FAQs

What is Barefoot Running?

Barefoot running is a term that means either running either without shoes or with minimalist shoes. Barefoot running has gained popularity over the last few years to return to pure running and proclaims to help reduce the rate of running injuries. But is this accurate?

To gain a more scientific basis on whether barefoot running is advantageous or not for you, let’s look at what researchers have discovered.

Who is Suited to Barefoot Running?

When you run without shoes, you tend to land on the front part of your foot. This impact is called a forefoot strike. Landing through the centre of your foot is called a midfoot strike.

If you were to land barefoot on your heel, it's called a rearfoot strike, the ground shock would be excessive, and you would develop heel pain or injury, plus some other injuries further up your leg. That's why most barefoot runners tend to have a forefoot or midfoot strike. When you put on a traditional jogger with rearfoot cushioning, this cushioning allows you to land on your heel without damage. This heel is why a lot of shoe runners become rearfoot strikers.

Ground Reaction Forces

Generally, the higher the force, the greater the risk of injury. Research tells us that ground reaction forces are higher in the forefoot strike. Surely this would mean that you would get more injuries running with a forefoot strike technique. Not exactly. As well as considering the ground reaction force, it would help if you also looked at the vertical loading rate.

Vertical Loading Rate

The vertical loading rate is a measure of how quickly the ground reaction forces increase.

The steeper the curve, the greater the risk of injury. Running with a rearfoot strike produces a steeper force curve and makes some leg injuries more likely, but not all.

Running Shoes vs Barefoot Running

Does this mean you should toss away all of your running shoes? Maybe hold on to them just a little longer. The evidence is not clear yet about whether a forefoot/midfoot strike reduces your injury rate. What appears to occur is the barefoot running reduces loads in one area only to increase loads in another. And, since you are probably running on firm or rough surfaces such as footpaths, roads or gravel, you'll need some form of cushioning and protection for your feet. Don't you hate landing on those little stones!

What Should You Do?

If you are running without injuries at present, you would probably be silly to change. Changing footwear and technique may add another increase in loading and create new injuries elsewhere. Indeed, at PhysioWorks, we see more forefoot injuries in barefoot runners, which makes sense given the load charts. Plus, most of these injuries occur within a few weeks of changing your running style.

However, if you have been suffering injuries from running, barefoot may be a consideration for you. Changes to your running technique, such as reducing your stride length or your shoe style, could help you. You may also have some muscle control issues in another part of your body that could be altering the way you adapt your running style. So, before you toss your running shoes, it may be in your interest to consult with a running physiotherapist, a sports podiatrist or a running coach. They can analyse your running style, assess your body for weakness or tightness, check your leg and foot biomechanics or help you to retrain your running technique or some slightly weak muscles.

Most problems that cause running injuries are simpler to fix than you may think.

More info: Running Injuries

Cool Down

Why Cool Down Is Important After Exercise

While often neglected a cool-down serves four primary purposes:

1. Immediate cardiovascular recovery.
2. You are normalising muscle length and tension.
3. Mental recovery
4. Preparation for your next exercise session.

Let's review these four purposes in a little more detail.

Cardiovascular Recovery

Immediate cardiovascular recovery is potentially life-saving. Your heart has been busily pumping blood at high pressure through your body. If you stop your blood suddenly can pool in the engorged muscles, typically your legs, and you may feel dizzy or collapse. Cool-Down acts as a steady "normaliser" that can also help to aid the dissipation of muscle contraction waste products such as lactic acid, and assist the normalising of "fight and flight" chemicals such as adrenaline in your blood. Only slowing down the vigour of the exercise you have just done for a few minutes is all it takes to normalise your circulatory system. Runners can walk. Swimmers can swim slower. All this happens as your heart rate, and blood pressure safely resumes your normal resting levels.

Resting Muscle Length

Normalising muscle length and tension. One of the byproducts of exercise is muscle bunching. Think of a bodybuilder post biceps curls. Semi-bent elbows become the immediate post-exercise elbow posture, and if this remains long term, they will have shorter and more bunched muscles in the long-term. During sports, this may be beneficial, but between your training sessions, it leads to hypertonic muscles, increased risk of muscle strain and in long-term cases, a loss of joint range of motion. Any of these factors may affect performance. A runner for example, with a tight hamstring, will have a reduced stride length and have a higher risk of injury. A tight muscle is usually a less efficient muscle, meaning less force generation and power.

What are the Stretches Recommended Post-Exercise?

The purpose of post-exercise stretching is to restore muscle length, so static stretching is the key. Research has shown that 30 second slow static stretches are the way to go (Ayala et al. 2010). Most researchers favour two to three repetitions. But, you should listen to your body, and if you feel an extra stretch or two of a tighter than regular muscle group is what you need, I'd suggest you give it a try. Your body rarely lies and has a pretty good idea what it likes. It is also important to stretch all the muscles that were involved in your activity.

What about Massage and Foam Rollers?

You can probably also guess that a light non-traumatic style massage or use of a foam roller may also be beneficial at restoring your post-exercise muscle length.

Mental Recovery

Mental recovery is an often overlooked part of the recovery process. We lead busy lives, and it is often challenging to ensure that we adequately take the time to relax and let our mind calms down. Relaxation techniques can be a useful tool. To help you with this, even taking a few minutes to cool down, some mindful relaxation such as meditation, or having a relaxing soft tissue massage can help you reflect upon your training performance. It also helps your or to recover for your next session mentally.

Re-Preparation

Preparation for your next exercise session. Sometimes cool-down is truly an ice-cold bath. That's why ice baths are used by professional athletes post-event or post-game. Research has identified the benefits of ice baths to assist post-exercise bruising and bleeding, joint or muscle inflammation and to provide pain relief - even if it is a bit chilly when you first hop it. Of course, the less brave can use ice packs to painful bits. It all aims to stop things swelling too much, which aids your recovery time.

Things to Avoid in Cool Down.

Just as there are a lot of good things to do in a cool down, it's also good to avoid other factors.

• Avoid heat - you're already hot, and further heat will only encourage bleeding.
• Avoid alcohol - I don't want to be a party-pooper, but alcohol encourages inflammation and dehydration.

As I mentioned earlier, the benefits of an active cool-down help you to recover from your session and prepare for the next. Now it's up to you!

More info

What Causes Post-Exercise Muscle Soreness?

What's The Benefit Of Muscle Stretching?

Recovery Massage

Stiff Joints in the Morning?

How to Overcome Morning Stiffness in Your Joints

As the cooler months approach, many find themselves grappling with sore, stiff joints upon waking. This discomfort can disrupt our morning routines and impede our overall mobility. Let's explore the causes of this stiffness and effective strategies to manage it. Discover tips to alleviate stiff joints, including appropriate exercises, dietary adjustments, and the importance of maintaining a warm sleeping environment.

Emphasising regular, gentle movement, such as stretching and yoga, can significantly improve joint flexibility and reduce morning stiffness. Incorporating these habits can lead to more comfortable mornings and better joint health.

The Chilling Effect on Joints

Cold weather significantly influences the comfort and function of our joints and muscles. A critical component affected by low temperatures is elastin, which is essential for the flexibility of our connective tissues. In the cold, elastin mimics a frozen rubber band—it loses pliability. Trying to stretch a cold, stiff rubber band without first warming it can lead to it snapping. Similarly, our joints suffer from reduced flexibility in cold conditions, leading to stiffness and discomfort.

Understanding Joint Pain Upon Waking

The discomfort in your joints in the morning could stem from the reduced flexibility of elastin due to the cold. Additionally, lying still during sleep allows fluids to settle within the joints, exacerbating stiffness and pain. This sensation is especially pronounced if your bedroom is colder or if you've had a particularly inactive day prior. Understanding the biological processes that affect your joints during the night can help in managing these symptoms effectively.

Why Mobility May Be Hindered in the Morning

Stiffness in the joints can significantly restrict your ability to move freely when you first wake up. Although morning stiffness isn't always indicative of arthritis, ongoing issues should be evaluated by a health professional. It's essential to note that this stiffness can be influenced by factors such as the type of mattress and pillows used, which should support the body adequately to prevent any additional strain on the joints.

Warm-Up Routines and Hydration

A dynamic warm-up first thing in the morning can activate your muscles and mitigate the risk of injury. Starting your day with gentle stretches or using a heat pack can alleviate early stiffness. Hydration plays a vital role here, as a well-hydrated body ensures smoother joint movements. Drinking water right after waking up can kick-start your metabolism and lubricate your joints, making the morning routine more comfortable.

Promoting Joint Lubrication

Maintaining regular physical activity and ensuring adequate hydration are crucial for lubricating your joints effectively. Activities like swimming, cycling, or even a gentle walk can increase joint fluid circulation, which helps in reducing stiffness over time. These exercises promote flexibility and strength in the muscles surrounding the joints, which helps in supporting and protecting the joints from excessive wear and tear. Regular movement breaks throughout the day are also beneficial in keeping joint stiffness at bay.

Optimal Exercises for Stiff Joints

Integrate low-impact exercises like swimming and cycling into your daily activities. These forms of exercise are fantastic for loosening and strengthening the muscles surrounding your joints, all while avoiding excessive stress. Additionally, consider adding gentle stretching and yoga to enhance flexibility and reduce stiffness. These exercises promote joint health, increase blood flow, and maintain mobility, making them ideal for those with joint concerns.

The Benefits of Therapeutic Massage

Massage therapy not only provides a deep, warming sensation that surpasses traditional heat packs but also significantly enhances tissue elasticity. The warmth from the massage helps improve the function of elastin in your connective tissues. Techniques such as trigger point therapy go further, offering extended relief from stiffness and soreness. Regular massage sessions can lead to better joint mobility, reduced inflammation, and an overall sense of well-being. This form of therapy is especially beneficial for those suffering from chronic joint stiffness.

Autoimmune Contributions to Morning Stiffness

Autoimmune disorders such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, fibromyalgia, and lupus can also manifest as stiffness in the morning. Early signs of these conditions often include joint stiffness, swelling, and pain.

Discover more about autoimmune conditions here:

• Rheumatoid Arthritis
• Psoriatic Arthritis
• Ankylosing Spondylitis
• Fibromyalgia
• Lupus

Vitamin Deficiencies and Joint Health

Vitamin deficiencies, particularly in vitamins D and E, may exacerbate joint stiffness. Consulting a healthcare provider is essential before starting supplements, as other underlying issues could also be contributing to the deficiency.

Seeking Professional Advice

Persistent joint stiffness warrants a consultation with a physiotherapist or doctor. These professionals can assess your situation and devise a personalised plan to enhance your joint health.

Conclusion

Although the chill of colder months can tighten our joints, adopting proactive measures significantly boosts our comfort and mobility. Staying active and keeping warm are vital steps in managing morning stiffness effectively.

Related Articles

1. Understanding Arthritis: Causes and Treatments
   • Learn about the various types of arthritis and their treatments to better understand joint health.
2. The Benefits of Hydrotherapy for Joint Pain
   • Discover how hydrotherapy can ease joint pain and improve mobility.
3. Managing Rheumatoid Arthritis
   • This page discusses strategies for managing rheumatoid arthritis, a condition mentioned as contributing to morning stiffness.
4. Effective Warm-Up Exercises Before Physical Activity
   • Find out why warming up is crucial and explore effective exercises to prevent stiffness.
5. How to Maintain Joint Health
   • Tips on keeping your joints healthy, including diet and exercise recommendations.
6. Physiotherapy Techniques for Pain Management
   • This article explains various physiotherapy techniques to manage pain, including methods to alleviate morning stiffness.

What is Therapeutic Ultrasound?

Therapeutic ultrasound involves physiotherapists using an electrotherapy modality since the 1940s. An ultrasound probe transmits ultrasound waves through a transmission coupling gel, directly contacting your skin.

Therapeutic ultrasound can enhance:

• Healing rates
• Tissue heating
• Local blood flow
• Tissue relaxation
• Scar tissue breakdown.

How Could Ultrasound Help?

Ultrasound boosts local blood flow, potentially reducing local swelling and promoting healing of soft tissue injuries. Scar tissue could soften with higher power density.

Specific Ultrasound Uses

Therapeutic ultrasound shows remarkable effectiveness in treating mastitis or blocked milk ducts, leading to noticeable improvement within 24 to 72 hours.

Common conditions treated using ultrasound encompass soft tissue injuries like muscle, ligament injuries, or tendinopathies.

Phonophoresis utilises ultrasound for non-invasively administering medications below the skin, benefiting patients averse to injections. Ultrasonic energy facilitates drug penetration in phonophoresis.

What is an Ultrasound Dose?

A typical ultrasound treatment spans 3-10 minutes, but for scar tissue breakdown, longer treatment times might be necessary. Throughout the procedure, the ultrasound probe's head is in constant motion, ensuring patient comfort.

Some conditions treated via ultrasound include soft tissue injuries such as muscle or ligament injuries, tendinopathy, non-acute joint swelling, and muscle spasms.

How Does an Ultrasound Work?

The ultrasound head's crystals vibrate, creating sound waves due to a piezoelectric effect. These ultrasound waves penetrate the skin, causing local soft tissues to vibrate. This repeated cavitation induces deep heating, generally without patient-perceptible heat. Athermal application occurs when heating isn't desired, often in acute injuries and associated inflammation.

When Should Ultrasound be Avoided?

Ultrasound is contraindicated in cases of:

• Local malignancy
• Metal implants
• Local acute infection
• Vascular abnormalities
• Active epiphyseal regions (growth plates) in children
• Areas over the spinal cord following laminectomy
• Over the eyes, skull, or testes
• Directly on the abdomen of pregnant women.

Professionally administered by well-trained experts like physiotherapists, therapeutic ultrasound rarely leads to adverse effects. Consult your physiotherapist for their perspective on whether therapeutic ultrasound suits your injury.

More Info

• Sports Physio Treatment
• Early Injury Treatment
• Therapeutic Ultrasound vs. Real-Time Ultrasound Treatment
• Common Physiotherapy Treatment Options
• Physiotherapy Treatments
• How Much Treatment Will You Need?

How Do I Know What Type Of Knee Injury I Have?

There are many structures in and around the knee which can be injured. Bones, joint structures, muscles, tendons, ligaments, and nerves can all be affected. It is pretty challenging to work out what is going on with the layperson! Although specific features are more likely to indicate one area than another, self-diagnosis is a hazardous road!

Assessment and treatment by a health professional will ensure that the diagnosis is accurate and that you do not find yourself doing more harm than good. Described below are a few examples of situations that may resonate with you.

A sudden onset of knee pain, followed by a slight swelling volume several hours later, can indicate the knee's meniscus injury. In contrast, rapid onset of swelling is more consistent with damage to the cruciate ligaments. A vague ache at the front of the knee that worsens with deep squatting and prolonged sitting can represent irritation of the joint beneath your kneecap, whilst a local pain directly below your kneecap can reflect conditions of the patella tendon.

This domain becomes increasingly complex when you consider that more than one body part can be injured at a time and underlines the importance of seeking professional assistance. If you are suffering from a knee injury, please call us or book online today to get you moving in the right direction!

What Does Arthritis In The Knee Feel Like?

Arthritis is an inflammatory disease of the joints. Ankle arthritis typically requires an injury to start the chain of events that lead to ankle arthritis. Knee arthritis can simply develop the disease over time. Given no precipitating event needs to occur, and it usually onsets gradually over time, it’s sometimes difficult to recognise the signs and symptoms of Arthritis. People can suffer from pain that they incorrectly attribute to general old age. If diagnosed and managed correctly, it can drastically improve function and quality of life.

Some signs your knee pain may be Arthritis are:

1. Swelling after activity - Your knee may appear puffy or be harder to bend. It may feel ‘full’. The knee swelling is being produced by inflammation. Other classic signs of inflammation to look for are redness, warmth and pain around the joint line.
2. Morning stiffness - Your knee doesn’t tolerate periods of inactivity as well as it used to. This is most noticeable in the morning after sleep but improves with movement.
3. Achy pain - Arthritic pain is most commonly described as achy. Sometimes it is broad and encompasses the entire knee. Other times it affects only one knee compartment, most commonly the inside compartment and thus produces pain only on the inside.
4. Clicking or popping sounds - In the later stages of the disease, Arthritis causes the cartilage surfaces to roughen. This can produce clicking or popping sounds in the knee. It's important to note that some knee sounds are normal. Your physiotherapist can help you decide what knee sounds are of concern.
5. Giving away or locking - Your knee may occasionally buckle when you put weight on it, especially when using stairs. It might also become stuck in a bent position for short periods. Bumpy cartilage surfaces may be stopping the joint from gliding smoothly, or pain might be inhibiting your ability to use your muscles efficiently.

Understanding what's going on in your knee will inevitably lead to better management. Much research has focused on improving function and avoiding surgery for knee arthritis, and these protocols have demonstrated excellent results. Whilst a diagnosis of Arthritis may sound daunting, all it means is you now have a ‘why’ for the pain and an opportunity to do something about it.

So please don’t delay in seeing your knee physiotherapist for their opinion on your knee pain.