With the exception of rigid knee braces, most items are available on a walk-in basis in our clinic.  If a rigid knee brace is prescribed or recommended, we book an hour long consult appointment to go through a thorough assessment, measurement, and fitting of the chosen brace. For off-the-shelf products, clients can take advantage of  booking a free consult for education and fitting if desired.  We also do special orders!

When we injure ourselves, whether through chronic repetitive strain or through an accident, our body jumps into protective mode.  Blood, rich in reparative cells, rushes to the site of injury and pools.  This delivers nutrients to repair tissues, clots the wound if it’s open, and acts as a kind of natural splint to reduce range of motion.  A classic example is jamming a finger from catching a ball.  Pain alerts the body to the injury (not your loud cursing!) and within minutes, the finger joint has swollen.  If you try to bend your finger, you will realize that you can’t move it in the same way because the area is so full of fluids.  This response mechanism is actually a good thing, even though it may be a minor annoyance.  Your body doesn’t like pain, so it protects the injured area to reduce the chance of further injury

On the other side of things, what happens when we want to get rid of that inflammatory response?  We can’t just let swelling and pooled fluid hang around forever because that impaired range of motion can start causing problems for other tissues.  Compensatory motions happen as a result of the lost range, and secondary injuries can develop.  How can we counteract that oh-so-nice body response to injury?  Well, the first step is to get rid of the pooled fluid.  In doing this, we flush the tissue and help bring range of motion back.  Constricting the vessels that carried that fluid to the injury can be achieved by using ice and compressive force.  Most people don’t like that almost painfully cold temperature change that ice brings on when we put it on our skin. Well, our tissues don’t like it much either!  When ice is applied, tissues and vessels shrink in diameter, flushing fluid away and disallowing further flow to the injury.  If we also add compressive force, say, in the form of a tensor bandage or compression garment, we further shrink the tissues to push fluid away and work against gravity.  This is why patients will commonly be prescribed the use of a cryo cuff cold therapy unit after surgery: the compressive wrap and flow of ice cold water around the surgical area won’t allow pooling of blood for an excessive amount of time.  A person who has had a knee replacement or ligament tear has to start to move the leg again sometime, so a cryo cuff can help counteract the effects of the inflammatory response.

Sure, cold has its benefits, but what about heat?  Generally viewed as the more relaxing temperature therapy, heat does just that: relax and dilate.  Applying heat to tissue will increase the size of blood vessels and encourage more blood to flow.  It can also help to loosen up the tight, protective muscles around an injury site.  However, its best to know when and where go apply heat.  Sure, heating an area of injury or pain might feel pleasant, but it can actually have the opposite effect that we want. We likely don’t want to create more swelling and splinting.  Therefore, a combination of heat and ice, applied at certain spots, can be more beneficial.

Keep in mind the splinting effect of swelling we spoke about earlier.  It’s not just the injured spot that becomes tight and restrictive.  Muscles and tendons surrounding the area try to restrict range of motion as well.  You might notice that if you strain a calf or hamstring during a run, that your gait starts to change as a result of pain.  These compensatory motions use our muscles in different ways than they are used to, creating a whole new section of trigger points and knots.  Heating these surrounding muscles before activity or when they feel tight is a good way to increase blood flow to, in turn, increase flexibility so the muscles don’t pull excessively around the injury.  This is something therapists will often advise to their clients who are still able to exercise at some level during strain.  After the exercise is over, there will likely be a return of swelling in the tissues.  Icing the sore spots is a way to counteract that, for the reasons detailed above

A general rule of thumb: ice the sore spot, heat around the sore spot.

Listen below (or April 6 edition found here) as Ryan Grant speaks with Mark Sutcliffe on the Team 1200 Running Show about his recent experience in Ethiopia (Ryan’s segment starts at 28:46):

Click here (Episode 8 on iTunes) to hear Neil Rosenthal makes a guest appearance on Distance Obsessed with Corey Turnbull and Alex Flint.  Neil talks about his recent racing, running technique, GoodGuysTri and Sears Great Canadian Run.

First of all a huge thanks to Joseph Kibur for putting together such a fantastic environment for elites and recreational runners to stay.  I would certainly encourage anyone who is looking for a safe, easy way to live among some of the worlds best runners and to run through the hills of Ethiopia to consider a stay at YaYa Village.  Joseph moved to Canada at a young age and was a very successful runner through the 1980s and 90s (former Canadian Cross-country champion).  He moved back to Ethiopia in 2008 and opened up YaYa Village with Haile Gebrselassie in 2011.

So, what makes the East Africans (and in this case Ethiopians) so dominant in distance running?  I had the privilege of sitting down with Haile Gebrselassie (who many consider to be the best runner of all time) one of the mornings at YaYa and he mentioned that at one time Ethiopia was very hesitant to let foreign runners come train in their country over concerns that these runners would learn the Ethiopian secrets.  Haile laughs at this now and stated that there are no secrets.  As much as there are certainly some genetic advantages, much of their running success comes from living and training at altitude, and pure hard work.  Running is a way of life and a potential way out of the poverty in many countries in Africa.  In Malcolm Gladwell’s best-selling novel ‘Outliers’,  he talks about the success of Kenyan runners and, as one writer summarizes,  that ”ideal environments + a tremendous amount of hard work and focus on a specific thing = success beyond what most people achieve”.  In Ethiopia, world-champion runners are idolized as super stars and their photos can be seen on huge bill boards and advertisements.  Certainly lots of incentive to run!  That being said, I’d like to talk a bit more in depth about what I think helps lay the groundwork for all this hard work and success.

Running is a sport that we as humans are born to do regardless of where we’re born.  We have all of the tools to be able to develop an efficient running style which is a phenomenal coordination of soft tissue and bone.  When everything works together, the soft tissue strength and flexibility allows forces to be distributed properly and for stored energy to be fully utilized in order to propel us forward.  Even though the majority of us are born with all of these tools to become an efficient runner, our lifestyle often does not nurture them.  We sit for much of the day, run on concrete, and wear footwear that is often less than ideal for our feet.  To the contrary, many Ethiopian runners come from backgrounds that don’t include a lot of sitting.  Many of their early days are spent moving (ie working in the fields, playing outdoors).  Many of these runners spend much more of their time barefoot.  I also found it interesting to see how much of their running is done on very varied terrain (running through tight twisting trails and up and down hills – very fun!).  This means that many of these runners are naturally developing the proper strength and flexibility (ie infrastructure) to be able to start to log the kind of running miles necessary to compete at such a high level.  Basically just being a human being the way we’re designed to function!

Of the injured runners that I saw, many of their issues were the same as we see here and often due to getting away from fundamentals.  I had a chance to sit down with one of Ethiopias top marathon runners (2:04 – wow!) and go through some injury treatment with him.  He recently did a big marathon overseas, took a bit of time off and then started to have an issue with his achilles tendon.  It seemed to be a relatively easy problem to fix and he’d done many things right, but because of his super high work ethic, he continued to push back too fast which continued to re-aggravate the injury. The amazing work ethic in pushing these athletes to succeed can be a real detriment when trying to return from injury.  I’m sure this sounds familiar to many of you reading this article as well!  There is also such an abundance of running talent in Ethiopia (estimated to be up to 50 men under 2:10 for the marathon and an equal amount of fast women), that when a top runner gets hurt there is often someone to fill their spot.  I’m sure this also leads to pushing back into high intensity training too quickly.

To me, footwear selection is also a huge factor in treating and preventing injuries for runners in this part of the world .  Once these runners achieve a certain amount of success, sponsors will often send them shoes that are overly cushioned and wedged up in the heel.  Because they already have a good foundation of strong feet and an efficient running gait, they don’t need to be wearing these types of shoes.  Certainly is a bit ironic on the footwear front that many African runners aspire to have what Western runners have (overly cushioned, flashy shoes), and many Western runners aspire to have what African runners have.  Unfortunately, the end result means that both sides often aren’t wearing the appropriate footwear!  The same principles apply to footwear selection in Ethiopia as it does here.  They just have less work to put in before being able to wear these low to the ground shoes.  For many of us, we have years of weak feet, muscle imbalances and flexibilty issues to overcome before we’re able to make a switch to a more minimalist shoe.  Basically, most Western runners don’t yet have the infrastructure to support what our bodies are meant to do.  It is cetainly something that we can aspire to, it just takes a little more prep work which is not going to be for everyone.

So as much as many of us will never have the time , determination, or environment to achieve the running success of the Ethiopian runners, we can certainly strive to try and get our bodies back to a more stable, efficient place.  There is no substitute for hard work and it’s difficult to train consistantly when we’re constantly injured.  By working at achieving a better infrastructure for our body, we not only can help to improve our performance but more importantly enable ourselves to continue to enjoy the activity that we love for much longer term without injury!

[Show as slideshow]

This is a statement and question we hear often at SoleFit from concerned parents.  Certainly a sensible question, especially in modern society where prevention is often percieved as such a valuable strategy.  So how does a parent know when to be concerned about the health and development of their children’s feet?

We’d like to offer some suggestions to guide the parent to know what to do in these situations:

Ask your pediatrician at annual visits from an early age if you have any concerns with the development of your child’s foot or if you think it’s hindering them in any way.  Young children’s feet are expected to be highly flexible and as a result are usually flat (45% in children 6 years and younger and 15% with 6-10 year olds).  A slow developing or abnormal foot type is recognizable and your paediatrician can evaluate this to determine if a specialist is required to examine things further.  A non-symptomatic (pain free) scenario where a foot is flat or seemingly abnormal is generally no cause for concern but best to ask the question for your own piece of mind.

Links to some published journal articles regarding treatment and assessment of a flat footed child are offered below:

Article 1

Article 2

Article 3

If your child is complaining of pain, especially in the foot, lower leg or during periods of activity or weight bearing, best to have it assessed. Children can become injured in the same way as adults and it’s important to have things looked at to determine the causes.  A child’s foot may directly or indirectly play a role in this and pain is a good indicator to check it out.  Start with a physician or with a specialist (Pedorthist, Physiotherapist, Chiropodist, etc.).

Prevent abnormal development of the foot by supplying the right type of shoes.  The initial 6-7 years of a child’s life mark the period where their feet will go through the most transformation and require proper development.  The child’s foot will critically assist as they learn to balance, walk, run, and coordinate.  A child’s shoe should not hinder these natural functions by being overly rigid, supportive, or corrective (unless recommended to treat a problem).  Shoes should be flexible, thin, and anatomically fitted to the natural shape of their feet and keep the child’s foot close to the ground.  This strategy should be implemented as much as possible into adolescence.  The exceptions are specific footwear such as cleats, skates, ski boots, etc.  A thorough video is linked below to Podiatrist Dr. Ray McClanahan suggestions of how to evaluate for children’s footwear.

Arch supports/foot orthoses for children should come as a last consideration.  Unless to specifically address dealing with pain caused by overuse, juvenile arthritis, rigid congenital deformities, and juvenile osteochondrosis, an arch support for children should not generally be used.  If a child’s foot or associated condition is not responding to treatment or is recurrent, an orthotic may be recommended for the short term to assist fixing the issue.  In many cases, custom orthotics are not required (unless it’s an irregular foot type) in which case an over the counter arch support will often be sufficient.  Arch support can however often prove beneficial in irregular footwear that impedes normal function such as dance shoes, cleats, ski boots, cycling shoes, etc.

At SoleFit our goal when assessing children is to look for the short and long term solutions to deal with problems. This often will include parent education of footwear selection along with factors to consider for flexibility, strength and coordination to improve the development and/or rehabilitation of the child’s foot.  If arch supports are recommended or required we can offer over the counter options along with specific custom orthotics when needed.  Plans for the length of time they might be required are discussed to ensure the best outcome while allowing the foot to continue to mature with natural function.

We will be posting monthly updates and pictures from the girls on our SoleFit Facebook and Twitter pages over the next year and look forward to tracking their progress!

More from the YaYa Girls Executive Summary:

“During their stay on campus, YaYa Girls receive intensive English tutoring and lessons on health, hygiene and nutrition. Additionally, Yaya Girls receive individually tailored and extensive vocational training through on-site internships and workshops. Graduates are guaranteed a three month job placement, increasing their chance to find gainful employment upon graduation. With the world class coaching and facilities provided to them, a select few YaYa Girls will be able to forge running careers but realistically it is vital to prepare the majority of YaYa Girls for work and life outside of running.
As gender roles are slowly beginning to change in Ethiopian society, the time is ripe to target impoverished teenage girls. Confronting the issues of gender inequality in Ethiopia by targeting adolescent girls and giving them support will expand these girls’ freedoms and will help break the intergenerational poverty that is passed down from disadvantaged young mothers to their children.

To learn more about the Program please visit us @ www.facebook.com/yayagirlsrunning or get in touch via email at yayagirlsprogram@gmail.com.”

[Show as slideshow]

Faster recovery

Reduced fatigue

Decreased muscle damage

Reduced swelling and delayed onset muscle soreness

Improved performance

How much of this is true?  What does the compression clothing concept involve?

Compression clothing has been on the market outside of sport for a couple of decades to treat numerous conditions that compromise circulation and lead to chronic swelling. Conceptually designed to assist in fluid movement and blood circulation, high grade compression stockings have graduated compression materials specific to each area in the leg and foot.

Compression stockings are specialized hosiery designed to help in the prevention and treatment of venous disorders of the lower extremity such as edema, phlebitis and thrombosis.  By wearing elasticized garments that exert pressure around the leg, they will compress the limbs’ soft tissue and can help to reduce the diameter of distended veins. This reduction in vein diameter can increase the blood flow velocity and valve effectiveness.  Compression therapy can also help to decrease venous pressure or damage of the vein walls, and can relieve the feeling of fatigue or aching legs.  These stockings are medically classified or graded using a scale of mmHg (millimetres of mercury, a measurement of force per unit area pressure compared to atmospheric pressure).  Lower graded support can be purchased over the counter, while higher grades must be prescribed by a physician and fitted using custom measurements of the clients lower extremity

Support (over-the-counter):

10-15 mmHg

15-20 mmHg

With the advice or prescription of a physician or medical professional and proper sizing from a trained fitter:

20-30 mmHg

30-40 mmHg

40-50 mmHg

50+ mmHg

Compression socks and sleeves such as EC3D that we carry at SoleFit are a Grade I-II compression (20-30 mmHg) and are used to control and assist in the support and circulation to the lower leg.  They are used during periods of strenuous activity, long periods of weight bearing activity or work , recovery, and swelling related to activity or soft tissue overuse or injury.

Socks and sleeves can effectively help control inflammation and reduce muscle fatigue. Studies have shown that compression can not only benefit those with jobs that demand long periods of standing/weight bearing (Flore et al. 2004: Occupational and Environmental Health) but also those who require help to repair, support and recover from repetitive impact activities (Ali et al. 2007: Journal of Sport Sciences, Kemmler et al. 2009: Journal of Strength and Conditioning Research).

Though research has not indicated that compression clothing is proven to improve athletic performance (Sperlich et al. 2010: Journal of Sports Medicine), it would appear that the benefit of improved circulation and blood flow may help to improve the aerobic capacity of the muscles. As well, if swelling and delayed onset muscle soreness is reduced, and thus the ability to continue to train with faster recovery, the user can maintain performance and potentially avoid overuse injury (Welman, 2010).