Kathleen McDonough holds a BA in Exercise Physiology/Physical Education, UC Davis and an MA in Physical Therapy, Stanford University. She has been a Physical Therapy professional for over 30 years and is a Nationally Certified Pilates Teacher (NCPT)
Her great depth of experience and education are brought together in her holistic approach to treatment, with an emphasis on creating a personalized plan for regaining your optimal health. Kathleen’s experience includes orthopedics, sports medicine, Pilates-based rehabilitation, classical Pilates and peak performance training.
Listen to this episode of The MOVEMENT Movement with Kathleen McDonough about the problem with stretching.
Here are some of the beneficial topics covered on this week’s show:
– How having strong flexible feet gives you a good foundation for barefoot running.
– Why natural movement shouldn’t be considered so controversial.
– How people were not born to bear weight on the arch of their foot.
– Why your joints stiffen when you run on a cushioned surface.
– How we should be dynamically stretching, not static stressing and what that means.
Connect with Kathleen:
Guest Contact Info
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facebook.com/McDonoughPT
Links Mentioned:
mcdonoughpt.com
Connect with Steven:
Website
Xeroshoes.com
Twitter
@XeroShoes
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@xeroshoes
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Episode Transcript
Steven Sashen:
You want to warm up for a run, or a hike, or a workout, so you got to stretch, right? What if that is the worst thing you could possibly do? Well, we’re going to find out more about that on today’s episode of the MOVEMENT Movement podcast, the podcast for people who want to know the truth about what it takes to have a happy, healthy, strong body starting feet first, usually, because those things are your foundation. And we’re going to be exploring the propaganda, the mythology, sometimes, the straight-out lies you’ve been taught about what it takes to run, or walk, or hike, or play, or do yoga, or crossfit, or workout, whatever it is you do, and to do it enjoyably, efficiently. Did I mention enjoyably? Because if you’re not having fun do something different so you are. That’s one of the important messages.
If you want to find out more about what we’re up to go to www.jointhemovementmovement.com. That’s where you’ll find previous episodes, all the different ways you can interact with us on Facebook, and on YouTube, and on Instagram, and Twitter, et cetera, et cetera, because what we’re doing here why it’s the MOVEMENT Movement we’re creating a movement that involves you about movement more specifically natural movement, letting your body do what’s it’s supposed to do. We’re helping people rediscover that natural movement is the obvious better healthy choice, the way that we currently think natural food is. And so you are part of the movement about that natural movement, so go check out the website, and like and share, and subscribe, and give us a thumbs up, or hit the bell on YouTube. You know what to do. In other words, if you want to be part of the tribe please subscribe. So let us jump in and find out why stretching is a horrible thing. Kathleen, hello. Do me a favor, tell human beings who you are, and what you’re doing here.
Kathleen McDonough:
Hello, I’m Kathleen McDonough. I’m a physical therapist, and a Pilates teacher. I’ve been in orthopedics and sports PT for 3-1/2 decades, more than I look, right?
Steven Sashen:
How could you have started before you were even born, Kathleen?
Kathleen McDonough:
Exactly, exactly. I was a child prodigy, but I’ve been working with athletes, with ballet dancers, with recreational athletes, professional athletes, and just normal injured folks that want to get back to doing what they’re doing for a long time. And just a little bit if you want to hear it my intro to minimal running.
Steven Sashen:
Sure.
Kathleen McDonough:
Back in maybe 2008, or so. I’ve been a recreational runner since I was a teenager, not because I love it, but because I love how it makes me feel.
Steven Sashen:
You don’t like running you like having run is that the idea?
Kathleen McDonough:
Yeah, exactly. Although, I get to run in a beautiful place, and it’s all good, but that’s another podcast, right? How we get ourselves out there, but my knees were always a little bit creaky. And I always switched my shoes at about four months, or so, even without running a lot of mileage because I could feel it in my joints. And then a friend of mine said, we were away on a trip, and she said, “I read this article. Do you think we should all do barefoot running?” And I thought that’s the stupidest thing I’ve ever heard of in my life. It will be good for business. I’ll have a lot of injured people, but that’s the dumbest thing I ever heard.
And then started reading more about it. And thought, well, if there’s ever a potential person to try barefoot running successfully I would be the poster child because I work barefoot. I’m a Pilates teacher. I have strong, flexible feet. I’m pretty aware of how I run, blah, blah, blah, so I made the transition. I was extremely careful. I would start out in my regular old shoes. I hate to call them traditional running shoes because they’re not traditional.
Steven Sashen:
No, they’re not.
Kathleen McDonough:
They were not traditional until the late ’70s or so, but I’d wear my regular running shoes with my other shoes tied around my waist. Partway through I’d switch my shoes. I was really careful. And even with that I got a bit of Achilles tendinitis on one side, and none on the other. Dealt with it, no problem.
Steven Sashen:
Well, wait, I want to pause there for two reasons. One, I like to say that things like Achilles tendinitis, or Achilles, or calf pain is totally optional depending on what you’re doing. And I always love uniliteral injuries. I love when something is wrong on one side and not the other because the good side is fine, but people rarely pay attention to the good side. They pay attention to the bad side. When you said so you got it on one side, and you dealt with it. What did you do? What did you discover in that process before you continue with the story?
Kathleen McDonough:
I did what I would do as a PT. I did some friction massage. I did a little bit of stretching. I love stretching. And that was about it. It pretty much took care of it. I already had pretty strong and flexible feet, which is a big deal. And I also did a Chi Running course, and I think changed my running style a little bit, and that made a big difference as well. And we can talk more about those kinds of things that I recommend to people a lot, but I found that instead of switching shoes, like, oh, I’ll do this shoe two runs a week, and I’ll do the minimal shoe two runs a week. It was like I didn’t like going back. Right away my knees felt way better in a minimal shoe, so I was hooked, and did a workshop with a Chi Running instructor at a running shoe store locally. And this is back maybe 2010, something like that.
We had standing room only in the running shoe store. And it was like if there would have been food served there would have a food fight. It was the people on the one side, and the people on the other side. And, like, “You’re crazy. You’re going to get stress fractures, and Achilles tendinitis, and plantar fasciitis, you’re crazy, blah, blah, blah.” It was pretty eye-opening. Since then, I’ve been able to study with the most prominent researchers in running from Harvard, from University of Wisconsin, from USC, from UCSF, brilliant people. There is no controversy about minimal running.
Steven Sashen:
Right.
Kathleen McDonough:
It just is. There is so much research about it.
Steven Sashen:
This is what I say when I say it’s like people love to say there’s a controversy, but there’s a ton of research supporting the benefits of natural movement, and zero good research supporting the benefits of big thick padded motion control shoes. And the few bits that are anti-minimalist, anti-barefoot, if you actually look at the studies they are not what people think.
One example is a study where they were examining VO2 max, basically, how well your body can handle oxygen as you’re exercising with the idea that investigating whether running barefoot improves your VO2 max. Well, no barefoot runner ever said that it did, so where did this come from? And the other one was that the study included people who were, quote, accomplished barefoot runners, but I know all the accomplished barefoot runners around here. The study was done at University of Colorado. I said, “No one that I know, nor I, were involved in that study.” But I know who was in that study, and these runners who were not accomplished barefoot runners. They’re accomplished runners who do a little bit of barefoot training on the grass. A whole different game, or my favorite one that I’ve been talking about lately is Nike has put out a thing saying, hey, here’s a study that shows our new shoe reduced injury by 50% compared to another shoe.
Well, first of all, the other shoe was their shoe, so their best-selling motion control running shoe was the one that caused more injuries than the new shoe, but the data I haven’t even seen it published yet. The only thing I’m seeing is people saying reduces injuries by 50%, but the data, because I got a copy of the study showed that the people in their best-selling motion control shoe, over 30% got injured within the 12 week study, which really means they got injured within about the first 10, 11 weeks because of how they determined the injury. And the new shoe only 14-1/2% got injured, which is kind of like saying do you want to go to a restaurant that will give you food poisoning in one of three meals, or one of seven meals?
Kathleen McDonough:
Exactly.
Steven Sashen:
So, anyway, you’re right. There is no real controversy. People like to act like there is.
Kathleen McDonough:
I mean, I come from the land of Dipsea. I don’t know if you know about the Dipsea race.
Steven Sashen:
Oh, yeah.
Kathleen McDonough:
It’s one of the oldest foot races in the country, and, unfortunately, was canceled this year for the first time the only reason other than World War II, right?
Steven Sashen:
I have to say, I’ve been to the Dipsea diner.
Kathleen McDonough:
There you go, and you didn’t get food poisoning, hopefully.
Steven Sashen:
Did not get food poisoning.
Kathleen McDonough:
Very good. So there are a lot of very confirmed runners. There is a local podiatrist who is really big on orthotics, and on big supportive shoes, and there are a lot of those runners that wear that. Now, I always tell my clients that we were not born to bear weight in the arch of our foot.
Steven Sashen:
Right.
Kathleen McDonough:
An orthotic is first aid. I wore one way back in my 20s because I had a stress fracture from doing aerobics on a bad floor. It’s first aid, but then you need to get out of that, right? You wouldn’t wear a brace, or a splint forever. And there are runners that I know that I’ve treated who are some of the people who have the most mileage on their feet in the world yet their body is so altered. I’m not sure if they structurally can ever get out of that, and they’re going to keep running. Runners are going to keep running, right? Some people don’t have the commitment to it. They’re very entrenched in what they do, and they do it, and that’s what they’re going to do, but I encourage all of my clients to think about transitioning to be a more natural running style because it’s better for you in so many ways.
Steven Sashen:
It’s funny, I’m on the track every week, and one of the things that I’ve noticed is a number of runners, especially, the good runners that I see are forefoot, or midfoot landing runners who are still in padded over controlled shoes, but what’s interesting is some of these runners their heels never come close to the ground. And so my thought has been why are you wearing that overblown, over-designed shoe? You’re perfect for what we do. Why aren’t you doing that? And some of it is because it’s what we get used to. It’s what someone’s told. They think that this is the intervention when this is what shoes were made like for, well, up until the early ’70s. Do you know how the padded motion control shoe was developed? Do you know the story?
Kathleen McDonough:
I think I’ve heard it, but feel free to riff.
Steven Sashen:
So, there’s two parts to the story. The first part is that when Nike was getting started they were sharing a building with some, I think, orthopedics podiatrists, or maybe sports podiatrists, and Bill Bowerman came and said, “I’m getting these runners with Achilles tendinitis. What do I do?” And they said, “Oh, well, their Achilles have shortened from wearing high-heeled dress shoes, so make a higher heeled running shoe to accommodate that.” Now, of course, once you make a higher heeled shoe it’s almost impossible not to land on it unless you already have great form. When you land on your heel it’s a ball so now you’re unstable so then they built in motion control. When you land on your heel by the time your foot comes down your foot and your plantar fascia are fully extended in a weak position, which puts strain on the arch, so that’s when they built in arch support to alleviate the strain. And so everything that we know evolved from this idea of put an elevated heel.
Well, not too long ago a friend was at a track meet with one of these podiatrists, and said, “What do you think about the fact that your idea has become the ubiquitous design for all modern athletic footwear?” And he said, “Biggest mistake we ever made.” But footwear, I have come to learn, is a bunch of copycats where if somebody starts to sell something everyone else freaks out that they’re never going to sell whatever they do, and they make their version of the same thing. And so that’s just the way it’s evolved in the last 50 years. Again, there’s just no evidence. I mean, you mentioned some of the people that you studied with, I mean, I don’t know if one of those people is Christine Pollard who has done a lot of research showing that the more cushion you have the more force you put into the ground, which sounds upside down to most people, but that’s how bodies work.
Kathleen McDonough:
The other thing that’s very interesting is if you run on a cushion surface whether it’s a shoe, or the grass, your joints are going to stiffen in response to that.
Steven Sashen:
Right.
Kathleen McDonough:
Right. If you run on a firmer surface your joints are going to soften and cushion in response to that. Now I don’t run on asphalt, or on concrete. I run on trails, but some of the trails are pretty hard, but it’s one of those counterintuitive things that you think you need more cushion. And a lot of people think they need more cushion it’s like, well, let’s look at your foot because the shoe companies have tried to out-engineer the foot, which is just hubris, right? We have this incredible structure in our foot with so many joints and bones, four layers of muscle, over 100 muscles in the arch of the foot itself. And yet we treat our feet like big dumb flippers. It’s a triplanar complex that can move in three different planes of movement. And if you take some of that away, or excessively load in one way or another which that big lateral heel on a shoe will do, it will make you pronate more, right?
Steven Sashen:
Right.
Kathleen McDonough:
It will throw more load that way then you’re going to be transferring the things that the foot is supposed to be doing that you’re taking away up the spine, up the knee, up the hip, right? So the more we try to out-engineer the foot the worse things have gotten.
Steven Sashen:
The worse it gets, yeah. One of my friends who was at Nike for 30 years said, “I worked with Bowerman for that whole time trying to figure out how to improve what feet do, and we couldn’t do it.”
Kathleen McDonough:
No, or NASA tries to make a foot for a robot that can accommodate different surfaces on a planet, right? And they can’t replicate what the natural foot does, right? It’s remarkable. I’ve spent a lot of time in anatomy labs, and have been lucky to volunteer at UCSF’s PT department in their anatomy lab, and a lot of the cadavers are older they’re in their 80s. I think about, okay, they’re in their 80s, but when did they live their life, right? But even in these 80-year-olds you can see feet that still have you can still fully dissect out of those muscles in the arch of the foot. It’s pretty remarkable. You think, oh, we’re 80, we might be kind of old and shriveled up, and you can’t really get those things because they’re not nice and juicy and vibrant, but they still are.
Steven Sashen:
Right.
Kathleen McDonough:
I think those 80-year-olds probably weren’t wearing those traditional running shoes. They were probably living their life in their Keds. Jack Kirk, the Dipsea Demon, who won the Dipsea more than anybody else, right? People would try and give him. He would run in I can’t remember if it was Keds, or just a flat.
Steven Sashen:
Like a Converse All Star.
Kathleen McDonough:
Exactly, or like what’s the Converse one that has a guy’s name?
Steven Sashen:
Yeah, it was in my head when you said that.
Kathleen McDonough:
Just a lace-up flat shoe, and people were trying to give him a better shoe, and he was like, “No, I got this.” And he ran it successfully. Had to be helped a little bit at 91, or something like that. The foot is an amazing thing. It’s an amazing piece of architecture and engineering.
Steven Sashen:
Well, and what’s most amazing is that major companies have spent the last 50 years teaching people the opposite so much so that everyone now thinks that it’s true that feet are inherently problematic. There’s a great story someone told me, and he’s actually a guy who does make orthotics for a living. I put him in a pair of our shoes in the Prio. And he’s walking around, and he said, “What do you see?” I said, “Well, technically, I mean, without your orthotics your right foot is pronating a little more because you have weak ankles because you haven’t been using them, but did you notice that?” He goes, “No.” I said, “Then it doesn’t matter, obviously.” And he was sort of dumbstruck by it, but he told me this great story that there was a podiatrist who went to Kenya, I think, in the ’60s to study the Kenyan Army who did a lot of their training barefoot because they couldn’t afford shoes. And so his report was a podiatrist will go broke in this country.
And there’s another thing where Americans are different than Europeans and Asians. So in Europe there are footwear brands that have been around for 250 years that are more about natural movement than anything that was ever done in America, and they get this idea. There is no controversy there. There’s no argument there. In Asia, same thing. Sandals and flip flops, and bare feet are an integral part of the culture in many Asian countries, and so this idea.
I’m watching big shoe companies try to convince them that they’re wrong, and they’re good at it. They’re good at making that argument because the idea of cushioning makes, quote-unquote, intuitive sense. You get a mattress you want it to feel comfortable. You step on memory foam it feels good at first. That doesn’t mean it’s good for you. What we always say when we’re talking to Asian dealers and distributors we say, “Look, you go to China, for example, or Hong Kong, or Tokyo, and every 20 feet there’s a foot massage place, or a reflexology place. You guys know the value of the foot. Why are you letting these big western companies try to convince you otherwise?” And then go, “Yeah.”
Kathleen McDonough:
Yeah, it’s all good.
Steven Sashen:
Well, backing to up to kind of where you got to, we’ll talk about the problems of stretching in a moment. Talk about the Pilates piece of this puzzle, and how that applies today because most people think of Pilates as what Hollywood actresses do if they can’t actually work out.
Kathleen McDonough:
Joseph Pilates was a man, right? He was a human being and he was born in the late 1800s. He was born in Germany he’s a German, and his family was sort of involved in the movement in Germany at the time of physical culture. They had a gym and he and his brother were models that would pose as human Greek statues. He was a self-taught fan of anatomy. He was somewhat sickly as a child and made fun of for that. And so he started developing a series of exercises. Interestingly, he interned at a camp for enemy combatants in England because he was living in England at the time during World War I. And he had a lot of people with a not to do that he got to practice on. He was sort of a Jack LaLanne of his time, to do his exercises with. And then he had bedsprings that he could innovate. And instead of using his body for resistance he could use the bedsprings for resistance.
Steven Sashen:
Oh, wow.
Kathleen McDonough:
His claim to fame, well, his claim was that during the pandemic of 1918 and 1919, that nobody got sick in his camp, and that it was because they did his series of exercises. Whether or not that’s true I don’t know, but it’s a good story.
Steven Sashen:
Well, no, it’s because they were all in his gym and they never dealt with anybody else who actually got sick. Yes, it was inadvertent social distancing.
Kathleen McDonough:
Exactly. We’re on an island here, but he developed this series of exercises that he called Contrology, and said that if you have a sound mind housed within a sound body, and your body would do what your brain told it to do that you would be at peace with yourself, and you would feel good spiritually. And if I did that that would be good, and if you did that that would be good, and if the whole world did that we would have world peace. That was his vision. He was a big thinker, right? And that was a big vision of world peace through feeling good in your body, right? Which is remarkable. Clearly, he had studied some Eastern movement philosophies as well, but that was kind of where it came from.
One of the things that he knew way back when, I mean, most of what he wrote in his book Return to Life, 19, I should know this, ’35, ’41, something back in there. There are things that he purports in that. It’s a little book. It’s cheap. It has all the mat exercises in it without any modifications, so it’s not an easy pick up and go through them and do them all, but in the introduction one of the things he really talks about is health, whole body health, and he really believed that we were not meant to statically stretch. That dynamic stretching was really what it’s all about, and now we know through modern science it’s caught up to what he knew intuitively watching the way the body moved.
Part of how he developed his method was studying the way animals moved in the wild. And so if you think about how a natural human animal would move we would not wear shoes. We might wear something to keep our feet warm if we were in the snow, or something like that, but we wouldn’t wear an arch support, a padded heel, all that kind of stuff, right? And we would be climbing trees, and we would be walking on unstable surfaces, and walking over logs, and doing all kinds of things that a natural human body would do. We don’t that stuff these days, right?
He was the crazy inventor, and a lot of people are familiar with the Pilates reformer, or some of the other pieces of apparatus, but there are many smaller pieces of apparatus that he developed like the foot corrector, and the toe corrector. And the chair, the Wunda chair, which everybody could have at home, and flip it over, and it becomes a piece of exercise equipment that you can do dynamic stretching as well. It’s a strengthening, it’s a whole body exercise, but it is dynamic stretching is built into that.
Steven Sashen:
So can you explain for lay humans, if you will, what the difference is between static stretching and dynamic stretching, and even more what I often start these podcasts with, and we didn’t do it is something that people can experience as well. So any sort of movement thing so they can get a flavor. So do the kind of distinction between them, and then if you can give somebody something so they can feel that distinction that would be awesome.
Kathleen McDonough:
Static stretching we think of as you put your foot up on something, and you hang out there, and you stretch it. You feel a stretch in your hamstrings, and you hang out there for a minute to two minutes, and you wait for this elastic deformation of tissues to happen, right? That you’re going to actually deform and lengthen the tissues. You’re going to overcome the stretch reflex, and you’re going to end up with a longer piece of meat, and its connection to the bones.
Steven Sashen:
I don’t know if that’s a better book title, or a band title, longer piece of meat.
Kathleen McDonough:
I don’t think we should. That’s a different podcast, right?
Steven Sashen:
Well, no, I was not thinking that when I said that, but then as soon as it came out of my mouth, I went, ah, this is not good, but it was too late to cut it, so anyway, all right, so that’s static stretching. And look, I’m getting flashbacks to my gymnast days when I was in high school where I would just spend the entire evening watching TV working on the splits.
Kathleen McDonough:
Yeah, or I remember when I was working at Saint Mary’s Spine Center back in the ’80s and ’90s, 25% of my clientele might be guys in their 20s, 30s, 40s that came in with back pain with very tight hamstrings, and so I would show them how to stretch their hamstrings by lying on the floor, and putting one leg up on the door jamb with your tailbone down and hanging out there.
Steven Sashen:
Right.
Kathleen McDonough:
I would do it with them. So I was stretching my hamstrings four or five times a day. Do you think my hamstrings ever got any longer? Never, never. Thankfully, I can stretch, and then I’d go run or workout, or something, and they tighten back up again. So I will say that I do for my clients that come in that are kind of pathologically tight I might include a static stretch, but I always include a dynamic stretch.
The difference being that a dynamic stretch we’re not just trying to passively lay the leg up there and get it to lengthen. We’re inviting the hamstrings to lengthen by activating the antagonist. So by using the muscles on the other side you are going to reflexively inhibit the muscles that you’re trying to stretch. You could think of if you’re trying to lengthen your hamstrings, which are hip extensors and knee flexors you’re going to use knee extensors and hip flexors, right? And there are lots of great ways to do that.
For example, there’s a Pilates exercise called side kicks. So you lie on your side. You pick up the top leg, and you’re going to swing it to the front, and then swing it to the back, and you’re stabilizing your trunk from your hips to your head, really, by co-contraction of the core, transverse abdominis, multifidus pelvic floor, lots of other stuff thrown in there, but you’re allowing the leg to swing to the front, and then swing to the back actively pulling it to the front, and then actively pulling it to the back, right? That’s great, but if you’re going out for a run how do you do that unless you get to your home, and then you get in your car, and you drive and go to whatever, and maybe you’ve tightened up by then, right?
So you can stand on a step if you’ve got it, or on a curb, and hang onto maybe the stop sign for balance. Get yourself nice and tall. Zip your belly muscles up a bit, and swing your leg to the front, and then swing your leg to the back, right? So you are actively doing a dynamic stretch for hamstrings, and also for hip flexors, which, by the way, can be a big problem. Tight hip flexors most of us have because we sit too dang much, and if you were trying to run, and run with a more natural style, and you have tight hip flexors that’s a big problem. There’s an example of a dynamic stretch that you can do before and a little bit after your run when you’re warmed up.
Steven Sashen:
You reminded me of two things back, again, thinking of when I was sitting on the ground trying to stretch in the splits. The other thing that I was working a lot is an important move for gymnastics. Well, there’s different ways of thinking about it, but imagine you’re sitting on the ground straddled, and then you put your hands between your legs, and just lift yourself up off the ground. So you need to have the flexibility for doing that, but you also have to have the strength. Your quads are pulling your legs up to do that. So I used to do that, too. I’d be sitting in that position and just lift up. And, of course, like you said, by strengthening the quads it allowed the hamstrings to relax, and quote-unquote, stretch from doing that.
There are a couple of body builders that I know of who are super, super flexible because they’re super strong, and they’ve gotten good at relaxing the other muscles. So body builders who do the splits, who do all these things. And there are a couple of people there’s another Xero Hero friend of ours he calls himself Jujimufu is Jon Call, and Jon is famous for being on America’s Got Talent, and doing the splits between two chairs while holding Heidi over his head. And Jon and a couple of other people who when they try to teach you about how to do the splits part of their teaching is strength for the quads and the hip flexors so that you actually can pull your legs into that position, which is another variation of a theme. It’s interesting because I was flexible doing leg swings like that never really did anything to me because I can get my leg way up, and way back, but for many people that’s a big deal to learn to relax things in one direction, then to relax the other things in the opposite direction.
Kathleen McDonough:
Right. And for those people that are really flexible, so gymnasts, figure skaters, dancers their issue is not flexibility. Their issue is often stability so how can you not over compress your joints? And how can you find the stability in maybe your trunk to be able to then move within your flexibility, and not abuse the flexibility that you’ve got?
Steven Sashen:
When we think about stretching we think about flexibility. It’s so perfect that you picked hamstring because that’s sort of like the yardstick for flexibility according to most people. What other ways do you see that people may need to work on some kind of flexibility and have some dynamic experience of that whether they’re runners, or office monkeys?
Kathleen McDonough:
One big problem that I see, also, besides us sitting and having tight hip flexors is being limited in dorsiflexion, in ankle dorsiflexion.
Steven Sashen:
Tell people what that is.
Kathleen McDonough:
Actually, hang on. I’m going to grab my bony friend here.
Steven Sashen:
Oh, wait, if you’re going to grab your bony foot, I’ll see you and grab my bony foot. I’m waiting for your bony foot. For people who aren’t watching I have a skeletal model of a foot here. Oh, you got a whole skeleton model. Oh, man. I just got a foot. You got the real deal. By the way, wait, hold on, I got to tell you this. My dad was a dentist, and when he was in dental school back in whenever that was in the ’50s, I don’t know how it was, but he had a human skull that they had made little windows so you could see the sinus. For whatever reason he got this in dental school. That was my show and tell object until I was 12 bringing in a human skull.
Kathleen McDonough:
When we run, when we walk or run, you need to be able to move the shin bones forward over the talus, right? So this has to happen. I’m kind of a joint head when it comes to what’s going on I kind of defer to the joints first. That’s just me. It’s not like it’s better or anything. So I always look to see how much range of motion and you should be able to get with the ankle in subtalar neutral so I can feel in position that ankle neutral you should be able to get on the other side of 90 degrees, right?
Steven Sashen:
For people who aren’t watching I’m going to try and give them an image in their mind, and you tell me if you want to correct it. So let’s say you’re sitting on the ground, for example, your feet are flat on the ground and you make sure that your shin bones are basically vertical. At the very least you should be able to lift your foot keeping your heel on the ground lift your toes towards your knees some amount.
Kathleen McDonough:
Yeah, exactly, or that if you were in a roller chair if you’re on a stool with wheels, and you start out in that position you just described you should be able to roll forward, and your shin bones can move forward over your ankle, right?
Steven Sashen:
Yep.
Kathleen McDonough:
That’s required for running. That’s required for walking. If you don’t have that then you are going to do a couple of things. You’ll toe out and pronate over your arch, or you’ll pick up your foot too soon. Those are two typical things, and none of those are good for your running style, right? Or for walking for that matter. So the length of the calf and the Achilles, so that whole gastroc soleus plantaris Achilles into the arch of the foot the plantar fascia all the way through great toe extension. You need all of that to be able to run with decent form, right? With good movement and good use of your foot and your leg all the way up.
Steven Sashen:
I want to address a point that you made that relates to this. You were saying your story that luckily for you, you already had strong flexible feet. There have been a couple of articles that came out lately suggesting that strong flexible feet was a prerequisite for natural movement, natural running, barefoot running, and this was something that actually happened around 2010 as well as people were trying to, I think, establish themselves as experts in the field of natural movement. They were saying here’s the things you need to be able to do in order to accomplish this thing of running barefoot. Most of those things I couldn’t do for whatever reason some of which I have a compromised spine. Some of which, whatever, but even with the new article saying people who are in this situation are better equipped to make the transition, but what they leave out is the phenomenon that just making the transition intelligently you can build that strength and that flexibility naturally.
So the idea that it’s a prerequisite is one that I think, again, a lot of hand-waving. A lot of people who think that, well, let’s say there are some people who are totally against this whole idea, and there’s some people who want to find a middle ground. It’s kind of like in 2011, or so, when a number of companies came out with what they referred to as transition shoes that were just a little lower heel rise, and it was all marketing. There was no evidence that that worked. In fact, Irene Davis at Harvard, her research shows that those transition shoes are the worst things you could possibly wear. Can we talk about just the phenomenon of that amount of movement, the strength and flexibility that you do need in the foot and ankle, and the development of it not necessarily as a prerequisite, but certainly let’s say as kind of hand-in-hand like a push-me-pull-you.
Kathleen McDonough:
I think of it a bit more as a prerequisite, but probably because of the clientele that I see, but you just have to think, all right, what’s going to make the safest experience for you? What’s going to be least likely to give you any trouble?
Steven Sashen:
I’m going to interrupt really quick. I mean, Irene Davis would agree with you, I think, more than I, which is that she thinks walking and strengthening is a prerequisite, and I would say if you just start small enough same thing. No amount of strengthening that you’re going to do that’s going to replicate that.
Kathleen McDonough:
I see people that have plantar fasciitis that can’t walk in their own house barefoot, right? So it’s like, okay, that’s a problem, right?
Steven Sashen:
Yeah.
Kathleen McDonough:
So that’s kind of the far end of the spectrum. I love Irene Davis. I love Irene Davis. Irene, I love you. I’ve been at conferences that she’s spoken at, and I brought a couple of Joe’s inventions with me, so the foot corrector.
Steven Sashen:
I was going to ask you about that. Wait, hold on, let me see that thing.
Kathleen McDonough:
The foot corrector.
Steven Sashen:
What the hell?
Kathleen McDonough:
I could show you how it works, but this is dynamic stretching and strengthening all in one package. And sometimes they look flat. This one is elevated and I like that one better, and then the toe gizmo.
Steven Sashen:
The toe gizmo.
Kathleen McDonough:
He was an inventive guy.
Steven Sashen:
Yeah.
Kathleen McDonough:
So during one of the breaks I went up and I said, “Irene, hey, Irene, I love this stuff.” And she’s all about the foot.
Steven Sashen:
Right.
Kathleen McDonough:
Chris Powers is all about the hip.
Steven Sashen:
Right.
Kathleen McDonough:
Bryan Heiderscheit at Wisconsin is like it doesn’t matter just change the cadence and everything will get better, right?
Steven Sashen:
Bryan will argue that that’s not what he says. I will argue back that that’s exactly what you say. I adore Bryan. He’s probably right. This is interesting because like for Bryan if you do pick up your cadence that’s usually going to lead to a number of corrections pretty naturally, but not entirely. And then for Chris, yeah, if you lean a little more that will make a little bit, but Irene, I mean, she just dives in deep.
Kathleen McDonough:
So I went up during one of the breaks, and I was like, “Irene, have you ever seen Joe’s?” And then Bryan was like, “What’s that?” And so I had them take off their shoes. Come on let’s try it. And they’re like, “That’s really cool. I’ve never seen that before.” So some other things that can be done. Do you want to see how they work?
Steven Sashen:
Yeah. And, again, we’re going to describe this for people who are listening and not watching. So the toe gizmo, you got to hold that up again so I can try to describe that to people. Oh, man, how am I going to describe this? So we have two loops that look like they’re leather, or something, that are connected with a spring. And then there’s some other kind of I’m not going to do it enough. Let’s just say it’s two loops that are connected with a spring.
Kathleen McDonough:
Yeah, and I will tell you that my home version of this game is this.
Steven Sashen:
A rubber band, oh, you got to be kidding.
Kathleen McDonough:
Right. I don’t have a broccoli band, but I usually use a broccoli band. So you can fake this with a broccoli band.
Steven Sashen:
All right. A big thick rubber band so the Pilates toe gizmo version is a high-tech version of a rubber band.
Kathleen McDonough:
Yes.
Steven Sashen:
Okay.
Kathleen McDonough:
So I’m going to try and point this so that you can see my feet. I would not be doing this lying down, so you can see me.
Steven Sashen:
All right. So we’re going to loop the loops around your big toes. You got a spring between your big toes.
Kathleen McDonough:
Can you see that okay?
Steven Sashen:
Yeah, I can.
Kathleen McDonough:
All right, so I would be on the floor probably. And I’m going to try and contact I think about the four points of the feet. Some people who have more of a yoga background think about three points, but the base of the big toe, the base of the pinky toe, and the inner and the outer heel, and I’m going to have equal contact reaching down into the ground with those points, and then I’m going to lift, dynamically lift my arch, so I’m going to dome the foot. Another one of my favorite exercises.
Steven Sashen:
Okay, so wait. I’m going to break this down. So for most people, and again, if you’re doing this with a rubber band go get a rubber band. Try this if you have one. So you’d be doing this standing. You want to, again, balanced along your feet so you’re feeling equal weight underneath the ball of your big foot, big toe, little toe, and both sides of your heel, and then this doming thing it’s really like an asymmetric thing where you’re almost trying to squeeze and shorten the distance between the ball of your big toe, and your heel, so you’re pulling up, but you want to do it without squeezing your toes. You’re trying to just create more arch by just squeezing.
By the way, if you’re standing, I don’t know if you do this, but I’m going to toss this out there. One thing that can often help for a lot of people is tighten your glutes, is engage your glutes because if you do that that tries to make your whole leg turn out a tiny bit because your glutes do that, and if your feet are planted they won’t turn, but that will also kind of create a little bit of an arch.
Kathleen McDonough:
Yeah, so can I add to that because sometimes we tell people to squeeze their glutes, and PTs say this kind of thing all the time, squeeze your glutes. That does not mean squeezing your butt cheeks together, and clenching, right? It is activating your femurs to wrap into the back of the socket, right? And that when you lift the arch of the foot and that line continues up through the legs the femurs will externally rotate a bit, and your inner thighs will turn on. Your adductor longus is going to work a little bit to help do that, which it almost functions like a hamstring in hip extension. Your pelvic floor is going to turn on. Your transverse abdominis is going to lift. You’re going to activate from the feet up. You get to decompress your whole body and be taller and lighter on your feet, right? And sometimes this is hard for people to do standing so they can do it sitting, too.
Steven Sashen:
Okay, so that was a bit of a detour from you got the rubber band around your feet. Your feet are well-planted. You’re doming. You’re trying to create that arch, all right, and now?
Kathleen McDonough:
I try to think about doming as coming also from the pinky side, so big toe and pinky side trying to shorten towards the heel because we have a lateral longitudinal arch as well as a medial arch. It’s lower and it’s shorter, but it’s there as well, right? If you wanted to really split hairs we could also talk about the transverse arch and trying to lift part of some of it. So now I’m going to pick all 10 toes up, and I’m going to try and spread that spring apart.
And this guy does not move a whole heck of a lot. It’s a pretty firm one. There are other ones that are a little bit more and the spring is not as tight. I know some people that don’t like this device because it abducts the big toe a bit, right? So if you have a bunion is that going to increase the bunion? I would say, no, you’re trying to activate all the muscles around there, and spread all of the toes out. So some of the intrinsic muscles in the feet spread out the metatarsals, and some of them pull the metatarsals together, right? So we are trying to find all the muscles that can spread my foot instead of my foot being squished into a narrow shoe, right?
Steven Sashen:
Got it.
Kathleen McDonough:
So then take it and loop that rubber band around the second toe and the big toe spread it out. And with the third toe and the big toe. So it’s just playing with your feet, right? Our feet can actually do everything that our hand can do except opposition. We can dome the foot. When you think about the things we can do with our hand we can do those things with our feet we just don’t it, right?
Steven Sashen:
Yeah. It’s funny, I was talking to someone who runs USA Archery, the Olympic archery team. And she was talking about the paralympic team, and that there’s a couple of archers on the team, or actually maybe just one, who has no arms, and so holds the bow with his foot. I think he actually might hold the string, might pull it a bit with his foot, or he might pull it in his teeth I don’t remember, but either way.
Kathleen McDonough:
Wow.
Steven Sashen:
I’ve seen, well, anyone whose America’s Got Talent has seen a contortionist take a bow and arrow and shoot with their feet. So there’s all these things we can do. I’ve seen people with their feet. And everyone always views that and they go, it’s amazing that they do that. It’s like, no, no, you could do that too. They just have that.
Kathleen McDonough:
Exactly. Okay, so do you want me to show you the foot corrector?
Steven Sashen:
Yeah. The foot corrector.
Kathleen McDonough:
This we definitely do in standing, and so I’m going to stand on a table. I’m going to get a pole so I don’t make a fool of myself and fall down.
Steven Sashen:
So a foot corrector for those of you who are not watching, basically, there’s like a piece of wood that’s kind of foot shaped-ish. And then there’s like imagine near the inside of your foot and the outside of your foot there are two posts coming up with springs on them, and then in between them is a curved piece of metal. All right, I’m seeing where this is going. It’s like maybe the posts are maybe three inches high. So if you put your heel on the piece of wood on the back the ball of your foot your toes go over that curved piece of metal, and you can squeeze it down with a spring so you’re pushing that curved piece down. I’m doing a horrible job. Just go watch the damn video. Do you want to say more about it, or what you’re doing?
Kathleen McDonough:
The thing on top, actually the holes are elongated they’re not round so I can, actually, I’m not just pushing on it. It’s not an accelerator pedal, right? I’m pulling my toes around this saddle thing. I’m compressing it, and I’m trying to pull it towards my heel. Let it go and stretch out. Here’s the dynamic stretch, right? Then I’m going to curl around and pull it. And we do this in a couple different positions. Now I’m more on the arch of my foot, and trying to do it with more of my arch. I broke my toe about three weeks ago, and I haven’t been doing this, and it’s like, wow, I should do this.
Steven Sashen:
You know, barber’s child.
Kathleen McDonough:
And then we can put it the other way, and I put the ball of my foot on the surface, and my heel is up on the saddle now. Again, I’m not stomping down with my leg power. I’m trying to pull the heel to the ball of the foot.
Steven Sashen:
I love it.
Kathleen McDonough:
And shorten the arch of my foot lengthening my Achilles as I do this, right? Not much, but certainly using some muscles to pull through the arch to lengthen that Achilles. Now it doesn’t stop in the foot it goes clear up. I’m organized in my other leg, my standing leg, and zipped up, and leaned into the wind a little bit so that I can feel if this is a whole body experience, right?
Steven Sashen:
Got it.
Kathleen McDonough:
That’s that.
Steven Sashen:
Very cool. Do you know about the research that Sarah Ridge did about foot strengthening and walking in minimalist footwear?
Kathleen McDonough:
Not off the top of my head.
Steven Sashen:
So the research was taking people who had a foot exercise program, one that Irene developed, actually, and then comparing those to people who just walked in minimalist shoes. And what the study showed is that people who just walked in minimalist shoes got the same benefits, same strengthening as if they did an exercise program. I asked her, she was on the podcast, and I asked her, but I can’t remember, what devices they used to measure foot strength. And they had come up with some very clever things that you’ll have to reach out to her and find out because they were super interesting. Not quite like those, which these are even more interesting because they’re very specifically about really working that arch. I don’t remember how much overlap that would be with Sarah’s, but take a look you’ll get a kick out of it.
Kathleen McDonough:
I know Irene has talked about teaching short foot exercise for sure.
Steven Sashen:
Correct, but there’s more to it because they had to actually measure foot strength. I mean, what they did was they did ultrasound and measured the diameter of intrinsic foot muscles, but they also, actually, had a number of foot strengthening devices that they had developed.
Kathleen McDonough:
I just have to put in a plug for physical therapists that do manual therapy because that population that they probably studied was probably a well population they were probably students that were younger, and didn’t have pathologies, or have injuries. So sometimes we need a little help. If you have a tight dorsiflexion and you’re trying to stretch, and trying to stretch, but really the tightness is in that joint you need manual therapists to get in there and mobilize it, so our body has physiologic movement that it can produce, but it also has accessory movement, little glides that happen biomechanically at the joint level that we cannot do with volition, right? So sometimes we need somebody to get in there. This is why I’m going to have really ugly hands when I’m an old lady. Get in there and work the joint a little bit, and then I have people actively move after doing that.
Steven Sashen:
Well, you’re moving the joint. I will never forget the day that I met our friend, Dr. James Stoxen, who calls himself the Barefoot Doctor sometimes, and he’s working on my foot, and he mobilizes this joint in that first ray, that big toe area, and popped that joint like when you crack your knuckles in your hand. And I thought he broke my damn foot. I didn’t know there was a joint there. I had never seen an actual skeletal model of a foot. Scared the crap out of me. Now it’s something I do on a regular basis, but every now and then, especially as a sprinter, I can just tell something is out of whack with all of those bones and joints in my foot, and there’s one person I go to and go, “Can you just pop all of those and get those back in place?”
Kathleen McDonough:
Exactly.
Steven Sashen:
And it’s like, oh, my God, that’s so dreamy, and most people don’t know to do that.
Kathleen McDonough:
Yeah. Before I switched to minimal shoes I used to feel like I wanted somebody to grab my foot and pop it that way like, kids, can you pull on my feet because I always felt really stiff after I ran. And then I switched my shoes, and changed my running style I never have that anymore.
Steven Sashen:
I don’t get it very often, but the thing with sprinting in particular, I mean, it’s just a lot of force, and just every now and then you put your foot in a weird position, or you do something, and just things get a little out of whack. And the exact feeling it’s like can you just grab and just give a yank on my foot, and it’s like, oh, God, so nice. I think my wife only wants me because I can crack her back. That and the hair. She likes the hair, but I think that’s it. I think those are the only two things. Oh, and I can cook. Those three things. Nobody expects the Spanish Inquisition.
Steven Sashen:
If you were going to give people, oh, boy, where do you even begin on this question. I’m just trying to think of the people who come to you why they come to you, how they have discovered that you are a person to go to? And for people who can’t necessarily come to see you there’s not a lot of people who have eyes to see is one way of putting it. People will go to a physical therapist who doesn’t understand natural movement, who doesn’t understand much of what we’re talking about. What is it that gets people to come to you? And if they can’t come to you what would you recommend someone do if they’re trying to find someone to work with, or something to do, whether it’s a program you’ve developed, or if they need to find someone locally, et cetera?
Kathleen McDonough:
That’s a great question. I think that why people come to see me is my background in Pilates, and that’s more whole body approach. I got to say that the early part of my career when I did some Pilates that I hadn’t really committed to learning the method, and doing a comprehensive teacher training program from soup to nuts, which I did at age 50, and you have to perform all of the exercises like Cirque du Soleil land stuff, so going from being stiffer to having to do all that was a very eye-opening experience, and body-opening experience for sure, but it changed my attitude from seeing what people couldn’t do as a physical therapist and thinking about, oh, that’s unsafe. Oh, that’s dangerous. Oh, you shouldn’t do that. Oh, we have take that out of your routine for a while, which there’s value in that, but it shifted my perspective to the potentially human body and what it could do.
I think that putting those things together is a really good thing to look for in a physical therapist, really any movement, any sort of body practitioner how do you look at the body as a whole structure, and how does it work together? It’s not just a part here, and a part there, and, oh, you’ve got knee pain, so we’re going to tape your knee, or we’re going to treat your knee. It’s like why do have knee pain? You probably have something wrong with your hip, or your foot, or your core strength.
So I would look for somebody, I’m a big fan of the Pilates method, and so I would say that, or the other thing is if you are just interested, and you’re not having pain that would necessitate seeing a medical professional see a movement practitioner like a Pilates teacher who is comprehensively trained in all these not just that I certified to mat, but the whole thing, and get some good work on your feet if you’re curious about what that could do for your running, for how you feel at the end of the day, whatever. Dive deep and go to somebody who actually knows what they’re talking about that’s been through a comprehensive teacher training program and is nationally certified.
Steven Sashen:
Well, look, let’s do the similar thing. Most people who either know of Pilates, or certainly do Pilates, or teach Pilates, most people who know of it don’t think of it in the same breath as physical therapy they don’t think of that. And most of the Pilates people that I have known over the years, and in Boulder, I think they all are. My line about Boulder is you can’t throw a tantrum without hitting a therapist physical and mental wise, but I mean, most of the Pilates people I know they kind of stop at your ankles. They don’t really pay attention to the feet, and most physical therapists that I know same thing. They won’t stop at your feet, but when they get to your feet they want to immobilize them. These are things to ask like what do you do for mobilizing and strengthening your feet? How do you view the foot as the foundation, and what do you do with that? What other questions do you think somebody might want to ask to try to suss out whether they’re finding a practitioner who could be useful?
Kathleen McDonough:
Boy, I don’t know if I could answer that.
Steven Sashen:
A little pondering, but it just popped into my head, but I knew I might knew it might be a bumper.
Kathleen McDonough:
Yeah, there’s so much information you can get about a person.
Steven Sashen:
Here’s one for the fun of it. I’m not sure what the question is, but I’m going to go back to the very first thing you said when you went to that Chi Running thing at the running shoe store. I was at an event at a physical therapy office in the early days 2000, it was after we started the company so 2009, 2010, where same thing. I mean, there were some people who were like you’ve got to wear big thick padded shoes, and the other people who were the exact opposite. And there was one physical therapist who said it could take you years until you develop the strength to be able to run barefoot. Finally, it hit me, and I asked the panel. I was not on the panel. How many of you have ever run fully barefoot for at least a mile on a road on concrete, or a road? And the only person in the room who raised their hand was me, and I was a sprinter. I mean, I don’t like doing that. I mean, I did when I went barefoot, but not my natural habitat, if you will.
And I said, “You guys are all talking out of your butt. You’re all just making up theories based on your existing repertoire of information, but you don’t have any experience to back this up. And I can tell you those of you who are saying it’s going to take two years complete lie. You’re completely full of it. And those of you who are saying you need these things.”
Kathleen McDonough:
Why tell people that?
Steven Sashen:
I can tell you why. Because they were, A, afraid that, again, everyone was going to leave because the early days of the barefoot running movement it was promoted as a panacea and a cure for all things, and so they were terrified that everyone was just going to leave. Imagine if everybody, this is going to sound funny. Back in the late 1800s a coke addicted doctor in Vienna came up with the idea that you have problems because of things that happened to you as a child, aka, Sigmund Freud. That was an interesting theory. There was no evidence behind it, and there’s still no evidence behind it because you could have two people who grew up in the exact environment who have a completely different psychological experience. So, imagine, if everyone lost the ability to believe the idea that their current things they were dealing with were, A, problems caused by something that happened to them as a child. If that happened suddenly there would be a large number of therapists would be out of a job.
Same thing. If we teach people how to build foot and ankle strength, and learned to have a strong foundation, or as Irene Davis says, if we got kids just wearing minimalist footwear in 20 years we wouldn’t have to treat them for the problems that now adults spend billions of dollars dealing with, so. I saw a lot of people who were terrified they were going to lose their income, and they were trying to come up with a way of transitioning so they were still useful during this process despite the fact that they weren’t useful during this process. That’s the way it looked. So the point being is another question may be what kind of barefoot training do you do? What kind of shoes are you wearing? Boy, that’s one.
Steven Sashen:
There’s a physical therapy office right across the street from where I work. Where I work, for my company, and when I had my shoulder surgery a couple of years ago I went to them they know what I do. They were interested in what I do. They were all wearing big thick padded motion control shoes. And so I wouldn’t touch them with a 10 foot pole for anything other than, hey, I got to work on my post surgical shoulder stuff. And it was fascinating they agreed with me about everything, and to this day, three years later, have not walked the 100 yards to come over and try on a pair of sh
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