Your thoughts on my Athletic Competency Measure

[Karl Bedingfield]

Hello all,

Yesterday I went to a sports clinic to have an Athletic Competency Measure which essentially means are my bones and muscles working correctly etc.

The report I got back (see below) kinda put me on a downer as they said there were quite a few things potentially wrong with my body.

I am about 2 months in to barefoot running and still get a slight ache in the calves and had been struggling a little with PF although it is on the mend now.

The clinic said that the 2 hernia operations (either side of groin) have probably contributed to my lack of flexibility.

I recently ran my first 10k forefoot running (with shoes) and finished in 41.32 and am aiming for sub-40 eventually.

Do you think I should be worried with what they found out about me or does the report seem extreme?

Many thanks,
Karl

23rd March 2012

Athletic Competency Measure Overview - Karl Bedingfield

Key History Points
· Left plantar fascitis
· Right Shoulder pain
· History Sports Hernia repair – Left side 20 years ago, Right side 8 years ago

Goals & Objectives
· 6 weeks – Improve Hip mobility and flexibility
· 12 weeks – Improve movement patterning/ Lower limb Stability
· Long term goal – Run 10 Km under 40 minutes

Main Considerations
· Trunk Stability - moderate weakness/ reduced coordination/
· Lumbar-pelvic awareness – forward tilted – difficulty maintaining neutral positioning
· Thoracic stiffness
· Scapular rhythm dysfunction
· Tight hip flexors - Psoas/ iliacus/ Rectus Femoris
· Short Adductors
· Reduced ankle/ knee stability
· Internal hip rotation restriction

Requisites
· Core Stability program – emphasis Lumbar-pelvic awareness
· Hip Flexor stretching - Static/ dynamic stretching
· Hip Mobility - Increase ROM in all planes
· Improve gluteal activation/ strengthening
· Thoracic mobility – improve extension
· Develop scapular stability/ awareness
· Develop lower limb stability
· Improve movement patterning i.e squat/ single leg squat.

 

[Dr James Stoxen DC]

Hi there

Thank you for your trust in our recommendations at the Ask The Docs forum.

What bothers me about this evaluation that you got is that you complained of plantar fasciitis and foot and calf stiffness but their entire array of problems they listed were everything except for the foot and calf area.

The first thing I'd like to know is what this Athletic Competency Measure evaluation was. Was it a screening evaluation that was done to introduce you to the facility or was it a full-blown examination that you paid for as part of your efforts to be coached into a better runner? Screening evaluations are sometimes done in a computer software that is manufactured by a company as a loss leader to get new patients from festivals and fairs and health screenings. Also it's important to know the qualifications of the individual that was evaluating you. Was it a coach, ATC, or trainer? Was it a doctor? What kind of doctor wasn't or was it a tech or marketing person?

The second question I have is, how did they arrive at these results?

GAIT EVALUATION: The most important evaluation that you can get to check your running is gait evaluation. This evaluation should be performed barefoot, while videotaped in walking speeds, fast walking speeds and running speed.

What I do at the gate evaluation is videotape it with a simple flip video camera and then downloaded into my Mac and go over the video analysis frame by frame in slow motion with the patient noting any and all flaws in the form and technique of walking or running movements. It's an eye opening experience that you will find fascinating and it will provide you tremendous insight into why you may be suffering from plantar fasciitis and/or calf spasms and pain.

By doing a gait evaluation and these different speeds you can determine the more exactly how strong the landing gear is and how much force your human spring mechanism tissues are capable of springing back. In some patients we see a pretty normal movement pattern in walking which is (1.25x bodyweight forces of impact) (F=M x A) yet when they run (3x bodyweight forces of impact) the force of impact exceeds the strength of the landing gear to spring it back safely. Yes the foot will either roll into supination or pronation due to the weakness.

If your foot can handle walking speeds but starts veering into abnormal patterns at higher speeds we at least know what your yield point is and we can work with you at that speed. If you don't know what impacts your mechanism is capable of then you cant even begin. Also it can help you to predict any future injuries that you may have as a result of these flaws in your movement patterns.

What you can do is get or borrow a inexpensive video flip camera, have a friend videotape you walking 10 paces towards the camera turnaround and walk away from the camera, then walk fast towards the camera, and walk fast away from the camera. This simple data analysis on video takes less than 30 seconds. You can evaluate your own gait pattern and also you can post it on YouTube and then pick out the link of the YouTube video and post it right here on the Ask the Docs Forum and we will give you our thoughts.

After the gait evaluation is completed any flaws in the gate can be pointed out. The next thing I do is bring the patient into the examining room where the patterns of muscle spasms that are normally predictable in this gait pattern that you saw on the video are checked with deep tissue palpation checking for tense muscles which are normally painful to the touch.

What slows performance or impedes performance is any internal restrictions on the elastic spring mechanism. This is also what can sabotage your training with an injury. The easiest way to get your speed and performance to just to keep you in the game long enough to get the results. With 70% of shod runners breaking down a year that means a high probability of breakdown. I saw this Associated Press feed to FOX which commented on BFR being an approach that can cause injury because of a few guys who got injured. They said this just after they said that 70% of shod runners get injured What a goofy article. Stay barefoot!

There are three different forces acting on the human body.

• 1. There is the normal internal compressive force which keeps your bones together so they don't fly apart.
• 2. There is the external compressor force of any clothing hats, eye glasses or any other items you may have on your body while you're running.
• 3. Then there are internal forces that come from muscle spasms that are tripped by the brain as a result of abnormal movement patterns that the brain recognize as something it doesn't like. The brain creates a muscle spasm to try to stop this abnormal movement pattern. Because muscles connect from joint if they are in spasm. Spasms will compress the joint and can be misunderstood as tight muscles. Sometimes trainers doctors and athletes stretch spasmed muscles when in reality they need to have deep tissue to turn off the spasm at the brain through the myotactic reflex work.

What bothers me about this evaluation that you got is that you complained of plantar fasciitis and foot and calf stiffness but their entire array of problems they listed were everything except for the foot and calf area.

The muscles and joints that they're talking about above the foot and calf area are reactive meaning that they react to the plant of the foot. You already have symptoms in that area which means that the abnormal movement patterns are far advanced in time from just silent inflammation or tightness into an inflammatory process that is actually causing pain. They didn't really get into the evaluation of the area that actually hurts. In fact, they looked at everything but that area.

What is required to check this area is to check the inter segment for motion of each of the 33 joints of the foot. That's what I do in the examining room is motion palpation of all 33 joints and checking for any painful muscle spasms in the foot that may be resulting from abnormal movement patterns. Any type of restriction of B's mode motions of the foot can lead to up hard landing that will stretch and inflamed fascia and turned the natural spring mechanism into more of a bang and twist motion that maybe the reason why your calves are hurting. Stiff sore muscles are usually the result of muscles that have to overwork because other surrounding supportive spring loading landing muscles aren’t doing their job or there's some sort of compensation for a natural movement that is not happening.

The laws of physics tell us that if the foot plans abnormally than the entire kinematic chain above will enter in an abnormal movement pattern. My feeling is that your focus should be on your foot and ankle both in removing all restrictions from that area as well as all the entire kinematic chain above to allow the muscle spasms to get out of the way to allow the elastic recoil mechanisms to work to improve your efficiency of the performance.

The next most important thing to look at his what your gait pattern is during walking and running. You should be practicing your gait pattern every day. That means practicing the spring, forefoot-midfoot, anything but heel landing while walking the shopping center, at school in the parking lot on the way to the store, everywhere.

The next thing to look at is what shoes you are wearing outside of you’re barefoot running training. When we’re not running, many of us do a lot of standing which is a sustained contraction of the spring suspension system muscles. Anytime you have sustained contraction of any muscle it causes tension soreness and spasms. But the fatigue that sets in also causes this area to drop and lock which is maybe why your plantar fasciitis is there. What I found is that the spring suspension system will collapse either in donated position or the soup in a good position at the deepest point of the spring down loading of the arch of the foot.

I didn’t see an evaluation of your gait in this study. That’s an important factor.

Also it didn’t go over your training regime, mileage, rest periods etc. It didn’t go over your mileage your accessory exercises such as drills plyometrics etc. You don't have any home self help tips?

I have a few blogs that will help you get more out of your body now:

The Human Spring Approach In It’s Relationship To Hooke’s Law Of Physics
http://teamdoctorsblog.com/2011/05/...in-its-relationship-to-hookes-law-of-physics/

Video Tutorial # 143 What I Learned From Studying Javier Sotomeyer Technique About Improved Performance
http://teamdoctorsblog.com/2012/04/...ximum-jump-capacity-example-javier-sotomeyer/

Why don't we start with this and you tell me what you think. Let me know how they found these issues in the study they did.

Thank you!!!

 

[Karl Bedingfield]

Hello Dr. Stoxen,

Thank you so much for your insight into my evaluation. You hit the nail right on the head because they didn't address my initial reason for visiting them - my feet. Instead they made me worry about other parts of my anatomy.

It a full-blown examination that I paid for as part of your efforts to be coached into a better runner. It actually cost £60 and was done by the resident Physio at Core Cambridge (you can Google them). Didn't want to link back to them!

All the analyses was done visually by making me do various squats, lunges, twisting and stretching various limbs. Made me do planks, push-ups etc. I really don't think they grasped what I wanted from them and my fear is that they were more interested in getting me to book my next session with them which is really sad.

I will get a video done and post it on YouTube and then onto this site. I feel the opinions here are much better suited to my needs

As regards to mileage, I was doing between 30-40 miles per week and running 6 days consecutively. Friday being my only rest day. Most of the runs were 5 miles with Saturday & Sunday being 9 miles. I do various POSE drills as well as traditional athletic drills. To strengthen my hamstrings and use them more to pull-up I recently brought some ankle weights.

Currently I have had to rest for a week as I appear to have strained my big-toe. I can bend the toe down but when I try to lift the toe up I get pain. Also walking in bare feet hurts and makes me shift my landing position when walking. Is there anything I can do to alleviate this?

Once again thank you so much for replying. It helped me a lot.

Going to read the blog posts now.

Best wishes,
Karl

 

[ElyDave]

Hey Karl, not trying to hijack your thread, are you talking about Cambridge UK? I'm just up the road in Ely, and we also have another member in Newmarket.

As for the to thing, are you sure it's not a bout of tendon trouble? I have occaisional flare ups in that area. There is a tendon that inserts on the top of the foot and splits to all 5 toes. I found massage on the top of th efoot and the outside of the calf very helpful. About 1/3 of the way up, you'll know it when you find the offending spot.

Dave

 

[Karl Bedingfield]

Hi Ely Dave,

I live in Little Downham

Most of the pain I have feels like it is just ahead of the ball of the foot. When I walk the pain at its most uncomfortable as I toe-off, basically normal walking. Walking down stairs offers no pain. If I try and lift the toe up it also is uncomfortable.

Having trouble identifying cause and what to do to fix it.

 

[ElyDave]

You are kidding!

I'm in Little Downham.

We must head out for a run at some point.

 

[Karl Bedingfield]

Very small world

 

[Karl Bedingfield]

Hi there,

Well, I shot a little video of my feet. Is this of any help for analysis? I really appreciate your time

 

[Dr James Stoxen DC]

I will have my evaluation of your gait by tomorrow. Thank you

 

[Karl Bedingfield]

Fantastic, thank you Dr. Stoxen. I appreciate your time.