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Eva Lowry - Very interested on your feelings about "barefoot" running. I know to start out slowly....I'm going to start with the beach for obvious reasons. What shoe do you recommend for pavement running that will most mimic barefoot running.

Mike Ryan (October 18, 2009): Hi Eva,
I'm a big fan of barefoot running. We spend so much of our day in comfy or hard shoes and our feet weaken because of this. Remember when we were kids and we lived barefoot 24/7? How many times did your mother keep you home from school and write your teacher to tell her that "Little Eva will not be coming to school today becasue she has a terrible bout of plantar fascitis"? Zero, I assume? There's a reason for that.
Running without shoes allows the little muscles of the feet, ankles and toes to do their job of stabilizing your base of support. Your arch is mechanically one of the most complex structure in your body so strengthening and normalizing its function are key steps of staying healthy.
Key Points for Barefoot Running:
1. Run on level and soft surfaces - golf courses are best.
2. Start slow with low intensity - easy striders on the beach or golf course after a bike or run is a great way to start.
3. Extra stretching of your calves is important as you add this to your workout plan.
4. Nike Free shoes are a great substitute as you progress into barefoot running. These shoes give you the cushioning while allowing the stresses to be properly distributed to your arch and foot.
I look forward to hearing back from you to see how you like getting a few new calluses on your feet!

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Lynne R. - Hi Mike,

Thank you for this fabulous resource! I have been having problems with my right hip and low back. It seems like sciatic to me due to the pain down my right leg into my lower leg. Icing my hip does help, running does not... I want to work out but feel like I will make it worse. What exercises can I do to help this heal? Should I ice every day? What about heat? Thank you!

Mike Ryan (September 21, 2009): Your hip/low back issue is a common problem for many adults. 80% of us 30+ year olds will suffer from back pain in our lifetime.
The first step I suggest is to see a low back/pelvis orthopedist to rule out the bad things: lumbar disc rupture, bone spurs and nerve damage.
Assuming those issues are not an issue, let me show you how to reduce your pain, increase your ability to be active and to minimize the likelihood of future trips to the doctor.
Keep icing...after all lower extremity activities, after a long day of sitting and whenever your symptoms think about paying you a visit. Ice is your friend so get use to the pain of icing, period.
It's important to note that your low back, your pelvis and your hip joint are all directly related to each other when we move. Any changes of any one of those three, good or bad, significantly alters the other two body parts. Knowing this, you will understand why I will be showing you ways to positively influence other areas besides your low back and hip.
You need to balance off how you move. From one side of your body to the other side, from the front of you legs to the back, from the low back to the abdominal muscles located in the front of the trunk, balanced motion is healthy motion. To do this, you should immediately increase your flexibility of your hamstrings, your hip flexors, your low back and your calves.
Functionally strong abdominal muscles ("Abs") are the cornerstone of your athletic lifestyle. (Read previous MRF Q&A's on Abs)
Crunches on a flat surface, pelvis/trunk stabilizing exercise on all-four and single leg balance drills are your best initial options for an initial Abs program without aggravating your back or hip.
Lastly, get physical. Cardio training other than running is a must. Improving your cardiovascular fitness without hurting the back is a great place to start. Elliptical trainers, biking (keep the seat high enough), swimming and walking are great places to start. The amount of core training with these cardio-exercises will pay off 2-4 weeks down the road when you are ready to get back to running. At that time.....enjoy your passion for running AND stick with your flexibility and Ab routine 2x/week to stay strong and flexible.

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Debra C. - Hi Mike,
I am in my mid 40's and over a year ago had gotten back into dance after many years of less strenuous exercise. I am having alot of trouble with inflammations that have even affected my walking for the last 3 months. My problems were instigated by a massage therapist I no longer see. The last thing he did was dig his finger into the side of my right ankle and he popped or flicked my peroneal tendon one time. He said this was cross friction massage. Afterwards he had me turn over onto my back and he squeezed my foot and pointed it downward. I had some very small local swelling were he dug his fingers in. Over the next few days I developed a very faint bluish tinge. 5 days later it started aching and now larger areas around it are bothering me. The doctor said at 2 weeks out from this I didn't have any mechanics of a sprain but that the massage therapist irritated and inflamed the tendon. It really bothers me to drive, pushing the pedal. I'm using Voltaren gel. So what do you think? How long will this last? Should I be limiting my walking? Your insight would be appreciated.

Mike Ryan (July 22, 2009): Hi Debra,
Sorry to hear of your right ankle/shin problems. From what you told me, it appears that your peroneal tendon is suffering from what they call tenosynovitis. This is a fancy way of describing an inflammation problem of the sheath that encompasses the peroneal tendon.
I can hear you say it now: "What do I have to do to get this better?" I treat similar ailments 4-6 times each football season. From the way I think about it, it comes down to two factors....what you DO and what you DON'T do.

What you should do:
1. Ice massage or ice bag the lower half of the outer right shin while placing a moderate stretch on the tendon with the ankle pulled upward towards the shin 3-6 times per day.
2. Gently stretch the peroneal tendon and lower calf with an achilles-type stretch with the knee in a bent position without creating any pain in the peroneal tendon.
3. Rent/Buy a walking boot from a rehab center or medical supply center. This is a great way allow the tendon to rest while walking.

What you should NOT do:
1. Stay away from the fancy lady shoes with any high heels or pointed toe box.
2. No more aggressive massage on the tendon. A moderate of the calf and anterior ankle will be very helpful.
3. Avoid allot of standing or running activities until the tendon is pain-free with no palpable swelling.

In summary, avoid anything that makes the tendon swell or sore, ice as much as possible with a easy stretch to quiet the metabolism of the inflamed tissue and utilize a walking boot to allow the area to improve. In doing so, I hope to hear back from you in two weeks with you feeling great and back to walking in normal shoes with no pain!
With Healthy Regards, Mike

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Lori T. - Hi Mike,
I read how important upper body strength training is for women over 35 years old. I enjoyed the weight workouts and notice how much better I look and feel. My question is that after about 2 weeks of aggressive shoulder strength work, my shoulders become very painful and weak. I have no history of injuries or problems with my shoulders. What am I doing wrong and how can I avoid this annoying problem?

Mike Ryan (July 13, 2009): Good for you, Lori, to be including upper body strength work with your fitness program. This helps you combat osteoporosis. Meanwhile, it helps you maintain more muscle mass to help you stay more functional as you age and to increase your resting metabolism....which makes your body burn more calories!
The reason for your shoulder pain is probably due to an ailment referred to as Impingement Syndrome. This is a non-serious mechanical issue involving a pinching of your rotator cuff.
When repetitive activities are performed with the hand above the shoulder level, the rotator cuff is vulnerable to being pinched under the outer edge of the clavicle or collarbone. When your upper arm bone (the humerus) is elevated to an angle of 70 to 90 degrees in relationship to your torso, this is the range when most impingements occur.
"Interesting", you say, "but just tell me how to avoid this problem".

How to Avoid Shoulder Impingement Syndrome:
1. Avoid resistive exercises above shoulder level. Stretch up there but strengthen below the shoulder level.
2. Work with a skilled personal trainer or certified athletic trainer to ensure that your strength program is balanced and effective.
3. Include resistive shoulder external rotation exercises in your program to balance your rotator cuff strength.
4. Warm-up well before lifting and ice your shoulders immediately after a lift if you are experiencing shoulder pain.
5. Utilize a physical therapist or massage therapist to help massage the anterior shoulder while strengthening the shoulder blade muscles.

In summary, your complaint is very common yet controllable if addressed early. If you avoid the problem lifts, balance out the stress on the many muscles of the shoulder and utilize a specialist a couple of times to get you back on track, you will feel great ASAP!
With Healthy Regards, Mike

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Larry B. - Are there any fat burners that work? Do you recommend any diet or weight loss pills products for before or after workouts while increasing muscle size?
Thanks,
Larry B

Mike Ryan (June 07, 2009): Hi Larry,
Your question is a common one and I have never published any of my replies to this topic on my website. Instead, I would email the reader directly to his/her email. Due to the importance of this topic, I think it merits a public posting.
My solution to your inquiry: STOP LOOKING FOR A DANGEROUS SHORTCUT!!
Was that subtle enough for you?

Obviously I'm very serious about this topic because I've known of athletes and non-athletes that have suffered from HEAT STROKE, HEART ATTACKS AND DEATH because of over the counter and prescription diet supplements.
ThInk about it this way, Larry: If you were to take something that helped you burn more calories with less effort, it can only be done by stimulating your metabolism to become significantly revved up and, therefore, your entire body to heat up. To do this to your body is EXACTLY like driving your car down the highway at 60 mph in 3rd gear instead of 5th gear! For everyone reading this Q&A, I beg you to try this with your car for one (1) mile. It will give you a realistic example that may very well save a life of a friend or loved one who is abusing diet pills.

"What should I do to drop these holiday pounds now that beach time is here" you ask.
1. MORE EXERCISE - Stop looking for the "perfect" workout. Get your heart rate elevated to 70% of your maximum heart rate (read my previous emails for details) and then look for "The Sign"....a puddle of sweat under you and in your workout gear! Simple enough, right?
2. EAT BETTER - You know the deal: Less volume, less dressings/creams/toppings, less sweets and sodas and eat dinner earlier. Always get a brisk walk after every meal.
3. STOP FEELING SORRY FOR YOURSELF - Some may be offended by this but you know it's true. To reduce your body fat and to be able to live the lifestyle that makes you happy, you need to stop looking for shortcuts and magic pills. Using the example of the old Teeter-Todder we loved as a kid...if the CALORIES BURNED outweighs the CALORIES EATEN, you will lose weight, body fat and pant sizes!

In summary, metabolism stimulators, under any name, are extremely dangerous and need to be avoided. The desired outcome you want starts with one step: The right attitude. Get with a highly qualified personal trainer and get back in shape with the right lifestyle changes so your great results are long lasting.
Good luck to you, Larry, and keep me updated on your great results! MR

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Mark C - Hello Mike

While playing soccer my left foot rolled over the ball with my right foot planted managed to execute a "gymnastic" split. Since then the area where my leg joins the groin all the way round to the buttocks is causing considerable pain. Lifting my leg even balancing on my left leg is difficult. This was about 8 weeks ago but I still feel the effects

Is this a muscle or tendon problem?

Mike Ryan (May 24, 2009): Hi Mark,
Sorry to hear about your groin/hip injury. My answer is not a simple one because there are many issues to consider with this very busy "intersection" of your body where your lower extremity meets your torso.
Based on the mechanism of your injury and the length of time that your symptoms have continued, it is important for your to rule of two factors:
1. Hip Labral Injury
2. Sports Hernia
The only way to do this is to see a orthopedic physician who specializes in the hip and sports hernia.
Based on what you've told me, there are a couple of points that I think will be helpful for you:
1. Your groin area has multiple muscles that all have varied roles to move the hip and stabilize the pelvis. With an aggressive abduction ("split") injury, various degrees of damage can be done to any one or more of these muscles.
2. The direction pain extending back towards your buttocks makes the concerns greater for hip labral and capsular involvement.
3. Beware of the Crazy World of Sports Hernias!! The terminology, the means to diagnose and the solutions vary greatly with each doctor and sports medicine specialist. The best tip: Know that YOUR feedback to these specialists is very important so be actively involved with your care.
4. Regardless of your diagnosis and recovery plan, CORE STABILITY will play a significant role in your return to soccer and every aspect of your life. Research the many forms of core stability and start to visualize your rehab as a great success!
I wish you the very best, Mark, and a full recovery.

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