Pilates For Achilles Tendinitis

June 3rd is National Running Day and many running organizations from across join forces in an effort to promote running as an easy, healthy, affordable form of exercise. Unfortunately, runners are susceptible to foot problems, including heel pain, tendinitis, ankle sprains, stress fractures and blisters. Proper shoe fit and training are two of the easiest ways to prevent foot and ankle injuries while running. This article review the top 5 foot problems in runners and simple tips for treatment and prevention. 1. Heel Pain and Plantar Fasciitis: Plantar fasciitis is caused by excess stress on the ligament-type structure within the arch of the foot. The tearing causes inflammation and the inflammation causes pain, most commonly at the inside of the heel. Over million runners develop plantar fasciitis each year. Although classic plantar fasciitis pain occurs at the heel upon stepping down first thing in the morning, this is not always true for runners. Many runners experience pain on the bottom of the heel and through the arch during the first 10-15 minutes of a run. In most cases, it works itself out as the run progresses, but returns at the end of the run, or later in the day. To prevent the development of plantar fasciitis when running or to help avoid re-injury, pay special attention to your shoes. Check your shoes for support and make sure they do not fold in the middle. Take the heel of the shoes and press the toe of the shoe into the floor. If the foot collapses under this pressure, it is much too flexible. A short run in an old pair of shoes can cause plantar fasciitis to development. Throw out old shoes when they are worn out and test all new shoes with this simple test. make sure your shoe is supportive. Just one run in that old, worn out pair of shoes can cause enough stress on the plantar fascia to start the process. If you are prone to developing arch pain or plantar fasciitis, stretch the arch before you run for at least one minute. Place one foot on the opposite knee while seated and grab the toes. Pull both the ankle and toes back. This will stretch the arch and you should be able to palpate the plantar fascia. Perform this stretch after the run as well. Calf stretching will also be beneficial, but if not done appropriately, can lead to Achilles problems. Warm up first, then perform calf stretches. Repeat the stretches when you are finished. Slowly progress with training by adding in distance and hills gradually and increasing pace and stride gradually. 2. Achilles Tendinitis: Achilles tendinitis and calf related injuries are the most common injuries experienced by runners. Pain may gradually develop at the back of the heel or calf, or come on suddenly as a sharp pain. Pain at the beginning of a run is common as well as pain and stiffness when first stepping down in the morning. Improper training, over training and poor footwear are the three most common reasons for development. A sudden increase in distance or pace or additional of steep hill climbs can strain the muscles and tendons in the foot and ankle causing microtears within these structures, resulting in pain and inflammation. Prevention for Achilles tendinitis and calf problems is similar to that of plantar fasciitis. Appropriate shoes and training are the most important. Calf stretching should be done after a 5-10 minutes warm up and it’s important to note that improper stretching or over-stretching can cause injury. 3. Stress fractures: A stress fracture is an incomplete break in the bone. In the foot, the long bones (metatarsals) are the most commonly affected. A sudden onset of pain and swelling on the top of the foot is an indication of a stress fracture. Stress fractures are generally not associated with blunt trauma or a specific injury, but are more often linked to unsupportive shoes in combination with overuse. Individuals with flatfeet, overpronation, hypermobility and tight calves are at the greatest risk. Those with very flexible feet tend to overstress the ball of their foot because the great toe joint tends to rise (hypermobility) during the push off phase of walking. The great toe joint does not take it’s fair share of weight and a greater force is placed on the smaller metatarsal bones. Individuals with tight calf muscles have a heel that lifts earlier than normal when walking. This also places excess stress on the ball of the foot and lesser metatarsals. Hypermobility and tight calves are linked to overpronation and this triad of abnormal foot mechanics, in combination with poor quality shoes and overuse can lead to stress fractures. Supportive shoes, heel lifts, orthotics (if necessary), proper training and stretching are the keys to avoiding stress fractures. 4. Ankle Sprains: Ankle sprains are a common injury experienced by runners. The most common injury is called an inversion ankle sprain and involves the ankle rolling out while the foot turns in. This causes a partial tearing of one or more of the ligaments on the outside of the ankle. Most ankle sprains are mild to moderate in severity, but some may be severe and involve complete tearing of the ligaments. Rest, ice, compression, elevation and early range of motion are the keys to treating most ankle sprains. Mild ankle sprains will need 2-6 weeks of rest and support, while moderate ankle sprains may take 6-12 weeks to heal. Severe ankle sprains will take 12 weeks to a year to heal and some involve surgery. An evaluation by a physician may be important to rule out a fracture or complete ligament tear. 5. Blisters: Almost all runners have experienced blisters and although they may not be as limiting as other running injuries, they are annoying at best. Blisters develop as a result of friction and shearing forces on the skin. Abnormal motion in the foot, such as pronation, excess moisture on the feet or within the socks, ill fitting shoes and foot deformities all increase the chance of blisters forming. The body’s natural defense mechanism to excess rub, irritation and shearing forces on the skin is to develop fluid between the outer layers of the skin. This provides a cushion and protects the under layers, allowing for a new layer of skin to grow. Blisters can be prevented with proper fitting shoes and appropriate socks. Finding the right combination of shoes and socks can be a challenge. Socks should be made of a wicking material which facilitate the transfer of moisture from your feet to the outer layer of the sock, so it can evaporate. Cotton socks absorb moisture like a sponge and should be avoided. The American Academy of Podiatric Sports Medicine recommends socks made with CoolMax. Shoes with mesh fabric allow for breathability and help with moisture evaporation. Supportive shoes with proper fit are important to avoid excess movement in the shoe. If you have orthotics, make sure you run with them, as excess pronation and abnormal foot motion are also factors causes friction, shearing on the skin and contribute to blister formation.

As the human body ages there is a greater tendency for discomfort and pain for the muscles and joints to the point where the body feels like it has stiffened up. This can make routine movements such as bending over or reaching uncomfortable at best and almost impossible at worst. By learning how to do Pilates, the greater flexibility and movement achieved will certainly alleviate these problems.

The actual problem of restrictive movement and discomfort does not emanate from the joints or bones but is due to the muscles and connective tissues that move the joints. Flexibility is used to describe the full range of motion of a body joint and the greater such range, the more flexible a joint will be. The problem lies in a situation where the muscles and joints are not moved in any discernable way on a regular basis through undergoing their full ranges of motion and this will obviously lead to a reduction in their overall capability. Once this occurs and there is a demand placed upon the body to undetake movement that it is not normally asked of it there really should be no surprise that some level of discomfort or pain is experienced, the result being a discouragement from further use. The muscles become shortened through prolonged periods of inactivity which can lead to the creation of spasms and cramps that can often become irritating and at times extremely painful.

For someone who does not get enough activity and movement on a daily basis any suggestion of undertaking any form of exercise can be met with a negative response as the imagined outcome will be pain and discomfort. All is not lost as there is available a range of movement exercises and techniques that are possible to use within daily routines even for people who, up until now, have never considered or wanted to undertake any form of regular exercise. A popular and acknowledged exercise regime to assist with improved body movement and greater flexibility is Pilates which anyone of any age and fitness level can immediately start to benefit from.

There are many different exercises included within a Pilates fitness program for any levels of fitness and age with the target being the improved tone and core strength of the muscles, greater flexibility plus also increasing the awareness of body form. The effect of undertakeing the techniques will be the reprogramming of the body with efficient muscle use resulting in great benefits such as improved posture.

By learning how to do Pilates and incorporating it into an existing exercise program or to use it on its own, you will notice beneficial results quite quickly that often elude those that wish to gain better fitness and greater body flexibility. With better conditioning of the body’s core muscles, the problem of muscle ache will reduce and over time disappear as you reap the benefits from the better conditioned, reprogrammed you.

The following articles report on research completed, in whole or in part, under a grant from ACFAOM. Thanks to all those whose voluntary contributions to ACFAOM’s Research Fund make such grants possible. Comparing Negative Casting Techniques: Foam versus Plaster of Paris Richard Berenter, DPM, FACFAOM Introduction: This study was undertaken to determine whether there was any difference in the clinical outcomes related to the type of negative casting technique utilized in the manufacture of functional foot orthoses. Those practitioners who favor foam casting blocks argue that the technique is cleaner, faster, more cost effective and just as reliable a method to produce functional foot orthoses versus the plaster of Paris technique. On the other hand, a number of practitioners have argued that the foam block technique is inferior because the foam is incapable of capturing the shape of the foot with the subtalar joint in neutral position and the midtarsal joint maximally pronated thereby leading to an inferior foot orthosis, which will be less effective at reducing patient symptoms. Materials and Methods: A total of 38 patients were enrolled in the study. All of the patients presented with lower extremity symptoms associated with abnormal lower extremity function as determined by gait evaluation. At the time of the initial visit, each patient signed a consent form and completed the top portion of the data sheet which included both personal information and the amount of pain in each extremity (patients were asked to circle the amount of pain on a scale from 0-10 with 0 being no pain and 10 being the worse pain ever felt). Upon completion of all paper work, both feet of each patient were casted via the semi-weight bearing foam block technique and by the non-weight bearing supine plaster of Paris method. Both sets of casts were sent to a professional orthotic laboratory with a prescription filled out for an orthotic shell with a medium amount of arch fill, average heel cup depth, normal orthotic width (to the lateral border of the 5th metatarsal and bisection of the 1st metatarsal shaft) and a thickness of polypropylene which would behave in a semi-rigid behavior for the patient’s stated weight. A laboratory technician was instructed to randomly select one of the two pairs of negative casts and keep track of which casts were used without the knowledge of the principal investigator. In this way, a double blind study was established since neither the principal investigator nor the patient knew which casts were used to construct the foot orthotics. Approximately 2-3 weeks following casting, the patient was dispensed a pair of functional foot orthoses and asked to walk around for a minimum of 10 minutes to gauge the comfort level of the orthotics. Each participant was asked to use one of 4 descriptive terms (very comfortable, comfortable, slightly uncomfortable or very uncomfortable) to describe the comfort level of 5 different regions on each foot orthosis corresponding to the heel region, medial arch, lateral arch, middle of the orthosis and distal edge. Patients were then sent home with standardized break-in instructions for the functional foot orthoses and returned to the clinic at intervals of 2 weeks and 4 weeks post-orthotic dispensal. At each follow-up visit, patients were asked to fill out a data sheet gauging the level of symptoms and comfort level of the orthoses. The data was then compiled and saved in a spread sheet format and upon completion of the study, the laboratory technician was contacted in order to identify which patients belonged to which study group, the foam box or plaster of Paris casting technique. Results: The data was compiled and the two study groups separated by casting technique. An independent investigator (non-podiatrist) was contacted and asked to analyze the data to answer the following questions: 1. Does the negative casting technique (foam vs. plaster) make a difference in the ability of the orthotic device to reduce symptoms? 2. Does the negative casting technique (foam vs. plaster) make a difference in how comfortable the orthotic device feels to the patient? The data was analyzed in a variety of methods such as the mean reduction of pain, Fischer exact test and Chi-square with T-tests. A simple comparison of the average reduction of pain after four weeks of orthotic therapy indicates that the plaster of Paris orthoses achieved a mean decrease of 82.43% of pain versus 61.14% reduction in pain with foam box cast orthoses, with a level of significance p

Pilates in an exercise ball. Pilates fitness band. Pilates with yoga. Pilates for tango dancing. Pilates in the pool. The list goes on, but are we really talking about Pilates even when presented mostly in the context of a system of exercises? Much of the Pilates community would say no, and much would say yes.

Joseph Pilates developed a wide repertoire of exercises based on the principles of very specific movement. Their exercises are done on a mat or one of the many pieces of equipment he invented, as the magic circle, a Pilates chair or reformer. That’s near the end of the story for many traditionalists in the world of Pilates. However, as the Pilates method has influenced the exercise science and vice versa, many new approaches and equipment have found their way in the formation of Pilates.

The key question then is: How far from traditional Pilates is too far? If you take a class or buy a Pilates video and pretending to be something, say Pilates and ballroom dancing, but there are only two traditional Pilates exercises in the whole thing, is Pilates? “And if we add fundamental building work? If you do a Pilates class and the instructor ball no more than a day “Pilates on the ball” certification from one of the many self-appointed certification companies, you will reap the benefits associated with doing Pilates correctly?

I can not answer those questions. My job is to bring to your attention and alert you that the fact that while most of Pilates-based instruction is excellent, there are a lot of Pilates combined with other teams and traditions and is derived from Pilates there is no real is in it – other than as a noun or as a marketing tool.

So how do you know if you go to a fusion of Pilates experience that Pilates gives you enough to be worthwhile, especially if there is no traditional Pilates taught? The 5 tips below will help you be a demanding customer:

1. The best solution is to know about Pilates. Take some Pilates classes, equipment or mate, with a fully certified Pilates instructor. Then go to the combination of Pilates with this or that. At least you have an idea of the basics of Pilates movement, and you will be able to see the principles in its fusion instructor or not.

2. Find out how much of his instructional Pilates Fusion Pilates teacher actually does. Do not settle for a one day workshop. If the instructor is the combination of Pilates with something else, yoga or ballet, for example, must be well trained in both.

3. Look for the basics of Pilates inspired instruction and an emphasis on abs who retired in supporting the core, the length and alignment, exercise modification, including the stability of the ABS base, shoulder and pelvis integrated breathing, and a sense of the principles of Pilates.

4. Ask yourself how you feel after a class. Are you getting the benefits associated with Pilates training? Do your limbs feel more and feel taller? Are you getting the strength without the stress? His posture is better and breathing is easy and completely? Are you more flexible?

Heel pain can occur at either of two places: the bottom of the heel or the back of the heel. The heel bone, the calcaneus, is the largest bone of the foot and bears our full weight during part of each stride. The painful heel, in almost all instances, is caused by excessive strain on one of the two major ligaments, and the pain occurs where these ligaments attach to the bone.

First, the Achilles tendon attaches at the back of the heel. This is the strongest tendon in the body and connects the muscles on the back of the calf to the heel. The force of contraction of the calf muscles enables us to stand on tiptoe and gives an extra thrust as we walk. Damage to this tendon attachment is called Achilles tendinitis. Frequently, there will also be tears in the tendon itself or in the lower part of the muscle.

Second, the heel spur syndrome affects the bottom of the heel. This is where the ligaments that make up the arch of the foot attach to the heel bone. These ligaments function like a bowstring to arch the foot, so they are under pressure every time we stand or step. If a problem at the bottom of the heel persists, calcium may develop in the inflamed area where the ligaments attach. The presence of the calcium spur may or may not cause additional pain. Many people have pain without visible spurs on X-ray, while others have spurs but no pain.

Usually heel pain is a simple result of a minor and forgotten injury. Unfortunately, since we strain the injured part every time we walk or stand, these problems can become a vicious cycle in which there is more injury, more inflammation, more injury, and so forth.

Rest, avoidance of further injury, and gradual resumption of activity as the pain subsides are indicated. Non-weight-bearing activities like swimming can be continued full tilt.

For Achilles tendinitis, rest the foot or feet. Use a shoe with a high heel wedge and a lot of padding, since this limits the stretch on the tendon. Warm up and stretch carefully for 10 to 15 minutes before exercise. Exercises such as tennis or walking uphill are not good; these stress the tendon. Remember that tight muscles on the back of the leg put extra strain on this tendon, so warm up with gentle toe touching or other stretching exercises for the calf muscles.

For the heel spur syndrome the activities to avoid are ones that cause pounding on the bottom of the heel. Heel padding will help, but support for the arch is even more important since this takes tension off the ligaments whose job it is to hold the arch. A strap around the foot at the level of the top eyelets on a shoe, secured firmly but not tightly by Velcro, can give good relief. Commercially made running shoes are sometimes very helpful. In most of these shoes the cushioning air cells break down after a few months, so you should change shoes even before they appear worn out. Don’t worry about wearing a silly-looking shoe; forget fashion and concentrate on getting well. This kind of problem can take a year or more to resolve, or it may go away quickly. Keep trying.

Just a few years ago, Kim Gibilisco, a choreographer, dancer and Polestar- and Stott Pilates–trained instructor, was teaching private Pilates sessions in her Manhattan studio. Today, she is an Assistant Professor of Dance at Shenandoah University in Winchester, Virginia, and the woman responsible for bringing a Pilates mat certification program to the school. Here she discusses how she came to be SU’s Pilates Program Coordinator and where Pilates fits in the university setting.

PP: How did the idea of a collegiate Pilates program come about, and what did it take to convince school officials?KG: When I accepted my position in the Dance Department at SU, my chairperson, Erica Helm, and I discussed the possibility of offering a Mat Teacher Training course to our students. I designed the curriculum in the summer of 2005 then applied for Pilates Method Alliance (PMA) approval as an Educational Member. Applying to the PMA was an important part of the process, as I wanted to be sure that our program was properly sanctioned. I also wanted to ensure that our graduates could apply for PMA membership and be accepted into Apparatus programs in the future if they wanted to pursue more. The Mat program was approved and we began running the program in Fall 2005. The program was embraced from the very beginning by our university.

PP: How did you design the curriculum and what are the requirements?KG: I designed the curriculum specifically for a student population (ages 19-25) who may not have had any experience with the method. One semester of college level anatomy is required to enroll. Since our students are in a four-year program (versus typical weekend-based training seminars), I wanted to capitalize on the available time I had to teach the material. I determined that a two-semester sequence was the most effective way to teach the material to this population.  Students must earn at least an 84% in the first semester to advance to the second semester.

The first semester entails 2 hour of Mat experiential and 1 hour of lecture per week. In the second semester, students take Mat once a week with me. Then students rotate in teaching the whole group a Mat class once a week. Following a student Mat class, participants offer feedback on the effectiveness and teaching style of the student instructor. In the second semester, the lectures focus on teaching methods and class design. Using their understanding of the Trilogy, the 6 Pilates Principles (control, centering, concentration, flowing movement, precision and breath) and the 5 Pilates Lab Principles (use of inhalation and exhalation, pelvic floor, restorative poses, visual gaze and neutral spine) students design a class with a theme or concept they want to address. Written and practical midterms and finals are also administered.

Using some of the Mat Teacher Training models I researched, I designed the curriculum to include lectures and practicums that I believe are important in becoming a well-rounded teacher of the method. For example, our students are tested in physical practicums where they must demonstrate their mastery of the 34 exercises as well as in teaching practicums where they must demonstrate their ability to teach confidently and effectively. I also wanted to offer students course work on the various props used in the Mat work, (e.g.: magic circle, foam roller and thera-bands and thera-ball) so that they did not need to attend continuing education courses outside of the university setting to develop their breadth of knowledge. In addition, I teach contra-indications for diabetes, orthopedic issues and pregnancy so that our graduates feel comfortable with teaching a variety of populations. What I stress the most is the importance of “knowing what you don’t know and to teach ONLY what you know.” For example, if a client asks them about an orthopedic issue that is out of their scope of practice, they know to refer them to a medical professional. Our students are taught how to self-assess and where to look for more information if they are unclear.

PP: Are you the only instructor involved with the Pilates program?KG: Yes, as per the PMA, all teachers must have at least 5 years of teaching experience to instruct teacher trainers.

PP: What type of students does the program attract?KG: Up until 2007, we have had primarily dance majors enrolled in the program. However, this academic year our Music Theatre majors and staff have also enrolled and successfully completed the program.  For the 2008-2009 academic year, we have dance majors, music theatre majors, SU alumni and community members enrolled.

PP: Are students who complete all the requirements considered certified Pilates instructors?KG: Only the PMA can “certify” teachers in the method. As an Educational Member of the PMA, our teacher trainers are given a certificate of completion with the SU and PMA logos on it.

PP: Is Pilates an actual major, and if not, how does it work into a student’s graduation plan?KG: Our Teacher Training Program is an elective course that can fulfill a dance elective requirement.

PP: How many students have been through the program, and are they actively teaching now?KG: We have had 26 students complete the Mat Teacher Training course of which 14 students are actively teaching Pilates Mat.

From Library Journal

There are plenty of good books on herbs, and some of them devote a chapter to essential oils, but there’s nothing comparable to Worwood’s work. Her premise is different from other herbalists–she believes that the most effective way to use herbs medicinally is by external application or inhalation. Both methods allow the essential oil to enter the bloodstream without passing through the digestive tract. Her grasp of basic physiology is somewhat confused, but (more…)

Pilates Style Magazine

“everything a beginner could ask for…. combines the best of yoga and Pilates… never get bored and steadily progress.”

YOUR NEEDS CHANGE EVERY DAY, SO SHOULD YOUR DVD! This DVD is for anyone who considers themselves inflexible. Joseph Pilate developed his method not for people who were already flexible, but rather to help inflexible and/or injured people become more flexible, strong and healthy. Pilates Complete for Inflexible People™ (more…)

Every day scientists learn more about how the body adapts to the stress of running—and how various body systems contribute to running performance. Leading the charge is a fresh generation of brilliant young exercise physiologists including Ross Tucker and Jonathan Dugas, whose work has demolished many long-standing beliefs about running. Now Tucker and Dugas, whose blog, Science of Sport, has already created a devoted readership, join with esteemed fitness author Matt Fitzgera (more…)

Cambion Heel Pads These supports absorb and disperse the jarring shock of heel strike. Recommended for Achilles tendinitis, metatarsalgia, heel bruises, arthritic joints, heel spurs and post-op recovery. The clear, single-layer, modular inserts can be positioned on the footbed for a custom fit. The colored inserts have two layers. Epolex viscoelastic layer absorbs shock and will not bottom out. Poron foam layer provides constant cushioning and even weight distribution. Mold and (more…)