Archive for the ‘miscellaneous’ Category

Reader Questions

Happy new year, everyone. I thought I’d start the year off with some information about my “Target” products. There are a few questions I get on a regular basis, so I’ll try to answer them below.

Q: What is contained in the free mini-course that you give away on the right side of your blog?

A: The mini-course is basically a quick education on plantar fasciitis, plantar fasciosis, and why you should treat them differently. It has some tips on nutrition and treatment, and clears up a lot of the confusion that people have about the two conditions. (The information is also relevant to tendonitis/tendonosis.) If you sign up for it, you’ll get an email every day or two for a couple of weeks, giving you various aspects of the issue. And yes, I’m selling something here, so you’ll also get some information about my ebook+video package. But it’s a pretty soft sell, and you certainly aren’t obligated to buy anything.

Q: I heard that your ebooks have sold in something like thirty countries. Is that really true?

A: Actually, they have sold in more than forty countries worldwide. If you’re interested, here’s a list for just the past month:

The UK, the USA, Cyprus, Switzerland, Australia, Portugal, France, New Zealand, Canada, Singapore, Japan, South Africa, Hong Kong, Turkey and Ireland.

Q: I was looking for Target Plantar Fasciitis on Kindle. I thought I saw it listed, but now I can’t find it.

A: I used to have both the Target Books (Target Plantar Fasciitis and Posterior Tibial Tendonitis, and Target Tendonitis) on Kindle, but I took them down. One reason, frankly, was that I was tired of paying Amazon two-thirds of the cover price, but the more important issue was that there wasn’t any way of getting the videos bundled with the book on the Kindle platform, and without those a lot of people seemed to have a hard time understanding how to perform the exercises I recommend.

Q: I don’t really like ebooks. Can I order a hard- or soft-cover version of TPF?

A: Sorry, but I don’t offer anything other than the PDF version. The reason is the same as the answer to the last question: no way to include the video without adding a lot to the cost. Plus, 99% of the people who buy my books are in fairly severe pain and want to get rid of it as fast as possible. They don’t want to wait 2-3 days (or longer in the case of international sales) for a regular paper book to be shipped.

Q: Do you offer your ebooks in languages other than English?

A: I’m working on it. The Japanese version of Target Tendonitis has been completed and is now on sale. Target Plantar Fasciitis has yet to be translated into another language, but if there is a demand for it, please let me know via the contact form on this website.

Q: Why doesn’t stretching work to get rid of my plantar fascia pain?

A: Stretching is great for preventing pain, but not really effective for getting rid of a problem once you’ve got it. If you have either fasciitis (inflammation of the fascia) or fasciosis (degeneration of the fascia tissue), stretching won’t help much. And in the case of fasciosis, too much stretching may actually cause further damage if the connective tissue has been weakened beyond a certain point.

Q: Is there a quick way to tell which condition I have, plantar fasciitis or plantar fasciosis?

A: Yes. The quickest and easiest way is to just take the test that I’ve put together here. It’s free and only takes about a minute to complete.

Hope this helps. If you have a question that you’d like to have answered, either leave a comment below or use the contact page to get in touch.

Do-it-yourself foam-roller for fasciitis and tendonitis

Recently, I’ve seen some videos floating around that promote foam-rolling as a way to cure tendon and fascia pain.  While this isn’t exactly true – foam-rolling can help prevent problems from happening in the first place, but won’t cure anything once the problem has occurred – foam-rolling is still a great idea and should definitely be on everyone’s list of body-work that they do on a regular basis.

If you’re not familiar with foam-rolling, here’s a brief explanation:

Basically, a foam-roller is, well, a tube of fairly dense styrofoam.  That’s it.  Rollers come in various sizes and lengths, but the most common ones are about three feet long and six inches or so in diameter.  Most gyms have them now, and they’re generally encased in blue vinyl covers for ease of washing and so on. The idea is that as you exercise, age, go about your daily activities (okay, as you live), you develop small areas of pain here and there in your body.  The pain comes from something called adhesions, which are places where the fibers in your muscles don’t slide smoothly alongside each other like they’re supposed to, but instead get stuck together, thus creating pain when you try to move in certain ways.  A good physiotherapist can massage these away for you, but with a foam-roller you can do it yourself by placing the affected bodypart on the roller and rolling back and forth a few times with a bit of pressure to break up the adhesion.

Amazon sells foam-rollers, although most of them are a little less rigid than the usual gym version.  This is actually good for people who are new to foam-rolling, as the practice tends to hurt quite a bit in the beginning, and a softer roller can limit the pain.  But once you’re used to it, a soft roller won’t do you as much good as a hard one.

On the other end of the scale is this monster.  It is not for the faint of heart.  It looks – and can feel – like something out of Torquemada’s dungeon, but it will absolutely destroy any adhesions you might have.  If you can stand the pain, that is.

RumbleRoller The RumbleRoller is specifically optimized for myofascial release.  And pain.

In-between are the regular gym rollers.  But if you want something that you can use around the house…as well as pack into your gym bag…as well as easily store away…as well as use for other purposes, then investing in a pair of FatGripz might be the way to go.  I realize that readers of this blog are generally runners, but many of you work out in the gym as well, and Fatgripz are one of the best ways to do great things for your arms.  Not to mention the fact that if you’ve developed tendon or fascia pain in your feet or ankles, there’s a good chance that you might end up with it in your arms and shoulders as well.  (Some people are genetically more predisposed to developing connective tissue pain than others.)  Fatgripz can virtually eliminate this possibility by changing the thickness of the typical gym barbell so that your hands don’t always close to exactly the same degree each time.

It’s kind of hard to roll a small tendon like the peroneal or post tibial, but for the plantar fascia or achilles tendon, foam rolling can be just the ticket to prevent injuries before they happen.  If you’ve already had an injury and have completely recovered, foam rolling can also go a long way toward making sure that injury doesn’t come back again.

But you don’t need a six-foot long roller to get at the soles of your feet or your ankles.  And if you do buy a regular foam roller, you really can’t use it for anything other than, well, foam rolling. FatGripz, on the other hand, are much more versatile.

FatGripz come in sets of two, and they are 2.25″ thick plastic attachments that you can put on a regular barbell to make it into a “fat bar”.  Why would anyone do this?  According to the company using FatGripz will increase both the strength and the size of your arms.  (It’s harder to grip a fat bar than a regular one, causing the arm muscles to work harder even if you’re doing the same exercises.)  For tendon purposes, having a choice of widths for your barbells is an excellent way to prevent repetitive stress injuries – especially in your forearms – if you spend much time in a gym,.

But here’s the other advantage.  You can take one FatGrip, slide a broomstick through it, and make your very own “foam” roller.  While it won’t really do for large areas like the back, the small size makes it ideal for rolling the major tendons and fascia of the ankles and feet.  And it’s a bit harder than your usual foam roller, which is nice.  (If you want a softer version, just wrap a towel around the FatGrip.)

Here’s a picture:

Stick through Fatgrip to make a foam-roller

Use your Fatgripz as a foam-roller.

The smaller diameter of Fatgripz doesn’t make much difference when you’re rolling, and unlike a lot of regular foam rollers, they come with a 60-day money-back guarantee. So if for whatever reason you don’t like the things, you can return them for a full refund.

But honestly speaking, I don’t know anyone who’s returned them. They work great for their intended purpose (in fact, they were named “Training Tool of the Decade”) and – as described above – they also can serve double-duty as a localized foam roller for smaller bodyparts like the soles of the feet. Check out the website here. You won’t be disappointed.

A lot of bad advice out there…

A silly video

I ran across a video the other day and thought I’d write a post about it because it gives a good example of just how much bad advice there is out there among “certified” physical therapists and so on.

Before I start, I want to say that I know (and have used) some excellent PTs, and I certainly do not want to say that everyone in the field is a quack or anything like that. There are definitely some good people out there, and if you have access to a really competent PT, he or she can often work miracles. But on the other side of the coin, just having a certification (of any sort) doesn’t necessarily make you competent in your job. And a lot of people get fooled by labcoats.

Personally speaking, I’ve received enough bad advice from “body professionals” over the years that nowadays when I have to see one I always try to assume that they know what they’re talking about…but I also always ask some pointed questions, just to make sure. I hope that this blog post will make you think about things a little, and encourage you not to blindly accept what you’re hearing the next time you go in for some “body work”.

I’m not going to link the video here, but you can find it on YouTube. Just go to the YouTube site and type in /watch?v=pn6i-_dTX0g after the www.youtube.com part of the URL. The video’s less than two minutes long, but if you don’t want to watch the whole thing I’ll give a brief summary below.

Strengthening a tendon

The video shows a PT who tells you how to “strengthen” an apparently healthy woman’s achilles tendon by using a stretch band. The woman is sitting on a therapy bed and takes the band, loops it around her foot, and then proceeds to exercise the foot against the band by pointing and relaxing her toes.

All this is fine, and the PT makes sure to cover some good points about getting in a full range of motion and so on. The problem is that the band only provides about five or ten pounds of resistance, and the woman in the video who uses the band has got to weigh at least a hundred and twenty.

This may not seem relevant, but think about it for a second. If she weighs 120lbs, that means that every step she takes she is putting 120lbs of pressure on her achilles tendon. How is a band with ten pounds of resistance going to strengthen a tendon when that tendon has far more stress put on it just when the woman walks? (We won’t even talk about how much more than 120lbs each step really is because of acceleration/deceleration forces.) If you can bench press 200lbs without any problem at all, you’re not going to develop more strength by working out with 20lbs.

What’s the point?

So what’s the point of using a very weak stretch-band for this? Basically, unless the woman was injured and spent so much time off her feet that her achilles tendons atrophied to the point that they can no longer support any weight (which would mean that she couldn’t even stand up), there is none. Maybe a polio victim would qualify, but exercising an achilles tendon in any realistic scenario will involve using a decent amount of weight, one that equals a significant percentage of the exerciser’s bodyweight.

Yes, if the woman was injured or is recovering from surgery it makes sense to monitor her level of pain and start out using a lighter weight. But not this light. Using a weak band like that reminds me of the housewives who walk into gyms, start using the one- and two-pound dumbbells, and then wonder why their bodies don’t change. It’s not hard to understand when you realize that the average bag of groceries weighs more than the “workout” weights! They’re not using enough resistance to have any effect on the muscles.

One other point about the video is that the PT says that the stretch band provides “constant resistance” so long as the hands holding the other end of the band remain stable, but this isn’t really true. If you stretch a rubber band out, there is going to be more and more resistance the further you stretch it (until it breaks, anyway). The resistance at the beginning is light, and gets progressively heavier the more you pull.

Admittedly, this is pretty minor. The range of motion that a foot has isn’t very great, and so there won’t be a lot of difference in resistance between the beginning and the end of the motion. But it’s disturbing that a trained and certified PT would say something like this in the first place, when a simple, “Be sure to keep your hands in the same place” would be fine. I think that a lot of times people in positions of authority like doctors and physical therapists have a need to justify what they’re saying to their patients, and sometimes this can lead to a little trouble.

Think for yourself!

In any case, please, if you have a problem with your achilles tendon, plantar fascia or anything else, don’t just blindly trust what someone in a labcoat tells you. Use your common sense and try to think critically about what’s being said.

Author: Alex Nordach

Quoted by Business Insider

Hi everyone,

Just wanted to share that one of my articles got quoted on Business Insider. One of the leading websites on pretty much everything related to business.

Why would a business website feature information on tendonitis?

Well, users of my eBook and video products range from professional bodybuilders to housewives to business executives. The fact is, tendon pain can affect literally anyone. And one of the most frequent problems people encounter nowadays is thumb tendon pain from using Blackberries, smart phones and the like. I know, this doesn’t have anything to do with foot or ankle tendon/fascia problems. Sorry! 🙂 But tendons are tendons no matter what part of the body they’re in, so the principles are the same. Check out the article here:

http://articles.businessinsider.com/2011-08-01/tech/29966407_1_iphone-users-blackberry-thumb-thumb-typists

Thanks,

Alex

Author: Alex Nordach

A short discussion about “pattern overload”

I’d like to talk a little bit about pattern overload today.

Fundamentally, pattern overload happens when too many repetitions of a given motion or exercise are performed. You don’t necessarily have to be using a lot of weight to incur pattern overload; your own bodyweight can be more than adequate…as can a one-pound dumbbell if the number of repetitions is high enough. Even typing can become a problem if you fail to alter your hand, wrist, chair and/or keyboard position on a regular basis.

Generally speaking, pattern overload isn’t too much of an issue because even with high-rep activities like running or swimming, each time your foot hits the ground or your hand slices through the water, your body is going to use a slightly changed “groove” when executing the movement. A highly trained athlete might be performing in more or less exactly the same groove for a time, but in the long run, as you begin to tire, your groove will begin to become looser and although this means that your efficiency of movement will degenerate, it’s one way that the body tries to stop itself from incurring an injury.

However, some types of exercise can be relatively worse for pattern overload than others. And this can create discomfort in your tendons and fascia. One example would be exercising on gym machines to an excessive degree. People who work out using free weights have a significantly lower rate of pattern overload than those who work only on machines. The reason? When you’re working with a barbell or dumbbell the weight moves in accordance with your body, but when you’re exercising on a machine your body moves along the machine’s predetermined and fixed weight-track. Even Smith machines, which incorporate a minor level of flexibility, are much more limiting and permit less natural “body adjustment” as you go through your sets than free-weight barbells and dumbbells.

Then, on the other end of the spectrum, there is Crossfit. It’s not that I disapprove of Crossfit in and of itself. I think that the essential idea of Crossfit – do something different each day, and keep good track of your rest times – has a lot of merit, and there’s no doubt that the training is stimulating and fun. But there are some drawbacks as well, particularly when you view Crossfit in relation to tendon injuries.

At base, a Crossfit workout involves choosing two or three exercises for distaff bodyparts, and then doing a lot of those exercises using a predetermined weight for a set time. The down time between sets is normally about ten seconds, and you rotate between exercises. As an example, one of the videos on the website shows three women doing bodyweight squats, then pull-ups/presses on gymnastic rings, then hang cleans with a barbell.

If you simply do too much of a movement, even if that movement is something totally “free”, like swimming, you can acquire tendon and fascia issues if you exercise so much that the amount exceeds your body’s capacity to recover. And this is where I have a problem with Crossfit. Yes, it’s true that on their site they pay a lot of lip service to not doing too much, but the reality is that they use technically complex movements (like cleans) and push to the point where correct form totally breaks down. It’s not the greatest idea for younger athletes, and for older ones it’s an almost sure-fire recipe for injury.

Naturally, you need to push yourself to some extent if you would like to make your body better. But there is a question of degree. Without getting into a long discussion about exercise theory, the bottom line is this: the idea is to provide enough stimulation to create an adaptation response, but not so much that it becomes too difficult to recover from the workout. As the great Lee Haney said, “Stimulate, don’t annihilate.” All too often, Crossfit crosses that boundary.

So if you’re suffering from fascia or tendon pain and have an exercise program (or doing some form of work) that incorporates too much pattern overload — either through limited and unnatural movement or by simply having too much volume — think about ways that will allow you to reduce or get around the problem. (You can take the free test on this page to see what sort of pain it really is.) You don’t have to stop exercising, but you will almost certainly be better off if you find ways to change up your routine a bit.

Author: Alex Nordach

Levaquin and fasciitis

Levaquin. It’s a drug that can completely destroy your body’s connective tissue, and I am encountering more and more people who have taken it at some point in the past and now have what seems to be irreparable tendon and fascia damage. Tendon problems get the most press, but it’s a fact that the fascia are often affected as well. I intend to write a more in-depth post about this topic soon, but for now, if you are suffering from tendon or fascia pain as a result of taking Levaquin, well… the outlook unfortunately isn’t very good.

One technique might have some potential: lowering the intensity of the reparative exercises that are given in my book. The usual prescription is to exercise while trying for about a 2-3 on a scale of 0-10, 0 being no pain at all, but people who have taken Levaquin seem to do better if they just aim for a “1”, at least at the beginning of therapy. Given proper nutrition and exercise, and enough time, you may be able to strengthen your fascia and tendons even if they’ve been affected by this drug…but it’s going to take a while and you’re probably going to have to start out from a lower threshold than people who have not had this particular type of debilitation.

Say goodbye to the Food Pyramid

In a long overdue move, the United States Department of Agriculture (USDA) has gotten rid of the famous Food Pyramid that for close to two decades was supposed to tell you how to eat. The new symbol is a plate-and-cup that will hopefully be easier to understand.

Michelle Obama, Agriculture Secretary Tom Vilsack and Surgeon General Regina Benjamin got together to announce the new paradigm, but the message seemed to be a little contradictory. According to Ms. Obama, parents “don’t have time” to measure out portions of food…yet, according to Dr. Robert Post, Deputy Director of the USDA Center for Nutrition Policy, “We know that with proper planning, you can get enough protein” from a vegan diet.

Hmmm. I can tell you from personal experience that, once you have the scale, it takes about ten seconds to measure out a portion of anything. On the other hand, I know very few vegans who actually (a) combine plant proteins properly on a regular basis and (b) get enough overall protein into their bodies (which is probably why so many of them start looking gaunt and eventually go back to eating animal sources). I have nothing against any particular diet plan, so long as it’s healthy, but let’s be clear about the realities of eating. Weighing food takes almost no time at all, and there is no better way of coming to grips with the reality of what you’re putting into your mouth–it’s just that it’s a bit of a hassle.

Anyway, time will tell if this new plate-and-cup idea takes hold. Meanwhile, if you have long-term tendon or fascia problems in your feet, here are some food-based issues to consider:

If you are overweight, an obvious first thing to look at is losing the excess poundage.
If you are underweight, are you eating enough good fats?
For any American male, do you consume a large amount of red meat versus little in the way of fish and/or nuts?

Any or all of these can be (and probably are) contributing factors to your pain. Fixing them is one step toward having healthy tendons and fascia and preventing recurrences of tendonitis/fasciitis. For more information about nutrition and supplementation as they relate to having healthy tendons/fascia, check out my book Target Plantar Fasciitis and Posterior Tibial Tendonitis.

Nutrition for tendon and fascia pain

I recently received a question from someone who purchased Target Tendonitis. He asked about the advisability of fasting if you have tendonosis.

Although fasting can have some beneficial effects, I do not advise anyone who is suffering from tendon or fascia problems to do it. The reason is simple: your body needs nutrients to heal itself, and if you’re fasting you’re not providing it with the basic “stuff” that’s necessary to do the job. I recommend some nutritional supplements in the book, but these recommendations are based on the assumption that your basic nutritional needs are already being met. If they aren’t, the supplements aren’t going to do you much good by themselves. A diet that is lacking in vitamins, minerals or protein (to say nothing of all three at once!) is going to pose serious, serious problems when it comes to healing your tendons.

Assuming that your basic diet is okay, one thing you can do to help heal yourself if you have tendonosis or fasciosis is get a good kelp supplement and take it regularly. Kelp contains iodine, which is helpful for the formation of collagen, the basic building block of tendons and fasciae. My favorite out of the products listed on Amazon is Icelandic kelp, which is harvested during the cold months and washed in high-mineral fresh water, which adds further minerals to the already good mix that kelp naturally contains.

Author: Alex Nordach