If the Shoe Fits: What Your Running Shoes Would Tell You If They Could Talk

At T.O.P.S. Physical Therapy and Osteopractics, we pride ourselves in our “shoe game” as we strive to put together the best outfits in the business. HOWEVER, there is so much more to a running shoe than the visual aesthetics, and we are reminded all too often of the implications from wearing the coolest looking kicks day in and day out instead of opting for comfort. We have come up with some helpful advice and tips about choosing the appropriate shoe to fit your training needs.

Take them out on a test run:
The right running shoes offer more than just comfort. Stores that specialize in running often have treadmills, so ask a salesperson to watch you run and recommend sneakers based on your running form and foot posture.

One shoe is not fit for every workout:
Running shoes are designed for forward motion. They lack the ankle support provided by cross-trainers, which are better suited for activities with lateral movement, like tennis and boot camp classes at the gym. To help avoid injury, save running kicks for the road or the treadmill.

Make sure the shoe fits:
Generally, your running shoes shoulder be a half size larger than your normal size to give your feet room to shift without jamming your toes. While standing, you should have half a thumb’s width of space between your longest toe and the shoe’s tip.

Hand-wash those bad boys:
For dirty sneakers, remove the insoles and spot-clean the outsides with warm water, soap, and an old toothbrush. Stuff newspaper inside the shoes and let them air-dry. Avoid putting your shoes in the dryer at all costs: direct heat can ruin the shape and adhesive on the shoes.

Do not exceed the ‘expiration’ date:
The best indicator of when to retire a pair of running shoes is mileage – between 300 and 500 – which you can track manually or with apps like MapMyRun or the Nike Running Club. Creases in the midsole (the squishy part of the shoe between the shoe’s bottom and the sneaker itself) are a better clue of overuse than worn treads are.

For more tips and tricks to keep you on T.O.P.S. of your competitors AND your shoe game, visit us at T.O.P.S. Physical Therapy and Osteopractics! Be sure to check out a few of these local retailers when you are looking to buy your next pair of running shoes.

DBS not to be confused with IBS (Although, you might develop DBS from sitting on the toilet too much)!

DBS not to be confused with IBS (Although, you might develop DBS from sitting on the toilet too much)!

Dormant Butt Syndrome (DBS). Sure, it’s a funny name, but it’s a condition that’s growing in our nation and causing people to experience much more than a ‘pain in the butt.’ While DBS stems from a patient’s gluteus (butt muscle) not working efficiently, it causes aches and pain in the knee, back, and hip areas.

When these muscles are weak, or inefficient, they aren’t able to sustain the shock that they should. With that, areas like the knee, back, and hip are forced into the responsibility of accepting additional stress – possibly causing pain.

The world we live includes a lot sitting – in our cars, at a desk, in front of our TV. This in turn, causes tightness in anterior chain, specifically the hipflexor in the front of the hip. Because these areas get so tight our hips never achieve adequate hip positioning allowing for efficient glute activation.

Seemingly, as our culture leans more and more on inactivity, incidents of this syndrome will only increase. In addition, beyond sitting and repetitive physical exercise, there are even certain sleeping positions – the fetal, for example – that can also contribute to DBS.

So how do you treat DBS? Get moving! TOPS Physical Therapy and Osteopractics can treat you with exercises that both stretch the hip flexor as well as strengthen the gluteal muscles. If you’re in pain from DBS, you can make it a habit to break your sitting habit – set an alarm to notify yourself to get up and walk around.

References:

  1. Dan Fleury PT, DPT, OCS, Diploma Osteopractic, FAAOMPT, ‘Dormant Butt Syndrome – The Newest Threat to Humanity’. Daily Press; Woods, Shannon. https://www.dailypress.com/brandpublishing/healthy-body-healthy-mind/dp-bp-osc-butt-syndrome-story-110116-story.html.

  2. ‘Aches and Pain? You Could Have Dormant Butt Syndrome’. CBS News. https://www.cbsnews.com/news/dormant-butt-syndrome-a-cause-of-common-aches-and-pains/.

What Is Osteopractic?

With healthcare, patients are more informed and knowledgeable than ever before. As with everything else in today’s world, they want things performed a certain way, done as quickly as possible, and they will use the internet to find the best place where they can get that service. These individuals want results, and they will shop around until they can find the provider that can effectively provide that in a shorter length of time.

As healthcare evolves, manual therapy is becoming increasingly important as it (1) provides results in a shorter time than traditional methods, and (2) it does so in a more personal, one-on-one manner. A Physical Therapist may find him or herself readily compared to massage therapists, chiropractors, or even craniosacral therapists, as patients are looking for just the right person to get them pain free. We Physical Therapists are the most qualified to return patients to a healthy lifestyle as we offer a broad scope of practice ranging from therapeutic exercise to pain management to, yes, manual therapy.

Hands-on treatment of soft tissue mobilization, joint mobilization, and dry needling therapy, among others, are rising to prominence in the field. With this, the newest form of PT is that of an Osteopractor, and our own Amy Brannon holds a diploma in Osteopractic Physical Therapy. The word ‘Osteopractor’ translates to ‘bone practitioner’ and they are therapists trained in diagnosing and treating neuro-muscluo-skeletal disorders. This diploma is given to a doctor or physical therapist who has completed an intense course of study that includes Certificates in Spinal Manipulation and Dry Needling, as well as IASTM (Instrument Assisted Soft Tissue Mobilization) and Extremity Manipulative Therapy. These techniques are proven to heal tissue, reduce joint impairment, and lessen pain.

An Osteopractor is a highly skilled, hands-on manual therapist who graduated through the Spinal Manipulation Institute. Dr. Brannon is one of a select and minimal group in the world to earn this title. If you are struggling with joint or muscle pain, and you’re searching for a solution…look no further than T.O.P.S. Physical Therapy.

Why “Sitting” Is Evolving Into Yesterday’s “Smoking”

There has been a lot of talk recently about the dangers of too much sitting, prompting many to say, “sitting is the new smoking”. Now for the good news. A meta-analysis of trials recently published in Lancet concludes that an hour of moderate-intensity activity offsets the health risks of 8 hours of sitting.

According to the meta-analysis, high levels of moderate intensity physical activity (i.e., about 60-75 min per day) seem to eliminate the increased risk of death associated with high sitting time. The activity could include brisk walking (at 3.5 mile per hour) or cycling for pleasure (at 10 miles per hour). However, even shorter periods of activity (about 20 to 25 minutes per day) could attenuate the mortality risks associated with prolonged sitting.

Companies are trying to implement new ways to avoid sitting for long periods of time. One alternative would be to have stand up operations or working tables that allow employees to have the ability to stand or sit! Although, a treadmill desk is the preferred method of beating the “sitting all day blues,” it’s not always practical. The next best thing is a standing desk. It’s also cheaper than a treadmill desk.

In the meantime until further change is implemented, there are things you can do right now to help this problem. If you can’t walk or stand at your desk, don’t worry. There are still lots of things you can do to minimize the health hazards of a desk job. For example, offset the effects of sitting by taking the stairs at your work place, instead of the elevator.

Lesson About Health Insurance

This is a quick 5 minute read that is important for all consumers to understand when getting medical services from an office! This is a simple lesson on health insurance and medicine…

Now that it’s the New Year, PT offices, and many other medical offices have to reset all of their insurance information. With that said, Ron Pavkovich gave a great summary of this fiasco, from the point of view of a PT front office…great read, not only for PT offices, but ANY medical office!

For those who don’t know, you, the patient, is ultimately responsible for knowing and understanding your benefits for medical care. The patient has the responsibility of knowing their plan, what is, and is not covered. As a courtesy, physical therapy and medical offices verify your benefits and explain them to you in a “language” that you can better understand. This courtesy of checking benefits is a relatively COST CONSIMUING gesture on their part. It is also ALWAYS an estimate. With that said, it is your choice and responsibility to either check your own benefits or know your plan. If your insurance does not pay for the services or care you received, it is still your responsibility at the end of the day. This is why you sign you initial paperwork advising that you understand and agree to pay for the services provided, in the scenario that your insurance does not pay.

If you have had a service performed, it is not the PT or MD office’s fault that your insurance did not pay. Therefore, you cannot, and should not, expect that office to not collect for services rendered and treat you for free.

This is a simple education lesson on health insurance and medicine. Please do not blame your provider for you not knowing what your plan does and does not cover. Your provider’s office is simply the messenger and doing you a courtesy by trying to help you understand the type of coverage you have. At the end of the day, your provider does not make these insurance policies nor do they have a say in what is paid for. Also, please keep in mind that your provider is likely only getting reimbursed about 40% of what they bill your insurance carrier. Insurance carriers are killing medicine!

Another point made is that often the PT or MD offices are responsible for pre-certifications. If the office is “in-network”, the office is obligated to write off some procedures, which are oftentimes beneficial.
Furthermore, if you provide insurance information that has lapsed after the first of the month, that carrier isn’t liable for payment! Good luck collecting or getting backdated approval from whatever carrier, if any, succeeds the lapsed carrier. And TPA’s will not backdate authorizations until you can prove they were wrong with processing it the first time. So in other words, they can allow for their mistakes, but never yours.

This becomes particularly frustrating for small private practices. They bill everyone the same, yet they generally are not able to negotiate with insurance companies, as they have no leverage. Thus, they have to either take what they pay (usually around $0.40 of every $1 billed) or not participate as in-network. They then approve the full rate, but pass it to the patient as an out-of-network cost. Most small private practices will offer anyone who pays day of service, a discount (and if insurance paid day of service, they would get it too). So anyone is welcome to see the prices, but insurances can change what they pay on a whim, so that is more difficult to keep up with.

This is an issue in our health care system that tends to be heated and followed with a lot controversy. Some responses we have had about this topic are:

  • Insurance anymore is only catastrophic Insurance at best. The deductibles are crazy and your 100% right about it killing medicine.
  • The mouse print on our patient delivery confirmation is extensive and has expanded to include all these points. Most folks have no clue how their insurance works. I have to explain regularly that office visits to their doctor and prescriptions don’t generally apply to deductibles.
  • I agree and fully understand your point. When will I be able to pay my doctors the same price for a service that they accept from insurance companies?
  • I agree the patient is ultimately responsible to know their benefits but we all live in the real world and that usually never happens. Protect yourselves and document, document and document some more!

MRI… Friend Or Foe?

There is always a question as to whether or not an MRI is needed, desired or unnecessary… which is what we address with each of our patients individually. If you talk to the experienced health care provider, the answer is probably “no” more than “yes”. However, if you talk to the patient, they oftentimes swear they need one, or will gain more confidence in getting one.

Here is some insight on why experienced health care providers shy away from getting an MRI until it is absolutely necessary!

Thank you to Adam Meakins for eloquently stating this information:

Do you think an MRI for that patient with persistent back pain will give you the answer?

This is an interesting study that highlights one issue with medical imaging.

1 patient with persistent low back pain had 10 MRIs in 10 different settings interpreted by 10 different radiologists.

49 possible pathologies where identified on the reports in total, but none, that’s NONE were reported consistently by all 10 radiologists.

Just how confusing is that for you as a clinician and the patient?

When it comes to medical imaging remember the 2 golden rules…

  1. Is there a high risk/suspicion of sinister life threatening pathology?
  2. Will the information gained from a scan change my management plan?

If no to both then DO NOT scan!

It will only hinder not help you or your patient!

For more information, visit: https://www.thespinejournalonline.com/article/S1529-9430(16)31093-2/abstract.