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Monday, October 15, 2012

Wounded Runner Open House/Medical Evaluation Night


Are you frustrated with a running injury that never seems to go away. Is your injury keeping you from enjoying an active lifestyle? Come hear how A Snail's Pace Running Academy & the experienced sports medicine team of FORMA can change your life.

Attend the Wounded Runner Open House and Injury Evaluation event. All are welcome to come hear how you can finally take your injury rehabilitation into your own hands with the help of this group.

At this event, you will meet your certified Running Coaches and the Sports Medicine Team dedicated to returning you to a fully active lifestyle. You will learn all the details of this 8 week, 3 times per week session.

We will describe in detail how this program is different from any other rehabilitation or recovery program you have attempted before. We will offer a full description of our customized training program designed to expedite healing at each stage of the recovery process, while providing focused physical conditioning aimed towards your return to a fully active lifestyle.

You will receive a pre-participation evaluation by one of our sports medicine physicians on the FORMA medical team to determine the root cause of your injury (or injuries). Your personal training schedule will be based on the findings and observation from the physician. With your permission, we will also work and communicate with your own physicians, physical therapist, personal trainer, and other health professionals who you think will help your participation.

The upcoming Group Class will begin on Nov 6th in Fountain Valley. We will only be offering a Wounded Runner class in Fountain Valley/Huntingon Beach for the FALL session.

This very unique course is designed to get you back into the fun of a group environment and still provide you with the one-on-one guidance you need at this stage of your recovery.

CLASS SIZE IS LIMITED TO 20 in each location-SO IF YOU ARE INTERESTED, PLEASE RSVP FOR THIS EVENT.
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Wednesday, February 1, 2012

Traditional Shoes vs. Minimalist Shoes

Traditional Shoes vs. Minimalist Shoes

In the last few years there has been an ongoing debate in the running industry regarding footwear. At one extreme are the barefoot and minimalist running shoe proponents who argue that no shoes or at most, shoes with minimal structure, are best. On the other end are experts who hold that the traditional thick soled, cushioned shoes are optimal for injury prevention.

Traditional Running Shoes

Until the 1970’s running shoes were manufactured with flat, thin-soles. Indeed the current growth in popularity of minimalist shoes can be seen as a case of old becoming new again.
In the late 70’s and early 80’s running shoe construction began incorporating thicker soles with elevated heels. The rationale for adding cushioning in the midsole and motion control features in running shoes was to absorb impact forces and control movement, specifically pronation, of the foot.
This rationale however was probably misguided. Cushioning materials in shoes actually increases overall leg stiffness (Bishop et al. 2006). Some leg stiffness is beneficial to running well but excessive leg stiffness may be a factor for increased risk of injury (Hewett et al. 2004).
A review study by Richards et al in 2008 concluded that the prescription of “pronation control, elevated cushioned heel (PCECH) running shoes to distance runners is not evidence-based.”
Additionally, a study by Ryan et al in 2010 showed that motion control shoes had the highest incidence of injury in their research group, regardless if the wearer had highly pronated feet or not.
There is good evidence that the shoe construction of the last thirty years or so has not accomplished what it was originally intended to do. Injury rates in runners today remain as high as ever.

Minimalist Shoes

Since Christopher MacDougall published Born to Run in 2009, there has been tremendous growth in the number and styles of so-called minimalist shoes. Virtually every major shoe manufacturer and a number of smaller upstarts now have minimalist shoes.
These shoes were designed to mimic how the foot functions barefoot. Generally, running barefoot will cause a runner to land with a flatter foot (De Wit et al 2000).
In addition, Lieberman et al. (2010) found that if a barefoot runner lands with a forefoot landing there is no impact transient (a very rapid rise in impact forces) as compared to landing heel first in shoes. It should be noted however that Lieberman and his group do not claim that heel striking in and of itself causes injury.
Minimalist shoes share the following characteristics:
  • They’re lightweight.
  • They have a flexible upper and sole.
flexible Traditional Shoes vs. Minimalist Shoes
  • They incorporate less or no cushioning material in the mid-sole.
  • And there is less difference between the heel and forefoot height (also known as heel drop). Traditional shoes have a heel drop of 11 – 15 or more mm while minimalist shoes have a heel drop under 10 mm.
Traditional Shoe 
Heel Drop
shoe 1 Traditional Shoes vs. Minimalist Shoes
Minimalist Shoe Heel Drop
shoe 2 Traditional Shoes vs. Minimalist Shoes
Within the minimalist shoe category are three main sub-categories:
  1. Barefoot-style shoe. This shoe is the most minimal in structure with no cushioning, a zero-drop (heel and forefoot are level) and the thinnest sole. Examples include the Vibram Five-Fingers and the Merrell Trail Glove.
  2. Minimalist shoe. These shoes have some cushioning in their midsole, small or no heel drop and a wide forefoot allowing the toes to be splayed. Examples include the Altra brand shoes.
  3. Transition shoe. These shoes are most similar to traditional running shoes but are lighter, more flexible and have a lower heel drop. Examples include the Nike Free, Saucony Kinvara or the Brooks Pure models.

    Take Home Advice

    Currently, neither the minimalist side nor the traditional side can conclusively say their method of shoe construction is superior in regards to injury prevention. More and more studies are being done with minimalist shoes and it will be interesting to see the data.
    In my opinion as a coach I think most runners could benefit from some amount of running in minimalist shoes. However caution must be taken in how quickly and how much a runner transitions away from a regular, traditional running shoe.
    There will be a wide range of individual variability in adapting to a more minimalist style of running. A runner’s experience, ability, strengths, weaknesses, injury history and psychology are all factors to consider.
    The choice of running shoe style needs to be part of a well-thought out training program. If a runner has been relatively injury-free and is content with their performance in traditional shoes I see no reason to push them into minimalist shoes.
    On the other hand, if a runner has had repeated injuries and setbacks with traditional shoes it may be time to transition to a more minimalist shoe.
    My advice would be to first look for a shoe with a wide toe-box to accommodate splaying of the toes during running. This will facilitate proper function of the big toe. Less cushioning and more flexibility are other characteristics to look for. Lighter shoes will help improve running economy.
    I would be more cautious in regards to heel drop. Going to a zero-drop shoe for many runners will be put too much strain on the Achilles tendon and lower posterior chain. Look for a 4 – 8 mm heel drop initially.
    Use the shoes indoors during strength training sessions first and then try them for short runs and running drills. Build the mileage gradually. Some runners may adapt to where they can run with minimalist shoes all the time. Others may only be able to progress to using them for shorter runs.
    But keep in mind that shoes, whether traditional or minimalist, are not a solution by themselves. Runners need to incorporate strength training, multi-planar mobility drills and technique exercises into an individualized conditioning program that includes adequate recovery and sound nutrition.

Monday, April 25, 2011

FORMA blog on "No Pain, No Gain"


April 10th, 2011 | By: Dr. Carvalho | Categorized Under: BlogPain Management,Running
Leg pain
We have all heard the saying, “no pain, no gain.”  But WHAT are we truly gaining from the experiencing of muscle pain?
To begin answering this question, an important concept needs to be understood in that muscles are the “final organ” of the neuromuscular system. To better explain, nerves are connected in a very tight network with all muscles, which depend on the nervous system to properly function to their optimal control and with the desired strength capacity. In addition, cellular organs within the muscles and tendons provide an automatically direct feedback to the nervous system to maximize one’s performance.  Our brain, being the organ where all sensations are interpreted and decisions are made, has the capacity override the neuromuscular control if needed. The brain will facilitate fluid movements if it feels safe and pleasant, and will inhibit or “guard to compensate” movement if there is a threat for injury or if pain is present.
Before we even feel muscle pain during exercise, we first experience fatigue and discomfort–like a tolerable burning or tightness. But even at the stage of feeling the fatigue, our neuromuscular machine is challenged to maintain balance and control while executing the best muscular performance. If our mind drives our body to continue exercising in this case, the neuromuscular system reorganizes the contractile activities within our muscles, which in turn, will require more energy from the body to keep up with the increased demand. This will trigger the signals for adaptation not only in the muscles, but also in the entire body in order to meet the increased demands for a higher level of performance.
Therefore, the goal of training is to drive our bodies to the point of fatigue while maintaining our proper form and control during exercise. This will result in developing the capacity for our bodies to adapt assuring our desired results for an improved performance.
Beyond the stage of fatigue and discomfort during exercise, pain is acknowledged.  Our bodies  react to it as a signal of impending or occurring injury.  If the pain becomes intense, we will not be able to continue to move, much less perform.  However, we can choose to “push” and keep on exercising with some level of pain.  As a result, our bodies will come up with strategies to guard and protect  ourselves by minimizing the weight to the painful areas of the body while in motion.  Additionally to compensate, our movements will begin to slow and become less efficient.  Pain during exercise also interferes with our natural posture by affecting our “core stability”, making it harder to breathe and causing increased stress on our cardiovascular system. These reactions to pain are the innate responses, learned to protect our bodies, but only short term.
Long term, adaptations to pain can be potentially harmful.  It tends to lead our nervous system to operate in fear of moving the affected area or body part, and then, our movements become compromised. The changes within the body brought on by constant pain will also cause a redistribution of the natural loads during exercise, requiring the body to compensate.  If the pain is left unresolved, these compensatory movements will lead to repetitive stress.  Affecting not only the painful area, but also the healthy body tissues, which is the basis for the cause of most “overuse injuries”.
Another consideration of not properly dealing with the cause of the pain is the exponential increased time necessary to recover from an injury once it becomes chronic.  In addition, painful sensations in any part of our bodies will affect our ability to rest and restore energy, thus, compromising the potential improvements from exercise that could have been made to the entire body.
A common example is to continue running or walking with some pain in one foot, knee or hip that forces the athlete to adjust his or hers “natural form” in order to complete a planned walking or running session. By doing this, not only is the athlete affecting the desired results they were determinate to achieve from the time spent training, but they are also greatly increasing the chances of worsening a potential injury. And, if this same pain is not resolved, and keeps coming back while the athlete continues to train, another healthy body part, such as the other limb or lower back, will potentially develop an injury.
So next time, you are pumped up and ready to push through that “muscle burning”… go ahead as long as the proper exercise form is maintained.  However, if the exercise becomes painful…..Stop and listen to what your body is telling you.
And remember, “NO PAIN, THEN GAIN.”

Tuesday, April 19, 2011

Wounded Runner Open House/ Medical Evaluation Event

Wounded Runner Open House/ Medical Evaluation Event
When: Tuesday April 26th, 2011 @ 6:30pm
Where: FORMA- 230 E.17th St. Ste. 202
              Costa Mesa  92627


All are welcome to attend the Wounded Runner Medical Evaluation Evening. On this date you will receive a pre-participation medical evaluation by a sports physician. This evaluation will assist in determining not only the injury itself but the cause of the injury. You will also hear the details of the program.

Sports injuries can be debilitating and can literally stop you in your tracks! They can be painful, and if not dealt with correctly, can take much longer to heal than you might have expected. Wounded Runner is a medically supervised eight week training program directed by a certified running coach and supported by the sports medicine team from FORMA designed specifically for runners with injuries.

A Snail's Pace Running Academy and an experienced team of sports medicine professionals at FORMA have developed this specialty training program to help runners to understand the cause of their injuries, to instruct about how to recover quickly, and most importantly, how to prevent re-injuries.

If the physicians determine you are ready to participate in the Wounded Runner program, they will communicate directly with your running coach to discuss a rehabilitative training program specifically designed for you.

This eight week program is divided into three workout-meetings per week. These training plans are dynamic and will include specific exercises tailored to expedite healing at each stage of your recovery process, while simultaneously providing a focused physical conditioning program aimed to get you back to a fully active lifestyle.

The classes are held Tues/Thur at 6pm and Saturday morning at 7am at the Huntington Beach Pier. The upcoming class will begin on May 10th.

If you have any questions or concerns, please contact your certified running coach Michelle Montiel at 714-392-3290 or Michelle.Montiel@ASnailsPace.net



PAIN VS. PROBLEM- CAN YOU IDENTIFY THE DIFFERENCE? DR.CARVALHO OF FORMA IS IN THIS VIDEO



Monday, March 7, 2011

Christopher McDougall: Are we born to run? | Video on TED.com

Christopher McDougall: Are we born to run? | Video on TED.com


This video searches the mysteries of the Mexican Indians who are great runners with a remarkable ability to remain extremely healthy. It also delves into the huge heart of a distance runners.

I also explains how women are not great at shorter distance races but that women excel in long distance running. As of date, the fastest women Paul Ratcliffe is only 10 minutes off of the mens world record of the marathon distance.

It also explains that as we age, we can be just as competitive at age 60 as we were as a young adult. It explains how we have a huge advantage because we are able to sweat. It is a very interesting video.