General

EBFA Year in Review 2014

Very special Happy New Year to all the health and fitness professionals and affiliates who have attended an EBFA workshop, supported our barefoot education and/or integrated our from the ground up programming into their practice!    We would not be where we are at today without YOU!

As we say goodbye to yet another year I like to reflect on all the past year’s accomplishments and celebrate the highlights in EBFA’s continued mission to spread the power of barefoot science and from the ground up training!

Below are some of my proudest moments for EBFA throughout 2014:

EBFA Launches Education Partnerships throughout SE Asia 

FITMalaysia1In March 2014 EBFA conducted it’s first Master Instructor Training in Bangkok, Thailand.  This MI Training and the subsequent partnership with Fitness Innovations Thailand (FIT) and it’s affiliates throughout SE Asia has allowed EBFA to rapidly spread the science, guidelines and programming for safe and effective barefoot training.

EBFA and FIT proudly partner in barefoot education throughout China, Malaysia, Singapore, Thailand

EBFA also has Education Partners throughout India, Japan and Korea

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EBFA Welcomes Over 30 Master Instructors in Barefoot EducationMI Collage

In 2014 EBFA conducted three Master Instructor Training workshops both in Asia and the USA with attendees representing nine countries throughout Asia, Europe and North America.    After successful completion of the MI Training and examination process EBFA was able to recognize over 30 professionals as EBFA Master Instructors in Barefoot Education.

EBFA Master Instructors include Chiropractors, Physical Therapists, Pilates Instructors, Running Coaches, Strength Coaches and Fitness Professionals.

You can find MI conducted Barefoot Training Specialist courses throughout Asia, Canada and the USA.

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EBFA Introduces Barefoot Education in the University Setting

As an advocate of higher education the introductiUWAon of EBFA’s Barefoot Education into a University setting is one of my proudest accomplishments for EBFA in 2014.   Being able to influence the next generation of health & fitness professionals is a powerful step towards changing the way the health & fitness industry looks at the foot & ankle, barefoot science and integrated movement.   In 2014 EBFA introduced it’s education at Bryan College in San Francisco, Georgia College, University of Massachusetts Boston and University of Western Australia in Perth.

EBFA continues to pursue the integration of barefoot education in a University setting in 2015!

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BarefootGeorgiaEBFA Initiates Toe Spread Research Study

To hold true to our name “Evidence-Based” Fitness Academy, being able to conduct research is one of my visions for EBFA and for the advancement of barefoot science in health & fitness.  After finally achieving IRB approval EBFA was able to initiate our first official research study looking at the benefit of abductor strengthening on great toe alignment (hallux abduction angle) and sesamoid position after 8 weeks and 12 weeks.

This study is done through the collaboration of ToeSox and is 4 weeks underway.  Updates will be made in early 2015 so please stay tuned.

In addition, EBFA is collaborating on research conducted through Georgia College and their Performance Degree Program to evaluate the immediate effect of barefoot movement prep on vertical change, agility, change of direction.   We look forward to future research projects and collaborations in 2015!

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Thank you again for all your continued support through 2014.   We are looking forward to a whirlwind 2015 as we continue to spread the power of barefoot science, host our first ever Barefoot Training Summit, launch our first book Barefoot Strong and introduce our first product!

Happy New Year – and remember to STAY BAREFOOT STRONG! 

Dr Emily Splichal & the EBFA Team

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Barefoot Science

Preventing Collagen Crosslinking with Anti-Aging Science

Since the earliest stages of my career I had a fascination with the science of aging.   Accredit it to my mom giving us kids vitamins as birthday and Christmas presents, I have teenage memories of spending hours reading about the anti-aging benefits of different supplements.

To satisfy this continual curiosity, in 2007 I joined the American Academy of Anti-Aging Medicine (A4M) and attended some of the most cutting edge conferences on the topic of aging.   From break through anti-aging cosmetics to innovative cancer therapies, the science revealed at these conferences was years ahead common medicine.

Surrounded by Plastic Surgeons and Dermatologists, most attendees didn’t understand why a Podiatrist and Movement Specialist would attend these conferences.  I would explain to other Doctors that similarly how they use anti-aging medicine to prevent collagen degradation in the face as a means to preserve the beauty of youth, I too use these anti-aging secrets to protect collagen degradation in the myofascial and myotendinous system to preserve the beauty of human movement.

Through my association with the American Academy of Anti-Aging Medicine, I quickly learned that collagen, whether it is in the skin of the face of the fascia of the foot, ages through the same process.   A process known as – glycation.

Collagen – Foundation to Skin, Fascia and Tendons

how-to-increase-collagen-in-the-face_3_7784Collagen, the main element found in connective tissue, provides the structural foundation to skin, fascia and tendons.   The soundness of these collagen units is determined by the stability of hydrogen bridges and covalent bonds referred to as crosslinks.   Although crosslinks provide strength and stability, excessive or non-specific crosslinks throughout the collagen fibers creates stiffness and a lack of elastic recoil in the connective tissue (think fascial adhesions).

These non-specific crosslinks are formed through a process known as glycation, which occurs in the presence of excessive glucose.

Although we often associate excessive blood sugar with diabetes we are all susceptible to elevated glucose levels and the process of glycation.   In fact, glycation is one of the most common reasons why we age as a whole.

Glycation & AGEs

So what exactly is glycation and how is it associated with elevated blood sugar?

Elevated or excessive sugar found in the blood stream spontaneously reacts with proteins forming a free radical known as advanced glycation end products (AGEs). These AGEs are responsible for forming non-specific crosslinks in collagen and subsequently stiffer collagen.

The stiffer the connective tissue (collagen) the increased risk of micro-tearing during dynamic movement.   Studies have shown that micro-tears in connective tissue are repaired with Collagen Type III vs. the normal Collagen Type I.

Collagen Type III is characterized as less elastic and stiffer compared to Collagen Type I which creates a repetitive micro-trauma cycle and eventual tissue degradation we know as tendonosis.

So what can we do to prevent the formation of AGEs and non-specific crosslinks in our collagen?

Tips to Preventing Collagen Aging in Fascia & Tendons

1.  Tight glycemic control

This probably goes without saying.   If elevated blood sugar levels set off the chemical reaction called glycation then avoiding blood sugar spikes is obviously important.

If you or your client have trouble controlling their blood sugar levels through diet and exercise consider the use of supplements such as Benfotiamine which has been shown to decrease blood sugar levels in diabetic patients.

A 2005 study demonstrated decreased formation of AGEs in diabetic subjects with a daily dose of 300mg Benfotiamine.   Benfotiamine is an active form of B1 and acts by inhibiting the deoxidation of sugar or glycation.

2.  Vitamin C & E supplementation

VitaminProbably two of the most common anti-oxidants Vitamin C and E have been shown to prevent the formation of AGEs and crosslinks in collagen.   A 2002 study by Abdel et al. demonstrated an 80% decrease in glycation / AGE formation in subjects supplemented with high dose Vitamin C.

Recommended dosage is 1000mg / day.

3.  Aspirin a day keeps crosslinks away

Not only is baby aspirin heart healthy, but now studies have shown that daily aspirin can actually offset the formation of collagen crosslinks. Aspirin inhibits the formation of AGEs by acetylating lysine residues (L-lysine + sugar = AGEs).

Recommended dosage is 81mg / day.

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Want to learn more about the science of aging, connective tissue and human movement – please visit www.ebfafitness.com

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Barefoot Science

The Neurology of Aging & Movement Longevity

You have probably read at least a dozen articles advocating the benefits of protecting cognitive function as we age.   From exercise to crossword puzzles, there are many ways to keep your brain sharp as you age.

But how much do you think about peripheral nerve health and age?

Our ability to maintain an active lifestyle and participate in the hobbies we enjoy is just as dependent on a strong and healthy peripheral nervous system as it is to cognitive function.

In this article we are going to explore the neurology of aging, how it affects all of us and exactly what we can do keep our peripheral nervous system vibrant and healthy ensuring what I call “movement longevity”.

The Nervous System

nervous systemComprised of both the Central Nervous System (CNS) (brain & spinal cord) and Peripheral Nervous System (PNS) (nerves & axons), our nervous system is responsible for coordinating voluntary and involuntary actions.

Our PNS is a complex network of spinal nerves and plexuses branching from the spinal cord, and includes the cervical spinal nerves, brachial plexus and lumbosacral plexus. Traveling distally from the spinal cord, it is the peripheral nerves which are sensitive to stimulation from the palm of our hands to the tips of our toes.

These peripheral nerves are sensitive to afferent stimuli or input signals which go back up to the CNS. The CNS then processes this input and sends an efferent signal or action signal back down to the PNS resulting in controlled, precise movements.

 

Movement Accuracy

To improve the accuracy and efficiency of each movement, our neuromuscular system is controlled by both a feed forward and feedback system or loop.   Feed forward responses (aka pre-activation responses) are based on previous experiences or muscle activation patterns.  These responses are stored in an area of the brain referred to as the cerebellum – and occur before the completion of the movement.   An example of a feed forward response would be activating the ankle stabilizers before foot contact.

Conversely, feedback responses (aka reactive responses) allow our neuromuscular system to adjust to errors, and auto-correct throughout a given movement.   An example of a feedback response would be activation of ankle stabilizers when walking on an uneven terrain.

Age & Input Accuracy

seniors_yoga_591Where the concept of neuromuscular control, movement efficiency and aging come together is through the accuracy of inputsignals as dictated by the peripheral nervous system.   The more accurate the information coming in, the more precise our movements will be.

If we were to imagine someone of an older age, we typically picture someone who is more frail and timid in their movements.   We may note a delay in the correction of movement errors and often associate this delayed correction with an increased risk in falls.

With falls being one of the biggest concerns as we age, instability and decreased control can often be attributed to an aging peripheral nervous system.   So is there anything that can be done to protect the nervous system as we age so that we can maintain the movement accuracy of our younger years?   Or must we succumb to the inevitable process of an aging neuromuscular system?

The good news is there is absolutely something you can do to protect your peripheral nervous system from the aging process. It is called neuroplasticity through barefoot science.  

To fully understand this concept let’s continue exploring the peripheral nervous system specifically as it relates to the plantar foot.

Plantar Proprioceptors

feet hipWhat’s unique about the PNS and the foot is this is where the smallest nerve branches exist.   Divided into both sensory and motor nerves, cadaver studies have shown that 3x as many branches off of the tibial nerve provide sensory function.

The peripheral nerves that have a sensory function to the skin are referred to as cutaneous nerves or in the bottom of the foot they are our plantar cutaneous receptors (aka mechanoceptors).   These small plantar cutaneous nerves are responsible for processing information such as texture, skin stretch, vibration, deep pressure and light touch.   All of the stimuli which allows us to maintain upright stance, manipulate uneven terrain and absorb impact forces.

Our ability to detect surface compliancy and impact forces is heavily dependent on vibration detection. The importance of this sensory input is demonstrated by the fact that 80% of our plantar mechanoceptors are sensitive to vibration!

If we go back to aging and the accuracy of input information for precise and controlled movements, the importance of vibration detection is of upmost importance.

So how does aging affect our ability to detect vibration?

Studies have shown that as we age, our ability to detect vibration input is impaired.   From decreased mechanoceptor density to increased input threshold, by the time we are age 70 our plantar foot requires twice the stimulation to create the same response. This means that we need to do everything we can to ensure accurate vibration input is entering our plantar peripheral proprioceptors.

Footwear & Impaired Vibration Input

One of the greatest inhibitors of vibration input are the shoes we love.   Regardless of their fashion and functional benefits, footwear is not a natural feature of our nervous system or environment.

Our nervous system and the bare foot were not designed to decipher impact forces through footwear and cushion.   This concept is now readily accepted within the running and minimal footwear industries.

So what can we do to offset the aging nervous system and maintain movement longevity in the unnatural shod environment in which we live?

Tips for Movement Longevity

Tip #1Keep blood sugar under control

Although we typically associated elevated blood sugar levels with diabetes, we can all experience fluctuations in our blood sugar levels (think Ben & Jerry’s ice cream).

Elevated glucose in our blood stream is converted to AGEs (advanced glycation end products).   The myelin that surrounds our peripheral nerves is sensitive to these AGEs – which cause demyelination and disrupts signal transport.

The formation of AGEs stimulates an increase in oxidative stress, free radical formation and an up-regulation in our pro-inflammatory markers.   Or essentially elevated blood sugar levels (even in a non-diabetic) causes aging and degeneration of peripheral nerves (with the foot nerves going first!).

Tip #2 – Consider Nerve Protective Vitamins

Vitamin

When I was in Graduate School a big part of my focus was on vitamin supplementation and diabetic peripheral neuropathy.   Having spent so much time researching this topic I became a firm believer in the benefits of the appropriate vitamins in protecting nerve health as we age.

Everyone can benefit from nerve protective supplements – especially if we consider that elevated blood sugar levels (even in a non-diabetic) can start to damage our peripheral nerve function.

Vitamin #1 – L-Methyl Folate

This is not your mother’s folic acid!

L-methyl folate is the activated form of folate (folic acid) which has been shown to increase nerve growth factor. When taken over a period of 6 months studies have shown an increase in epidermal nerve fiber density (or in other words more peripheral nerves!).   Link to study 

Dosage: 1000 ug X 3 times day

Vitamin #2 – Acetyl-L-Carnitine

ALC is another powerful nerve protective supplement.

ALC has been shown to decrease painful nerve symptoms, as well as increase vibratory sensation. Remember that we maintain balance and absorb impact forces based on our ability to detect vibration so this is extremely beneficial as age!

Dosage: 500mg x 2 times day

Vitamin #3 – R-Lipoic Acid

This is probably my favorite supplement! (Yes I do get that excited over a vitamin)

Touted as one of the most powerful anti-oxidants, ALA has been shown to improve micro-circulation to peripheral nerves while decreasing oxidative stress.   A key point about ALA is that it must be taken in the R-LA form. “R” form is one that is biologically active (vs. “S” form).

Dosage: 600mg x 1 time day

Tip #3 – Cardiovascular Exercise

Cardiovascular exercise has many benefits, one of which is related to peripheral circulation.   The vascular system, just like the nervous system, is very intelligent meaning that if there is a loss in circulation to one area of a muscle the vascular system will create what’s called collateral circulation (or in other words form new blood vessels).   This is why cardiovascular exercise is beneficial for those with peripheral arterial disease.

So just like the collateral circulation formed in muscles, our vascular system can create new micro-vascular pathways to our nerves. The more blood and oxygen to our nerves the healthier they are!

Tip #4 – Myofascial Release

When I have a patient with idiopathic nerve symptoms I often include myofascial work into their recovery program.   Our complex network of superficial and deep fascial is intertwined with just as complex of a network of arteries, veins and peripheral nerves.

As our peripheral nerves course from the spine down to the foot it is only inevitable that they may get “stuck” or “sticky” at some point.   From muscle adhesions to a loss in fascial flexibility, our inflexibility can often impede nerve conduction.

Just like when you sleep on your arm and wake up with it tingling, to a smaller degree this is what’s happening to our peripheral nerves when they get caught in fascial tissue.

I often recommend to my patients to release their plantar foot, up the back of the calf to the hamstrings and into the glutes and piriformis.   For those with nerve symptoms this should be done daily.

Tip # 5 – Go Barefoot!

feet

This one pretty much goes without saying!     If our small nerves are on the bottom of the foot we want to keep them sensitive and awake through frequent barefoot stimulation.

Our nervous system is very plastic – which means that it can be shaped, challenged and molded based on the stimuli it encounters.   Conversely, if you do not stimulate your peripheral nervous system it will begin to weaken, fade and atrophy.

Whether your barefoot routine includes vibration training, standing on different textures or simply walking around your home – daily barefoot stimulation is enough to keep these small nerves on point!

Want to kick it up a notch?   Workout barefoot!

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To learn more about foot health, barefoot training and EBFA Education

please visit http://www.ebfafitness.com

 

 

 

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Barefoot Science, General

What does it mean to be BAREFOOT STRONG?

As a Doctor one of my favorite aspects of my job is educating and empowering patients to take their health and well-being into their own hands.

Most patient complaints could have been prevented if they had a little deeper understanding of the way the body moves, how forces are transferred through the body and the importance of soft tissue recovery.

As a means to further spread the message of foot health and my approach to patient rehab I have decided to compile all my blog posts, webinars and workshop content into a book designed with the wellness professional and patient in mind.

I have decided to write a book that shares the power of natural movement and innate loading responses through barefoot science.   Through this book and through my teachings it is my goal to teach the world how to become BAREFOOT STRONG.

feetAs I began outlining the underlying message of the book, I started to question the meaning of “barefoot strong”?   As I looked down at the myriad of research articles, notes and sample chapters I began to see the deeper meaning of BAREFOOT STRONG and what these words meant to me.

I began to see that BAREFOOT STRONG means so much more than simply working out sans footwear.

To truly become BAREFOOT STRONG, I believe that one must:

  • Accept that the neuromuscular system is a deeply integrated network of joints, fascia, muscles and nerves which work together like a symphony providing the beauty we call human movement
  • Respect the foot as a kinematic structure serving as the foundation to all closed chain movements
  • Appreciate the sensitivity of the plantar proprioceptors and their role in maintaining balance, perceiving impact forces and stabilizing the lumbopelvic hip complex for human locomotion
  • Refuse to allow the continuous damping of neuromuscular input due to footwear and unnecessary orthotics but rather welcome the proprioceptive input from the ground on which we stand.

So what does BAREFOOT STRONG mean to you?

I’m curious to hear your perspective and look forward to sharing my book with the world in early 2015!

Stay barefoot strong!

Dr Emily

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Barefoot Training Summit

Barefoot Training Summit Presenter Spotlight – Stacey Lei Krauss, Creator willPower & grace®

As barefoot training STACEY LEI KRAUSScontinues to gain traction within the fitness industry, EBFA wanted to take a few moments and speak with Barefoot Training Summit Presenter and Creator of willpower & Grace® (wPg) – Stacey Lei Krauss.

In 2000, Stacey introduced her first barefoot fitness class and now 13 years later wPg can be found health clubs and movement studios across the world.   Stacey has played a key role in the growth of barefoot training within the fitness Industry and we proudly welcome her to both the Delhi and Denver Barefoot Training Summits!

Thank you for taking a few minutes to answer my questions and share with our readers your passion for barefoot training and foot fitness. In 2000 you first launched your willPower & grace® workout. Can you tell us a little bit about the history of wPg, what led to the creation of a barefoot workout and what the name represents?

In 2000, I was living in NYC – developing a smart workout for discerning NYC ladies. I blended elements of cardio, strength, endurance and flexibility; a workout that could “get it all done” in an hour.

Mindful movement, at this time was still a “specialty” – in fact, most fitness consumers didn’t even know what Pilates was. I wanted my students to be aware of their bodies – to work with precision and focus. My workout evolved into a sequence that challenged my students to work without props (weights and steps). I fused functional training with old school calisthenics and dance, yoga fundamentals and Pilates principals. It became a fusion of the industry’s most efficient and effective workouts. I began to see movement quality improve, and I loved what I saw. We had started working “smarter” instead of harder.

The name? At the time, it was a play on “Will & Grace”, the hit TV show about hip NYC singles. As I coached my class, I cued “building willPower like a muscle” (self control) and “moving with grace” (elegance of action). Post 9.11, however, the philosophy grew much stronger. Each exercise started to have its own metaphor with regard to cultivating strength and flow in everyday life.

I was surprised, and honored when an instructor asked me if I would teach her my format. From there, the program began, and now, here we are, 13 years later… and we’re global.

wpg-590x270

Have you always had a love for feet or did you have an experience that made you want to focus on foot fitness?

I grew up dancing and I was barefoot whenever I could be. As an adult and a fitness professional, when I took aerobics classes, I was barefoot. Of course, when I taught I wore my “uniform” – highly cushioned and supportive shoes.

One summer morning, I walked to the gym in flip-flops. When I arrived in the studio, I realized I’d forgotten my athletic shoes. So, I announced that I’d be teaching barefoot. With this, a few of my students asked if they could kick off their shoes as well. Since our workout was equipment-free, I didn’t need to worry about my students dropping weights on their feet.

What I saw (and heard) amazed me. It was natural for me to move effortlessly and gracefully across the floor without cushioning. I didn’t make a sound. However, my students were thudding, clunking and banging their skeletons against the hardwood floor. Wow!

What a moment. I realized then, that I had a tremendous teaching opportunity. And so it began. willPower & grace® became one of the first “modern” barefoot cardio workouts, and certainly the very first to cue foot fitness as a fundamental concept.

As a bizarre side note, my high school year book aspiration was “To walk barefoot in the sand, with the world at my feet.” Being that I didn’t grow up on the water, or even near a beach, I think someone “up there” was making plans for me.

What is your response to the increased awareness in foot fitness and barefoot training that is happening throughout the fitness industry? Has barefoot training reached its peak? How big do you see barefoot training becoming within the industry?

My response to the increased awareness? IT’S ABOUT TIME

It’s been a tough decade, as I’ve needed to convince people to take their shoes off and exercise the feet the way they exercise the rest of the body. Until a few years ago, there was no evidence-based information that supported foot fitness. Now, as the Fitness Advisor for Vibram FiveFingers® (the shoe with toe pockets), I present to fitness professionals and consumers about how to train the feet and the multitude of benefits.

Thanks to Born to Run, running has become the modality that’s brought barefoot training into the spotlight – but what I teach reaches far beyond running. This is the evolutionary path that our industry will need to take.

From an industry perspective, barefoot training is barely in its infancy. I predict that within 5 years we will not see cushioned, structured shoes in the fitness arena at all. Those big bulky shoes will be sitting in a box with those big leather lumbar support belts that we used to wear.

Not familiar with willPower & grace®?

Check out the video below!

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Stacey Lei Krauss is schedule to teach at the Delhi Barefoot Training Summit 13 – 15, March 2015 and Denver Barefoot Training Summit May 8 – 10, 2015.

In addition, Stacey will be teaching her willpower & grace® Certification as a Post-Conference on 16, March 2015 in Delhi, India

Learn more or register by click HERE

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Foot Function & Fascial Lines Series

Big Toe Biomechanics: Beyond Dorsiflexion

The average adult takes between 5,000 – 8,000 steps a day.   Often completely unaware of the complex motor programming that goes into each step we take, walking is one of most common movement patterns taken for granted.

In today’s blog we are going to focus on an aspect of gait (or rather a joint) that is often overlooked and where biomechanics are often over-simplified – meet the great toe joint aka the first metatarsophalangeal joint (MPJ).

Big toe

Playing a critical role of how we push off with each step, the great toe joint can be linked to compensation patterns ranging from over-recruitment of the adductors (secondary to an early heel lift) to inhibition of the gluteus maximus (secondary to shortened stride length or apropulsive gait).

These faulty push-off mechanics are related to a limitation in great toe range of motion or dorsiflexion.   Requiring at least 30 degrees of dorsiflexion for push-off, the optimal range of motion we want to see in our clients is actually closer to 65 – 75 degrees.

So what do we do if our client or patient presents with limited dorsiflexion?

We will explore below that due to the complexity of the foot (and human body in general) the goal of optimizing great toe dorsiflexion is not as simple as “stretch the joint”, “mobilize the joint” or “decompress the joint”.

Introducing the Roll, Slide and Compression 

If we took a closer look at the biomechanical studies related to great toe dorsiflexion, we would find that shifting into propulsion or onto the great toe is a complex series of muscle activation patterns.   Any delay in the timing of these muscle activation patterns, limitation in dorsiflexion will occur and compensation patterns soon follow.

Let’s take a closer look at how our great toe actually achieves the 30+ degrees of dorsiflexion necessary for push-off:

Step 1 – Roll (first 20 degrees of dorsiflexion)

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First step of great toe dorsiflexion requires that the great toe be fixed to the ground while the 1st metatarsal head rolls over the base of the proximal phalynx.   To adequately roll over the base of the proximal phalynx the great toe is stabilized by the following muscles:

conjoined tendon

Flexor Hallucis Longus (FHL) – inserts on the plantar aspect of the distal phalynx and is responsible for keeping the great to fixed to the ground during propulsion.

Flexor Hallucis Brevis (FHB) – inserts on the plantar aspect of the proximal phalynx and is responsible for stabilizing 1st MPJ.   Running through the tendons of the FHB are the sesamoids.   These small bones act as a fulcrum for the 1st metatarsal head as it rolls over the base of the proximal phalynx.

Abductor Hallucis – inserts on the plantar aspect of the proximal phalynx and shares a tendon with the medial belly of the FHB.   This muscle helps maintain 1st MPJ stability in the transverse plane.

Adductor Hallucis – inserts on the plantar aspect of the proximal phalynx and shares a tendon with the lateral belly of the FHB.   Helps maintain 1st MPJ stability in the transverse plane (opposes the abductor hallucis)

Step 2 – Slide (> 20 degrees dorsiflexion)

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After the 1st metatarsal head rolls over the base of the proximal phalynx, now it is time to slide.   This step requires the 1st metatarsal head to slide plantarly relative to the base of the proximal phalynx.

The muscle responsible for this step is the peroneus longus.   Acting as an antagonist to the tibialis anterior (remember your spiral fascial line), the peroneus longus is a primary stabilizer of the first ray.   When the peroneus longus engages it plantarflexes and laterally compresses the 1st metatarsal – creating the stability needed for push-off.

If a client cannot engage the peroneus longus fast enough what happens is we see them bypass Step 2 – Slide and head directly into Step 3 – Compression.   Early compression of the 1s MPJ can lead to jamming, synovitis, capsulitis, pre-mature arthritis and an array of proximal compensation patterns.

This bypass of Step 2 into Step 3 is often referred to as Functional Hallux Limitus.

Step 3 – Compression

As our 1st MPJ moves into this final stage of dorsiflexion provides the stability requires for optimal transfer of forces and balance.

Optimizing 1st MPJ Dorsiflexion

So what is one of the best ways to optimize our clients or patients’ 1st MPJ dorsiflexion?

For the answer we need to go back to this bypassing of Step 2 – Slide.   We must be asking ourselves, how can we assure proper peroneus longus function and activation?

The answer?  Look at the rearfoot.   Is it everted?

footblog

Reason #1 – Peroneus Longus Function

In an everted subtalar joint the peroneus longus muscle is made lax or it loses it’s natural tension for proper force production.     If the peroneus longus muscle is not able to properly oppose the tibialis anterior we begin to see what’s called metatarsal elevatus or dorsiflexion of the 1st ray.   This leads to jamming of the 1st MPJ during dorsiflexion.

Reason #2 – Posterior Tibialis Function

In an everted subtalar joint the posterior tibialis is often underactive or weak. In previous blog articles we discussed how the posterior tibialis is part of the Deep Front Line and actually inserts into the peroneus longus tendon.

In a weak posterior tibialis there is no deep reflexive stabilization activation from the foot, and therefore no co-activation pattern between the Deep Front Line and the Spiral Line.     This delay in activation leads to a bypass of Step 2 – Slide

So what can you do?

In patients with Functional Hallux Limitus or a delay in peroneus longus activation it is my goal to:

  1. Activate their intrinsics and Deep Front Line through short foot and barefoot training.
  2. Restore subtalar joint position through foot and glute strengthening
  3. Orthotic management if necessary (ideally temporary until they are out of pain)

If you are looking to learn more about foot function and the integration of this powerful complex into your client or patient programming please check out EBFA’s Programs including our 

Barefoot Training Specialist® and BarefootRx® Rehab Specialist Certifications.

http://www.ebfafitness.com

Are you barefoot strong? 

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