Bob Eckles is a podiatrist who started his career in California in 1984. He moved to New Zealand and worked as a surgeon in the state penal system, before returning to New York in 1997. He joined the faculty of the New York College of Podiatric Medicine, became Associate Dean and Director of the 3-year post-graduate foot and ankle surgery residency program, and a board member of the National Board of Podiatric Medical Examiners and Chair of the New York State Education Department Podiatrists Board. Today, Eckles works to advance the cause and science of foot and leg mechanics. He believes foot and leg mechanics is a unique expertise that should inform foot surgery, wound care and sports medicine.
Doing non-weight bearing stretching range of motion exercises before you get out of bed and doing a range of motion for the metatarsophalangeal joints helps to strengthen and stretch the muscles in the foot. Fascia, ligaments, tendons and muscles can all be stretched safely but never with pain or to the point of pain. Transcript: "Good day, Melanie. Thank you for the question. It's a short one with a long, fairly complex answer. I recommend two things, doing non-weight bearing stretching range of motion exercises before you get out of bed helps prepare the foot for weight-bearing stress, making figure of eights and so forth with your ankle in inversion, eversion, flexion, and extension makes a lot of sense. On the ground, I recommend a range of motion for the metatarsophalangeal joints, the knuckles of your feet by curling your toes under the foot and then conversely going up slowly onto the ball of your feet, heels off the ground. Doing this slowly and then gradually bringing the heel back down to the ground helps in many ways to strengthen and stretch the posterior muscles of the calf, recognize there are two of these, but also gives a necessary range of motion stress to the ball of the foot. Naturally, we all become a little bit stiffer as we get older. Exercise in fact manifests through strengthening and shortening of the muscle. It actually inhibits elongation. So stretching becomes very important. I would also point out some tissues need to be stretched and stressed. Others are not so, shall I use the word, happy to be stretched. Fascia is one structure like that. The plantar fascia on the bottom of the foot is dense, non-contractile, and relatively inelastic, and in most cases should not be stressed unless there are specific clinical reasons. Ligaments, a step up from that, can be stretched a little bit to a certain tolerance. And finally, tendons and muscles enjoy much more leeway and range of motion for stretching. It can be done safely. Never stretch with pain or to the point of pain. I hope this helps to answer your query. Thank you."
It appears that our muscle fibers are genetically predetermined with fast-twitch muscle fibers tending to be found in white meat, and slow-twitch muscle fibers in dark meat. However, it is also possible to induce the activation of either type, particularly in young adults. Transcript: "Good day, very interesting question fast and slow twitch muscle fibers. The data appears to show that we are engineered towards one or the other different muscle groups will have different percentages of slow versus Fast. Which interestingly poultry give us a little bit of insight into this and look at the difference between dark meat and white meat in a Key for example or even a chicken, the white fibers, the white meat tend to be fast which the dark, the darker meat. Dark fibers tend to be more slow twitch. So you look at birds like ducks and geese who tend to fly long distances and they don't do it particularly quickly. Their muscle components are Actually all dark meat, so, so that is one genetic reason to think that you can't undo, what, what you've been given. On the other hand, I think it's also fairly clear that that you can induce activity of short versus long or slow twitch fibers. And I think, particularly in young adolescent teen and younger adults, it is certainly possible. To induce the activation of and the percentage of fast twitch fibers. You know, to a point we're always going to be constrained by our genetics. So I hope that helps and good day."
The most effective way to strengthen your feet is to use them on a variety of different surfaces in different shoe types and over different terrains and at different speeds. Exercises like weight-bearing exercises, gripping the ground, going on your toes and doing range of motion exercises can also help to strengthen your feet. Transcript: "Hi, Melanie. Again, another good question and I see we've already generated one response, so make my response, relatively short and, and pointed. And that is that the most effective way to strengthen. Your feet is to use them, is to use them on a variety of surfaces in a variety of shoe types and over a variety of terrains and speed. All right. Naturally, all tissues will adapt to stress and strain, keeping your, your, your fitness regimen oriented always in One Direction that one speed with one pair of shoes over one, terrain is never a good idea. Strengthening your feet, your legs, enhancing your balance and manger motion is best done over as wide, a range of conditions as you can find. Right foot, strengthening occurs as you use it, naturally. There are those athletes and performers Among Us dancers, ballet, dancers in particular, and gymnast, who develop extraordinary in foot strength. This is r.l. rather difficult for normal human beings, but it certainly can be pursued Doing weight-bearing exercises gripping. The ground gripping pencils, going on your toes, doing range of motion exercises like that can be very good adjuncts. But again, as I said, my best recommendation is use the feet over as many wide and varied conditions as you can find. Thank you."
Pain on the top of the foot is rare but can be caused by tight laces or downhill running causing overworking of the extensor tendons, or it could be related to a stress fracture, arthritis, or a ganglion. If the pain is chronic and resistant to changes in training and shoes, seek professional guidance. Transcript: "Good day regarding pain on the top of the foot, lot of room for discussion here. I'm not quite sure if you're referring to top of the arch, the metatarsal region or the toes. So I'm just going to try to wing it. You're a little bit paint on the top of the foot near the arch is rather rare often related to compression. Of the tendons on the top of the foot by laces that are too tight. You can aggravate this problem by a lot of downhill running. For example, when the extensor tendons are overworking and they're compressed against the bone, on the top of the foot, by the laces of the shoe, apart from that, this problem needs to be investigated to rule out stress fracture of the metatarsals. Arthritis of the joints of the mid-foot, there are even occasionally issues where you get a ganglion, a benign, soft-tissue fluid filled out, capturing from a tendon or joint. This is usually on the top of the foot. Usually over to the lateral side, the outside. So the answer depends on where you're looking at. And in any case, I do it, Buys it if you have this problem and it is somewhat chronic resistant to changes in training and shoes that you you seek professional guidance. Thanks."
When considering whether or not you no longer need orthotics, it is important to consider why you got them in the first place. If they were prescribed for a fixed functional or anatomic alignment condition or relationship, then it may be in your best interest to continue using them. However, if the orthotics were prescribed due to an intense training program or new pair of shoes, then it may be appropriate to stop using them once those conditions are no longer present. Transcript: "Good day dr. Bob here, I see a couple of answers. They're already shown up on the on the app to this question but it's a good question and so I wanted to weigh in. There's really one question that you have to ask When considering do you, no longer need the Orthotics that have been a benefit to you? And that question is, why did you get them in the first place? Why did they work? I guess that's two questions. The point I'm trying to make is that many times musculoskeletal injury occurs for reasons that have to do with behavior it. Intense, intense training programs that people initiate and conduct a new pair of shoes, something different occupationally perhaps. And in those cases If an orthotic is proved valuable. Once those conditions are no longer present, then what's the purpose of an orthotic on the other hand? When an orthotic is prescribed for a fixed. Functional. Or Anatomic. Now, the alignment condition a relationship, that's not likely to change over time and may represent a long-term vulnerability. Therefore reason to continue with the Orthotics. So, if you're doing well, without them fine, but it's worth considering how you got them in the first place. What is your overall injury history? And what are your goals Orthotics? Can be used preventatively, as well as to remediate a condition. Hope that helps thanks."
Heel pain in children, especially athletes is usually related to the growth plate. Generally, switching to cushioned shoes, using a deep cushioned heel cup and stretching can help resolve the issue. X-rays may also be recommended to rule out any other possible causes. Transcript: "Good day, thank you for the question. Heel pain in children, especially athletes is not uncommon, especially around this age group and generally if the pain is at the bottom, especially if it's at the back of the heel, it's related to the growth plate. At the posterior calcaneus, this growth plate is incomplete in this age group and is subject to stress, both from weight-bearing. And from the pole of the Achilles tendon in the leg, this is usually resolved by switching to appropriately. Cushman shoes. Sometimes the use of a deep cushioned heel cup is assistive sometimes the use of a functional for Doses and occasionally stretching will also manage this condition x-rays will confirm. The presence of a normal growth plate in most instances, but would be recommended to rule out the possibility remote as it is of a stress fracture or other condition. Thank you."