Heel pain continues

Discussion in 'Ask the Docs' started by Mangesh, Aug 26, 2017.

  1. Mangesh

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    Dearall.. i needed one advice... I was having knees pain problems before, which has come down a little bit after barefoot running.


    However, my heel pain still remains, particularly the right heel.

    I am following the steps elaborared by barefoot ken bob in his book, barefoot running.

    I do a run walk combo( 100 paces each) for 3.5 km in the morning and repeat it in the evening daily.

    I choose gravel whenever i can, in my running stretches

    Can you help me with this pl?
     
  2. Barefoot TJ

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    I think they might need a little more background and detail as to why you are having pain, Mangesh. Thanks.
     
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  3. Backfixer

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    Not everyone will do well with barefoot running if they have core issues. It sounds like you are having a problem in the core and it is likely distorted. Usually, this is a compensation to a gait style that is uneven. Typically, we see that patients who overpronate will tighten in the back of that leg and on the opposite side, the tensor fascia will tighten decreasing shock absorbtion on that side causing pain.

    Have you tried to go to a certified sports chiropractor who does myofascial release. With the right practitioner, you can get this resolved. To understand the mechanisms behind this type of pain, read my book Cheating Mother Nature, what you need to know to beat chronic pain. It will help you understand what is happening. It is not a heel problem but a gait issue.

    Hope that helps
     
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  4. Barefoot TJ

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    Thank you, Doc! We haven't had much activity in this forum for a long while. Good to see you are still around too.

    When you say, "Not everyone will do well with barefoot running if they have core issues," is the issue really with running "barefoot" or running period with any style of running, heavily shod, minimalist, bare, etc.? I mean God didn't create us with high-heeled, thick, heavy soled feet, so adding heavy shoes surely would throw off our natural biomechanics, right?
     
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  5. Backfixer

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    Basically, it has to do with impact. We are all built differently and as a result, adapt to our unique body mechanics. Some of us are very asymmetrical and more prone to injury since asymmetry will distort the core, tighten the legs and reduce stride and cause the myofascia in the core to become very tight. Most of us are unaware of this, or attribute our lack of flexibility to age or other reasons. The best way to see this is to put someone on a treadmil at their normal running speed and shoot a 30 second clip. We can slow it down but I can tell you already this runner over and under strides barefoot or shod, and likely hunches their shoulder as a compensation and probably has their hands crossing the body as they stride. Just an educated guess but if they are kind enough to upload a video, I would be happy to give them my long distance opinion
     
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  6. Barefoot TJ

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    Thanks for that, Doc. We appreciate what you do and your help with our members.

    I agree, the OP should post a video of their running (barefoot and shod).


    If there are core issues, etc., running of any type would be problematic, not just barefoot running. (Did cavemen have core issues?)

    If you're talking about impact being the difference, most people who run barefoot impact the ground with a lot less force than someone wearing big, cushioned running shoes that deafen their gait and their feedback from that gait. People who run barefoot ten to run gingerly; people who run shod tend to pound the ground. Some studies have shown that impact forces increase when running shod versus barefoot. Proprioception and sensitivity are lost the moment we cover our feet with anything, right down to a pair of socks. Many here can attest to this, including me. (The reason there are more nerve endings in our feet than anywhere else in the body...well...except one area...is so we can feel the earth, so we can tell where we are at any given time and moment in space.) This loss of feeling contributes to our haphazardly pounding the earth trying to find solid ground, solid footing.

    Of course, some would argue that it's not about what is on one's feet or not on one's feet, but rather, the running style being used. We don't learn to run naturally when something covers our feet. We do learn to run naturally when nothing covers our feet. (How could shoes ever be "natural?") "How one runs probably is more important than what is on one’s feet, but what is on one’s feet may affect how one runs." ~Dr. Daniel Lieberman

    This review talks about the evolution of running from unshod to shod, the differences, the outcomes...:
    Daniel E. Lieberman. 2012. “What We Can Learn About Running from Barefoot Running: An Evolutionary Medical Perspective.” Exercise Sport Science Review, 40, 2, Pp. 63-72; https://scholar.harvard.edu/files/dlieberman/files/2012c.pdf


    Barefoot Ken Bob slow-motion on treadmill - YouTube
    View attachment 8405 ▶ 0:40

    Aug 17, 2010 - Uploaded by Ken Bob Saxton
    Harvard University, Dr Daniel Lieberman's Skeletal Biology lab Note the subtle fore-foot landing. I'm not ...
     
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  7. Backfixer

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    Of course, everything is theoretical until we see the video. I have seen shoulder problems destroy ones gait. Unfortunately, our health system tends to look at us as if we are parts that go bad and most of us have pains that appear to be the problem or are they?

    Pain needs to have a mechanism and heel or foot pain is a biggie. Barefoot or no, it is about impact. The example I always give is by hitting my patient lightly on their shoulder and then asking them how they would feel if I did this for hours. This describes most heel, foot and lower extremity running issues and even the walking ones.

    We are not widgets and regarding cavemen, how long did they live and did they have pain? Not sure that we are the only generation in the industrialized age that has pain. I always look at movement and impact and the way we learn movement with our own gait, not someone elses.

    Putting the foot in a box definitely deconditions the foot and can cause issues, but runners with issues shod often have other issues barefoot. Is it conditioning or is the body, our accommodation of the fascia and our unique skeletal design the issue and does it run in families. It is a real eye opener when we finally become less dogmatic and look at the person on a video and get their complete history
     
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  8. Barefoot TJ

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    Oh, I agree. There are a lot of dynamics that can contribute to one's pain and improper running form and vice versus o_O. It's a unique, individual thing. I just believe that most of our problems with our feet, our knees, our backs, etc., would not exist if we had never conformed/confined our feet to shoes in the first place. We've introduced shoes (or the wrong types of shoes), and we've introduced problems that can affect every aspect of our bodies.

    My "caveman" comment was to say--running was intrical to survival (hunting for prey, hiding from predators). If we tried that today, we surely would be eliminated. :nailbiting:
     
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  9. Backfixer

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    And just to riff on cavemen, getting a date was as simple as clubbing your woman :). Sorry about that, but while we were getting neanderthal.
     
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  10. trevize1138

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    My usual simplified take:

    Studying up Ken Bob's tips and watching videos on running stride really took a while to sink in for me. I was spending so much effort studying all the various aspects of proper form but never really catching on. I would try to strive for shorter strides, strive for higher cadence, strive for landing more forefoot or midfoot, strive to run with quiet steps ... None of my direct attempts to do any of those things or a combination of them worked and I struggled.

    I didn't start doing all of those things until I focused on just one thing: "run like you're barefoot on hot coals."

    When I finally internalized that visualization it all clicked and my feet stopped hurting while barefoot. I've started modifying my advice to others by suggesting your focus should be 100% on lifting your feet off the ground the instant they touch the ground. The hot coals visualization got me to do that and for others thinking of running like you're sneaking up on someone or prancing or marching works. Focusing on the lift and nothing else at least gets you to use your upper legs for running not your lower and could help with things like heel pain because you'll be lighter on your feet as a byproduct.

    The reason it works to focus on something like that which isn't very logical (you really can't lift your feet off the ground the instant they touch the ground unless you're running in place) is that mind-body connection is weird. You have to trick yourself into doing the right thing and sometimes you can't "logic" your way to solid form.
     
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  11. Mangesh

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    Wow!! Thank you all for this wonderful "reach out"

    I am grateful for the same.

    I will try and upload a video soon.

    Also... One more development has happened recently....

    After my run, i feel a pain in the lower back, specifically on the right side of my waist... Dont know the medical term for that part...

    If i keep my hands on my waist with thumbs at the back, it is the spot where my right thumb would be, on my waist.

    I do have numbness and tingling on the right side of my leg

    When i rub my right thigh, on the outer side, it feels kind of dead, upto the knee

    Is this the cause of the waist pain and the heel pain?

    Also the heel pain on my right leg is more than the heel pain on my left.

    Please help me with a solution that will ensure that i continue running and only barefoot!!

    Once again... Thank you all for helping out and i really look forward to some nice solutions from you.

    Btw... From where i come from in india, we do not have access to chiro practors and most of the physios that i met are asking me to stop running and i have absolutely no intention of doing that!!

    I love my run and will continue to do so.... Come what may...
     
  12. Mangesh

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    Also one more thing.... All these right leg problems occured when i was wearing shoes and running.... for years....Continued even when i wore vibrams and ran....

    Now, since the last 5 months that i am running barefoot, at least the knee pain has reduced to a very bearable level... Still there... But very bearable.

    My instinct and intuition tells me that barefoot running alone is the way forward...
     
  13. Mangesh

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    I have tried and got a video taken.

    I hope this helps doc.

     
  14. trevize1138

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    There are a lot of good things about your form I want to make sure you continue doing:

    * good tall posture
    * quick cadence
    * minimal over-striding

    What I've noticed is that third point. Minimal over-striding but still over-striding. That's about where I was a year ago and, yes, I had that same lower back pain. I used to be a horrible over-strider which meant shin splints and pulled hamstring tendons constantly so my lower-back was fine because my legs would get injured before that ever became a problem.

    When I was only over-striding a little bit the impact was reduced so I didn't get leg injuries (just like how your knee isn't as bad) but I was twisting my hips in relation to my lower back to accommodate for reaching out just a bit too far with each step. So, I'm sorta congratulating you for going from a 2 pack-a-day smoker to a 1/2 pack-a-day smoker. Time to quit cold-turkey! :)

    The other side of this is the second bullet point: cadence. Your cadence is a tad on the slow side as a side-effect of the slight over-striding. One thing is connected to the other.

    As you've already got the good, tall posture I'd suggest focusing on that lift lift lift lift I talked about in my other post. Get your foot lifted off the ground the very second it touches the ground. Right now your running is still sort of "aspirational" with a bit of "leaping" from one foot to the other. Not a lot of leaping but just enough that it's twisting your hips and making your feet land a little too far out in front and hitting the ground a little too hard. You're aspiring to run faster with a bigger stride and your back is complaining about that. Try not to leap leap leap but lift lift lift. Really pick up those feet and that'll get them landing much more squarely under you and quicken that cadence naturally without focusing on either of those things. Just get the feet off the ground.

    Try this drill at home (start at 3:25)



    Really internalize that feeling when running in place of that quick/springy cadence vs the slow/sticky. Once you feel that spring just lean forward at the ankles to go from running in place to forward momentum.
     
  15. Mangesh

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    Thank you very much trevize for taking the time to go through my case and for reverting with solutions.

    Your insights are precise and valuable

    I need to:

    Lift lift lift

    Reduce over striding

    Increase cadence

    Ok will do starting asap n report

    Also... I will surely do the drill.

    Please let me know if you think i am overpronating.

    I have been researching on the same today basis doc william's book " cheating mother nature"

    Looks like i am overpronating... Not sure though...
     
  16. trevize1138

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    The very last thing I'd worry about is over-pronating. Too often I see people needlessly obsessed about pronating or over-pronating when it's just normal, good, healthy ankle motion. And, if you truly do have a problem with over-pronation often it's a result of too many years in cushioned, structured shoes and your ankles and feet have been pushing to get past all that to find solid ground, therefore being barefoot and minimalist by itself will help correct it as your feet and ankles start to relax knowing they don't have to fight through foam any more.
     
  17. Mangesh

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    Dear doc williams... I eagerly await your revert.

    If the video i sent is not informative enough, please do let me know.

    I will send a better one
     
  18. Mangesh

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    Dear doctor,

    As requested, i have posted my video in the thread.

    I would be grateful if you could give me your valuable feedback
     
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  19. Mangesh

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    Dear sir,

    Please find the video below

     
  20. Mangesh

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    Also... One more development has happened recently....

    After my run, i feel a pain in the lowerback, specifically on the right side of my waist... Dont know the medical term for that part...

    If i keep my hands on my waist withthumbs at the back, it is the spot where my right thumb would be, on my waist.

    I do have numbness and tingling on the right side of my leg

    When i rub my right thigh, on the outer side, it feels kind of dead, upto the knee

    Is this the cause of the waist pain and the heel pain?

    Also the heel pain on my right leg is more than the heel pain on my left.

    Please help me with a solution that will ensure that i continue running and only barefoot!!

    Once again... Thank you all for helping out and i really look forward to some nice solutions from you.

    Btw... From where i come from in india, we do not have access to chiro practors and most of the physios that i met are asking me to stop running and i haveabsolutely no intention of doing that!!

    I love my run and will continue to do so.... Come what may...
     

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