Lessons from the FIRST and ORIGINAL Barefoot Doctor
Dr. James Stoxen DC., FSSEMM (hon) is the president of Team Doctors®, Treatment and Training Center Chicago, one of the most recognized treatment centers in the world.
Dr. Stoxen is a #1 International Bestselling Author of the book, The Human Spring Approach to Thoracic Outlet Syndrome. He has lectured at more than 15 medical conferences on his Human Spring Approach to Thoracic Outlet Syndrome, 7 lectures where he was the keynote speaker. Editors from over 30 peer review medical journals have asked Dr. Stoxen to publish his research on The Human Spring Approach to thoracic outlet syndrome specifically. Dr. Stoxen’s publishing company, Masters Academy Publishing published the book which is a #1 best seller in 8 countries.
He has been asked to submit his other research on the human spring approach to treatment, training and prevention in over 250 peer review medical journals. He serves as the Editor-in-Chief of the Journal of Orthopedic Science and Research and the Editor-in-Chief of the Journal of Dermatology and Aging. He is the Executive Editor or the Journal of Trauma and Acute Care, Chief Editor, Advances in Orthopedics and Sports Medicine Journal and editorial board for over 40 peer review medical journals.
Listen to this episode of The MOVEMENT Movement with Dr. James Stoxen about being the first and original doctor barefoot doctor.
Here are some of the beneficial topics covered on this week’s show:
– How your feet protect against impacts, recycle energy, and open spaces for joints and tunnels in the body.
– Why incorrect stretching practices can lead to injuries especially for the neck and ribcage.
– How physical therapists and trainers must have a deep knowledge of the body and movement to provide effective care.
– Why understanding muscles, joints, biomechanics, and physiology is crucial to address chronic pain effectively.
– How overpronation can lead to various lower-body issues and injuries.
Connect with Dr. Stoxen:
Guest Contact Info
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@vibeassage
Facebook
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Links Mentioned:
teamdoctorsusa.com
Connect with Steven:
Website
Xeroshoes.com
Twitter
@XeroShoes
Instagram
@xeroshoes
Facebook
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Episode Transcript
Steven Sashen:
Many people think this whole barefoot idea is a fad that only started very recently, and many people think that it started around 2009, with the book Born to Run. Well, we’re going to talk to someone today who predates that by a long shot. He’s the original Barefoot Doctor, and you’re going to be blown away by the things that he was doing before people even knew this was a thing. That’s today’s episode of The Movement Movement, the podcast for people who want to know the truth about what it takes to have a happy, healthy, strong body, typically starting feet first, those things at the end of your legs that are your foundation.
On this podcast, we break down the propaganda, the mythology, sometimes the outright lies you’ve been told about what it takes to run, walk, play, do yoga, crossfit, whatever it is you like to do, and do that enjoyably, effectively, efficiently. Did I say enjoyably? Wait, I know I did. It’s a trick question, because look, if you’re not having a good time, you’re not going to keep it up, so find something you like to do. I am Steven Sashen, co-founder, co-CEO of Zero Shoes, and we call this the Movement Movement Podcast because we’re creating a movement about natural movement, letting your body do what it’s made to do. The movement part involves you, and it’s really simple. Just spread the word.
You know how that works. You can go to our website, www.jointhemovementmovement.com. There’s nothing you have to join, actually, that’s just the URL we got. There’s no secret handshake, there’s no song you have to sing, but that’s where you’ll find previous episodes of the podcast, you’ll find all the ways you can find us on social media, all the places you can give us a review, and a thumbs up, and like, and hit the bell icon on YouTube, to make sure you hear about future episodes. Subscribe to get future episodes. You know the gist, if you want to be part of the tribe, just subscribe. I’m really looking forward to this, and let’s get started. Dr. James Stoxen, A, welcome. B, tell people who the hell you are, and what you’re doing here.
Dr. James Stoxen:
Well, for your viewers, I’m the barefoot running doctor from way back. There’s a lot that I’ve done over the course of the last 37 years, but I think one of the things that matches what your viewers are looking for, is that I started training my athletes barefoot in 2000, I think. We’re talking about what, 23 years ago?
Steven Sashen:
Yeah. Backing up a little bit, describe what you were doing prior to that, and how you got hip to this idea to begin with.
Dr. James Stoxen:
Okay. Well, I think it goes way back to the beginning. When I first got out of practice, I just got lucky. I’m 24 years old, I’m a licensed doctor, chiropractor at 24, and in walks Ed Coan. If anyone knows powerlifting, you know Ed Coan. God is good, you know?
Steven Sashen:
For people who don’t, pause there. Describe Ed in a couple of sentences. Ed is a miracle, but say something about who Ed is for people who don’t know, in a way that’s going to make them go ooh and ah.
Dr. James Stoxen:
Well, here’s an example. When you have a powerlifting meet, you have two days. One day for the lightweights and the heavyweights. The heavyweights, they add weight each time they go up. As you get to heavier weight when they’re doing their lifts, let’s say a guy who’s 6’7″, 300 pounds, 12% body fat, who was a linebacker for some football team, competitive powerlifting, squatting 800. When you see a giant like that, everybody’s like, “Oh, my God. Look at how huge he is. And that weight, as the bar is bending,” and everybody’s going crazy, “Oh!” The last lifter is Ed Coan. So the previous lift was the 800, and you’ve got this guy who walks up that’s five foot six.
Steven Sashen:
No, no, no. Ed was shorter than that. It was five-four.
Dr. James Stoxen:
Actually, we’ll give him five-six.
Steven Sashen:
Okay.
Dr. James Stoxen:
Ed walks up, five-foot-six and 220, and the weight classes go to 280 and 300 open. You could be as big as life gives you, just massive human beings with chests are literally this big. Ed walks up at 220, five-foot-six, and they rack the bar with 920 on his opening lift. When I was a fresh graduate, I went to the World Championships, and I’m thinking… He took his shirt off and I said, “What is that?” He goes, “Oh, the bruises.” I said, “Yeah.” Because I don’t go to the gym with him, he comes to the office. I said, “What is that?” He goes, “Oh, those are just my blood vessels exploding with this pressure on my body with the 960. Then his second lift, he goes up with 965 in the squat.
I don’t know if you’ve ever seen 965 pounds, but I mean you can’t even push it across the ground. It’s a massive amount of weight. And you’ve got six guys, three on either side, that are about 300 pounds spotting the actual bar, and then a guy behind him that’s probably 300 pounds, behind him just to make sure that if he missteps that they’re going to be able to pull the weight off of him. But what scared me was that I was thinking like, “Well, what if he doesn’t lift it? What if he passes out?” It’s possible, and the bar comes down on him, it would literally kill him. And also, I’m in charge of the health of this athlete, so he’s required at the World Championships to break additional records in six months because that’s what you expect from… You know, in powerlifting weightlifting, you have Nationals and Worlds, and you have to qualify.
Well, if you won the Nationals, you go to the Worlds. But every year you have to qualify for the World Championships by going to the Nationals. So Ed Coan is like the Michael Jordan of powerlifting. He broke seventy-one world records. So getting back to what we used to do is that I said, “Well, after I saw that I was like, oh my God, what am I going to do? How am I going to keep this guy healthy?” And I can’t wait for him to have an injury, because he did have injuries, that’s why he came to me.
I said, “Well, I’m going to start from the bottom, regardless if he has pain or not, at the foot. And I’m going to check every single joint of his foot, his ankle joint, his calf, his thigh, his TFL, his hamstrings, his hips, every single inch of his body, and I’m going to remove every single muscle tension from it, every single bit of inflammation from it,” so that we didn’t get to that point where he had an injury. And it worked. I mean, over the six years that we worked together, he didn’t have one single injury lifting those massive heavy weights. He was grateful. Like I said, he broke seventy-one world records, and we’re still friends after, now going on 37 years. I talk to him every day.
So that’s where it gave me the idea that lower back pain, cracking knee, TFL spasms, iliotibial band issues, chondromalacia, shin splints, plantar fasciitis, all came from the foot. So for 30-something years, every single patient that walked in the office, we did a video of their gait and analyzed their walk, and then brought these cameras to, those clunky video cameras, to the all African track and field championships. Where you’re sitting in a track in Algeria, which is kind of a rough place, Muslim country, but it’s cool. Nobody bothered us, but it was a little different, and that’s okay. But you’re on the track and you’re videotaping these incredible track athletes from Africa. There was 30 countries there from Algeria, the great runners of-
Steven Sashen:
Well, Kenya, among others.
Dr. James Stoxen:
Ethiopia and-
Steven Sashen:
Ethiopia, yeah.
Dr. James Stoxen:
And what was happening, is that as I kept applying these techniques from the foot all the way up, they would come back with the coaches and say, “Oh, what happened? He broke a personal best. What did you do? What did you do?”
And the times kept coming down drastically for these athletes, right on the spot. So you would have coaches that all started to watch everything you did while you were treating, like you had an audience of 30 or 40 athletes and coaches, just watching everything that you did with the foot and with the body to see what the secret was. Because the times were just coming down at the meet by a second, or a tenth of a second, or two-tenths of a second, which doesn’t happen. And so when that happened, I knew we had something going because of course Ed, we don’t know whether it’s a stretching or what we’re doing, if he’s just really not injury-prone. But we knew he was doing well. But when these things happened at the track and field championships, just before the Olympic games in 1988, I knew that this human spring concept was really fantastic.
It was breakthrough. So that’s when we did it with every patient. Herniated discs, chondromalacia like I had mentioned, and reset the entire spring mechanism of the body from the bottom. And then trained everyone barefoot in the gym to develop a stronger foundation, to allow the athlete, or the patient, to bounce off the ground instead of banging into the ground. You get that? It’s like, “Okay, we’re going to bounce off the ground, or spring off the ground, when we walk instead of banging into the ground and twisting off the ground,” causing all kinds of compression disorders and accumulation of inflammation and muscle tension from the feedback loop of the inflammation, and just the entire body just squeezing down. And of course, when you have muscle tension anywhere in a spring system, a body frame, the first thing you’re going to have is drag on the frame.
So you’re going to have slower speeds. You’re going to have drag on the frame, which will show up for your competitive athletes on slower speeds during hundreds and two hundreds, and also distance running as well. But the other thing you’re going to find is the fatigue starts coming in, because the spring mechanism does four functions. It protects you from the impacts, which is your shin splints and the bang and twist. Number two, it recycles the energy, because if you look at the body as inverted pendulum model, which is kind of like where you reach the leg forward and land on the heel, the old heel-toe concept, and then the momentum carries you over that planted leg, which is just… It doesn’t even abide by the laws of physics.
When you try to, they said, “Okay, well walking is this inverted pendulum.” Okay, okay, I get that. Well, how do you explain running then? Well, it’s bouncing off of inverted pendulum. I’m like, “No, that’s springing.” Okay, so it’s not an inverted pendulum, it’s an integrated spring system, actually integrated spring mass. The mass is the head that teeters on this spring system, balances on the spring. So for the first thing, like I had mentioned, is protect you from the impacts. Second thing is that it allows you to recycle energy through the spring system for long distance running. And of course, whatever you put into the spring you get back. So if you’re trying to run fast, you want to load in as much energy into the spring so you get more out of it. Because when you look at simple things, like just an example would be like my finger here, if I try to hit this object with my-
Steven Sashen:
You’re going to have to describe it, because I can’t see what you’re doing. And of course, people are listening and they can’t see-
Dr. James Stoxen:
If I do this, can you see it now?
Steven Sashen:
I can see, but you want to describe it for people who are just listening,
Dr. James Stoxen:
Describe it like using with muscle. That’s as hard as I could do it. Well, when you-
Steven Sashen:
So here, let me describe what you’re doing for people. So imagine… Excuse me. Putting your hand flat on a table and lifting up your second finger, and just trying to slap that second finger down on the table. You can only apply so much force when you’re doing that. Did I get that right?
Dr. James Stoxen:
Right. And then use the spring, you can hear it.
Steven Sashen:
So the flip side is put your hand flat on the table, lift your second finger up with your other hand until it stretches, and then release, and it just springs down. So you’re using that kinetic energy, or that potential energy stored in the tendons to just be able to move faster and stronger than you could volitionally on your own.
Dr. James Stoxen:
Well this is not a video podcast then, right?
Steven Sashen:
It’s both.
Dr. James Stoxen:
Okay, got it.
All right, well the third thing, is that the spring system opens up spaces for joints and that would be your discs and your knees. And the last thing is it opens up spaces for tunnels to allow the safe passage of blood vessels and nerves. Like your shoulder is the roof of a tunnel that allows the blood vessels and nerves to go on your arm, and the rib cage is the floor. So that rib cage and that shoulder can start to compress with tension from using the cell phone too much, bad posture can start to compress the thoracic outlet. And that’s a real big problem lately because of COVID. And we have a computer in our hand all day long, we’re looking at which cranes the neck, tech neck, called thoracic outlet syndrome. If you get that, you’re kind of in big trouble, because for me, it takes me about… See, what you’re talking about is that, for instance, if you have inflammation of an area, that can be detected by nerves called nociceptor nerves, they’re kind of like a chemical receptor that can measure the amount of inflammation or toxins in the tissue.
And that’s related to the brain. If you drink too much alcohol, you have sensors in your stomach lining that can tell the brain that, “Well, he’s about to die, so we need to act very quickly to save his life.” So that becomes a dominant reflex by the way, where you’re going to vomit, and if you try not to vomit, you can’t. I mean it’s like people try, I hate vomiting, everyone does, but it’s really not possible to stop it because it’s a dominant reflex, which means that you weren’t able to handle your situation. So the brain says, “Hey, look, get out the way and let me take care of this. And you’re not getting in the way because I’m going to save your life and you’re going to vomit.” So then you have this period of time where you think that you’ve made it through, but then it’s going to take a second reading if everything settles down and you’re like, “Oh, I’m glad that’s over with.” When it takes a second reading, it’s like, “We’re not done yet,” and you vomit again.
Well, that’s a reflex that is protecting you. Just like if you have a car accident, you have some inflammation, or you run with bare feet with a locked up spring that bangs into the ground and creates inflammation of the muscles and tendons of your foot, the joints, that creates a reflex muscle action that says, “Well, things aren’t good. There’s some inflammation, so we’re going to contract the muscles of the surrounding area until he figures it out.” And that’s your stiff neck after car accident. When you limp, that’s a stiff leg. And so that’s a protective reflex. Well, the problem is that that is a contraction. And so when people get a stiff neck, these therapists, they don’t think. It’s like when in doubt stretch it out. It’s sort of like if tight muscle stretch, no. Okay, I can tighten a muscle when I do a curl. Watch me. Are you going to push it back the other way? That wouldn’t be smart.
Well, it’s the same thing. So why do people stretch muscles that are in a protective state with inflammation? And it doesn’t reduce the inflammation, so the circuit is the same. I’ve never stretched a muscle that is inflamed. We just do the deep tissue and the Vibeassage to move the inflammation out because it’s simple. It’s the trigger, and the tight muscle goes away. So this stretching thing, it’s just a lack of knowledge, it’s a lack of insight. And it’s embarrassing to see therapists on all these TikTok channels. I just cringe when they take the head and they pull it like this for a stiff neck. I’m like, “Oh, my God. You’re lifting the rib up even higher into the outlet, making it more susceptible to blockage and clot formation.” When the rib keeps rolling up into this tunnel, where the blood vessels go. And sure enough, in two or three weeks of doing that, they end up with a blood clot and you’re no longer your patient, okay? They’re in surgery.
So you have to understand, not only muscles, joints, biomechanics from a high level, but you also have to understand how physiology changes muscle tone. If you don’t, somebody can show you a video and they go like this, pulling on the neck to stretch it to the side. And then you go, “Oh, that sounds logical.” And I’m thinking, no, no. Because if you get an injury or if you have something that’s lingering, like it’s not going away, if you don’t understand it cold, a doctor can tell you anything and you have to believe them. And I will tell you the mistakes, I’m in the trenches with the worst chronic pain cases on earth. That’s all I treat. Okay. Now, I don’t do office visits, I do contracts for one week at a time where we take patients that have had 30 doctors look at them, nobody can help them, and things are getting worse and they can’t take it anymore.
And then they call me, and I say, “Okay.” We go through their symptoms, all their findings, all their X-rays. They’ve already had every test on the planet because nobody can figure it out because they don’t touch them, they scan them. So we have plenty of those scans that don’t tell you anything. And then we say, “Okay.” We give them an estimate based upon what we’ve seen before. And the estimates are coming out around five days, to get rid of severe, chronic pain. And by the way, Steven, I just sent a pitch deck to the Primus Medical Group in Bangalore, and they had a innovation award competition, and there were 134 companies that submitted pitch decks. And we made the finals on that pitch deck. Well, I would think so.
Like you’re saying, “Well, I can get rid of chronic severe, chronic pain in five to seven days.” Well, how do you do that? Well, that might be an innovation. Yeah, sure it is. We didn’t win because Johns Hopkins had an artificial arm that had already won 17 million, they won 17 million in NIH grants. And the girl who gave the pitch was brilliant, from Johns Hopkins, from India to Indian judges. So I really thought she was good. I would’ve given her the award. She was quite well… She had her pitch down. I don’t do presentations on pitch decks very often, so I need to polish up my act on that.
Steven Sashen:
You got time.
Dr. James Stoxen:
But that was one very good thing to see, that we actually made it to the finals with that idea.
Steven Sashen:
I want to back up. I mean, first of all, there’s a whole lot to unpack in everything you said. But the biggest thing I just want to kind of reiterate, is that there are a lot of ways of attending to the… Wait. I’m going to do this a different way.
So when I spent time with various track coaches, I noticed that a lot of them were clearly just regurgitating something they had heard from somebody else. My first track coach, the drills that he was suggesting we do, he was either suggesting things that clearly had no relationship to running, or sprinting in my case, or they were things that clearly had no real impact. They weren’t really doing anything. Or the way they were doing, there’s drills called A skips and B skips. And the way they were being done, it looked like just a bad marching drill. Maybe it’s getting a little blood flow, but it’s not really doing anything specifically. And I stopped hanging out with those people much to their chagrin.
And so what I see a lot in the fitness world, and what you were describing, is people who aren’t looking at the body in a way where they’re really starting from the ground up, and we’ll come back to the ground up version from feet, to really look at it with, let’s say fresh eyes. They’re doing something they’ve heard, they’re doing something they’ve been taught, they’re not getting in, and like you said, they’re not touching someone and really trying to feel what’s going on, get some information there. And the interventions they’re doing are often things that it’s like, “Well, that’s the way it’s been done, so that’s the way way we’re going to do it.” And you found this whole other way of addressing… By the way, I don’t want to lose this one. You did mention the Vibeassage, and we’ll come back to that in a sec. But if people picked up that word and they didn’t know what it was, it’s a tool that you’ve come up with and we’ll talk about that.
But the other thing… Where did I want to go with this? The other thing is, especially for runners, but also for anyone just walking-
PART 1 OF 4 ENDS [00:25:04]
Steven Sashen:
… especially for runners, but also for anyone just walking. The whole idea of the spring mass model for movement is something that could not be more obvious, and I want to dive into that a little more so people understand it more deeply, but not something that people pay attention to. And you gave me a flashback, Glen Mills, who was Usain Bolt’s coach, took Usain from being a 400-meter runner to being the fastest man in the world in the 100. And when asked what they did, Glen said, “I spent a year working on him to get stronger so he was a better spring, so he was a tighter spring.”
And like you were saying, when you’re applying force into the ground, if you do it correctly, you’re getting as much force back out of the ground as possible. That’s just Newtonian physics. And if you’re using your muscles, ligaments, and most importantly ligaments and tendons correctly in the spring model, because your tendons are essentially springs, then you are getting as much energy back as you possibly can and storing that energy for being used later. So, did I get anything that you want to clarify from my little synopsis?
Dr. James Stoxen:
Yeah. Okay. Well, here’s an example. There are some coaches that talk about spring stiffness and spring compliance. So, spring compliance would be like a jog where you’re actually jogging and you’re allowing the spring to load deep and slowly, and it’s good-
Steven Sashen:
Wait, I want to pause there. So when we talk about the spring, what we’re talking about is all of the structure, musculature, skeletal structure, starting in your feet, your ankles, your knees, your hips, your back. I mean, really going all the way up to your head, but primarily people think about it sort of from the navel down.
Dr. James Stoxen:
Well, you can’t because it’s actually a torsion spring and, well, if you do it from the navel down, you’re not incorporating the arm swing into the running gait, which is obviously something very important. And also the head position is kind of… Because all the sensory apparatuses in the head. Here’s an example. So what we were talking about is that you were saying that they were giving you these drills. Well, what people don’t realize is that because they don’t… When I was a student, most everyone wanted to know the muscles they could see, well, not the ones that function. So you look at the gastroc, soleus, but the ones that are the… I’ve examined calf muscles and calf for 37 years, tens of thousands of visits. I have never in my entire career, well, very seldom found a muscle trigger point or whatever in a gastroc, okay. I’ve seen a little bit here and there in the soleus, but the majority of them are in the tibialis posterior.
You have this group of tendons that actually form a slingshot. The tibialis posterior or the anterior, the peroneus longus and brevis actually form a slingshot by attaching at the back of the calf behind the gastroc and soleus. And they loop around to have strategic attachments, these tendons, on the actual arch of the foot on either side of the metatarsal-cuneiform joints, okay. So what you’re looking at, it is actually a slingshot.
So when you look at running, the human foot as if it was the shoulders or the chest area, the human foot is a three-dimensional object that actually has a posture that has to be trained in multiple directions in order for it to remain healthy. Now, if you want it to have maximum spring, there are two factors. Number one, you have to have movement in all 33 joints of the human foot to pull off that spring action. So you have to be really sharp as a practitioner or even as an athletic trainer or as a person that’s self-managing. You have to be sharp at knowing all these 33 joints and to know which joints are more apt to lock up or become stiff and how to release them. Okay, so if you’re self-treating, you have to know what to look for. If you don’t, you’re going to bang into the ground and twist off the ground.
Steven Sashen:
I’ve got to pause there and tell a story.
Dr. James Stoxen:
Now, that’s the first thing. Okay, go ahead.
Steven Sashen:
So I have to tell a story about that. So when we first met, which was like 2011-ish, I can’t remember the specific date. You had me hop up on the table and you started working on my foot, and at one point you… I’m going to try and tell the story sort of in the way that it felt. You manipulated a part of my foot in the longitudinal arch, what most people just think of as the arch of their foot, where suddenly there was a snap and it had the sound of when you crack your fingers, but it’s like a really loud one. But I thought, “What the hell just happened and did you just break my foot?” Because I didn’t know there’s a joint in there that’s actually supposed to be mobile.
Dr. James Stoxen:
Right.
Steven Sashen:
And so I freaked out. I mean internally, I didn’t express that. And then you asked me to stand up and see how that felt. And I was, again, literally terrified to get off the table. And as soon as I put my foot on the ground, it’s like, oh my God, this feels so much better. I feel like I’m moving better, like I’m actually using my foot and it was more springy. And now this is one of those manipulations that I do. I don’t try to crack it all the time, but I’m making sure that joint that I didn’t know existed, and I think most people don’t, was actually still flexible and mobile.
Dr. James Stoxen:
Right. Well, the human foot has 33 joints, but the majority of the weight is held on the first and second toe. So where it locks and why it locks is usually when the tibialis posterior gets weak, because that’s the strongest muscle that when the foot lands on the outside, rolls to the inside, that muscle prevents over-pronation, catches that longitudinal arch and just springs it off like a slingshot. So if that muscle isn’t as strong as the opposing side, which is the peroneal muscles, and if it’s not strong enough to handle the amount of force being put through it, then the whole kinematic chain will internally rotate and create inflammation and muscle tension. And then the leg has more drag on it and then you’re not going to run as fast, and then you get injuries from there. Over-pronation is like the number one cause of almost every ailment in the lower body.
Steven Sashen:
Well, I want to pause there because many people go into some running shoe store, sometimes they’re put on a treadmill where somebody who has been given nominal training or training for a specific reason looks at what they’re doing, says, “Oh, you pronate,” and then tries to put them in a shoe to try to compensate for that. So there’s so many people that I’ve met who think that they have some massive amount of pronation. And what I see when I look at them, it’s like, no, no, what you’re seeing is just the normal spring-like mechanism of the foot, and you’ve been sold a bill of goods from someone who was able to show you something on a screen, misinterpret it, and then use that to sell you a particular product.
Dr. James Stoxen:
Well, here’s another point. Let’s say that I have a kid that walks in with his shoulders rolled forward, like a 15-year-old. I’ve got two choices. Either I’m going to train him in the gym to do some back exercises and well-rounded routine, or I’m going to put a brace on him. Obviously we’re not going to put a brace on the kid’s shoulders. You could buy them on Amazon. If you lack intelligence, you’ll do it that way. But the bottom line is that you don’t do that with the foot either. So what we do is we certainly… If you’ve got a herniated disc, well, we have some pain there. We can’t have that over pronation because it actually is causing pain. So we do want to limit the pronation just to calm the area down, but for an athlete, what we would do is we would do the deep tissue to release the spring-
Steven Sashen:
Wait, I’m going to-
Dr. James Stoxen:
Hold on, hold on. We would do the deep tissue-
Steven Sashen:
Wait, I’m going to pause there again because what you just said is super important. So you’re going to use, and we’ll come back to what you’re going to do for an athlete. You’re going to use posting the foot or keeping the foot slightly immobile, adding some support as a technique for calming things down to let things heal. Which to the best of my understanding, that’s what orthotics were designed for is to let the foot basically rest while the tissue is taking some time to heal. Now of course they-
Dr. James Stoxen:
Well, I would never put an orthotic on any-
Steven Sashen:
So let me rephrase, or then clarify for me. So what you said that I was riffing on was that you’re going to do something to basically let the tissue heal, let that pain settle down before you start working on the foot. So what are you doing in that case?
Dr. James Stoxen:
Well, if I’ve got a 70-year-old with a weak tibialis posterior that allows the foot to pronate, I could do the deep tissue around that metatarsal cuneiform joint, the longitudinal arch between the metatarsal cuneiform joint of the first and second toe, and maybe the third, which is usually the area. It’s a pattern, you know? And then you could do it on the subtalar joint to keep that area from… Get the movement smooth. And then you are not going to be able to do zigzag runs and circle runs-
Steven Sashen:
Got it.
Dr. James Stoxen:
… and side runs on a 70-year-old in barefoot, plus he’s diabetic, let’s say. So we have a different way to handle that. Let’s just stick with mostly athletes. Let’s just talk about how we would train an athlete. So what we would do is we would release the spring system by working on the muscles, the intrinsic muscles of the foot, deep tissue to release, push the inflammation out of the muscle into the interstitial fluid space, which is the space between the muscle and the skin.
When people do deep tissue, they call these trigger points. We need to get off of that. That’s the old way of thinking. Like Janet Travell, trigger points. There’s this mysterious thing called a trigger point, and we could see them and all. And they’re really not trigger points, they’re actually muscles that are involuntary… You have involuntary muscle contractions because there’s inflammation there, and the brain is controlling the tension on the spring because it’s getting a message that there’s inflammation in the area and it’s contracting muscles of the surrounding area. So this whole thing about trigger points is silly.
This muscle tension that you call trigger points, they actually form in predictable patterns based upon how the body moves outside of the normal engineering path, based on how it’s designed. So if it’s designed to land the outside, roll to the inside, and at the same time load into the arch, the force of the impact… And it doesn’t do that, that’s the normal engineering. Then it creates an inflammatory area, and then maybe it’s up the entire spring.
There’s a predictable pattern. It’s usually first and second metatarsal, the lateral calf area, which is the tibialis posterior, and then the iliotibial band, the gluteus medius, and that’s the typical pronation pattern, okay. So you have inflammation there, and until you move the inflammation out, the pattern remains. Because the brain decides if they’re still getting signals from the tissue that it’s inflamed, that muscle tension remains. So if you want to just putz around with rolling these rollers to roll out the iliotibial band day after day, it’s like there’s a hole in the roof and you put a bucket underneath it.
It’s not how it works. And if you’re a PT, you’re a moron, okay. Get it straight, figure it out. It doesn’t work like that. It’ll never work. You could do 1,850 foam rollers across the TFL and you’re just wasting time. You have to reset the foot so that it can get the full impact all through all 33 joints. And then you have to rebuild the spring suspension system, which is the tibialis posterior, anterior, and the peroneal muscles, the slingshot. You have to build the slingshot. Well, why is it the slingshot doesn’t work after we get older? When we’re kids, we run around barefoot all day long, we never have a problem. When we’re like 32, we have this over pronation, we have to shore everything up, and we need an orthotic and braces.
It’s like what I used to call barefoot to bedridden. Okay, well, I can’t figure out how to restore it, so let’s put a brace under it, a orthotic. And I’ll charge you $400 for that, and that will jam the spring from the bottom. And we got the leather from the foot jamming it from the top. And the longer you wear that, the stiffer your spring becomes. And also by the way, if the arch doesn’t descend to stretch these spring suspension system tendons, there’s no adaptation. So they get weaker by the day. And then who argues with me? People who manufacture orthotics.
Steven Sashen:
What a shock.
Dr. James Stoxen:
We can go head-to-head on this, but then when… I remember I was in this forum and this guy was banging on me, it was laughable. There was a lot of people watching this conversation, and then I can’t remember what happened, but I said one thing that he couldn’t refute, it was the end of the argument, and he got so pissed off that he screamed and called me every name in the book, and then he disappeared. That was it. It was done, finished, okay.
So like I said before, you want to put a brace on a kid because he doesn’t have strong back muscles? You want to put a brace underneath the arch, like the natural… God gave us the arch for a spring system to be efficient runners. Or do you want to restore it? So the way you do it is with the zigzag runs. Of course you can put a cuff on the foot and do low pulley exercises with inversion, eversion, supination, pronation movements to build the muscle up, and the tendon will get stronger through adaptation, Wolff’s law, but you’ve got to get out there and start running.
Now, if you want to create an adaptation process for being able to run barefoot, you have to understand that as you… For instance, if we do a proper analysis of the body spring system, the lower leg, the first video comes from equal weight on both feet. And so we’re looking at impact speeds and how much force is going through the actual lower body. So we would stand with weight on both feet. So if you weigh 200, makes it easier for the math, you’ve got 100 pounds on the left and 100 on the right. When we lift the foot off the ground and you have all the weight on one foot, now you have 200 pounds on one side and zero on the other.
So then you can put a camera on that patient to look straight up the middle to see if the foot pronates just from lifting the foot off the ground to determine if the tibialis posterior muscle and the spring suspension system slingshot is able to keep the legs straight and maintain the foot posture during that amount. So you’ve got 200 pounds. When you walk, it’s 1.25 times body weight. So it would be like 250 is the impact through the spring system when you’re walking. So when you’re doing a gait analysis and somebody’s walking, it’s 250 pounds of force through the limb and through the spring.
Now, when you go to running, there’s estimates of three to four to five times body weight. So it would be like three would be 600, four would be 800, and 900 to 1,000 pounds. So in between there, in between walking speed, which is 1.25 and 3, as we start working down the dumbbell rack, I say. If you want to go from 40 pounds to 50 pounds, that would be safe and prudent. You don’t go from 40 on the dumbbell rack to 80 pounds, and you wouldn’t go from walking speed when you’re trying to build a strong spring suspension system to full out sprinting, you would start by increasing speed and increasing the adaptation of the tendons, because that’s really what is creating the spring, not the muscles, okay.
The Japanese did a study where they put a ultrasound on the calf and watched walking and running. And what they found was when you transition the weight across the limb, the calf muscle remained the same length. Now, how could that be? Because you’re landing, that’s absorbing an impact and transitioning weight across the limb, and there’s the push off. How could that be? How could the muscle be the same length? And really what the muscle is doing as we’re changing from speed is it’s actually tuning the tension on the tendon and the tendon is stretching, creating the differences in the speeds and the impacts that you have to absorb rather than the muscle pushing. Because you know that these impacts at high speeds are so fast that it’s quicker than muscles can actually contract.
So how could it possibly be that people think that the calf muscle contracts and pushes you forward during running? That’s not possible. So what I see is if I’m going to step off a curb, the muscle knows for some reason exactly how much tension to put on my calf muscle to absorb that landing, and then it changes the tension on the calf muscle to tune the tendons for walking speed, jogging speed, and running speed. And it goes like, jogging is what we call a compliant spring, and sprinting would be a stiff spring where you’re more ricocheting off the ground like a super ball, and the muscle tension on the actual tendons is stronger because the tendons have a tighter snap to them. And when you run, it’s so crazy. If you and I were running, of course you would beat me because you’re the fastest man in the world. You had told me at least fastest-
Steven Sashen:
No, no, no, no. I’m the second fastest Jew in the world in my age group.
Dr. James Stoxen:
You know what? I’ll be honest with you, I had to be careful what I said there. Well, but the bottom-
Steven Sashen:
No, no, no, it’s fine. Well, I used to say that I might be the fastest Jew in my age group in the world, but then I met my now friend Alan Tisenbaum, and Alan crushes me.
Dr. James Stoxen:
Okay.
Steven Sashen:
Alan is a complete genetic freak who I adore, and yeah, he beats 35 year olds. I mean, he’s a machine.
Dr. James Stoxen:
Yeah. So when you’re increasing speed, let’s say for instance you and I are jogging. I’m just out for a run and I just want to just give you some crap and I say, “Hey Steven, I’ll race you to the end of the block, okay?” Immediately what happens to us is we get this new facial expression. I’m going to beat him, and the face tightens up, okay. The face, and then the upper body and the lower body, it starts to stiffen. And we’re going to go from this jog thing, which is this compliant spring, and then all of a sudden we’re going to stiffen it and our face is going to change. And all of our muscles start to stiffen, which is the tuning, the tuning of the spring system to create the ricochet effect, which is the stiff spring rather than compliant spring, so that we can get speed out of this spring system versus… You have two things. You have the speed, which also makes you more vulnerable to injury, and then the compliant, which is where you get a deeper loading of the spring, which makes it more injury resistant.
Steven Sashen:
If you’re aligned well. But you left one part of that story out though. If you said, “Hey, I’ll race you to the end of the block,” the first thing that would happen is I would say, “For 100 bucks?”
Dr. James Stoxen:
Yeah. It’s stiffer then.
Steven Sashen:
Well, I do the opposite when I’m at track meets. Invariably there’ll be some guy who’s twice my size who just looks at me very intently and says, “Hey, good luck, man.” And I go, “Hey, there’s no prize money involved. I just want you to have a good time, get to the end of the race, still be healthy. And oh yeah, by the way, I totally want to kick your ass.” And I do that because it’s like the unspoken truth. We’re stupidly competitive, but there’s no bonus points for doing it. And so let’s have a good time and admit that we’re each trying to beat each other.
So you said something I want to back up to. So I know this is going to sound silly because people can figure it out without confirmation, but I want you to do the confirmation. So we’re talking about increasing the strength of the tendons by putting them under load. You mentioned two things. One, obviously just going from jogging, slowly building up speed, because that over time will create these adaptations. Another thing you mentioned is, there’s two other things you mentioned, I’ll do them one at a time. One of the others was zigzag run, and I know it’s exactly what it sounds like, but do me a favor, please describe that for people.
Dr. James Stoxen:
Well, people think that zigzag run is where you cut to the-
PART 2 OF 4 ENDS [00:50:04]
Dr. James Stoxen:
… Run is where you cut to the right, and then plant the foot, and then use the planted foot to cut to the left, and then plant the foot, and you back and forth. In reality, a zigzag run to me would be where you have a line on the road. What you have to do is you have to stay off the heel. The way you do that effectively is that the head and the upper body are thrown into the direction that you’re changing.
If I’m running down the path and I want to cut to the left, what I’m going to do is like what Michael Jordan used to do and all these great athletes. You’ve got a choice of planting and pushing off, or what you can do is much easier to stay on the forefoot as well, is that you throw your head in the direction that you’re going, and then because the head and the upper body is ahead of the spring, you’re automatically on the forefoot. You’re automatically on the spring system. The foot will not, the muscles won’t tighten up.
They’re just going to bounce the body in the direction that the mass is traveling. There’s no tension moving you there. You’re in a controlled fall state, you’re using that controlled fall to keep the tendons from tightening, while they’re actually absorbing this impact force through these tendons, and adapting, without tightening the muscles more than they have to, just to maintain the tension on the spring to get the safe impact through the spring to that direction.
Then if you’re going to the left, you just throw your body to the right, and then your body turns to the right with the head and the shoulders leading, and the foot remains behind the mass. The body is ahead of the spring so that you’re always on the forefoot, and that’s called the controlled fall. That’s why athletes, when they load up in the blocks, they’re low to the ground, they’re already falling.
You see also, this is crazy that lately it’s happening, where there’s a really tight race, and I seen it with a couple of ladies, where it was a very important race. They were neck and neck, and the girl just thought, “I’m going to fall over the finish line.” When she did, she beat the other girl, but she was behind her. When you fall forward, you have gravity pulling you, and the spring energy speed at the same time. It adds speed to the body part by simple, applying gravity to it.
I remember when I used to run fast, when I wanted to run faster, all I had to do was lean forward more to get more of a controlled fall, but at the same time, not lean forward at the waist and tighten up my back muscle. The whole body would be leaning forward at the ankle. The whole body would be fairly straight and leaning forward at the ankle. If you bend forward at the waist, you create a muscle tension within the spring system that creates drag on it and tightens it up so that it can’t get the maximum spring out of the body spring.
When you bend forward at the waist, when you’re trying to get that controlled fall effect, you can’t bend forward at the waist. That’s where you get maximum spring and not using muscles. That creates the tendon strength. If you want, the tendon strength is where the snap comes from and the speed and the efficiency. Muscles burn energy. Do you want to crap out at 95 yards, or do you want to get a boost? The spring doesn’t get tired, tendons don’t get tired. They’re non-contractile element. Use them, you’re going to have an advantage there.
Steven Sashen:
Two things, or maybe more than two things. One, backing up to just sort of zigzag run instruction, you gave the good example for what you’re going to want to do to shift to the left, shift to the right. It’s not just bouncing from one foot to the other, but you’re going to have, well, it doesn’t have to be some predictive amount of strides where you have lean to the right, and you’re on the right side of that line. Then you’re throwing your body to the left to get to the other side.
Dr. James Stoxen:
Oh, it is predictable.
Steven Sashen:
Son of a bitch. All right.
Dr. James Stoxen:
You know what? I’ll tell you. What happens is you get in a rhythm. Oh, here’s another thing that was-
Steven Sashen:
You’re not going to say, and correct me if I’m wrong, you’re not going to say, “Get over to the right of the line in three steps, then three steps to the left, and then five steps.” It’s not going to be…
Dr. James Stoxen:
What’s going to happen is that you’re going to go from left to right of the line, and it’s going to fall into a groove. You’re not going to say, “Well, I’m going to do three steps,” or whatever. As soon as you get to the left side of the line, it’s time to go to the right side of the line. You’re maybe two steps on either side. You can’t go four or five, because if you’re jogging on the lakefront, you’d fall in the lake. You know what I mean? Just keep drifting.
Steven Sashen:
Well, the other thing I want to highlight is, because this is a thing that I do with people when I’m teaching them to run barefoot, it’s something very similar. I go, “Hopefully we’re in a place where there’s little kids, like two to three, because this is how they move. Their head is so damn heavy that they lean it in one direction to the other, and they try to keep up with their head, and they can’t.” Literally, this is what I do with people.
Rather than being on a line, I go, “Just play with it. Just once you feel like you’re starting to catch yourself, then go in a different direction. Just use your head to pull you in a different direction, and don’t let yourself catch up.” Then eventually, you sort of let them learn to kind of catch up a little bit because by then, they’ve gotten on their forefoot. Another thing they’ve started doing is started having fun, which is another thing. People take this all way too seriously.
I always remind people, “First of all, anyone else who’s in this park doesn’t know you. They’re far enough away that they will never spot you in Whole Foods. They don’t know who you are. If you really are having fun, they’re going to want to come and join you anyway, so where’s the downside?”
Dr. James Stoxen:
Well, this is a crazy thing that happened. I have to tell you this story. If there’s any really great track coaches or athletes out there, you’ve got to hear this. Okay. Let’s say you’re running and you have a pace, and you have this, your respirations are easy to match up with the speed of your running. You’re running, you’re like… You have this speed. It’s pretty much the same. Okay?
What I noticed, which is so crazy, but it’s explainable, is that when I started doing zigzag runs, I’d be running straight. Let’s say I’m running straight like this, like… As soon as I transitioned to zigzag run, I’m like this. Same speed. I’m racking my brain. It was so noticeable. The respirations slow down, because I was using less oxygen at the same speed running in zigzag patterns than running in straight paths. What in the heck is going on?
What I thought of was that, this might be sound crazy, but when you do zigzag runs, you use a different muscle group when you’re turning to the left, and then as you’re going to the right on the zigzag, you rest that muscle group, and then you use the other muscle group-
Steven Sashen:
Oh, interesting.
Dr. James Stoxen:
You’re resting the other one, but they’re all providing enough speed that you’re going the same speed, but you have slower respirations, which means you’re using less oxygen. When I would get up, say, five o’clock in the morning, got to get to work, you not have time, I would do a six-mile run on the Lake Michigan, on the concrete path of Lake Michigan from, if you know Chicago, it would be from Grand Avenue or Lake Point Tower where I live, and to Fullerton, which is like three miles, and then back.
I would do that in an hour. It would be six miles in an hour, barefoot. When I did it zigzag the whole way, I remember when I tried to shove my foot into pronation, the slingshot tendons were so strong that if I push my foot into pronation, just went, it snapped right back into the normal posture. I was trying to push it into pronation, and I couldn’t get it to stay. It was so strong, it just snapped right back into the neutral posture.
What’s so great about running like that six miles was 3,000 impacts on the left side of the calf, and 3,000 impacts on the right, which creates this balance of strength within the pronation, supination cuff, or we call it the spring suspension system cuff, that it equalized, it creates an equal amount of strength through the slingshot, that allows that pronation, supination to be equal. You can’t even push your foot into pronation. It’s so strong. Like I said, it’s equal.
Instead of like, “Oh, I went in the gym and I did some inversion, eversion with the low pulley in a cuff,” forget it. You don’t pick up a box of cereal with your foot. If you want to know what puts you in the nursing home, go to the elevator and see the line of walkers, people with walkers. Like I said before, if you want to fight aging, you can’t support the body with the orthotic, because the next support is the cane. The next one is the four prong walker, then the wheelchair, then you’re bedridden, fully supported.
If you want to go that route, you’re going to end up bedridden. If you want to go the other way, work barefoot. You got to-
Steven Sashen:
I love this story. In the very early days when we started the company, I had written a blog post, commenting on a bit of research where they had taken these vibrating insoles and put them in the shoes of older adults who had poor balance, and found that it improved their balance. I said, “Well, you don’t need magic vibrating insoles. Just take after your shoes and go for a walk.”
I got an email sometime later from a guy, 82-year-old man, who said, “I heard about the magic vibrating insoles and I was looking for them, but I found your blog post instead. Since I couldn’t even find the magic vibrating insoles, I thought I’d put your theory to the test. That was two weeks ago, and I just threw away my walker.”
Dr. James Stoxen:
You know what? We used to have a big bucket in the office, and it was full of canes.
Steven Sashen:
Oh, my God.
Dr. James Stoxen:
I swear to God.
Steven Sashen:
That is great.
Dr. James Stoxen:
When my dad and I were practicing, the office had wood paneling. That’s how far it went back, okay? Paneling. What’s so crazy about wood paneling is if you put a picture up and you hammer it into the wood paneling, it’s like over. Wood paneling was a fad, but we had wood paneling, and we had a big bucket that was about two and a half feet high. That’s where you put your cane.
Every time we got the person off the cane, we said, “Your cane is, in two weeks, it’s going in that bucket right there.” We had a bucket full of canes. People would walk in, you go, “Well, is that bucket of canes for people when they can’t walk, you give them a cane so that they can walk out?” “No, that’s when can we take them away from them.” They were like, “You take their canes away?” What’s wrong with you? They need their canes.”
Steven Sashen:
Oh, my god, I love it.
Dr. James Stoxen:
Oh, I got a great story for you. I hear, now, I’m going to talk about this because he’s passed away, but I heard from Bob Goldman, the guy who started NASM, the founder of NASM, the first personal training, certification program in The Academy of Anti-Aging Medicine, he’s my personal friend, that Joe Weider was in a bad way. He had a surgery at Cleveland Clinic for his back.
Steven Sashen:
Sorry, wait, we have to do Joe Weider, for people who don’t know Joe.
Dr. James Stoxen:
Joe Weider had the first Muscle magazine in 1939. Joe Weider started bodybuilding, the whole concept of bodybuilding. Joe Weider’s first weights were sewer caps and train wheels, wagon wheels and train wheels with a bar. Him and his brother, Ben Weider, in Canada, would lift weights that were wagon wheels with a bar, and nobody had dumbbells back then. You’d just lift rocks. It was like the Flintstones, right?
Joe Weider started developing barbells and dumbbells, and he created this concept of bodybuilding and having symmetry. That was when Charles Atlas was around. That migrated into Muscle and Fitness Magazine, Flex and Shape. There were 7 million people that read Joe Weider’s magazine every month. If you got on the cover of Joe Weider’s magazine, you were like a rockstar. When Arnold was doing so well in Europe, Joe Weider paid to have Arnold come to America. He put him in an apartment, gave him a phone and said, “You train here, I’ll make you into a superstar.”
The writing’s on the wall. Arnold was eight time Mr. Olympia. That was Joe Weider’s event, Mr. Olympia. Joe Weider was the father of bodybuilding, and his books are out there, and he was a god, he was a legend. He still is, to us that we know him. Everybody wanted to know Joe Weider, because then you could get in the magazine and get your 15 minutes of fame.
Well, I was working with the American Power Lifting Federation. I was the doctor for their whole national and world team, and I was at the meet, and then guys from bodybuilding would come to power lifting because that was kind of like a transition. These writers would come and they’d say, “Hey, who are you? What are you doing with these athletes? You’re treating them backstage before they’re lifting these heavy weights and all that. What’s this technique you’re using with the foot and all that?”
Then I started writing some articles for Muscle and Fitness, and then I got a call one day. We didn’t have cell phones. It was one, somebody named Joe is on the phone. “Hello? “Dr. Stockton, I like your articles. I want to put you on our advisory board for Muscle and Fitness Magazine.” I’m like, “Oh, God, Abdo or somebody’s pranking me.” I’m like, “Yeah, okay, sounds good,” hang up the phone. Three months later, somebody calls me up, says, “Hey, man, you’re in Muscle and Fitness Magazine on the editorial advisory board,” which is like this slit that’s right on page three.
Month after month for 20 years, I’m on the advisory board. I find out that Joe Weider had the surgery and he’s in a wheelchair, he can’t walk. I said to Bob, I said, “Bob, I’ve got to go help Joe, because he did so much for me. I’m going to go there.” Bob set it up. I went out there, and he had a bunion on the right side, and the right side is where he had the operation. Well, I know he’s over-pronating because he’s twisting off that foot. I said, “Okay.”
We had the Vibeassage. We blasted the muscles and did the human spring approach with the foot and the leg. Then the next day, he had about 10 Filipinos that were servants, Philippine gentlemen. They were really wonderful people, nice people, all Philippine people usually very nice. They’re very go
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