Barefoot Ted is a barefoot running icon that stared in the book Born To Run by Christopher McDougall. He started running barefoot by accident after buying pair after pair of the most expensive and advanced running shoes on the market and having more running injuries and pain - instead of less - as the shoes advertised. In frustration he threw off his new $300 pair of running shoes and walked home barefoot and noticed that by the time he got home he was pain free. The next day he did his first barefoot run and it was also pain free. He quickly realized that he had been out of balance with his body, with nature, and with his approach to running. 

Barefoot Ted realized that running barefoot allows (or forces) you to be more in touch with your body, your form, and your environment and really helps you regain balance in these things. He has been running barefoot all around the world pain free since that first barefoot discovery run.

At Oregon Exercise Therapy, as an Egoscue University certified Postural Alignment Specialist and Advanced Exercise Therapist, I look at balance in regards to a client's joint alignment, muscle development, and range of motion in their body. We all share the same musculoskeletal design which is designed to be symmetrical left to right in bone alignment, muscle development, and joint range of motion and balanced front to back in weight distribution. Our eight major load joints (ankles, knees, hips and shoulders) are designed to vertically align from the front, back, left and right sides. 

I love Barefoot Ted's quote above because it speaks to what each of my clients have gone through. They have gotten out of balance with nature and the human requirement for motion. Their body has responded by altering its postural position and movement patterns. Painful symptoms don't always show up right away, but the body is no longer working in an efficient pattern which can be seen in how the body moves. Looking at how someone walks, runs, gets out of a chair, or ties their shoes can show us whether a person is in balance or out of balance. Look at the runners below and see if you can spot what I'm talking about with inefficient movement:

Yes, the runners in the video are "faking" bad running form, but you get the idea of inefficient gait and compensated movement. If we can learn to recognize these imbalances early on and do something to correct why they are there, we can regain balance. If we don't learn to recognize these imbalances, we will "fall" as Barefoot Ted says, meaning we end up with sports injuries, muscle spasms, back injuries, and chronic pain.

My job as a Postural Alignment Specialist and Advanced Exercise Therapist at Oregon Exercise Therapy, is to help you learn how and why your body is out of balance and help you regain balance. This can help you avoid injury and improve performance or if you are in pain already it can help you out of chronic pain and get you back to the point where you can be as active as you want and live your life without limitations.

Stop what you are doing, don't move, and notice your posture. How are you sitting or standing? Then take a minute and look at the people around you and see what their posture looks like. It's a pretty safe bet that most people you see are not exhibiting great posture and maybe you weren't either. It's very common to see people sitting and standing that look like this:

We all know sitting like this can lead to all sorts of health issues and chronic aches and pains. 

The economics industry has been trying to fix peoples poor posture for years using different approaches including fancy ergonomic desk chairs (with lumbar support, headrests, and countless adjustable features) to kneeling chairs and stools, to swiss or balance balls and even taking NASA research about the perfect 135-degree back-thigh sitting posture. But most people who try these ergonomic fixes look like this using them:

The ergonomic fixes didn't really help because the person just went back to their old habits and default muscle memory of bad posture. A person's sitting posture has very little to do with the chair and a lot to do with that person's muscular imbalances. But this hasn't stopped ergonomic manufacturers from constantly trying something new. One new device, designed by Martin Keen of Keen Footwear, is getting a lot of media attention. It's called the Mogo, "the human kickstand," and is a portable lean-on seat that is supposed to help you maintain the healthy neutral S-shaped spinal curve. 

Take a look at the photo below to see how well it's working (note this is an official Mogo company photo):

The two individuals closest to the camera sitting on the Mogo's certainly don't have an S-curve to their spine and are displaying the classic flat lumbar curve, excessively rounded upper back and head forward posture that is all to common today. 

So what are we to do if all the ergonomic advancements of the last 100 years can not help us maintain the natural and neutral S-curved spinal posture? Should we give up hope and just assume that human evolution looks like this?

I don't think so. I believe we need to stop looking for a device outside of ourselves that will fix the problem and start looking inside ourselves for the solution. If we have trained our muscles to hold our bodies in a slouched position for years it is unrealistic to expect some ergonomic device to be able to come in and save the day. I think if we focus our time and energy correcting our muscular imbalances and retraining our body to hold itself in an upright posture we will be able to sit with a perfect S-curve no matter the chair (or lack there of). 

Exercise therapy routines designed specifically for your postural imbalances can create fast and efficient change in your body, in how you feel, and in how you sit. This will allow you to save money on not buying the latest and greatest ergonomic device and enjoy comfortable sitting and standing unassisted - the way nature intended it to be. 

A recent study found that children's endurance and fitness is decreasing worldwide. In the United States children today are 15% less fit from a cardiovascular standpoint than their parents were as youngsters. This amounts to running a mile 90 seconds slower than their parents did as children. The study found 30-60% of the decline in endurance can be attributed to higher body fat levels and the growing obesity epidemic. 

I believe there are many factors involved including: 

• Kids watch more TV now than ever before
• Children spend hours a day playing video games and other electronics
• Physical Education is being cut in schools nationwide
• Parents are less likely to let their children play outside freely and roam the neighborhood
• Kids are fatter today than any previous decade which makes physical exercise less enjoyable
• Many kids eat more junk food and less whole foods which decreases energy levels
• Kids are more dysfunctional than ever before

I want to expand on that last point: kids are more dysfunctional than ever before. What does dysfunctional mean? Not posturally aligned. Kids today look a lot more like this:

Than like this:

All the sitting, playing video games, watching TV, and not playing outside has led to the youth of today having terrible posture. Poor posture leads to inefficient movement. Inefficient movement means exercise and active play is no longer fun, it's a chore. Kids don't like chores, which is why they say "I don't like running" or "I don't want to play basketball" or "I'm not any good at soccer". It just isn't fun for kids to try to play sports, climb trees, or exercise with a body that is fighting itself and losing energy because of inefficient movement patterns all because of faulty posture. 

To illustrate how postural imbalances lead to inefficient movement, look at the two pictures below:

Now, let's go back and look at the picture in the Runner's World and Running Times online article. 

When running forward, everything should be moving in a straight line - feet, knees, arms - allowing all the energy to propel you forward. The photo at left shows very little forward motion and is very typical of kids today. The girl with the pink pants is swinging her right leg across the midline of her body, severely adducting and internally rotating her femur. This is most likely because her primary hip flexors (psoas and iliacus) are weak and she is using her secondary hip flexors to try to accomplish the task. The price to pay is slower running times, IT band syndrome, hip problems, and possible low back issues because the psoas and iliacus play a very important roll is supporting and stabilizing the lumbar spine and her's are not able to do the job. 

The boy with the green shirt is showing a similar pattern of swinging his left leg across the midline of his body rather than straight ahead. His left foot is very turned out (everted) during swing phase which creates torsion in the knee joint and will create excessive stress on his ankle and foot when he strikes the ground. This gait pattern often leads to landing with the foot excessively supinated and then progresses to excessive pronation and foot eversion at toe off as seen in his right foot. His upper body is trying to counterbalance the inefficient leg movement and creates the arm swing seen above: forward swinging arm crosses midline of body and backward swinging arm flares out to the side excessively. 

All these movement patterns are a waste of energy, create stress on the tissues of the body, and make exercise less fun. Faulty running gait like this comes from postural misalignments and can not be fully corrected by coaching or training the kids to run with better form. The underlying muscular imbalances must be corrected and when they are natural, smooth and efficient running form will naturally return…as will the kids' smiles as running and exercise become fun again. 

When the body is posturally aligned, movement and exercise become fun, which leads to active play and less time for inactive play like video games and TV. I believe this is one of the (very overlooked) keys to rescuing this generation from the downward health spiral that they are in and getting their body fat and running times down to that of their parents…or maybe even better!

CrossFit is growing in popularity every day in the US and internationally. The number of CrossFit gyms or "boxes" worldwide is around 10,000 and the number of participants in the Reebok CrossFit Games has grown to over 138,000 and the winners take home $250,000 each and the title of "Fittest on Earth". 

One reason CrossFit is growing in popularity is that it is more "functional" and fun than sitting on a weight machine in a gym. In CrossFit workouts you use your whole body doing multi-joint movements including squats, lunges, pull-ups, pushups, and burpees. These movements are much better for us than the single joint weight machines because they ask our muscles and joints to work with each other all while maintaining balance, stability, and coordination. CrossFit workouts develop strength, power, endurance, agility, balance, speed, and proprioception which will help you at any sport you play and help you not get injured while gardening, moving boxes, or cleaning out the garage. 

But there is another statistic related to CrossFit that has been growing rapidly at the same time as participation: the number of injuries sustained and number of participants who drop out because of injuries like torn rotator cuffs, herniated discs, knee injuries and "rhabdomyolysis" - where your muscles basically explode from extreme overworking.

Everyone who has tried CrossFit knows most Workout of the Day (WODs) routines are intense, demanding, exhausting, and often puke inducing. But every CrossFitter has also probably either been injured themselves or seen someone else get injured pushing their body too hard. Statistics have claimed upwards of 16% of participants get injured. 

How could the "functional" exercises used in CrossFit be both good for us and be so dangerous at the same time?

It comes down to how each CrossFitter is doing each exercise. Yes, CrossFit trainers stress "good form" and stopping an exercise if you are not able to maintain good form. But what is good form? And is good form really all that is needed?

Let's take a look at the man in the photo doing the "thruster" again. Most people will say he has good form. Which I guess you could say he does. But he is not maintaining postural balance which I, as a certified Postural Alignment Specialist and Advanced Exercise Therapist, know is the most important factor in injury prevention. 

The camera angle is off just a little bit, but we can still see what we need to do a postural and functional analysis on him. Notice his left foot is more everted (turned out), his left hip is more abducted and externally rotated (angled out to the side), his right hip is elevated (higher than left), his right shoulder is depressed (lower than left), and his spine is offsetting to the left (leaning left) and laterally flexed to the right (curving to right). 

But he looks like he has good form right? Nice and low with his hips, chest up, back straight. But posturally he is a mess! I have no idea his injury history but if he has survived so far without injury he has been lucky and his luck will eventually run out. He is asking for a knee injury on his left side from overloading it in a faulty position. He could easily have a disc and nerve compression in the right lumbar spine from the hip and spine imbalances. Back spasms, upper trapezius pull, hip flexor injury, foot pain. The list could go on and on. 

Will he come down with all these injuries? No. His body will continue to compensate, finding ways to adjust to the imbalances altering his alignment to continue to CrossFit. But eventually he will get an ache, a pain, a chronic soreness, or a big blowout. The body can only handle the stress for so long. Something will give way. It could be career ending and life altering. Let's hope it's not. 

Let's hope he, and every other CrossFitter in the world, reads this and realizes that you can only push a dysfunctional and posturally imbalanced body so far. Let's hope they slow down, find an certified Postural Alignment Specialist and Advanced Exercise Specialist with a degree in Exercise Science and experience working with athletes who can do a complete postural assessment and functional analysis on them. Their exercise therapist can then give them simple corrective exercises in a E-cise menu that will balances their posture, restore function and allow them to return to full training and all-out competition without fear of injury. Let's hope enough CrossFitters get balanced before CrossFit's reputation gets further damaged and participation falls and "boxes" have to close. 

Related articles:
Is training your "core" really helping you?
Straighten before you strengthen
Sports and the blame game
Preventing ACL injuries

“When you question your stressful thoughts, you come to see that everything that has been troubling you is just a misunderstanding.” – Byron Katie

Byron Katie, in her many teachings, explains how much of our suffering is caused by believing our thoughts that are not true. I want to talk about how this idea applies very practically to your physical pain- whether you have back, neck, knee, hip, shoulder or any other type of pain.

These are 5 common thoughts people have about their bodies and their pain:

1. “My hip is bone-on-bone or degenerative. Surgery is the only option.”
2. “Everyone in my family is overweight. It’s genetic.”
3. “The herniated disc is what’s causing my back pain and sciatica.”
4. “All runners have bad knees.”
5. “I have scoliosis. Nothing can be done about that.”

These thoughts, as I have hinted at, are not true – even if you believe them now and have been told so by well-meaning experts who are trying to help you. Let’s take them one at a time and explore them.

1. If the degeneration in your hip is causing your pain, your pain would be the same all the time – it’s not. The question to ask is “why did the joint degenerate?” Compromised posture and movement patterns will wear the joint surface away over time. When these postural and movement imbalances are corrected, the pain will go away.
2. Science has shown that genetics plays a role in obesity, but the not the dominate role we once thought. Epigenetics has shown us that environmental factors "turn on and off" genes, including those implicated in obesity.
3. Studies show that many people have disc herniations but have no pain. This means something else is causing the pain. Again asking different questions often helps bring out the answer you are looking for: “What caused the disc to herniate?” “Why that disc and not the one above or below?” “And why to one side?” Exploring those questions will lead you to understand the disc is only responding to the forces put upon it by the spine, pelvis, and shoulders being out of position and/or imbalanced. Correct the postural position and the pain goes away.
4. All runners do not have bad knees. Thus running doesn’t cause bad knees. Faulty running mechanics causes friction and stress in the knee joint, causing people to feel they have “bad knees.” The faulty running mechanics are caused by postural imbalances, which are fixable. This means your knees can be “good” again.
5. With scoliosis, as with any misalignment of bones, it’s important to remember that muscles move bones. You can change muscle memory with specific e-cises, and since form follows function, the bones will move back into their proper place.

Questioning our beliefs and thoughts about our bodies will allow us to see that many of them are not true. When we realize that our stressful thoughts are not true the stress goes away, the power is back in our hands, and peace of mind is restored. 

Before you go running, lift weights, or do any workout you always do a warm-up right?

After you workout you know you’re supposed to also do a cool-down. Every expert out there will tell you how important doing a warm-up and cool-down are. 

But…

What about little kids? If you have been around anyone under 10 recently at a playground or park you will notice they never do a warm-up before running, jumping, climbing or falling all over the playground. And they never get injured.

How is that?

Most people (kids) under 10 years old move enough on a daily basis to maintain proper posture and thus are functional enough to hit the playground running without needing a warm-up. But the average person over 10 years old has developed poor posture and because of that are at increased risk of injury. All the experts out there are trying to find a way to keep these dysfunctional people from getting injured and the best they have come up with is a warm-up and cool-down.

But they have missed the real problem…

The real problem is our posture is compromised which means our joints are not able to move correctly creating increased stress on joints, ligaments, tendons and muscles leading to injuries and pain. When we correct our dysfunctions and fix the faulty posture, our joints are back in their proper position and the length and tension of ligaments, tendons, and muscles returns to normal. This means we can move like a 6 year old again – pain free movement with no need for a warm-up!

I came across an article in the New York Times in which Dr. Dennis C. Turk mentions:

“REALLY?!” I immediately thought.

Dr. Russell K. Portenoy said:

Is it?! You might just scare the you-know-what out of every patient out there! Think about being the patient with chronic back pain who is coming to the doctor looking for answers and the doctor says, “Well, we have no idea what’s causing your pain but…” Not what the patient is hoping to hear!

The article asks:

Good question. The article starts talking about drugs and surgery and the side effects and unreliable results of them. But I think, before we start talking what to do, we should figure out why the cause of back pain isn’t found. THAT is the BIG question.

Why is the cause of back pain never found in 85% of patients?

It all comes down to WHAT we are looking for. If we believe the cause, or underlying source, of someone’s back pain is a disc injury, facet joint damage or arthritis, then we will look for damage using X-rays, MRI’s and CAT scans. When or if damage is found, treatment that will attempt to address that damage will be recommended. And then we see the painful statistics that large numbers of people who have surgery still have the pain afterwards and many people will have to have repeat surgeries. If drugs are recommended, well we all know that’s not fixing the problem, it’s just trying to cover it up – not good!

Here’s what’s important: doctors are trained to look at the condition of the body – disc injury, facet joints, arthritis – but what causes the condition of the body? Doctors often get this wrong – it’s not age, activity, or genetics – it’s position.

“Position?” You ask. Yes.

The position or posture of the body causes the condition of the body.

It’s that simple. The determining factor in your health is not your age or genetics as many people will try to convince you. Your pain is not caused by the activities you do as you have been told. Those are cultural lies. Stop believing them…or you may never get better. "Better" to me means 100% better. No pain. No limitation. No excuses. Freedom.

You’ve experienced this state before. We all did. When we were 5, 6, 7 years old. We could do anything with no pain or limitations and we loved it! We lived free. When we are free of physical pain and limitations something else very powerful happens: we start living the rest of our life without limitation and anxiety. We have piece of mind.

So now what do you do? Where do you go from here? Need help figuring out what you need to do to correct your postural imbalances? 

Contact me today for a free consultation with a Postural Alignment Specialist and Advanced Exercise Therapist and we will happily help you learn what your postural imbalances are and what you need to do correct them allowing you to live a pain free and active life. 


Related articles:
True source of back pain
Low back pain video
Spondylolisthesis and Egoscue
Dangers of epidural steroid injections for pain relief

What causes ACL injuries?

That question has been asked and answered by thousands of people – both athletes who have had anterior cruciate ligament tears and sports medicine doctors, physical therapists, orthopedic surgeons, and athletic trainers who have worked with athletes and studied ACL injuries. Let’s take a look at what we’ve learned from this:

A group of 21 specialists from around the country got together in 1999 in Hunt Valley Maryland with the goal of figuring out why ACL injuries occur and how to prevent them. These are some of their findings:

• An estimated 80,000 ACL tears occur annually in the US.
  
• The highest incidence is in individuals 15 to 25 years old who participate in pivoting sports.
  
• ACL injuries have an estimated cost of almost a billion dollars a year!
  
• 70% of ACL injuries occur in non-contact situations.
  
• The risk factors for ACL injuries fall into four categories: environmental, anatomic, hormonal, and biomechanical, with biomechanical being the most common factor.

Many training programs have been designed as "ACL injury risk reduction" programs, but do they really focus on the true cause of ACL tears and correct it?

What if they just pass the stress onto another joint structure or part of the body all together?

Here’s an example: This is a before picture of an “untrained athlete” performing a box jump. The website explains “This shows some of the predisposing problems that might lead to an ACL injury.  The 2 most notable are the upright landing position and the valgus alignment.”

This is the same athlete following the 6 week training program. The website says “Notice the depth on landing and the more neutral position of the knees.”

But also notice that her feet are everted (turned out) severely in the “after” photo. What does that do for her ankle and foot? That position predisposes her to ankle sprains and fractures, stress fractures of the foot, and Achilles tendinitis. Is that a good thing? Is this athlete better off now?

Go back to the first photo and compare her right and left sides. What jumps out?

Her right leg is more valgus (knock-kneed) showing that hip is unstable predisposing her to injury on that side. She is also dropping her right shoulder forward and down in an attempt to help stabilize the unstable hip. This compensation could lead to a hip or low back injury or shoulder or neck issues.

Now compare her right and leg sides in the second photo. What jumps out?

Her right foot is more everted than her left meaning she still has a hip disparity and her right hip is still less stable still predisposing her to injury on that side. In the first photo her femur is internally rotating and in the second photo her femur is still internally rotated compared to her foot – same issue – same stress. And the same compensation pattern is present: she is still rotating her right shoulder forward and down.

Is this athlete better off now? I don’t think so. The same underlying dysfunctions are still present and this athlete is no more “functional” than before.

The problem with this and most training programs is that they work to improve the athletes strength, flexibility, agility and teach the athlete to focus on where their knees are and keeping them straight consciously. The problem with this is the underlying muscular and postural imbalances were never corrected. This means the athlete is no more functional and no less prone to injury than before – the injury might just show up somewhere else so it looks like the ACL injury prevention program worked! These training programs will end up strengthening the athletes imbalances leading to a less functional and more injury prone athlete over time. This is seen in high school sports, collegiate athletics, and professional sports with the increasing number and severity of injuries even as athletes are stronger, more flexible, and increasingly agile each year.

What if we take the Oregon Exercise Therapy approach to this athlete's biomechanical issues?First, we at Oregon Exercise Therapy remember that the entire body works as a unit and must be treated as a group of interconnected load bearing joints with the bones, muscles, nerves, and ligaments linking it together. Second, Oregon Exercise Therapy's Advanced Exercise Therapists and Postural Alignment Specialists understand that any biomechanical and postural imbalances are correctable because the body is a living organism that responds to its environment. The goal is to realign the body to its original design blueprint where the athlete's load joints are lined up vertically and at 90 degree angles to each other. This is done by a “menu” of  E-cises (posture correction exercises) which promote functional muscle engagement without the use of drugs, surgery or manipulation. The result is an athlete who never has to think about how to jump or move and his or her body – because it is now posturally balanced – will automatically move with the correct joint alignment, muscle engagement, and proprioceptive response.

​For your free posture evaluation contact me today.

References: 
http://www.jaaos.org/content/8/3/141.abstract
http://drwaltlowe.com/acl-injury-risk-reduction/

Related Articles: 
CrossFit: How to survive injury free and achieve success
Why Lebron James cramped up
Patellofemoral pain syndrome and your posture
Sports and the blame game
5 things runners should know about knees

Chronic Pain.

• Every day, 60% of men and women experience some pain.
• Pain affects more Americans than diabetes, heart disease and cancer combined.
• 80% of the people in the United States will develop chronic pain at some point of their life.
• 1 in 3 Americans lose more than 20 hours of sleep each month due to pain.
• Chronic pain is the most common cause of long-term disability.
• Pain costs an estimated $100 billion each year.

So what can you do about Chronic Pain and is it actually curable?

I think it all starts with what you believe. You see, if you believe your back hurts because of a genetic flaw, you won’t look at any treatment/program or specialist that says otherwise. But what if your pain isn’t caused by a genetic flaw, but something treatable? You’ll never explore those ideas if it’s not within your belief system. That is why I believe we must first examine our beliefs about our bodies and our pain.

I encourage you to take a couple minutes and write down 5-10 beliefs you have about your body and your pain. Once you have your list continue reading below.

The Egoscue Method and Oregon Exercise Therapy is based on certain beliefs that Pete Egoscue and I have. Let’s call these beliefs “Pain Free Convictions.”

• You know more about your health that anyone in the whole world.
• Your instincts will guide you if you listen to them.
• The body has no design flaws.
• Pain is merely a signal – the body’s voice. It should not be feared and will not if you are listening to your instincts.
• Effective therapies treat the whole body as a unit.
• Age is not the determining factor in health.
• Your attitude must be positive.
• Thoughts unexpressed are detrimental to good health.

Which of these statements challenge your current beliefs?

Do you see any of your current beliefs that might be worth reexamining?

Let me know what you discover by commenting below.

Thanksgiving is right around the corner and Hanukkah, Christmas, Kwanzaa and New Years following closely behind. The holiday season is one of my favorite times of the year and a great chance to give thanks and think about how we can help those less fortunate than us as well as give gifts to our loved ones. Many of my favorite gifts in years past have been donations given to charities in my name. 

Here is a list of some of my favorite charities that are making a real difference in the world:

• Against Malaria Foundation - Mosquitoes love me. I'm lucky to live in a malaria free area, but millions are not. A $5 donation will provide a insecticide-treated bed net to a family in Africa that will last for years and save lives. Probably the biggest life-saving impact you can make with your money. 
• The Malala Fund - I am amazed by this young woman! The Malala Fund was started by Malala, the beautiful 15 year old girl who was shot by the Taliban for encouraging girls to go to school. The Malala Fund aims to end the social, economic, legal and political factors that deny girls around the world the education they deserve. Hear Malala talk about her mission here.
• First Book - My kids are all addicted to books and I can't imagine them not having access to books to read. First Book distributes books and educational resources to low-income families and schools throughout the United States and Canada. Many of these books are used by children who otherwise would have no access to books which are a cornerstone of learning to read which is necessary for education. 
• Unicef - Typhoon Haiyan hit the Philippines last week and Unicef needs donations to help the thousands in need. United Nations International Children's Emergency Fund is a United Nations Program that provides long-term humanitarian and developmental assistance to children and mothers in developing countries. 
• Schistosomiasis Control Initiative - I can't pronounce the name either, but as one of the three highest ranked charities in the world for providing the most good per dollar, SCI needs your help! Assits African governments with treatment and prevention of parasitic worms. Worm-based diseases can be prevented for less than 50 cents per child per year and this results in healthier children with improved school attendance. 
• Heifer International - Alton Brown does a good job explaining how Heifer International works in this video. With a "teach a man to fish" philosophy, Heifer International donates animals and training to families in need around the world.

What are your favorite charities and how are you going to help those in need this holiday season?