want to keep barefoot/minimalist, but having challenges

[hollyk]

Hello, Doctors!

Let me apologize in advance for a lengthy post. I would really like to stay barefoot, and my body appears to disagree with me. I don't know how much info you need, so I'm just going to start typing.

I'm a 33 year old female, standing 5'8” and about 170lbs, I have been as high as (at least) 240, and as low as 159 in my adult life. Right now I fluctuate between 178ish and 165ish. I am a massage therapist and have been teaching Yoga for about 2 years. I spend a lot of time unshod, if I can help it.
I have decent arches, my feet seem to be wider now that I'm shod less often. I often have a heavy step, my heels hit hard and sometimes the balls of my feet drag a bit before the heel makes contact.

In the past 10 years or so, I have developed knee pain. It started with grinding (without pain) when I went up stairs, and progressed to pain in the lateral knees, down into tibialis anterior. It's also ITB pain and up into the greater trochanter area.

I am a creature of ease (that sounds so much nicer than lazy). I don't like exercise unless it's fun, or going somewhere. Swimming, dancing, hiking, bellydancing classes, that sort of thing. I was drawn to barefoot/minimalist living about 2 years ago, because it seemed like a way to make running fun, and I had heard about how it helps one run without knee pain. I am not a runner, other than some long jump in High School track junior year. I read Jason Robillard's The Barefoot Running Book, and did some of the exercises, and then started walking/running in preparation for the Color Run 5k. I may not have done enough of the preparatory exercises in the book. I cannot do a full squat with heels down unless I'm holding onto something in front of me. I wear Vibrams when walking/really slowly running. It seems that riding my bike makes the ITBs worse. I live in a small town, so I like to ride to work and running errands, if possible.


I have been seeing a physical therapist who does Alexander Technique and Postural Integration. My understanding of his diagnosis is that I have ITB inflammation, tight gastrocs, piriformis that are angry, and Gluteus Medius that aren't firing. At first he was okay with the vibrams, but he has me now wearing shoes with arch contact, firm heels and no flexion in the sole (from heel to ball of the foot) while I massage. The arch contact is meant to help keep the glute meds firing. It seemed to work for a while, but I'm still sore. He has me doing pt exercises to stabilize the pelvis, strengthen the glute med, and stretch the mediastinum area (I have a weird hitch/cough when I inhale while twisting from side to side), and stretch the calves. I get to exercise my feet by jumping on landscaping rocks. No, really. I also try to foam roll my ITBs, it's excruciating (of course).

I see the Chiropractor (the office I have my massage practice in) once a week for adjustments, he also does gait assessment and a technique to encourage glute med to fire when walking. He also cold lasers my ITBs. It was 2+ times a week, now we are down to 1x.

Would it be helpful to wrap or tape my arches when I am unshod? Should I wear shoes more often? I want to Warrior Dash next year, and need to decide if I am going to stick with my Vibrams or change to traditional shoes. Are there things I can do more or less of?

I want to keep doing this, but I'm tired of hurting. I hope I've given you enough info to help me, would gladly give more if you need it.

 

[Backfixer]

Wow, how frustrating this must be, especially since you are in a profession of giving. I feel your pain. Some things to understand is that you cannot force your body to do something it will not do gracefully. My conclusion after doing my own study on myself (

http://www.backfixer1.com/?cat=16&s=barefoot+almost&submit=Search you can read all three parts in my blog here) is that we are all built differently and asymmetry is what kills running for people. If you are more symmetrical barefoot or barefoot like, great, however many people find out what works for them using trial and error.​

Based on your body style, you may actually do better with arches in your shoes. Many massage therapists have a thing about massaging barefoot however, if your body style is markedly asymmetrical, or in the case of a female, you are tall and have wide hips, a moderate amount of asymmetry will be exaggerated due to the wider hips and your height. These are things you cannot obviously change but based on your description, you did see some improvement with arches in your shoes which is not what you wanted but you are still having glut and it band issues which are related and then of course tight calves. This really means you have a torqued core, which will cause you to have a heavy heel strike.​

What works is to have fascial release done to the obliques, diaphram, erectors and Quadratus lumborum. It does not sound like anyone has looked at this and to have your chiropractor look at your upper body including the ribs, subscapularis and shoulders.​

I am guessing that you hold your shoulders stiff when you run which has a breaking effect on the body and will cause you to over and understride or exacerbate the condition you already have by shortening your stride.​

What may be helpful is foam rolling. Check out our foam roller video here for some ideas. Also, you may want to do bridges, gluteal kicks, lateral leg raises and pushup exercises which are excellent for runners. They can all be found through our website backfixer1.com.​

Without actually evaluating you, I cannot be more specific however, you can send me a video of you on a treadmill and I can give you a better take on what is happening.​

 

[migangelo]

i don't have the experience of either of you but do read a lot. dragging your feet is because of trigger points in your tib anterior. it band problems are from weak hips but i don't know if i've read which muscles specifically.

going back to bf is a journey. it won't magically cure you right away. one problem, weakness, will surface one after the other until you take care of each and everyone. going back to shoes will relieve current pain but then you're just using credit. buying now and paying for it later. invest now while you're younger so you can reap rewards later.

 

[hollyk]

Thank you so much for your responses! I do so want to have more barefootedness.

I have a friend who is extremely talented at MFR, I will discuss the fascial release with her. I have had abdominal work before, and miss it. I always have a good release.

I led my post with the knee pain, but it's more ITBs most of the time.

The torqued core bit is interesting. My PT has said something similar.

I'm honestly not much of a runner. I had thought minimalist running would be fun...but you know. This stuff. So your suggestion is to wear arched shoes when I am walking/running as well? Should I do this in my day-to-day too? I'm not a heelwearinwoman. If shoes aren't comfy, they come off quickly. I'm thinking Birkenstocks. I also saw some wraps that gymnasts use, would they be useful for me? Also, should I nix the bike?

Is it feasible to try to transition back to my Vibrams someday? I would love to send you video, I will have to find access to a treadmill. Also, I become very self conscious when being assessed, and I'm pretty sure my gait varies quite a bit.

Well, that's a bunch more questions.