates an increase in the circulation in your lower body.  

Because it works the muscles deep in the calf it will stimulate the circulation to the deep arteries and deep veins of the calf.

Stagnation of blood flow could lead to swollen ankles, varicose veins, clot formation, deep vein thrombosis and obviously a stroke.

You don’t have to put yourself at so much risk.  You can do this exercise while standing and oftentimes no one will even notice.

Anatomy of the foot

I do it all through the day and recommend you try it.

I Have listed additional  Resistance Exercises to Strengthen the Spring Suspension System Below:

Video Tutorial #148 Bosu Ball Foot Training, click here to view 
Video Tutorial #76 Bosu Ball Lateral Step, click here to view
Video Tutorial #177 Side Lunge With Cable, click here to view
Video Tutorial #105 Foot Eversion Exercise, click here to view
Video Tutorial #106 Foot Inversion Exercise, click here to view
Video Tutorial #107 Ankle Exercise Training, click here to view
Video Tutorial # 108 Cable Hip Adduction And Foot Inversion, click here to view
Video Tutorial #109 A Great Hip Adduction Exercise , click here to view
Video Tutorial #109a A Great Hip Abduction Exercise,  click here to view
Video Tutorial #110 Dr. James Stoxen DC loses An abdominal Exercise, click here to view
Video Tutorial #111 Rectus Abdominal Cable Crunch, click here to view
Video Tutorial #112 Abdominal Oblique Exercise , click here to view
Video Tutorial #176  Half Foam Roll Exercises, click here to view

I have listed some impact exercises to Supercharge the Spring Suspension System below:

Video Tutorial #149 Figure 8 Runs, click here to view
Video Tutorial #133 Circle Walk, Jog, Run And Sprint, click here to view
Video Tutorial #90 Obstacle Course, Combining Exercise Drills, click here to view
Video Tutorial #136 Double Leg Cone Jump or hop, click here to view
Video Tutorial #147 Single Leg Hop, click here to view
Video Tutorial #150 8-Point Step, Lunge, Hop or Bound, click here to view
Video Tutorial #152 Ricochet Box Jump, click here to view
Video Tutorial #167 Side Shuffle, click here to view
Video Tutorial #178 High Skip/Vertical And Horizontal, click here to view
Video Tutorial #179, 45 Degree Zig-Zag Hop, Jump Or Run, click here to view
Video Tutorial #151 Lateral Cone Jumps, click here to view

Disclaimer

Video Tutorial #202 When my feet hurt.. I did this pressure point and got relief.

MY FEET HURT! Tips For Better Health Ask the doctor, Dr James Stoxen DC Dr. James Stoxen DC of Chicago IL, USA and Dr. Amir Majidi DC of  Toronto, Ontario, Canada, April 29, 2012 at a park, Kuala Lumpur, Malaysia I remember standing on my feet all day 14 – 16 hours a day for 135 days in a […]

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MY FEET HURT!

Tips For Better Health

Ask the doctor, Dr James Stoxen DC

Dr. James Stoxen DC of Chicago IL, USA and Dr. Amir Majidi DC of  Toronto, Ontario, CanadaApril 29, 2012 at a parkKuala Lumpur, Malaysia

I remember standing on my feet all day 14 – 16 hours a day for 135 days in a row on one of those runs when I was getting calls from so many big name entertainers that I could not say, NO!

But I ended up with sore toes,  pain on the bottom of the foot pain on the side of the foot.  Lets just say my feet were in pain!   I also remember I had pain in the big toe like a turf toe.

I did this deep tissue treatment for my foot so I could get pain relief from aching foot pain.

Are you asking yourself, Do I have to go to a pain center and get pain killers?”  Do I do foot exercises?

Maybe.  Maybe not if you can work out the spasms around the toe.  I don’t know what your condition is but this is what I do for my big toe.

Here is some deep tissue self – help pressure points for the big toe.  Just remember if it does not help you may have to go to a foot specialist.

Today i’m going to demonstrate for you how to release the muscle spasms, from your Big toe. (the inside)

This did help with my foot swelling and severe foot pain.

I cannot promise it will help you.

When you stand walk or run barefoot, most of the weight is spread over the big toe and the second toe.

The force or mass of the impacts rolls over these two areas the most.

The human spring as I call it, is built into the body to absorb the force of the landings.

When the body is not moving correctly or if the body is moving in ways that it was not engineered to move in, then the Human Spring becomes locked.

This can happen in a variety of ways:

  • wearing shoes that do not fit our feet
  • wearing high heel shoes
  • abnormal walking patterns
  • weak feet

Today I am going to show you how to release the muscle spasms from your first toe. (the inside)

deep tissue point to release the big toe underneath

The Deep Tissue point is shown above and in the video as well.

Helpful Excerpt from Anthony Fields book, ‘How I Got My Wiggle Back“,

For this exercise use your thumb to apply slight pressure down to the bone, if possible, in the designated areas; you’ll know when you’ve hit the exact spot-if you have inflamed ligaments or muscles in that area there will be some pain. Don’t worry, you are not causing damage. It hurts because the muscles are stiff and inflamed. Now, gently apply pressure with your thumb or finger and hold it. Don’t panic if it is painful, after about two to three minutes, the discomfort starts to subside. The pain will come and go in waves and a few times and eventually all you feel is pressure. If you don’t hold the point until all the pain goes away, you will feel sore in this area the next day.

Measure the area you are treating using your thumb print—-it’s called a Chinese inch. Move one Chinese inch at a time until you have covered the entire area.

You may feel a rush of blood and energy through the treated area.

Once you have hit all the secret spots, your arch spring may be loose enough to be “unlocked”Anthony Field shares how Dr. James Stoxen DC and Dr. Richard Gringeri Helped him back to health

You can find this self – help release exercise and many more in Anthony Fields book, ‘How I Got My Wiggle Back’, click here to order now!

To learn more about releasing the toe underneath watch:

Video Tutorial #82 Dr. James Stoxen Demonstrates Self-Help Deep Tissue Treatment Under the Big Toe And Second Toe, click here to view

 

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Video Tutorial #201 Can You Pass The Foot Ankle Toe Raise Alignment Test? (Posterior View)

  Dr. James Stoxen DC of Chicago IL, USA and  Dr. Amir Majidi Dc of  Toronto, Ontario, Canada April 29, 2012 at a park Kuala Lumpur, Malaysia   Today I am going to help you evaluate if your Human Spring Suspension System muscles are weak by doing the Foot and Ankle Alignment Test. Dr. Amir […]

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Dr. James Stoxen DC of Chicago IL, USA and 
Dr. Amir Majidi Dc of  Toronto, Ontario, Canada
April 29, 2012 at a park
Kuala Lumpur, Malaysia

The Foot Ankle Alignment Test (back view)

 

Today I am going to help you evaluate if your Human Spring Suspension System muscles are weak by doing the Foot and Ankle Alignment Test.

Dr. Amir Majidi Dc from Toronto, Canada, my research assistant will be demonstrating for you how to execute the test.

This is the sister test to the Foot-Ankle Toe Raise Alignment Test (Front)

Video Tutorial #200 Can You Pass The Foot Ankle Toe Raise Alignment Test? (Front View)

The Foot Ankle Alignment Test (Anterior) and (Posterior) are two of the tests in Anthony Field’s book, How I Got My Wiggle back.  You can get the book from Amazon.com or purchase it at your local bookstore.

Yes, I did these tests on Anthony Field and…  he failed both tests miserably!  

So don’t be discouraged because if you read the book you will find:

Field, the creator and a founding member of the world’s most successful musical groups for young children, The Wiggles, was handicapped by chronic pain, chronic, chronic fatigue, misdiagnosed fibromyalgia and depression during his 20 years on the road.  I am proud to say, I was able to assist him.

It covers our consultation in detail and provides a comprehensive, plain-English explanation of the drug free approach, and the results, that helped him get in the best shape of his life.

Excerpt taken from the book, How I Got My Wiggle Back, page 127, 

The Foot – Ankle Alignment Test (back view), Turn around so your back is facing the mirror. If you can look over your shoulder and see the back of your feet we’ll proceed, otherwise get a friend in here with a camera and get them to take a snapshot of the back view of your legs. Yes, yes I know, it must be a trusted friend.

Draw an imaginary line from the feet, through the heel one, and up to the back of the knees. Again, check to see if it’s straight. 

The above test will give you a good indication whether your arch spring is locked, weak, or stiff. Even if you only have one “issue” it’s quite possible that over time it will start to limit your exercise and daily leisure activities and cause damage to your joints. 

Directions:

  1. Raise up on your tip toes
  2. Try to maintain a proper alignment with your second toe, ankle and shin bone
  3. Try to balance and see how long you can stay in the aligned position
  4. If you cannot maintain straight alignment you failed the test
  5. To see what that means read on….

Dont worry if you failed, because…

  1. I have resistance lever exercises for you to improve to 1x bodyweight strength at the end of this article
  2. I have  impact spring exercises or you to improve to 1.25x bodyweight – 3/4x bodyweight and more impact drills for you to practice at the end of this article

Mild to Moderate Foot/Ankle Misalignment

Pictured above is mild to moderate misalignment of the foot/ankle. This is cause to work on strengthening the spring suspension system muscles.

Moderate to Severe Foot/Ankle Misalignment

Pictured above is moderate to severe foot/ankle alignment which means you should work on strengthening your spring suspension system muscles.

To give you a better idea to compare good alignment vs misalignment I have put the graphic models side by side above. click on the picture to enlarge

If your foot goes out of alignment  and turns out then that means you have a weakness in the spring suspension system muscles.

If one foot can go up in alignment and the other one turns out and cannot go up then you have a weakness on one side.

supportive cuff muscles close- up

The Muscles of the Pronation Supination Cuff

If you look closely at these illustrations of the feet, (If you look closely at these illustrations of the feet, (click here to open a separate page with this diagram to study while you read)) you will see that the pink and purple tendons ( peroneus longus (also known as fibularis longus) is a superficial muscle in the lateral (outside) compartment of the leg.  It acts to counter that abnormal turn out of the leg or evert the leg.

Just look at how the tendon of the peroneus longs (pink tendon) extends under your arch and attaches to your your big toe.   These are the muscles that are not engaging or weak in your suspension system muscle group.

The muscles of the spring suspension system of the foot and ankle consist of the tibialis posterior, tibialis anterior, peroneus longus, and peroneus brevis.

As you can see the peroneus longus coming from the lateral aspect of the foot cross over to add some support to the first ray because this is where the foot usually collapses and locks.

The Peronæus longus also everts the sole of the foot, and from the oblique direction of the tendon across the sole of the foot is an important agent in the maintenance of the arch.

The Tibialis Posterior Muscle

This is the tibialis posterior (blue tendon) that supports the first metatarsal-cuneiform, second and third. You can also see the tibialis posterior (blue tendon) which attaches at the mid-arch  at the first second and third metatarsal cuneiform joints where the spring action happens on impact.

If this joint area is stiff or locked then the tibialis posterior cannot contract maximally against this joint. It’s impossible if the joint is locked.I find this muscle to be the weakest of the cuff.

They even have a syndrome named for it:

Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot deformity in adults. Although this term suggests pathology involving only the posterior tibial tendon, the disorder includes a spectrum of pathologic changes involving associated tendon, ligament, and joint structures of the ankle, hindfoot, and midfoot.

Early recognition and treatment is the key to prevention of the debilitating, long-termconsequences of this disorder. Conservative care is possible in the earliest stages, whereas surgical reconstruction and eventually arthrodeses become necessary in the latter stages. The purpose of this article is to review the symptoms, physical examination, radiological examination, classification, and treatment of posterior tibial tendon dysfunction. / Orthop Sports Phys Ther 2000;30:68- 77. 

The blue tendon represents the tibialis posterior muscle and tendon.  This muscle stabilizes the arch from the medial aspect.

This test can give you a good evaluation of the strength of your spring suspension system up to your bodyweight ONLY!

It is important to have strength in your foundation to protect your body from impacts as well as help with balance, agility and coordination.

The muscles which support the foot and ankle in this position are the achilles as a primary however the tibialis anterior, tibialis posterior, peroneus longus and brevis stabilize the foot with respect to preventing rotation and lateral motion.

The trick is to test them for how long they can maintain this position to measure “static” strength endurance.

Here is the math:

You are testing the muscles acting on a lever system which is actually 50% body weight force you are lifting as 1/2 of the body on each foot.

  • 50% Bodyweight Foot-Ankle Toe Raise Alignment Test (above) – This evaluates the strength of the muscle groups with 50% of the bodyweight on each limb.
  • 100% Bodyweight Foot-Ankle Toe Raise Alignment Test - You can do a variant of this test that measures the strength and static strength endurance by having them stand on one foot in the same test position
  • 50% Bodyweight Bosu Ball Foot-Ankle Toe Raise Alignment Test - is this same test while attempting to balance your body on a Bosu ball. You cannot use any assistive devices to hold yourself on the ball. You can practice by hanging onto something to practice letting go periodically to challenge your muscles. Its not easy! Ultimately you attempt to do the test, with a straight limb and not a lot of motion.
  • 100% Bodyweight Bosu Ball Foot-Ankle Toe Raise Alignment Test - This is the same test as the one above except with one leg. This is an extremely challenging test that most top athletes have difficulty with.

You are testing the muscles acting as on the body as a lever. So, the forces are no more than 1x bodyweight because there is no movement (walking or running) so no impact.

So what does this mean if you cannot pass the test?

If you cannot do a single Foot-Ankle Toe Raise and maintain proper alignment with 50% of your bodyweight on either limb then we know for sure you won’t be able to walk without your foot and ankle misaligning at the impact point and through the loading of your bodyweight into the human spring.

Why do we know that?

Walking is 1.25 x bodyweight impact force per step.

This is one contraction of 50 % of your bodyweight!

So, if you have conditions related to excessive strain on tissues then that is a sign that your spring mechanism could have fatigued, dropped and locked and/or it is too weak to absorb the impacts by springing your bodyweight off the ground and instead the bodyweight is banging into the ground.

Banging your bodyweight into the ground obviously stresses your tissues more than springing off the ground.

Also springing off the ground is more efficient movement than banging into the ground!

Lets see…

Banging into the ground instead of springing off the ground…  

What is the effect on the body?  

Banging into the ground means little to no protection during impacts and a locked spring which is compressive stress on the weight bearing joints.

This can manifest as any of a number of conditions related to an overstress of tissues or bone such as:

  • plantar fasciitis
  • heel pain
  • heel spurs
  • calf cramps
  • shin splints
  • meniscus tears
  • knee pain and chondromalacia or cracking knees
  • hip pain
  • herniated discs
  • herniated discs that don’t heal

If your body works as a lever instead of a spring due to weakness in the spring suspension system your gait is not as efficient.  You move by pushing your bodyweight instead of bouncing or springing your bodyweight forward burning vital energy.

This is called chronic fatigue!

When you test and train as a lever mechanism, you are getting stronger and able to stabilize your limbs over the foot in the safe range between supination and pronation better during walking.

We call this chronic pain and some doctors can confuse this misdiagnosing your condition as fibromyalgia!

Inflammatory Diseases of Aging

Dont forget, if your body is stiff and sore all over because its locked or too weak to absorb impacts of walking speed or running speeds then your body is accumulating inflammatory chemicals (cytokines) which are damaging to your health if they remain chronic.  Go to the pub med search page and put – cytokines inflammation depression – in the search box and see how many articles come up referencing depression and its connection to chronic inflammation!

If the maximum resistance you can get doing resistance exercises with your bodyweight is 1.0 x bodyweight and impacts of walking are 1.25 x bodyweight you have to add weight to your body when doing resistance exercises or introduce progressively greater impact forces into your spring to strengthen your spring suspension system enough to handle impacts of walking safely.

Running involves using your body as a spring

Walking involves 1.25x bodyweight impact forces which is greater than the 100% Bodyweight Foot-Ankle Toe Raise Alignment Test.  

So the next progression is to do this test while walking checking the alignment of the foot-ankle-shin complex at impact and through the loading of the bodyweight mass into the spring suspension system or mechanism.

I suggest you do this test while being videotaped from the front and back.  Simply walk towards the camera, turn around and walk away from the camera.  Try to walk the second time as fast as you can.

That adds speed to the formula F = M x A which means you are checking the suspension systems ability to maintain the foot in the safe range between supination and pronation at a higher force of impact

How To Train the Suspension System to Handle Greater Impact Forces

If you would like to increase strength of the supination pronation cuff (landing muscles) or spring suspension system muscles then you have to move from training as a lever and begin to introduce progressively greater impact forces.

If you want to train to maintain your foot in the safe range between supination and pronation during impacts such as walking, running and the participation of sports to avoid over pronation and over supination at foot strike you have to train with progressive greater force impacts.

This means you have to start with walking speeds training these muscles in all angles such as inversion, eversion, abduction, adduction, pronation and supination.

F = M x A

So if you understand Newtons Law the force of your impact is determined by your mass x acceleration or speed of running. Since your mass stays the same the way to progressively increase force is to run faster.

I recommend barefoot zig zag runs, side shuffle runs, carioca, ricochet, and lateral bounds, hops, etc

Phase I Release the Spring Mechanism

This involves removing all joint play stiffness and/or locking by releasing locked joints and muscle spasms in the weight bearing joints from head to toe nail.  This is done by hand and I have excellent self help tutorials for you to learn how to do this yourself!

Search for Video Tutorials 77 – 89 to find them or find them on this page where all of my video tutorials are located!  View all video tutorials here… 

 Click the links below to strengthen and supercharge the spring suspension muscles system muscles:

Phase II Strengthening:

Video Tutorial #148 Bosu Ball Foot Training, click here to view 
Video Tutorial #76 Bosu Ball Lateral Step, click here to view
Video Tutorial #177 Side Lunge With Cable, click here to view
Video Tutorial #105 Foot Eversion Exercise, click here to view
Video Tutorial #106 Foot Inversion Exercise, click here to view
Video Tutorial #107 Ankle Exercise Training, click here to view
Video Tutorial # 108 Cable Hip Adduction And Foot Inversion, click here to view
Video Tutorial #109 A Great Hip Adduction Exercise click here to view
Video Tutorial #109 A Great Hip Abduction Exercise click here to view
Video Tutorial #110 Dr. James Stoxen DC loses An abdominal Exercise Competition By One Rep click here to view
Video Tutorial #111 Rectus Abdominal Cable Crunch Pull Downs, click here to view
Video Tutorial #112 Abdominal Oblique Exercise  click here to view
Video Tutorial #176 Improve Your Balance With Half Foam Roll Exercises, click here to view

Phase III Supercharging:

Video Tutorial #149 Figure 8 Runs, click here to view
Video Tutorial #133 Circle Walk, Jog, Run And Sprint, click here to view
Video Tutorial #90 Obstacle Course, Combining Exercise Drills, click here to view
Video Tutorial #136 Double Leg Cone Jump or hop, click here to view
Video Tutorial #137 Why Plyometric Jumping Or Impact Exercises Increase The Level Of Human Performance  click here to view
Video Tutorial # 142 Improve Your Jumping Ability And Supercharge The Human Spring With Speed Bounds, click here to view
Video Tutorial #147 Single Leg Hop, click here to view
Video Tutorial #150 8-Point Step, Lunge, Hop or Bound, click here to view
Video Tutorial #152 Ricochet Box Jump, click here to view
Video Tutorial #167 Side Shuffle, click here to view
Video Tutorial #178 High Skip – Vertical And Horizontal, click here to view
Video Tutorial #179, 45 Degree Zig-Zag Hop, Jump Or Run, click here to view
Video Tutorial #151 Lateral Cone Jumps, click here to view

Learn how to test the front view by viewing
Video Tutorial #200 Can You Pass The Foot Ankle Toe Raise Alignment Test? (Front View), click here to view 

Video Tutorial #12 Is Running Bad For Your Knees? How Does The Body Spring Back Safely From Impacts Of Running and Walking?

Is Running Bad For Your Knees? How Does The Body Spring Back Safely From Impacts Of Running and Walking? Running and walking involve impact with the ground. Doctors and scientists currently believe the body resists impacts as a lever mechanism. Hmmmmm I guess I should beleive it.   Its in the book! The lessons taught […]

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Is Running Bad For Your Knees?

How Does The Body Spring Back Safely From Impacts Of Running and Walking?

Running and walking involve impact with the ground.

Doctors and scientists currently believe the body resists impacts as a lever mechanism.

Hmmmmm I guess I should beleive it.   Its in the book!

The lessons taught in medical schools, medical books and scientific papers about how the body works and how it breaks down, though based on modern medical constructs, just didn’t add up.  There were just too many unexplained mysteries that perplexed doctors and scientists and left patients feeling hopeless, frustrated and in a chronic state of pain and suffering.

I began to see the human form through a whole new lens.

My mother always said if something doesn’t make sense, keep asking questions until you find the answers.

A Radical Change In Perspective

How can lever mechanisms, spring back impact forces of walking and running?

The answer is that levers cannot spring back impact forces. Levers push things!

Only spring mechanisms can spring you back from impact forces. Period!

Here is the key to understanding how to prevent injuries and improve human performance in sport and every day activities.

Every movement you make is powered by a miraculous spring mechanism. Once you learn how it works, the important functions it serves, how it breaks down and locks, and how it effects so many aspects of your health, you will see why so many suffer and are misdiagnosed.  Dr James Stoxen DC

How is it that doctors think the body moves as a lever?

When the spring mechanism locks it turns into a lever and you switch from springing off the ground to banging and twisting into the ground and that leads to painful conditions.

Think about it…  All doctors see is levers because by the time the patient comes in with a condition their spring mechanism is already locked.  Most have never seen an intact spring mechanism nor do they know how to determine it is strong enough to handle impacts from running or walking.

How do you know that?

Have you ever asked a doctor, Is is it safe to run now?  

Do they sound confident in their answer?  

I have been “tuning” spring mechanisms of elite athletes right on the track, top dancers backstage for Dancing with the Stars, So You Think You Can Dance, Cirque Du Soleil and thousands of elite athletes entertainers as well as training athletes for national and world champions for years.

African Track Athletes Have More Spring – Lessons Learned from the 5th All African Track and Field Championships

My specialty is releasing, strengthening and supercharging human spring mechanisms, thus restoring lever mechanisms back into spring mechanisms.

Unless your body has an intact spring sechanism these impacts can create common running injuries. One of the most common knee running injury is, chondromalacia of the patella or (runners knee)  you may have knee pain, knee swelling and you might hear your knee popping or knee clicking. Another injury to the knee due to running is Iliotibial Band Syndrome (pain on the outside of your knee).

Other common running injuries include lower leg pain which may include shin splints.

Why is there stress on the tibia and surrounding tissues”  

It is because the stress was not taken up by the spring mechanism below.

Because it was too weak, stiff from tension or locked it could not spring you back from the impact and the excessive stress went into the tissues instead.  

What about stress fractures (tiny bone cracks)?

Stress Fracture Of the Second Metatarsal – Self Help Tips to Treatment and Prevention from The Barefoot Running Doctor

There are stress fractures because there is too much stress there because because the stress was not taken up by the spring mechanism below.

Is this starting to make sense?

Foot and ankle injuries include an ankle sprain, heel pain, plantar fasciitis (bottom of foot pain) and the swelling of the Achilles (Achilles tendinitis). Pelvic and hip injuries include muscle pulls, growth plate stress injuries, tendonitis, groin pain and buttock pain.

Running without injury and walking without injury is ideal.

The only way you will able to accomplish this is by having an intact strong spring mechanism that has no tension on it to absorb and spring back from the impact forces of the landings.

Is there a way to prepare our bodies for running?

Is there a way to prevent overpronation of the foot or oversupination of the foot to avoid running injuries and to avoid walking injuries?

The answer is yes!

What do people normally think about?

What kind of shoe will help me protect my body from the impacts?

What do barefoot runners, like me, think about when they have plantar fasciitis, shin splints or knee pain?

“How can I release, strengthen and supercharge my human spring to better absorb the impact forces of the landings?”

Video Tutorial #157 Barefoot Running Is Normal. Shod Running Is Abnormal? Rationale Based On Solid Training Principles

That is what you should be thinking about!   

Thinking of what shoe is a wimpy attempt at improving your human performance and doesnt really get at the source of the true problem. Does it?

In this post I will explain how the body can spring back from impacts of running and walking.

Running involves impacts.

They say impacts are bad for our joints.

Does that mean that running is bad for us?

They recommend walking instead.

Did you know?

  • A 150 pound man has 1.25 x bodyweight impact force during walking or about 187.5 pounds of force depending on speed of walking?
  • A 150 pound man has 3x bodyweight impact forces or around 450 pounds of force per impact depending on speed?
  • The average 150 pound person endures approximately 3,650,000 impacts or collisions with the ground of 187.5 pounds resisting 684,375,000 pounds of impact forces into their body a year walking?
  • The average runner that runs 15 miles a week has only 351,000,000 pounds of impacts a year running the 15 miles a week?

Does walking every day effect our knees more than running?

The numbers say it does..

And, walking involves impacts just like running.

Next thing you know, they will tell us walking is bad for our joints too.

Read on…

How does the body absorb or spring back from the impacts of walking, running and the performance of sports such as plyometrics?  

The answer: The human body is a marvel of human spring engineering.

Arch Leaf Spring Down

This spring mechanism has a leaf spring (which absorbs impact without muscle contraction) it is suspended by the spring suspension system muscles.

1.  The Arch Leaf Spring - There have been studies on the arch with all muscles removed leaving just the bones and ligaments.  These were extracted from cadavers.  What the study showed was that the arch complex itself has the ability to spring back forces without the aid of the muscles.

 2.  The Spring Suspension System Muscles - I coined these muscles as the spring suspension system muscles, the landing muscles or the pronation-supination cuff muscles.  I identified this new medical terminology myself in order to better explain the function of this area.
I did not like the way it was explained in the text books and scientific literature because it confuses people so much that they give up trying to understand how it works.  That is where you just give in to what ever anyone says and you become a victim or drone to who ever is directing you.

supportive cuff muscles

 

Human Spring Suspension System in Action

How is the body engineered to take up impact forces of 270,000,000 collisions in our lifetime?  

Does it take up impact forces as a lever as they see it, or as a lever and a spring as I see it?

I see the body as a human spring while other doctors and scientists see it as a lever.   I will prove that the body is not a lever in this post with common sense reasoning, something not so common in medicine.

The first step in our understanding of the human spring is to understand how the arch works through the muscles and tendons that attach to it and control it. I call these, the spring suspension system muscles!

As you can see from the video above, there is a tendon that appears through the medial aspect of the ankle. That tendon has strategic attachments at the first and second metatarsal cuneiform joint. The name of this muscle is the tibialis posterior.

The muscle loops around the medial malleolus and attaches on the posterior fibula. (see the picture below)

Spring Suspension Muscles

It’s interesting that we don’t have any exercise machines or exercises to develop this muscle in the gym. Its what I call the missing training routine!

AKA Pronator/Supinator Cuff Muscles

The tibialis posterior, tibialis posterior, peroneus longus and brevis form the pronator/supinator cuff.  Like the rotator cuff, these muscles stabilize the foot and ankle in the “safe range” between the rolling of the impact force from supination to pronation (inside to outside)

Doctors Argue About What Over Pronation Is And What Causes Over Pronation

So many medical specialists talk about over pronation, over supination, being a pronator or a supinator and within their own profession they argue about what it is and what causes it.  This is the core of what causes the majority of conditions in the foot and ankle and what runners focus on when they buy shoes (braces)

When any bone or bony complex (like the foot and ankle) moves out of the safe range of motion it is ALWAYS because of a weakness in the muscle or muscle group that controls this movement or stabilizes this bony complex.  

Introducing… The Rotator Cuff of the Shoulder

At one time we did not know what caused instability of the shoulder girdle.  There was a time when we did not have awareness of the important supportive function of the rotator cuff to stabilize the shoulder so the primary movers could do their work without injuring the shoulder.

Introducing… The Pronator/Supinator Cuff of the Foot and Ankle

So, if you want to know why your foot and ankle rolls out of the safe range just look at the muscles which are responsible for this movement and you solved the riddle.  I made this determination based on solid training principles because I wasn’t TOLD or INSTRUCTED on what caused it based on some text book.

How do the Pronator/Supinator Cuff AKA the Spring Suspension System Muscles Work?

I will teach you how these muscles work and show you innovative exercises that I have found and developed that you can use to improve your ability to spring back from the various impact forces of landing such as:

  • walking (1.25 x bodyweight)
  • running (3x bodyweight)
  • plyometrics (3-5x+ bodyweight)

The body springs off the ground when its working the way its designed.  The natural spring mechanism occurs at the arch and transfers its protection and spring energy through the 7 floors of the human spring.

The body is a giant spring with 7 floors of springs:

  1. The arch
  2. The subtalar joint
  3. The ankle mortise
  4. The knee
  5. The hip
  6. The spine
  7. The head-neck

There are two mechanisms that allow spring to happen at floor one:

  1. The configuration of the arch with the 26 bones and the ligament attachments.
  2. The spring suspension system which is composed of the muscles and tendons that attach on the under surface of the arch.

In the walking or running game, whether you are running for weight loss, running to prepare for a 5K, 10K, half marathon or marathon or running for your life, the key to this game is successfully absorbing each impact.

Regardless if you use Chi running, pose running or human spring running, the key to avoiding abnormal movement patterns from a weak or locked human spring that cannot effectively absorb impacts is to have NO spasms or locking of the joint play in the entire spring mechanism and a strong spring suspension system for this three dimensional structure.

Spasms in the muscles that cross a joint or two joints cause the joints to become compressed and when we apply this understanding to the human spring model, spasms cause a preload internal compressive force on the human spring.  This preload internal compressive force reduces the overall force of impact capacity you can load into the spring mechanism.

  1. When your spring mechanism gets weak your spring mechanism collapses into a lever mechanism.
  2. When it collapses, the brain senses the abnormal movement patterns of walking as a lever and tries to protect you from the stress and strain by tripping spasms.
  3. Spasms compress the spring further.

Could you see how a weakness, stiffening and or locking of the human spring mechanism could cause widespread chronic pain, chronic fatigue, misdiagnosed fibromyalgia and inflammatory diseases of aging?

That is what happened to Anthony Field.  You know the Wiggle guy?

Field, the creator and a founding member of the world’s most successful musical groups for young children, The Wiggles, was handicapped by chronic pain, chronic fatigue, misdiagnosed fibromyalgia and depression during his 20 years on the road.  I am proud to say, I was able to assist him.

Read his story of triumph over chronic illness in his book, ‘How I Got My Wiggle Back’, which covers our consultation in detail and provides a comprehensive, plain-English explanation of how he was helped with the human spring approach, and the results, that changed his life. You can order the book from Amazon.com

What about you? If you are having these spasms what should you do?

It is critical for you, your coach and your doctor to:

  1. Understand what causes these spasms like abnormal movement patterns
  2. How to check for them like gait evaluations and hands on deep tissue palpation
  3. Learn how to remove spasms that compress the human spring (joints) to insure there is no internal compressive force preloading the mechanism.  This is done with muscle spindle work and other hands on treatments.

I developed a 3 step approach to enhancing spring loading capacity:

  1. Release the compressive forces on the human spring
  2. Strengthen the spring suspension system muscles
  3. Impact train the spring suspension system

This three step approach will help you expand the force loading capacity of your human spring to better spring off from impacts, to have maximum performance and reduce risk of injury.

What does the human spring suspension system muscles do?

The human spring suspension system muscles help you spring off the ground.

What if the spring suspension system is weak, fatigued or locked?

Or what if we didn’t read the owners manual that came with our pogo stick, I mean human spring mechanism?

To help you learn more read the two posts below:

Video Tutorial #168 The “Controlled Fall” And It’s Importance In Efficiency In Walking, Running And Especially Barefoot Running, click here

Video Tutorial #169 How To Land Your Foot When Walking, Running And Barefoot Running, click here

Do you know how to walk and run the right way so you don’t damage your joints?

Bang and Twist Walking VS Spring Roll Walking

When you are not springing off the ground then you bang into the ground (foot plant) and twist off the ground (toe off) when you walk, jog, run or participate in sports or leisure activities.

Obviously springing off the ground provides better protection from impacts and allows for a more efficient recycling of energy through this natural spring mechanism.

What you need to do is study the engineering in detail so you can develop the best treatment, training and maintenance for your human spring.

Is that what you do?

Most don’t!

What spirit is so empty and blind, that it cannot recognize the fact that the foot is more noble than the shoe, and skin more beautiful than the garment with which it is clothed?
  Michelangelo

So many are looking for the best shoes for running, when they should be looking for the best preparation of the body  for running.

Dr James Stoxen DC

That sounds logical, doesn’t it?

Most of you will focus most of your time looking for shoes!

How do I know?

I did a Google search for key words of barefoot running and found a few million people searching for shoes and now the barefoot shoes i.e. the fivefingers, 5 fingers, vibrams and about 2500 people searching for the best technique for barefoot running.

That means your focus on being able to run for life is what brace is best for your weak foot and what cushion to use because your spring suspension system muscles aren’t trained, right?.

I spend ZERO time looking for the brace (shoes)

That is because I spent all my time studying what conditioning is right to build a strong spring suspension system so I didn’t have to wear braces on my feet. (shoes)

Do you only do bench press when you go to the gym?

Do you only run in straight paths when you run?

Do you wear braces on your elbows when you bench?

Why do you need cushions and braces on your feet when you run?

Why does grandma need:

  • Orthotics
  • Orthopedic Shoes
  • A cane
  • A walker
  • A wheelchair
  • A hospital bed

The doctors said her muscles could no longer support her.

Maybe its a good idea to learn how to condition your spring suspension system muscles of your body for impacts instead of looking for the next brace?

So, before you get up and running, you are going to want to learn about the engineering of the human spring and specifically what the spring suspension system muscles are and how they assist you in springing off impacts safely.

As you know I also refer to them as the landing muscles, the pronation supination cuff or the arch foot and ankle sling muscles, as one famous doctor from Bangkok, Thailand called them.

Most of you work on your “take off” muscles yet the “landing muscles” are hardly EVER exercised because so few even know they exist!

Dont you think that if you put a bigger, more powerful and heavier engine on a plane that it would fly faster?  You might want to put a stronger landing gear on the plane too?

With this simple logic, why are so many of you training the take off muscles and completely neglecting  the landing muscles?  

No wonder you have so many impact related injuries like plantar fasciitis, heel pain, stress fractures, shin splints, knee pain, hip pain and herniated discs!

So many people are told that impacts are bad for you in running.

That is just wrong!

Impacts are only bad for you if your human spring mechanism cannot handle the force of the impact safely!  Period!

There are millions of people that have been running for decades with millions of impacts that are without any musculoskeletal pain.

 In the book, ‘Born To Run’, written by Christopher McDougall, he tells the story about the Tarahumara Indians and  how these old indians ran for miles in the mountains for decades with minimal footwear.

So what’s the difference between you and them?

The idea that you have to have cushioned footwear to absorb the force of the impacts doesn’t really make sense, unless the impact resistance mechanism, the spring suspension system muscles and mechanism cannot handle the impacts.

So if your doctor, your coach and your conscience told you that you needed a cushion between yourself and the earth to absorb the impacts I guess what they were really saying was YOUR spring suspension system muscles and joints are not healthy enough to take the impacts but other peoples are.

Did you ever see the old 70′s commercial for Chiffon Margarine where this company made a scientifically designed  butter like substance called margarine and tricked Mother Nature into thinking it was better than butter?   She wasn’t happy!

Whoops! Lets get back to the logical explanation!

Is the human body a lever or a spring?

The first thing we have to determine is what the human body is in the world of physics so we can better understand the model of the object that has to collide with the earth 100,000,000 times before our 30th birthday.

There is a fundamental difference between the way I see the human body and the way most other doctors and scientists see the human body.

I say that the body works as a lever and a spring.

Most doctors and scientists say human body ONLY works as a lever system

I think it is because they still memorized the old text book instead of observing how it truly works to protect us from impacts.

I also think that maybe its because the spring mechanisms of the patients that levered into their clinic with pain already had their spring mechanism lock up before they walked into the office.  When they observed them it was while they were limping into their offices with their levers so they could sit or lay down during the examination of their locked levers.

I haven’t seen many doctors training or observing top athletes doing double fulls, standing fulls, or plyometric drills.

Many just recite “the body acts as a rigid lever at take off”.

You can tell when they talk like that there is no independent thinking.

Why is the body NEVER a rigid lever during running or walking?

When the body is working the way it was designed.

When the foot lands on the ground it rolls from the outside to the inside called rolling from supination to pronation.

safe range/supination to pronation

At the same time it is loading from the force of the landing like lowering a weight on the bench press.

With all that rolling and loading in a three dimensional plane across 33 movable joints it never becomes a rigid lever!  Its just impossible to think that can happen with a rolling loading bag of 26 moving bones.

For me, with my experience studying impacts in sports such as running, jumping and  plyometrics, I find it ridiculous to think that the body absorbs these incredible impacts with levers.

How can a lever protect two objects (earth and human) that predictably will collide over 250,000,000 times in a lifetime?

Lets see… this object will collide with the earth 250 million times so lets design it as a lever.

Are you thinking what Im thinking?

It doesn’t make sense!

Is it just me or do you think it’s hard to imagine that we can launch our 150 pound bodies against 450 pounds of impact resistance force for over 26,000 consecutive impacts with ultimate efficiency as a lever system.

If you believe what you are saying, then you are saying that is the way you launch your body against this 450 pounds of resistance or approximately 11,700,000 pounds of work load!

The same person can’t do 200 calf raises (working as a true lever) amounting to 30,000 pounds of work.

Here are the exact formulas:

  • 26,000 impacts/26 miles
  • M x A = F      (M)150 pounds x (A)3 = 450 pounds force per impact
  • 450 x 26,000 = 11,700,000 pounds of impact over the course of that marathon
  • 150 pounds x 200 total calf raise reps before exhaustion = 30,000 pounds of work

Why do we become exhausted at 30,000 pounds of work during calf raises (working as a true lever) but can run 26.2 miles for 26,000 impacts of 450 pounds of force amounting to 11,700,000 pounds of work?

Its because:

  1. The body works as a lever mechanism when doing calf raises.
  2. The body works as a spring mechanism when running.

Its obvious which one is more efficient!

Do doctors and scientists disagree with me?

You wouldn’t think so but they still hold on to this lever model!

OK OK the body does work as a lever and a spring.

Does that make you happy?

In my opinion, the body does move at as a lever system such as when we are going up on our toes, walking up stairs, doing raises, but it also functions as a spring mechanism when we are walking, jogging, running, and participating in sports activities.

If we look at the body as a spring mechanism we have more effective ways of treating and training the body than as a lever.

Also looking at the body as a spring mechanism helps us explain many mysteries that baffle doctors and you.

Like…. CHRONIC PAIN – The body bangs and twists into the ground 10,000 steps a day (walking) rather than springs off the ground so it cannot protect itself from the impacts resulting on an assault on the muscles and joints.

Maybe that is why my plantar fasciitis, heel spurs, shin splints, knee pain, hip pain and herniated disc won’t heal!  

Like… CHRONIC FATIGUE – The body bangs and twists into the ground 10,000 times a day (walking) rather than the more efficient way of ambulation, springing the mass off the ground.  (some have estimated that 25-60 percent of the energy is recycled through this spring action)

Force Of Impact/Energy Stored And Released

The human body abides by the Hookes Law of Physics

Hookes Law applies to spring mechanics.  It does not apply to lever mechanics.  Read this article I wrote and give me your comments at the bottom.

The Human Spring Model and Approach in its Relationship to the Hookes Law of Physics

When you think about impacts there is a force that impacts your body on each landing. If we understand how this force absorbs into our body safely then we can look at those structures that absorb the force and release them, strengthen them and supercharge them for optimum performance.

Then we can run barefoot because we won’t need an artificial cushion to do what our human spring is designed to do for us!

Why don’t doctors and scientists let go of the lever model for the more accurate spring model of evaluating, treating, training and maintaining the human body?

Why do they still hang on to the lever model if it doesn’t make sense?

They can’t prove it is a spring by EMG testing because EMGs don’t measure the spring of tendons and connective tissue complexes (the arch)  

Most of the muscles that control the safe rolling of the foot from supination (outside) to pronation (inside) and the spring action of the foot originate outside the foot on the calf.  They become tendons in the foot.

The muscles have strategic attachments at the underside of the foot where the spring action occurs but they originate in the calf.  (see the illustration below)

Spring Suspension System Muscles Bottom

Scientists do gait studies to determine what muscles are used during walking or running. They use EMG testing, which measures muscle activity.  These electrodes are either on the surface of your skin or inserted into the muscle like a needle.  OUCH!

The problem with measuring the body with this method is that it doesn’t measure for the elastic recoil of the tendons (spring) and that is a very important component of how our body protects itself as a spring and how it recycles energy during walking and running!

This represents a huge amount of work performed by the body, which provides FREE ENERGY to the body through this spring action.

How can you measure a tendon recoil when you are testing for electrical activity of muscle contraction?

So when they’re using the EMG to study about how muscles work during impacts such as walking or running they think we run by using the foot as a lever to PUSH it forward when we all know the body SPRINGS the mass forward.

This is only part of the big picture.

Locked Spring and Spring Walking

Spring Suspension System Muscles 

Spring Suspension system muscles

So what do they account for the inability to measure for arch recoil and tendon recoil?

Because they can’t accurately understand how it propels itself so many studies just model the human foot as a solid lever unit, as if your foot that was stuck in a freezer, a solid lever mechanism.

This is obviously, not an accurate way to describe the foot during its role in absorbing impacts from running or walking.

Also when your body is functioning correctly the foot is a very wiggly, springy mechanism when all 33 joints are moving according to way they are designed like in the children’s foot.

Unfortunately, when doctors see patients, they are injured.  No one gets their feet examined when they are pain free.  If they already have had an injury then the body has already created muscle spasms to protect it which stiffen or lock it up like a lever.

Is your foot springy when its injured or in pain?   NO!

I have been a guest doctor at track and field championships examining healthy springy feet and evaluated the springiness of the feet of every patient that comes in my office.

Coaches, trainers  and managers send me athletes and entertainers to tune them up to improve their performance.  They do not have any injuries. I evaluate them head to toe nail to see what areas we can release to increase their spring performance.   I know what a springy, fully released human foot is supposed to feel like.

I work 10 – 30 hours on stiff or locked feet to remove preloaded compression forces by deep tissuing out every single spasm and releasing every single joint to maximize the ability of the foot to load impact forces into a spring mechanism safely.  When Im done, the feet feel a much different than they did when they started.  More springy!

Imagine how springy your feet and legs would feel if a deep tissue specialist worked 30 hours releasing the tension and spasms on your lower body!

Read why I feel that African Track Athletes Have More Spring – Lessons Learned from the 5th All African Track and Field Championships, click here to view 

There is a huge difference in the springiness of the foot of a patient with a plantar fasciitis, bunions, chronic knee pain and or herniated disc that hasn’t healed.  Why do I know? Ive been working on thousands of feet with my hands for 25 years, 6-7 days a week a minimum of 10 hours a day.

Feet that have stiff muscles around them or have locked joints function as a lever mechanism so they cannot absorb the force of the landing as effectively .

To think any differently violates the laws of physics!

Lets see…  A stiff foot or a springy foot….

Which one is going to bang on impact?

In the examination of the walk you often see the calf muscle shake on impact with a patient who’s foot is locked.

That tells you right away there is no spring in that step!

If you have plantar fasciitis, foot or heel pain, heel spurs, calf pain or swelling, shin splints, knee pain, hip pain or back pain, walk barefooted (shorts too) towards a camera and away from it fast. When you look at the video watch to see if your calves shake.  You might be amazed!   I did a post on you might like titled,

Foot Lock! What You Get From Standing Too Long And How To Prevent It, click here to view

In order to absorb millions of impacts it must be designed as a spring mechanism.

When the Spring Mechanism Breaks Down it Becomes a Lever Mechanism

What about the studies?  Are their any studies that prove what you say?

Almost every gait study done in America or anywhere except a third world country will provide inaccurate data that will confuse you into thinking that the human body moves, protects you from impacts and recycles energy as a lever mechanism rather than a spring mechanism.

How can I say that?

If a scientist selects a study group from people who have worn shoes for 20-30 years then the human spring mechanism has been tampered with extensively and therefore the results and interpretations and conclusions from these studies are not as helpful to prove the body is a spring vs a lever when it is working right!

Imagine if we were doing a study of elbow movement and decided to use a student who had a brace on his elbow for 20 years and another who did not have any braces on the elbow his whole life.

Are they going to have different elbows with different movement patterns and strengths?  Of course they are!  Logic!

One would have to study how normal healthy children walk who have never worn shoes or habitually barefoot subjects from some third world country would have to be selected.

The other problem with the way gait is studied is, the subjects are commonly selected who are pain free.  That doesn’t mean there isn’t already substantial plastic deformities and locking of the spring mechanism represented by a locking of any one or many of the 33 joints of your 26 bones of your foot.

People have advanced bunion deformities that are painless that obviously effect impact resistance.  The reason why these deformities happen without frank pain is because we take about 50,000,000 impacts into each foot by our 30th birthday.  Even subtle abnormal loading position of the foot can cause a lot of deformity in that many impacts.

Did someone qualified to evaluate for the joint motion of all 33 joints check these subjects before they were included in the research?

You rarely see a doctor do motion palpation of each individual joint of the foot to make sure they are all moving according to the way they were designed even when the patient has a condition like plantar fasciitis, Mortons neuroma, heel pain, bunions, calf cramps and the list of spring compressive conditions goes on up the floors of the human spring.

In fact I once had a doctor question me when I suggested that the most commonly locked joint of the foot was the second and third metatarsal cuneiform joint.

He suggested it wasn’t supposed to move because it was a saddle joint.

If it is a joint then it is supposed to move!  What are you talking about?

Why would the joint be there if there was no movement needed there?

I guess if he believed it was not supposed to move he wouldn’t have to examine the joint for movement there.  If he believed there was no movement there in the mid arch then he would not feel so guilty locking the arch up with an orthotic from the bottom and the shoe from the top.

Click to Enlarge


Why do we have joints?  

To protect us from impacts!

How do we check for joint play in a joint?

I was not taught how to evaluate for loss of joint play in a joint and for abnormal movements in the spine for all my years in chiropractic college.  I had one (2 credit) class on examining and adjusting the extremities such as the foot and ankle but there was not so much emphasis on it as I put on it now.

I make sure there is no restriction on any joint from the tip of the head to the toe nails on every patient.  

I learned how to evaluate for restrictions on the joint play affecting the ability of the body to load the forces of the impact into the spring mechanism by absolute necessity.

My first patient started off the education process of human spring!

My very first patient was powerlifter, Ed Coan, as described as “the greatest powerlifter in the history of the sport“…

He  was attempting to break world records in powerlifting by lifting close to 1000 pounds. (watch video below)

Out of necessity it was imperative that I remove every single restrictive spasm from his spring mechanism to ensure that he could load the maximum amount of force of lift load into his human spring.

For more information on The Ed Coan Story – What I Learned from the Strongest Man in the World, click here

If the doctor doesn’t  even have the skill set to be able to evaluate the joint play in all 33 joints of the human foot and after that if he cannot manipulate these joints then he can’t understand how the locked joints behave differently when it is in fact released. He has nothing to compare.

I can tell you that when you release the mid foot locking and the metatarsal cunieform joints of the foot,  there is a loud cracking noise from the release of the fixation.

Watch the video below of me resetting the talus in the ankle mortise.  The sound of the release of the locking of this joint may startle you!

Many patients say afterwards it feels more bouncy or springy when I walk.

It just makes sense!

Safe and Unsafe Range

 

Whenever the foot rolls out of the safe range into a over pronation position, the ankle joint is affected. This over rolling stresses the ankle joint and many times the talus bone which is like a ball bearing of the foot, jams into the joint above called the ankle mortise formed by the extension of the tibia and fibula.

When I trained for 3 months running barefoot in zig-zag patterns I noticed a huge improvement in my foot-ankle alignment.  If I tried to over pronate, my pronation/supination cuff muscles would immediately “snap” my foot back into the safe range!  I have noticed the differences in my patients as well.  

Why use a brace like an orthotic or motion control shoe when you can train your body to correct its own alignment?  

How can you treat a patient with a knee cap misalignment in the trochlear groove which is essentially a pulley mechanism without addressing the ability of the foot to plant without torquing the tibia and fibula out of alignment with the knee cap?  Think logic!

To read more about Cracking Achy Knee Pain or Chondromalacia Patella – Treatment and Prevention Tips from The Barefoot Running Doctor, click here

When you look at it, it looks like a saddle on a horse’s back.

When I make adjustments of the talus that is jammed in the medial aspect of the ankle mortise, the release of this joint makes a very loud audible crack or release. Here is a video of me below releasing a talus joint locking.

How else does this “locking” of the many joints of the human foot affect movement and development?

If muscles pull against the joints they must be moving for the muscle to get full contraction and full development.

This is obvious!

Just think of how much development you’d get from your bicep during a curl if your elbow was completely locked.

The lever system model claims that the body becomes a rigid lever as if it’s some kind of stiff unit when it pushes off.  

If that was true, then the forces of the impacts of between 300 – 800 pounds would literally destroy the cartilages in a short time and end plates of your bones if it became a solid unit.

I contend that during running for sure that the foot is never an 180 lb  solid unit unless it’s locked or frozen.

But if it’s working right it’s in a constant elastic deformation process, constantly moving the load across the ever-changing deforming structure that  protects you from these impact forces and stores energy only to release it for maximum efficiency.

It’s ridiculous to think that it’s okay to have joints locked up and that it won’t affect the development of the muscles control the landing and absorption of impact forces.  If you don’t check for the joint play in these important joints then you may be missing something very crucial in the treatment of the patient!

As I said many times the primary landing muscles, the spring suspension system muscles that load the force of the impact into the spring mechanism and release the energy or  unload the forced back into the mechanism I refer to as the spring suspension system muscles.

You won’t find that word or concept in any book or taught at any school because I coined the muscle group to fit the human spring model because it was not possible to explain what was available in the human lever model.

The muscles that absorb the forces of the impact are the tibialis posterior, tibialis anterior, peroneus longus and peroneus brevis and a few others up the floors 1-7.

The impacts are also absorbed from other muscles such as the soleus however we are always developing those muscles.  Exercise is needed to supplement what we are NOT exercising in our daily lives.

The Foot/Spring Engineering


To think that the body is a solid lever during walking or running is not as logical as the human body modeled as a human spring.  

Dr James Stoxen DC

From my clinical experience, the majority of the people who have injuries from running such as plantar fasciitis, shin splints, heel pain, torn cartilage in the knees, hip pain and herniated discs are because the spring mechanism can’t effectively absorb the impact into the spring.

Because the human spring is preloaded with compressive force from muscle spasms and locking of joint lay there is no room to load all the impact force.

Because of that, the impact is absorbed into the tissues as chronic stress and strain, wear and tear inflammation and pain called degenerative joint disease during running or simple walking.

Then you have the acute injury resulting from an acute overload of the force of impact into the compression spring, the vertebral disc, which is really a plastic deformity.

I explain elastic vs plastic deformity in depth in Video Tutorial # 143 What I Learned From Studying Javier Sotomeyer Technique About Improved Performance and Reducing Injury Risk, click here to view

In the knee we call it torn cartilage.  In the foot or shin or tibia bone we call it  stress fractures.  When the preload compression force overloads the compression spring of the lower back it causes a plastic deformity of the disc or a herniated disc.  If the overload is severe acute with no room to absorb the forces into the mechanism you can have a fracture or fractures.

Damage to ligaments, tendons, cartilage, bones or discs occurs when the force of the impact exceeds a spring mechanism’s capacity to store the impacts either over time as a plantar fascitis shin splint, heel spur or cartilage wear or instantly as a herniated or bulging disc.

The spring suspension system muscles help absorb impacts.

All joints that are involved in absorbing these impacts must be moving.

If the joints don’t move where the tendons attach then the tendons cannot pull against these joints.  That makes it impossible to get full impact force into these joints and it’s also impossible to get full positive adaptation leading to maximum development of the muscles, tendons and connective tissue of joints.

The body does not only use muscles to propel.  The arch would spring back impacts even without the muscles just by its very design. 

The arch configuration is 26 joints wrapped by ligaments and this connective tissue that forms a springy bow or leaf spring, that adds impact resistance and free energy to impact activities such as walking, running and the performance of sports.

Footwear alters movement patterns in the foot and most footwear either binds, deforms or reverses the human spring mechanism.

A few doctors and academics have argued with me that there is no scientific proof that shoes binds or restrict movement in the foot.  

I agree that assumptions must be based on peer review literature, however I do not need peer review studies to tell me that a shoe that I wrap around the foot and lace tightly does not alter the movement in any way in the foot or the joints above.

People who talk like this either work as consultants for footwear companies or will wait for 30 years for 10 studies to say it does while thousands of patients have rapidly deteriorating health because they are treated the opposite of what is best for them in the long run. Meanwhile they wait for someone to do a study that tells them what they already know.

restricted shoe

It is obvious that footwear binds the foot and alters the natural movement of the foot to some degree. Each style of footwear and the size of the shoe etc. determines how much it binds the foot. If it did not bind in some way it could not stay on your foot.

Do you think you can attain full range of motion in adduction, abduction, inversion and eversion of the foot with a shoe on? No way

movement training

How can a body part attain full range of motion in abduction, abduction, inversion, eversion, supination and pronation when there is a piece of leather wrapped tightly around it?

This is where they contradict themselves!

On one hand, footwear companies and doctors say that you have to wear shoes to support the foot which means that it’s applying a pressure to the foot to provide the support.

So just by saying that it supports a foot you are admitting it affects the movement of the foot, period!

I’ve had arguments with other doctors in forums where they say show me the proof that the shoe inhibits the movement of the foot. Then in another forum topic they will say that the shoe supports the foot and therefore it’s an important item to wear when you’re running because your body can’t absorb the force of the impact as a lever.

They contradict themselves!

If shoes give an athlete a competitive advantage then isn’t that a form of cheating?

No athletes train with wraps or braces if they KNOW they give them a lift or advantage because they KNOW this takes away from the positive adaptation they need to get stronger.

Do you tell your friend to lift the bar off you at 3/4 way up or grunt out that last rep yourself?

When lifting you could injure yourself so why not wear a brace on every joint of your body?  Im sure some doctor could convince you this is a good idea!

BENCH SUITS!

I remember in the early 80s, I was the doctor for the American Powerlifting Federation for six years, 1986 to 1992.

To hear more about the beginning of powerlifting in the soviet union watch Historic First Sports Medicine Course In Russia – Sports Chiropractic Journal – August 1989, click here to view

At that time these new bench shirts were coming out. What they were was a  T-shirt that was made from a very tight fitting elastic nylon material which protracted your shoulders into the extreme negative position related to the bench press.

watch this video to see an example of how a bench shirt was used,  Johnnie Jackson puts on bench shirt at 2008 USPF Nationals

When athletes would load the weight on their bench, they lowered the weight into the muscles and tendons and at the bottom of the bench shirt it stretched and helped them to propel or push the weight up off the bench which added about 40 pounds to their maximum bench press.

You’re wondering how they got away with that!

They made claims that the bench shirt was developed that way to prevent injuries during the bench.

Doesn’t that sound familiar?

The difference is that the athletes were smart enough about principles of training never to train with the bench shirt.  WHY?  If it helps you to do the bench press BY LESSING THE STRESS ON THE JOINTS AND MUSCLES then you are not allowing your body to adapt to the weight and get stronger!

They just put the bench shirt on a week before the competition to make sure it fit right then ONLY used it to try to get some extra boost to win the competition or break a record.

Was the record legitimate?  Not to me!

If you cannot get full range of motion on the joints of the foot with a shoe on, then you cannot get full adaptation.

Test your foot motion with and without a shoe in full inversion, eversion, adduction, abduction, pronation and supination motions and I guarantee you will feel the shoe material restricting you because the sole is a stiff unit that prevents the full range of motion in movements. Listed below are two exercise posts that you can do to try testing your foot:

  1. Video Tutorial #105 Foot Eversion Exercise,click here to watch
  2. Video Tutorial #106 Foot Inversion Exercise, click here to watch

I guarantee you you’re not going to get the same range of motion as if you’re training barefoot.

You cannot get the same adaptation running with shoes as barefoot! Period.

So how do you think you’re going to develop these landing muscles to best absorb impacts when you’re running with shoes?

If your body is a perfect spring, capable of absorbing impacts why are you running with a binding device that has a cushion to absorb the impacts your own body is capable of absorbing?

  • Did some shoe company brainwash you with their Madison Street advertisement?
  • Are you afraid?  You could run barefoot as a child but you are more afraid as an adult than when you were a child?  Be brave…
  • Is it because you don’t have anyone to release the 33 joints of your feet?
  • Is it because you don’t want to do the strengthening drills to strengthen your suspension system landing muscles?
  • Is it because you want to wear shoes that match your outfit?
  • Is it because you don’t want to work on your form and technique and think the shoe will make up for your form breaks and weaknesses?

Millions of people run distances barefoot around the world…..

Check out the Barefoot Runners Society and find a chapter near you. Here.. 

Watch this video below of  former Olympic track world record holder, Zola Budd, who, in less than three years, twice broke the world record in the women’s 5000 metres and twice was the women’s winner at the World Cross Country Championships. She mainly trained and raced with world record speed, barefoot.

Remember F = M x A

That means the forces of the impacts on her foot were greater than any other female runner in the world at that time her same weight.

Its proven with newtons law.  Do you want to argue with me on that too?

Please don’t…. I don’t want you to embarrass yourself.

Watch her smoke all of the other runners’ wearing shoes, to break the world record.

How do you do run barefoot on the street and not have impact related injuries or conditions.

All I had to do was figure out how to safely load the impact force into my human spring that was represented by the cushion and I could throw those bench shirts whoops! I mean running shoes away.

Even if you don’t want to throw out your running shoes don’t you do want to condition your human spring mechanism to absorb impacts more effectively, more safely and at greater forces or speeds?

Of course you do!

Im a 50 year old doctor who stands on his feet all day working late and still figured out how to take impacts safely into my barefoot human spring without damage and run 9 minute miles in the 5 K without wanting to run fast. watch the video below as I demonstrate barefoot running in slow motion.

How to strengthen your spring suspension system muscle group.

What I recommend is that you train the foot with drills in directions that stimulate the development of these spring suspension system muscles.

This requires you to:

RESISTANCE TRAINING – Train with resistance exercises adding cuffs  strapped to the foot moving it in a variety of  directions such as eversion, inversion, abduction, adduction, pronation and supination.

IMPACT TRAINING – run barefoot in zigzag patterns, circular patterns, shuffle patterns as well as doing multi direction plyometric drills.

Then when you’re in the competition you can cheat by putting shoes on that allow for additional recoil of the elastic of the shoe!

We need barefoot running records and shod (cheating) running records!

Resistance Exercises to Strengthen the Spring Suspension System Muscles as Levers

Exercises for the development of the spring suspension system muscles must be done barefoot.  I guarantee you if you tried to do exercises with cables which I’m suggesting in this article that you are not going to be able to do them with shoes on.

It’s absolutely ridiculous to think that it’s possible to get full range of motion in these directions that are essential to development of the spring suspension system muscles with shoes on.

It’s amazing for me to think that runners think that their bodies follow some other principle of training that allows them to only move their body in one direction to fully develop the human foot which is a three dimensional object that moves in multiple directions.

A healthy foot has to be developed in all directions just as much as the upper body has to be trained in all directions such as back, biceps, triceps, chest, shoulders, arms and wrists.

So when you take off down the trail in that straight path remember that’s the first exercise that you have to do that really doesn’t take up as much of those spring suspension system muscles that move the foot in these other directions that demand you move or run in zigzag patterns side shuffle circular patterns and other patterns.

Kids Should Run Barefoot and have Fun and So Should YOU!

It’s interesting that kids seldom have chronic injuries, their spring suspension system muscles are fully developed as they’re running around in free play in the backyard with no shoes on.

This goes on very successfully until mom screams out,

Put your shoes on and stop running around like a crazy kid!”

We don’t realize what we’re doing to our children when we tell them that they should behave and act like us. What we are doing is we are taking them away from the developmental plyometric exercises of leaps, bounds, hops and skips in multiple directions and making them conform to our boring straight path routine that causes us to have an imbalance in the spring suspension system muscles of our body.

As kids we run around in the woods chasing animals, animals that run in multiple directions and as adults we run down the path to try to get to first base then stand around for a few minutes, run to second base on a straight path in then of course there is this matter of having shoes on to protect us from these impacts in different directions that will make us stronger.

The moral of the story is that the spring suspension system muscles must be developed in relation to the amount of impact forces that you are planning on absorbing or springing back from.

These are the fundamental causes of weakness in the spring suspension system muscles.

  1. The spring suspension system muscles are not completely developed by running straight ahead. You must move the foot in all ranges of motion against resistance.
  2. You must develop the foot in these ranges of motion with impact forces that are equal to the amount of impact forces you plan on absorbing. That means if you are planning on running you must run drills in all ranges of motion so that the spring suspension system muscles are able to move and develop.
  3. Footwear inhibits the development of these muscle. So training must be done with bare feet. Shoes only inhibit the movement of the bones so the muscles can’t fully develop.
  4. Start with slower speeds and work your way up adding an increment of speed every two weeks.

Impact Drills and Plyometrics

Your spring suspension system must be completely released during these impact drills.  If you have a locking or more stiffening of any of the joints by either joint stiffness or muscle stiffness surrounding the joints the suspension system that represents a preload force on or a compression of the spring suspension system.

That means that the total capacity to load the force of the impact into the spring mechanism is reduced because it’s preloaded already with some force. If you try to load maximum force into this preloaded spring mechanism there is no room for the force to go.

That is when it has no other choice but to cause injury when the force plastically deforms the disc. This is what we call a herniated or bulged disc.

Internal External Forces Conditions


If the force is overloading the spring mechanism of the knee then you can get a a meniscus tear or anterior cruciate tear.  If it’s in the foot then it can become a heel spur, plantar fasciitis or a shin splint.

These muscles are essential for absorbing impacts so if you’re having impact injuries such as shin splints plantar fasciitis, herniated discs, heel spurs, then you can suspect that your spring suspension system of the arch of your foot is locked.

The most likely area for the spring mechanism to lock is at the metatarsal cunieform joint number two and three.  (mid-arch)  Also the talus can lock in the ankle mortise medially.  When I release these joints they make a loud crack and the patient feels an instant release of the joint stiffness.

If your spring suspension system muscles are stiff the most likely ones are the medial intrinsic muscles of the foot, the tibialis posterior, tensor fascia and gluteus medius.  You can start releasing these muscles by doing the spring release techniques to release these joints in tutorials #77-89, the links are below:

Video Tutorial #77 How to Self Adjust Your Toes   
Video Tutorial #78 Deep Tissue Treatment Of The Knee Popliteus Muscle
Video Tutorial #79 Deep Tissue Treatment Of The Gluteus Medius Muscle of the Hip
Video Tutorial #80 Deep Tissue Treatment Of The Subtalar Joint Of The Ankle On The Inside
Video Tutorial #81 Deep Tissue Treatment Of The Ankle (Subtalar Joint Outside) 
Video Tutorial #82 Deep Tissue Treatment Under The Big Toe And Second Toe
Video Tutorial #83 Deep Tissue Treatment Above The Big Toe And Second Toe 
Video Tutorial #84 Scissor Stretching Of The Feet
Video Tutorial #85 Stretching Great For Mortons Neuromas And Heels
Video Tutorial #86 The Best Shoes To Prevent The Foot From Deforming
Video Tutorial #87 Deep Tissue Of The Ankle Mortise
Video Tutorial #88 Stretching Of The Foot While Sitting At Your Chair
Video Tutorial #89 A Stretch To Increase The Flexibility Of Your Foot

I Have listed some  Resistance Exercises to Strengthen the Spring Suspension System Below:

Video Tutorial #148 Bosu Ball Foot Training, click here
Video Tutorial #76 Bosu Ball Lateral Step, click here
Video Tutorial #177 Side Lunge With Cable, click here
Video Tutorial #105 Foot Eversion Exercise, click here
Video Tutorial #106 Foot Inversion Exercise, click here
Video Tutorial #107 Ankle Exercise Training, click here
Video Tutorial # 108 Cable Hip Adduction And Foot Inversion, click here
Video Tutorial #109 A Great Hip Adduction Exercise, click here
Video Tutorial #109 A Great Hip Abduction Exercise, click here
Video Tutorial #110 Dr Stoxen loses An abdominal Exercise Competition By One Rep, click here
Video Tutorial #111 Rectus Abdominal Cable Crunch Pull Downs, click here
Video Tutorial #112 Abdominal Oblique Exercise, click here
Video Tutorial #176 Improve Your Balance With Half Foam Roll Exercises, click here

I have listed some impact exercises to Supercharge the Spring Suspension System below:

Video Tutorial #149 Figure 8 Runs, click here to view
Video Tutorial #133 Circle Walk, Jog, Run And Sprint, click here to view
Video Tutorial #90 Obstacle Course, Combining Exercise Drills, click here to view
Video Tutorial #136 Double Leg Cone Jump or hop, click here to view
Video Tutorial #137 Why Plyometric Exercises Increase Human Performance In Athletes and YOU too!, click here to view
Video Tutorial # 142 Improve Your Jumping Ability And Supercharge With Speed Bounds, click here to view
Video Tutorial #147 Single Leg Hop, click here to view
Video Tutorial #150 8-Point Step, Lunge, Hop or Bound, click here to view
Video Tutorial #152 Ricochet Box Jump, click here to view
Video Tutorial #167 Side Shuffle, click here to view
Video Tutorial #178 High Skip – Vertical And Horizontal, click here to view
Video Tutorial #179, 45 Degree Zig-Zag Hop, Jump Or Run, click here to view
Video Tutorial #151 Lateral Cone Jumps, click here to view

This video tutorial was taken from the lecture:

Title: Run For Life! Barefoot
Presented by Dr. James Stoxen DC
The Second World Anti-Aging Medical Conference
February 4th-6th 2011
Mexico City, Mexico

Video Tutorial #200 Can You Pass The Foot Ankle Toe Raise Alignment Test? (Front View)

Dr. James Stoxen DC of Chicago IL, USA and Dr. Amir Majidi Dc of  Toronto, Ontario, Canada April 29, 2012 at a park Kuala Lumpur, Malaysia Today I am going to help you evaluate if your Human Spring Suspension System muscles are weak by doing the Foot and Ankle Alignment Test. This is the sister […]

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Dr. James Stoxen DC of Chicago IL, USA and
Dr. Amir Majidi Dc of  Toronto, Ontario, Canada
April 29, 2012 at a park
Kuala Lumpur, Malaysia

Dr. Amir Majidi DC and Dr. James Stoxen Dc

Today I am going to help you evaluate if your Human Spring Suspension System muscles are weak by doing the Foot and Ankle Alignment Test.

This is the sister test to the Foot-Ankle Toe Raise Alignment Test (Posterior)

Dr. Amir Majidi Dc from Toronto, Canada, my research assistant will be demonstrating for you how to execute the test.

The Foot Ankle Alignment Test (Front) and (posterior) are two tests in Anthony Field’s book, How I Got My Wiggle back.  You can get the book from Amazon.com or purchase it at your local bookstore.

Yes, I did these tests on Anthony Field and…  he failed both tests miserably!  

So don’t be discouraged because if you read the book you will find:

Field, the creator and a founding member of the world’s most successful musical groups for young children, The Wiggles, was handicapped by chronic pain, chronic, chronic fatigue, misdiagnosed fibromyalgia and depression during his 20 years on the road.  I am proud to say, I was able to assist him.

It covers our consultation in detail and provides a comprehensive, plain-English explanation of the drug free approach, and the results, that helped him get in the best shape of his life.

excerpt taken from the book, How I Got My Wiggle Back, page 127, The Foot – Ankle Alignment Test (front view), Back to the mirror, please. Stand up straight and do a little jig. OK, that has nothing to do with this test, but it’s always healthy to have a bit of dance.

Right back to it. Draw an imaginary line from your second toe running up through your ankle to your knee. Is the line straight or is it broken around the ankle area? If it’s broken, then the muscles that suspend your arch spring or your foot are probably not strong enough and your spring suspension system could be damaged.

Directions:

  1. Go up on your tip toes
  2. Try to maintain a proper alignment with your second toe, ankle and shin bone
  3. Try to balance

 

Ideal Foot/Ankle Alignment

 

Pictured above is an example of an ideal foot/ankle alignment which will only make your spring suspension system muscles stronger. This is your goal!!!

Mild to Moderate Foot/Ankle Misalignment

Pictured above is mild to moderate misalignment of the foot/ankle. This is cause to work on strengthening the spring suspension system muscles.

Moderate to Severe Foot/Ankle Misalignment

Pictured above is moderate to severe foot/ankle alignment which means you should work on strengthening your spring suspension system muscles.

To give you a better idea to compare good alignment vs misalignment I have put the graphic models side by side above. (click here get a separate page to view while you read)

If your foot goes out of alignment  and turns out then that means you have a weakness in the spring suspension system muscles.

If one foot can go up in alignment and the other one turns out and cannot go up then you have a weakness on one side.

supportive cuff muscles close- up

The Muscles of the Pronation Supination Cuff

If you look closely at these illustrations of the feet, (If you look closely at these illustrations of the feet, (click here to open a separate page with this diagram to study while you read)) you will see that the pink and purple tendons ( peroneus longus (also known as fibularis longus) is a superficial muscle in the lateral (outside) compartment of the leg.  It acts to counter that abnormal turn out of the leg or evert the leg.

Just look at how the tendon of the peroneus longs (pink tendon) extends under your arch and attaches to your your big toe.   These are the muscles that are not engaging or weak in your suspension system muscle group.

The muscles of the spring suspension system of the foot and ankle consist of the tibialis posterior, tibialis anterior, peroneus longus, and peroneus brevis.

As you can see the peroneus longus coming from the lateral aspect of the foot cross over to add some support to the first ray because this is where the foot usually collapses and locks.

The Peronæus longus also everts the sole of the foot, and from the oblique direction of the tendon across the sole of the foot is an important agent in the maintenance of the arch.

The Tibialis Posterior Muscle

This is the tibialis posterior (blue tendon) that supports the first metatarsal-cuneiform, second and third. You can also see the tibialis posterior (blue tendon) which attaches at the mid-arch  at the first second and third metatarsal cuneiform joints where the spring action happens on impact.

If this joint area is stiff or locked then the tibialis posterior cannot contract maximally against this joint. It’s impossible if the joint is locked.I find this muscle to be the weakest of the cuff.

They even have a syndrome named for it:

Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot deformity in adults. Although this term suggests pathology involving only the posterior tibial tendon, the disorder includes a spectrum of pathologic changes involving associated tendon, ligament, and joint structures of the ankle, hindfoot, and midfoot.

Early recognition and treatment is the key to prevention of the debilitating, long-termconsequences of this disorder. Conservative care is possible in the earliest stages, whereas surgical reconstruction and eventually arthrodeses become necessary in the latter stages. The purpose of this article is to review the symptoms, physical examination, radiological examination, classification, and treatment of posterior tibial tendon dysfunction. / Orthop Sports Phys Ther 2000;30:68- 77. 

The blue tendon represents the tibialis posterior muscle and tendon.  This muscle stabilizes the arch from the medial aspect.

This test can give you a good evaluation of the strength of your spring suspension system up to your bodyweight ONLY!

It is important to have strength in your foundation to protect your body from impacts as well as help with balance, agility and coordination.

Lets understand the importance of this test…   

Just look at how the tendon of the peroneus longs (pink tendon) extends under your arch and attaches to your your big toe.   These are the muscles that are not engaging or weak in your suspension system muscle group.

This can give you a good evaluation of the strength of your spring suspension system.

What

It is important to have strength in your foundation to protect your body from impacts as well as help with balance, agility and coordination.

The muscles which support the foot and ankle in this position are the achilles as a primary however the tibialis anterior, tibialis posterior, peroneus longus and brevis stabilize the foot with respect to preventing rotation and lateral motion.

The trick is to test them for how long they can maintain this position to measure “static” strength endurance.

Here is the math:

You are testing the muscles acting on a lever system which is actually 50% body weight force you are lifting as 1/2 of the body on each foot.

  • 50% Bodyweight Foot-Ankle Toe Raise Alignment Test (above) – This evaluates the strength of the muscle groups with 50% of the bodyweight on each limb.
  • 100% Bodyweight Foot-Ankle Toe Raise Alignment Test - You can do a variant of this test that measures the strength and static strength endurance by having them stand on one foot in the same test position
  • 50% Bodyweight Bosu Ball Foot-Ankle Toe Raise Alignment Test - is this same test while attempting to balance your body on a Bosu ball. You cannot use any assistive devices to hold yourself on the ball. You can practice by hanging onto something to practice letting go periodically to challenge your muscles. Its not easy! Ultimately you attempt to do the test, with a straight limb and not a lot of motion.
  • 100% Bodyweight Bosu Ball Foot-Ankle Toe Raise Alignment Test - This is the same test as the one above except with one leg. This is an extremely challenging test that most top athletes have difficulty with.

You are testing the muscles acting as on the body as a lever. So, the forces are no more than 1x bodyweight because there is no movement (walking or running) so no impact.

So what does this mean if you cannot pass the test?

If you cannot do a single Foot-Ankle Toe Raise and maintain proper alignment with 50% of your bodyweight on either limb then we know for sure you won’t be able to walk without your foot and ankle misaligning at the impact point and through the loading of your bodyweight into the human spring.

Why do we know that?

Walking is 1.25 x bodyweight impact force per step.  

This is one contraction of 50% of your bodyweight!

So, if you have conditions related to excessive strain on tissues then that is a sign that your spring mechanism could have fatigued, dropped and locked and/or it is too weak to absorb the impacts by springing your bodyweight off the ground and instead the bodyweight is banging into the ground.

Banging your bodyweight into the ground obviously stresses your tissues more than springing off the ground.

Also springing off the ground is more efficient movement than banging into the ground!

Lets see…

Banging into the ground instead of springing off the ground…  

What is the effect on the body?  

Banging into the ground means little to no protection during impacts and a locked spring which is compressive stress on the weight bearing joints.

This can manifest as any of a number of conditions related to an overstress of tissues or bone such as:

  • plantar fasciitis
  • heel pain
  • heel spurs
  • calf cramps
  • shin splints
  • meniscus tears
  • knee pain and chondromalacia or cracking knees
  • hip pain
  • herniated discs
  • herniated discs that don’t heal
If your body works as a lever instead of a spring due to weakness in the spring suspension system your gait is not as efficient.  You move by pushing your bodyweight instead of bouncing or springing your bodyweight forward burning vital energy.

This is called chronic fatigue!

When you test and train as a lever mechanism, you are getting stronger and able to stabilize your limbs over the foot in the safe range between supination and pronation better during walking.

We call this chronic pain and some doctors can confuse this misdiagnosing your condition as fibromyalgia!
Inflammatory Diseases of Aging

Dont forget, if your body is stiff and sore all over because its locked or too weak to absorb impacts of walking speed or running speeds then your body is accumulating inflammatory chemicals (cytokines) which are damaging to your health if they remain chronic.  Go to the pub med search page and put – cytokines inflammation depression – in the search box and see how many articles come up referencing depression and its connection to chronic inflammation!

If the maximum resistance you can get doing resistance exercises with your bodyweight is 1.0 x bodyweight and impacts of walking are 1.25 x bodyweight you have to add weight to your body when doing resistance exercises or introduce progressively greater impact forces into your spring to strengthen your spring suspension system enough to handle impacts of walking safely.

Running involves using your body as a spring

Walking involves 1.25x bodyweight impact forces which is greater than the 100% Bodyweight Foot-Ankle Toe Raise Alignment Test.  

So the next progression is to do this test while walking checking the alignment of the foot-ankle-shin complex at impact and through the loading of the bodyweight mass into the spring suspension system or mechanism.

I suggest you do this test while being videotaped from the front and back.  Simply walk towards the camera, turn around and walk away from the camera.  Try to walk the second time as fast as you can.

That adds speed to the formula F = M x A which means you are checking the suspension systems ability to maintain the foot in the safe range between supination and pronation at a higher force of impact

How To Train the Suspension System to Handle Greater Impact Forces

If you would like to increase strength of the supination pronation cuff (landing muscles) or spring suspension system muscles then you have to move from training as a lever and begin to introduce progressively greater impact forces.

If you want to train to maintain your foot in the safe range between supination and pronation during impacts such as walking, running and the participation of sports to avoid over pronation and over supination at foot strike you have to train with progressive greater force impacts.

This means you have to start with walking speeds training these muscles in all angles such as inversion, eversion, abduction, adduction, pronation and supination.

F = M x A

So if you understand Newtons Law the force of your impact is determined by your mass x acceleration or speed of running. Since your mass stays the same the way to progressively increase force is to run faster.

I recommend barefoot zig zag runs, side shuffle runs, carioca, ricochet, and lateral bounds, hops, etc

Phase I Release the Spring Mechanism

This involves removing all joint play stiffness and/or locking by releasing locked joints and muscle spasms in the weight bearing joints from head to toe nail.  This is done by hand and I have excellent self help tutorials for you to learn how to do this yourself!

Search for Video Tutorials 77 – 89 to find them or find them on this page where all of my video tutorials are located!  View all video tutorials here… 

 Click the links below to strengthen and supercharge the spring suspension muscles system muscles:

Phase II Strengthening:

Video Tutorial #148 Bosu Ball Foot Training, click here to view 

Video Tutorial #76 Bosu Ball Lateral Step, click here to view

Video Tutorial #177 Side Lunge With Cable, click here to view

Video Tutorial #105 Foot Eversion Exercise, click here to view

Video Tutorial #106 Foot Inversion Exercise, click here to view

Video Tutorial #107 Ankle Exercise Training, click here to view

Video Tutorial # 108 Cable Hip Adduction And Foot Inversion, click here to view

Video Tutorial #109 A Great Hip Adduction Exercise Demonstrated by WBC Pro Boxing Champion Miguel Macho Hernandez at Team Doctors, click here to view

Video Tutorial #109 A Great Hip Abduction Exercise Demonstrated by WBC Pro Boxing Champion Miguel Macho Hernandez at Team Doctors, click here to view

Video Tutorial #110 Dr. James Stoxen DC loses An abdominal Exercise Competition By One Rep. Watch And see, click here to view

Video Tutorial #111 Rectus Abdominal Cable Crunch Pull Downs, click here to view

Video Tutorial #112 Abdominal Oblique Exercise Demonstrated by WBC Pro Boxing Champion Miguel Macho Hernandez And Fighter Adrian Grenados at Team Doctors, click here to view

Video Tutorial #176 Improve Your Balance With Half Foam Roll Exercises, click here to view

Phase III Supercharging:

Video Tutorial #149 Figure 8 Runs, click here to view

Video Tutorial #133 Circle Walk, Jog, Run And Sprint, click here to view

Video Tutorial #90 Obstacle Course, Combining Exercise Drills, click here to view

Video Tutorial #136 Double Leg Cone Jump or hop, click here to view

Video Tutorial #137 Why Plyometric Jumping Or Impact Exercises Increase The Level Of Human Performance In Athletes and YOU too!, click here to view

Video Tutorial # 142 Improve Your Jumping Ability And Supercharge The Human Spring With Speed Bounds, click here to view

Video Tutorial #147 Single Leg Hop, click here to view

Video Tutorial #150 8-Point Step, Lunge, Hop or Bound, click here to view

Video Tutorial #152 Ricochet Box Jump, click here to view

Video Tutorial #167 Side Shuffle, click here to view

Video Tutorial #178 High Skip – Vertical And Horizontal, click here to view

Video Tutorial #179, 45 Degree Zig-Zag Hop, Jump Or Run, click here to view

Video Tutorial #151 Lateral Cone Jumps, click here to view

Learn how to test the front view by viewing Video Tutorial #200 Can You Pass The Foot Ankle Toe Raise Alignment Test? (Front View), click here to view 


Cracking Achy Knee Pain or Chondromalacia Patella – Treatment and Prevention Tips from The Barefoot Running Doctor

  Chondromalacia Patella ICD-9 733.92 What is chondromalacia patella? Athletes and trainers call it runners or jumpers knee. Non-athletes call it cracking knees. Doctors call it chondromalacia patella. It has many names which confuse people.  Some people even split up the word as chondro malacia patella but it should be chondromalacia patella. chondromalacia patella or CMP, sometimes called anterior knee […]

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Chondromalacia Patella ICD-9 733.92

What is chondromalacia patella?

Athletes and trainers call it runners or jumpers knee.

Non-athletes call it cracking knees.

Doctors call it chondromalacia patella.

Knee Pain

It has many names which confuse people.  Some people even split up the word as chondro malacia patella but it should be chondromalacia patella. chondromalacia patella or CMP, sometimes called anterior knee pain; patellofemoral pain syndrome; patellar tendinitis; patellar tracking dysfunction; patella femoral syndrome; tendonitis of the knee; patellar dysfunction; patellofemoral arthralgia and chondromalacia patellae, is the softening and breakdown of the tissue (cartilage) that lines the underside of the kneecap (patella).

People come into Team Doctors and say “My knee hurts” or “I have a swollen knee, a bad knee, achy knees or bad knees.”  

Patients ask questions like:

Why is my knee sore and especially pain behind, under or below the knee cap?

Why do I have a sore knee cap and when is it chronic, why is my knee swelling?

Why is my knee popping or why do I have cracking in the knees?

Why is it my knee hurts when I bend it?

Why does my knee hurt when I squat down?

Why do I have, after running, knee pain?

When patients ask these kind of questions I am always thinking chondromalacia knee.

What is chondromalacia patella (walkers) or runners knee (runners)?

Patello-Femoral Syndrome or Chondromalacia Patella (of Greek origin meaning “softening of the cartilage”) or “Runner’s Knee”

Runners Knee refers to pain on the inside of the knee, although pain on both sides  of the knees or pain beneath the kneecap can also occur. It is more commonly seen in runners as opposed to walkers due to a higher level of activity, particularly mileage.

The key element in this injury is due to over pronation causing a repeated stress of the patella bone moving abnormally from side to side over the groove of the thigh bone (femur), gradually softening the cartilage under the kneecap.

The result is the surface of the joint can become rough. Kneecap pain may be just a prelude to further destruction of the surface (traumatic arthritis). This injury can be confused with “Patella tendonitis” which is usually pain beneath the patella bone. In either case it is the “tracking” of either the bone or tendon which needs to be addressed.

The patient commonly has no history of a knee injury like a twisted knee, nor can they pinpoint any particular event that initiated the pain in the knee cap.

Do you have patella pain,  achy knee pain or cracking or popping in the knee? Is your knee swollen or do you haven chronic knee pain? Do you have patella groove pain or patellar joint pain?  has your knee doctor or knee surgeon told you that you need knee surgery or injections for knee pain?

If you hear your knee cracking or if you have knee pain when you walk up the stairs, knee pain after running, knee pain while running, knee pain when getting up from a chair or knee pain when bending, infraptatellar pain, you might have chondromalacia patella.

Some other symptoms of chondromalacia patella are;  knee pain when you do lunges, knee pain when squatting, knee pain when doing extensions, a feeling of water on the knee, dislocated knee cap or dislocated patella.

What I have found in treating patients with pain in the knee is that knee inflammation and  intense knee pain could be caused by a locking of the Human Spring. Over pronation could be a factor so LOOK AT THE FEET FIRST!

The first thing we need to do is look at the anatomy of the knee.

What tendons are in the knee?

As you know, the patella is a pulley mechanism. (see picture to the right)  I observe many coaches looking at hamstring and quad strength as the key to patella motion in the patellofemoral groove or the trochlear grove.

note: The trochlear groove is the concave surface where the patella (kneecap) makes contact with the femur (thighbone). Also called the ‘trochlea’.

The way I see it is that the hamstrings and quads are in the middle of the kinematic chain or spring mechanism of the body. So therefore, they don’t influence. They are influenced by the way the mass transitions across the foot spring mechanism.

The answer to your Cracking Achy Knee Pain is not to pop an advil, ice pack or to do some hamstring stretches. That is like putting a bandaid over a bullet wound.

React!

What is chondromalacia?

chondro malacia patella; Anatomy of Chondromalacia Patella:

  • Chondro = cartilage
  • Malacia = softening of tissues
  • Patella = knee cap

Chondromalacia patella is abnormal softening of the cartilage of the underside the kneecap (patella) or patellar joint. It is a cause of pain in the front of the knee (anterior knee pain). Chondromalacia patella is one of the most common causes of chronic knee pain. Chondromalacia patella results from degeneration of cartilage due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). This process is sometimes referred to as patellofemoral syndrome.

What causes chondromalacia patella?

I have treated thousands of patients with chondromalacia patella. A patient might come in with complaints of  knee cap pain or knee osteoarthritis. The pain in the knee cap goes away without any training of the quads or hams. What I find is that on the involved side of infra patellar pain is an abnormal foot plant (over supination/ over pronation).

When transitioning the impact forces of the landing, the foot adjusts for the impacts two ways:

The 33 joints of the foot and ankle spread across the force of the landing. When this happens the impact is received as a “negative” by the tendons of the landing muscles.

The problem with the current mechanical model being used for the study of biomechanics (the lever system)–the way most podiatrists, etc., look at the body–is they look at it as a rigid lever when it is not rigid at all.

Assuming the human body ambulates, protects itself from impacts and recycles energy through a lever system is illogical and actually defies the laws of physics. A lever cannot protect an object from a lifetime minimum of 250,000,000 collisions with the earth. The body must be a spring mechanism.

The Human Spring

The body springs off the ground when its working the way its designed. The natural spring mechanism occurs at the arch and transfers its protection and spring energy through the 7 floors of the human spring.

The body is a giant spring with 7 floors of springs:

  1. The arch
  2. The subtalar joint
  3. The ankle mortise
  4. The knee and the knee cap
  5. The hip
  6. The spine
  7. The head-neck

When your spring mechanism is weak it collapses into a lever mechanism. When it collapses, the brain senses the abnormal movement patterns and tries to protect you from the stress and strain by muscle spasms. spasms compress the spring further.

Weakness, stiffening and or locking of the human spring mechanism could cause widespread chronic pain, chronic fatigue, misdiagnosed fibromyalgia, chronic inflammation as well as Chondromalacia Patella, knee cap pain, knee osteoarthritis and knee inflammation.

We must first gain an understanding of overpronation and oversupination

 

Safe and Unsafe Range

The foot rolls from supination to pronation. Have you ever heard of over pronation?  That is where to foot rolls too far inward outside the green safe range for foot rolling in the graphic above.

When this happens, the limb internally rotates on impact. That does not put the patella (knee cap) in a good position to allow for stress and strain free motion.

What is a knee cap?

A knee cap is like a wire in a pulley mechanism.  So the key to understanding this is simple. If the foot rolls out of the safe range the knee cap will also rotate out of the safe range in its grove as well.  Does that make sense?

If I have an athlete with patella groove pain or infra patellar pain I always do a simple gait study.

During a normal gait cycle, the femur and the tibia (thigh bone and shin bone) rotate together (i.e. outward when your foot first lands on the outside then inward when it rolls to the inside).

However, chondromalacia occurs when a person over-pronates (over rolls the foot out of the safe range) because the tibia (shin bone) is locked into the talus (ankle bone) and therefore continues to rotate inward the femur receives its orders from the brain and begins to rotate outward when your foot is planted.

This seems complex but simply stated patellar tendon pulls the knee cap out of the groove it is supposed to be in causing grinding of the undersurface cartilage leading to pain in the knee cap, patella pain, knee pain below the knee, and just general pain around the knee.

The resulting counter rotation of the femur and the tibia causes the patella to rub against the cartilage in the grove instead of moving smoothly up and down in its normal track, which causes the pain felt by the patient and the damage to the cartilage.

Over Pronated Foot

Therefore, if the foot rolls outside the safe range (green-black-green) then the limb rolls in or outside the safe range this causes the knee to be in a position where the knee cap will grind against the pulley mechanism gro0ve (trochlear gro0ve) This can cause irritation to the cartilage, chronic inflammation and knee pain.

Pain at the front/inner side of the knee is common in young adults, especially soccer players, gymnasts, cyclists, rowers, tennis players, ballet dancers, basketball players, horseback riders, volleyball players, and runners.

Knee Pain

The pain of chondromalacia patellae is typically felt after prolonged sitting, like for a movie, and so it is also called “movie sign” or “theater sign.” Snowboarders and skateboarders are prone to this injury, particularly those specializing in jumps where the knees are under great stress.

Skateboarders most commonly receive this injury in their non-dominant foot due to the constant kicking and twisting that is required of it during skateboarding. The condition may result from acute injury to the patella or from chronic friction between the patella and the groove in the femur through which it passes during motion of the knee.

Other possible causes include a tight iliotibial band, neuromas, bursitis, overuse, malalignment, core instability, and patellar maltracking.

Chondromalacia Treatment

The problem with trying to adjust the position of the patella with the training of muscles above the patella is that the most common abnormalities of limb position that effect the glide of the patella come from below, in the foot and ankle.

We all know that if we have poor posture it is because the muscles don’t have a balance of strength with respect to what role they are supposed to play. Obviously you know long term chondromalacia treatment involves chondromalacia exercises to strengthen the muscles so there is a balance of strength in the foot rolling mechanism so the foot, shin bone and thigh dont over rotate causing chondromalacia symptoms.

However, patients with a sore knee cap dont want to exercise because some exercises like knee extensions actually track the knee cap leading to under the kneecap pain the next day.

We know that we can change the position and motion of bones by training. Is it possible to train muscles when the joints they affect are locked? Its not safe for many reasons

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That is why we must first stabilize the foot rolling within the safe range to stop the stress and strain that is leading to the wear and tear under the knee cap that is leading to the sore knee cap.

We do this with a shoe that has a strong medial extended counter support.

Safe and Unsafe Zone

I have treated some of the most amazing dancers from Dancing with the Stars, So You Think You Can Dance, national broadway touring companies and over 100 other tours of top entertainers.  Many are fitted for $500 custom shoes for performances and wonder why they are still in pain.

What did you do Saturday after rehearsal?

I went shopping on the sidewalk with flip flops for four hours.

Oh!  Well why do you wonder why your knee hurts?

Read these video tutorials to understand what shoes are required and why:

Video Tutorial #97 On Your Feet All Day? Fatigued? Achy? Over Pronation? I Recommend Footwear with Extended Medial Counters

Video Tutorial #86 Dr James Stoxen DC Recommends The Best Shoes To Prevent The Foot From Deforming

Why is it any different from the elbow joint where we demand form and technique be perfect during exercise to maintain limb alignment and prevent stress or strain?

If I have an athlete with patella groove pain or infra patellar pain you should do a simple gait study.

watch above as Dr. Stoxen evaluates a gait study with a patient at Team Doctors

Get a $140 HD flip video camera. Video the athlete walking barefoot 10 steps toward the camera and back. Do this while the athlete is walking, fast walking, and running. Download it and watch the video frame by frame and you will see why the patella is not in the groove. It is obvious and enlightening.

 Here is a blog post you may like that talks about “foot lock” which is when joints of the foot are locked causing abnormal movement patterns (compensations) which effect patella position and a lot more! click here to view

If you hold a curl at 90 degrees of flexion for 30 minutes the muscles go into a spasm, the joints stiffen and sometimes there is pain and altered motion. Why wouldn’t you think this same locking would happen in the foot and ankle spring when you stand for 30 minutes?

It does!

The next step in the protocol for the human spring model is the release the tension on the human spring suspension system and the mechanism throughout the entire flooring system of this integrated spring mechanism.  We start at the foot and work out way up.

watch the video tutorials below to release the human spring with my deep tissue release tips:

Be sure to start on Video Tutorial # 78 and go through Video Tutorial #89:

Watch above as Dr James Stoxen DC Demonstrates Self-Help, Deep Tissue Treatment Of The Knee Popliteus Muscle

Watch above as Dr James Stoxen DC Demonstrates Self-Help, Deep Tissue Treatment Of The Gluteus Medius Muscle of the Hip

Watch above as Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Ankle (Subtalar Joint Inside)

Watch above as Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Ankle (Subtalar Joint Outside)

Watch above as Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Treatment Under The Big Toe And Second Toe

Watch above as Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Treatment Above The Big Toe And Second Toe

Watch above as Dr James Stoxen DC Demonstrates Scissor Stretching Of The Feet

Watch above as Dr James Stoxen DC Demonstrates Stretching Great For Mortons Neuromas And Narrow Heels

Watch above as Dr James Stoxen DC Recommends The Best Shoes To Prevent The Foot From Deforming

Watch above as Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Of The Ankle Mortise

Watch above as Dr James Stoxen DC Demonstrates Stretching Of The Foot While Sitting At Your Chair

Watch above as Dr James Stoxen DC Demonstrates A Stretch To Increase The Flexibility Of The Arch Of Your Foot

What exercises strengthen the knee?

Chondromalacia Exercises - People are always asking about what exercises strengthen the knee when it is really what exercises strengthen the feet and ankles.  The position of the 3 dimensional foot determines how the knee tracks.  In other words the knee is a victim of foot and ankle react to the landings.

The next step is to train the foot and lower extremities as lever systems in all ranges of motions with strength training 

To learn more about strengthening the human spring mechanism please read these two tutorials:

Video Tutorial #12 Is Running Bad For Your Knees? How Does The Body Spring Back Safely From Impacts Of Running and Walking?

Video Tutorial #28 Self-Tests & Exercises To Reduce Over Pronation and Over Supination From Impacts During Walking and Running

The foot is a 3-dimensional structure that has to be trained in all ranges of motion and without a binding or motion altering device.

This article and the articles that are linked to this article will give you a step by step action plan to reducing chondromalacia patella or cracking knee pain.  In order to get the best results you need to do all the steps and not miss any.

In patients with obvious over pronation I have not been able to resolve their choncromalacia pain without counter support footwear.  You can try it but I will save you the effort of making the mistake. I have never been able to do it and I doubt you will either.

Good luck treating the snap crackle pops of the cracking knee syndrome. If you need any help, please contact me in the comments section of this article and I will do my best to help you.

Thank you for sharing this article with your friends!  Dr James Stoxen DC

Disclaimer

 

 

What Songs Do You Listen To When Running?

    What are the top three songs you listen to when running? When you run barefoot, part of the analysis of form and technique is to hear the sound your foot makes on impact. By listening very carefully and making adjustments to the tension of your landing gear you can soften up your landing […]

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What are the top three songs you listen to when running?

When you run barefoot, part of the analysis of form and technique is to hear the sound your foot makes on impact. By listening very carefully and making adjustments to the tension of your landing gear you can soften up your landing from a bang and a twist to a spring….

When it comes to running efficiency and reduction of injurious conditions…

The “SPRING IS THE THING”

As a reporter I met from the ‘Malaysia Star’, Jaya J says, “Footwear is comparable to mothers who smother. You know, you have all good intention of protecting and giving your feet the best care, but what you’re actually doing is smother those feet by binding them in that cushion so much that they lose their natural sustainability, which is the Human Spring.” To here more of what Jaya J says on her blog, click here 

So protecting them from the impacts you can no longer tell if you are impacting with spring or bang because the cushion fools you into thinking your spring is working when its really a cushioned, bang and twist.

Then you further isolate youself from hearing how hard your foot impacts with music you make it more difficult to fine tune your landing as a spring and not a bang.
BANG! BANG! BANG!

The next music you will here will be coming from the reception area of Team Doctors, Treatment and Training Center or worse the hospital.

Im sure some sweet lady is going to flip out on me with a comment. :)

I like to listen to music to relax or I use the beat of the music 180/min to pace my run cadence!

hahaha

Im cool with that. Dont break a nail!

I listen to the pitter patter of springy bare feet.

Its a new song I hope to be a big hit!

Seriously, feel free to post comments below on what music you like.

Barefoot Running Doctor

Video Tutorial #75 The Deep Tissue Treatment Dr. James Stoxen DC Uses For Shin Splints

   Dr. James Stoxen DC Demonstrates The Deep Tissue Treatment He Uses For Shin Splints   Today i’m going to talk about Shin Splints. I am going to show you how to get some relief from the pain from shin splints by doing some deep tissue work. This is helpful if you have major or […]

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 Dr. James Stoxen DC Demonstrates The Deep Tissue Treatment He Uses For Shin Splints

Dr. James Stoxen DC Demonstrates How To Relieve Shin Splints

 

Today i’m going to talk about Shin Splints.

I am going to show you how to get some relief from the pain from shin splints by doing some deep tissue work.

This is helpful if you have major or minor shin splints.

This is exactly what I do with patients in my office which means i’m teaching you all of my tricks.

  1. First you find the shin which is located in the picture above and in the video.
  2. Then you roll off of the bone with your thumb where the bone drops off into the muscle.
  3. Your thumb should sing right in there.
  4. Start at the bottom and hold that point down to the bone. (it may be tender)
  5. Hold your thumb down until the pain goes away and move your way up through the shin one thumb thickness at a time.
  6. Work your way up to the knee. As you go up towards the knee you will have to work your way deeper to get inside deeper. What you might want to do it employ the other thumb to help push down into the tissue with extra pressure on that area.

(be sure to take your time applying the deep tissue treatment. The example I depict in the video was done quicker than normal as I was focused more on showing area to be treated and not the timing)

You can do a couple of passes up and down the shin. You may find that the first time might hurt but the second and third time the pain might is less severe and improvements are being made.

What is happening when your putting pressure on the muscle the brain gets a message that things are getting better. For some reason the brain decides to let go on the lock down that it has on that muscle on your human spring.

In my opinion the shin splint is formed when the human spring is locked and can’t absorb the force of the landing comfortably into the spring with spring protection. Instead it bangs into the ground and sends splintering force up to the shin and the tibia which creates muscle spasms from that abnormal movement pattern.

By releasing these muscles your actually reducing cause of the shin splints.

I recommend that you go through all of the Video Tutorials on the blog especially the Self Help Release Video Tutorials #77-89 to help you release your human spring

Disclaimer

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