Too Much Arch Support??

Everyday it seems I talk to a patient or friend and they mention how flat their feet are and that they make sure they have good arch support in their shoes. Everyday, all the time. REALLY?! Could it be that a majority of the population has fallen arches?? I don’t buy it and neither should you.

Is it true that we set up our kids up for failure by putting them in hard, way too supportive of a shoe before they can even walk? Absolutely! I see it all the time. Just like the natural curves in our spine that need to develop as we go from crawling to walking as do the arches in our feet. As we start to walk our arches and the muscles and tissues that give them support and stability begin to strengthen and develop. Unfortunately we don’t give their feet a chance because we throw these over-supportive shoes on them. Imagine wearing a cast from your wrist up to your shoulder eight hours a day for a year. What will happen? It’s simple. The ol’ use it or lose it principle. The muscles will get smaller. Joint degeneration will begin to set in. The arm will lose that ever so important connection to your brain, etc etc. But does that mean our feet are doomed to never have strong stable arches again?

Of course the best way to help our feet is to start at the beginning with our kids. It’s good to give kid’s feet a chance to get strong as soon as they start walking and you can do that by either letting them go barefoot whenever possible or providing them with a soft sole shoe that challenges the foot. Now if you are reading this you are probably beyond just starting to walk. You have probably already exposed your feet to some potential weakness. Many people actually have weakness only in one foot which can lead to many biomechanical issues such as: leg length discrepancy, pelvic torsion, lack of tibial rotation which can inhibit the quadriceps, and many knee issues due to unilateral wear. Having weakness in both arches can cause the same as above along with having problems in your spine down to the joints in the legs. Our arches provide us with extra shock absorption to help decrease ground reactive forces produced while walking, running, and jumping. If you have fallen arches you have to provide your feet with some form of external arch support for cushion or…..you can try and re-strengthen them.

Let me back up just a second and speak to the ones who are not sure if they have fallen arches. I’m going to help you find out so that you can be on your way. Grab two index cards and a pen and mark L on top of one and R on the top of the other. In the seated position make sure your feet are flat on the floor. Find that bony prominence on the inside part of your ankle and trace with your finger one inch down and one inch forward toward the big toe. This will land you approximately in the middle of your foot at another boney landmark called the navicular bone. Use a pen and place a mark right in the middle of that bone on both feet. Now place an index card on the floor and next to that pen mark. Mark on the index card exactly where the mark on your foot is. Repeat other side. The next part would be easier to have a buddy help you out. Keeping the card next to your foot, stand up. Now mark on the card where the line on your foot has dropped. Repeat other side. Finally using a ruler measure the distance between the two lines on each card. The separation of those two lines represents how much your arch falls when you go from non-weight bearing to weight bearing. It is normal for them to fall slightly but not more than 4mm. If your measurement is 5mm or more you might have weak and unstable arches that need to be addressed.

            Ok so you have either been diagnosed by a healthcare provider or you just diagnosed your- self with fallen arches. How do you fix it? Keep in mind that this is an issue that you have created over the course of your whole life so it might take a few months to stabilize and gain optimal strength back. Here are a couple of exercises to do to rebuild that neurological connection to your foot and help strengthen. The first is balancing on one leg. This might sound simple but can be difficult if you have weak arches and is absolutely crucial for rebuilding. With no shoes on stand on one leg as long as you can.  Switch to the other side. Your goal is to work your way up to one minute. Perform a couple sets twice a day. The second is a towel curling exercise. Place a hand towel on the floor all spread out. Put your toes on the edge of the towel and begin curling your toes in until the other side of the towel reaches your toes. Switch to the other side. Perform two sets twice a day. After doing those exercises for 6 weeks, it is time to start transitioning into a neutral shoe. Add this shoe in slowly. Wear them only a couple hours a day or a mile or two while running or walking and slowly increase time and/or distance. Then potentially down the road you can move into a “natural” shoe like the Nike Free.

            While strengthening and stabilizing your arches you might notice some changes: a decrease in back pain, decrease in knee pain and hip pain, no more plantar fasciitis, increase in running/walking distance and many more pleasant side effects. Remember to have patience with this rebuilding and not to get too hurried. Jumping into a neutral shoe too soon can cause more problems. So take your time and enjoy the ride.  

Any questions about this article or general health related questions please contact Dr. Mike Gensler at mgensdc@gmail.com.

Kinematic Sequence of the Golf Swing: Part One

The game of golf is the most challenging sport I have ever played. So many things have to come together in order for you to hit a little white ball into a small hole in the ground 500 yards away. And unfortunately it’s not the person with the highest score wins. But that is why golf is so appealing and extremely popular in all age groups. The player doesn’t have a shot clock and there isn’t a 250lb linebacker chasing you down. What golf does have is a chain of events that must take place in order for maximum power and consistent ball striking to occur. This chain of events is called your kinematic sequence or sequence of movement. This specifically takes place from the top of your backswing and through impact. About 90% of amateur golfers I have seen lack a proper kinematic sequence.

Why is it that many successful pro golfers like Jim Furyk or Kenny Perry have such an awkward looking swing, yet they are great players and consistently win? Because every great golfer, no matter what their swing looks like from the outside, has an efficient kinematic sequence. They transfer their speed and energy segmentally in proper sequence from the top of their swing through impact. Here’s a look at a proper kinematic sequence: the down swing is initiated by the lower body specifically the pelvis, then follows the trunk or torso, followed by the arms, and then finally the club. Energy is transferred from the lower body to the torso to the arms to the club. And this energy builds or accelerates as it is transferred through each segment like a whip or a wound up coil. So as the lower body accelerates to initiate the down swing, the coil begins to unwind. This activates the torso to unwind and accelerate and at the same time the pelvis is decelerating and so on down through the sequence. Swing consistency and club head speed begins and ends with this whip like action. Unfortunately most amateurs begin the down swing with the upper body thereby disrupting the kinematic sequence.  So in order to have an efficient golf swing you must have muscles that fire in the appropriate pattern or order. Next month I will get into the muscles responsible and what to you can do to fix an improper or inefficient kinematic sequence.

Off-season training for Golf

As much as I hate to say it, but golf season is coming to an end. For some of us that is a good thing. This downtime from golf gives us a chance to truly work on our game. It’s a chance to work on flexibility, power, or maybe to work through some aches and pains that we didn’t have time for because time would much rather be spent on the course. Can’t blame you there. The offseason lets us reflect back and think about “What part of my game, body, or physical conditioning do I want to improve?”.  Of course everyone has a different answer. What is yours?

Lets say you want to work on your swing because you have a sway swing fault. The first question that needs to be addressed is: what’s the cause? Once the cause is nailed down: how do we fix it? Two of the most common causes of a sway is lack of good internal rotation of the trail hip during the back swing and gluteal instability. Both easy to fix.

Ok, so you want to work on your body or some part of it. Maybe you get back or elbow pain midway through a round and your score shoots up. Same thing applies here. What is the cause and how do we fix it? A couple of the most common causes of back pain for golfers is a S-posture at set up and reverse spine angle swing fault. Most common cause of elbow pain is a scooping swing fault at impact position. Fix those issues and your game will only get better.

If you are already doing some sort of in-season training program, the transition to an off-season program is fairly simple. Starting a golf training program from scratch is a different story. If starting from scratch, depending on what is going on, you might have to do in-season/off-season combined program to get things started. There are many websites and programs out there that are good, but can be confusing as well. I highly recommend talking with your golf pro or golf fitness pro on how to get started. The off-season can be a great tool, use it wisely. Look for my next blog where I will dive into an actual training program.