| How to Choose Shoes to Help Reduce Your Back Pain Posted: 10 Oct 2016 09:00 AM PDT Back pain is a significant problem in the United States — more than 31 million Americans experience backaches at any given time and about 50% of workers claim having moderate-to-severe back pain every year.[1] There are numerous causes of back pain, but many cases are related to poor posture and misalignment of the spine. Shoes are important for hip and spinal alignment because your feet form the base for the rest of your body. Getting new supportive shoes that accommodate the biomechanics of your feet can help reduce back pain depending on its cause. As such, it's important to understand the cause of your back pain and how your feet may be involved before buying new shoes. EditIdentifying the Cause of Your Back Pain - Identify the cause of your back pain. Schedule an appointment with your family physician if you develop back pain that won't go away after a few days of taking it easy. Your doctor will examine your back (spine) and likely ask you about your family history, job and lifestyle. If your back pain is severe, then x-rays of your spine might also be taken. Your doctor will try to rule out the most serious causes of back pain, such as a herniated disk, spinal infection, bone fracture, arthritis and cancer. Once those are ruled out, then considering how your posture, foot shape and shoe choices may be causing your back pain is appropriate.
- Your family doctor is very likely not a back or spine specialist, so consider seeing an osteopath or chiropractor to diagnose your back pain as an alternative approach.
- Signs accompanying back pain that indicate you should immediately seek medical care include: muscle weakness and/or loss of sensations in your arms or legs, loss of bladder or bowel control, fever, sudden weight loss.[2]
- Check your arches. After you understand your back pain is not caused by a serious condition or disease, then look at your feet (particularly your arches) for a possible connection. Flat feet are a common contributor to back pain, especially for people on their feet frequently, because arches act as shock absorbers and prevent force from being translated up to other joints of the body.[3] A good objective test to see if you have flat feet is the "wet feet" test.[4] Dampen the bottoms of your feet with water and walk across a large piece of cardboard or thick paper that clearly shows your wet footprints. Make sure to get prints of both feet and examine them closely.
- A foot with a healthy arch will leave a heel print connected to the front forefoot by a strip about 1/2 the width of the foot on the outside of the sole. If you have flat feet, you'll see a print that reflects the entire underside of your foot with no space between the forefoot and heel.
- Both feet usually leave very similar footprints, but in some cases differences exist due to previous foot / ankle injuries or leg length differences.
- A 2013 study revealed that American women with flat feet are 50% more likely than those with normal or high arches to develop low back pain.[5]
- Look at your posture. Looking at your posture in a full-length mirror is another good method to gauge if the shape or positioning of your feet, ankles and knees is potentially contributing to your back pain. While wearing shorts and standing straight, look at the angles of your feet, legs and ankles. If your feet point outwards, your ankles roll in (termed over-pronation) and/or your knees are close together or touch (termed genu valgum) then you are at much greater risk for back pain because these postures put more strain on the hips and lower spine.[6] People who are overweight tend to have all three postural issues, which partially explains why back pain is much more common in obese people.
- Over-pronation of the ankle, flat feet and genu valgum are sometimes hereditary (genetics control physiological development), but in many cases they are the result of the body carrying far too much weight.
- For reference, if your legs look fairly straight (at least a few inches between your knees), your ankles appear in a neutral position and don't collapse inwards (medially) and you can fit a few fingers underneath your feet while weight bearing, then likely other issues are causing or contributing to your back pain.
- Be aware of inequalities in leg length. It's actually quite common to have one leg that is longer than the other – according to the American Academy of Orthopaedic Surgeons, one study found that 32% of 600 military recruits had a 1/5 inch to a 3/5 inch difference between the lengths of their legs.[7] However, any difference in length greater than this can have serious affects on your health, which may include lower back pain.[8]
- Correcting a leg length inequality is easy to do with a shoe insert. It's also inexpensive and can easily be stopped if no changes are seen. A foot doctor or health professional trained in assessing and treating the foot is the best option to assess your need for a shoe insert.[9]
- Examine your shoes. For further clues as to the cause of your back pain, take a good look at the soles of your most commonly worn shoes. For people with normal posture and biomechanics while walking, their heels strike the ground slightly on the outside or lateral edge, which causes wear on that area of their soles.[10] If the soles of your shoes appear to be worn directly in the middle of the heel area — or worse, on the inside or medial edge — then you likely pronate too much at the ankle while walking. As noted above, over-pronation and flat feet often go hand-in-hand and significantly increase the risk of knee problems, hip issues and low back pain.
- Wear patterns are easier to notice on well-used running shoes with rubber soles because they wear down quicker while walking / running on asphalt and cement.
- Keep in mind that wear patterns on the extreme outside (lateral) edge of the heels area indicate too much rigidity in your ankles and/or arches of your feet (termed over-supination). However, this type of posture is not linked to back pain nearly to the extent that over-pronation / flat feet are.[11]
EditChoosing Corrective Shoes - Buy shoes that fit properly. A significant number of people wear shoes that don't fit well, perhaps because the shoes were on sale or they're hand-me-downs, or various other reasons. Regardless, always wear shoes that properly fit your feet, not just in terms of length, but also in terms of width. Wearing shoes that don't fit not only cause blisters, bunions and calluses, but they can reduce the stability and compromise the biomechanics of your feet and subsequently trigger back pain and other joint issues.
- Get fitted for shoes later in the day because that's when your feet are a little larger, usually due to swelling and slight compression of your arches.
- Most off-the-shelf shoes are regular (medium) width, so you may have to order shoes from the manufacturer if your feet are really narrow or wide.
- Some footwear may fit well, such as flip-flops, but they can still cause foot and other musculoskeletal problems due to the lack of arch and heel support.[12]
- Buy supportive shoes. Regardless if you have flat feet or not, wearing shoes with strong arch support is going to benefit your feet and improve your gait during walking / running at the very least. Wearing more supportive shoes may also significantly reduce your back pain or relieve the symptoms entirely, depending on its cause.[13] As such, when buying new shoes, look for a comfortable walking or athletic shoe with substantial arch support, roomy toe box, firm heel counter and a flexible sole. Buy quality and avoid trendy styles that look flimsy.
- Wearing flat sandals, flip flops and other slip-ons on the beach or around the pool is likely okay, but they shouldn't be used for extensive walking or any kind of exercise.[14]
- Avoid shoes with heels higher than two inches because it changes the center of gravity and causes strain on the lower back.[15] However, wearing completely level shoes may put too much pressure on your heels, so consider buying shoes that are elevated in the heel by about 1/4 or 1/2 inch.
- Get an evaluation done before buying runners. If you are a regular jogger and think that your feet, shoes or running style may be causing your back pain, then get an evaluation done at a reputable running store. High-end running stores often employ people who are qualified to assess your gait, examine your feet and check the wear patterns on your shoes. These employees are not doctors, but they are usually experienced runners who can give you sound advice on what types of running shoes to buy, which can make a positive impact on your back pain. If you're a serious runner, you should be replacing your shoes every 350 to 500 miles or 3 months, whichever comes first.[16]
- You may be asked to run over a force plate that's hooked up to a computer, or get video-taped jogging on a treadmill as part of your assessment.
- If you're an over-pronator, shoes with lots of medial support in the arch will likely be recommended to prevent ankle collapse. If you're an over-supinator, then more lateral (outside) support is needed to force your foot into a neutral position.
- Make sure the rigidity of the heel counter (back of the shoe) is vertical and not tilting to one side or the other.[17] Shock absorption is also important for running shoes, which is why many brands have air pockets within the soles.
- Get a pair of custom made orthotics. If you have flat feet and over-pronate, then you may be better off with custom shoe orthotics instead of new shoes. Orthotics are semi-rigid shoe inserts that support the arch of your foot and promote better biomechanics while standing, walking and running.[18] By providing cushioning and some shock absorption, orthotics will also reduce the likelihood of problems developing in other joints such as your ankles, knees, hips and spine. Health professionals who make custom orthotics include podiatrists, as well as some osteopaths, chiropractors, physicians and physical therapists.
- You should realize that orthotics don't reverse any structural deformities of the foot nor can they reconstruct an arch by wearing them over time.
- When wearing orthotics, you'll likely need to take the factory insoles out of your shoes first.
- Custom orthotics can be expensive without medical coverage, but off-the-shelf insoles may provide relief for back pain also.
- To maintain good posture when standing and reduce your risk of back pain, stand with your weight equally distributed over both feet and avoid locking your knees. Tighten your stomach and butt muscles to keep your back straight. Wear supportive shoes while standing for long periods of time. Alleviate muscle fatigue by periodically resting one foot on a small footstool.
- To maintain good posture when sitting and reduce your risk of back pain, choose a firm chair, preferably with armrests. Keep your upper back straight and your shoulders relaxed. A small cushion behind your lower back can be helpful in maintaining the natural curve of your lumbar spine. Keep your feet flat on the floor, using a footstool if necessary.[19]
- Don't wear other people's shoes (eve if they're high quality and supportive) because they're already molded to their feet and arch shape.
- Don't be in such a rush buying shoes. Take your time and wear them around the store for at least five minutes to make sure they're comfortable first.
- If you have any sort of foot condition, see a podiatrist (foot specialists) for a consultation and treatment advice.
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| How to Make It Through the Day After You Have Stayed up All Night Posted: 10 Oct 2016 01:00 AM PDT Whether you pulled an all-nighter to study for a test or you're just a regular night owl, you may be wondering how you can make it through the day on little or no sleep. It'll be hard to stay awake without dozing off, but not impossible. These tips will help you make the most of your day after staying up all night. EditMaintaining Your Energy - Eat breakfast. Studies have shown that people who eat a healthy, balanced breakfast in the morning are more alert and energetic than those who skip breakfast.[1]
- Aim for foods high in protein, like eggs, tofu, yogurt, or peanut butter. Or choose nutrient-rich food options like oatmeal and fresh fruit. These foods will fuel your body through the day and give you the energy you need to stay awake and active.[2]
- Drink coffee or tea. Caffeinated beverages can help you combat sleepiness and make you feel more wakeful and energetic. And drinking coffee or tea can bring plenty of health benefits, too. These naturally caffeinated beverages are chock full of antioxidants[3], and recent studies suggest that drinking coffee can even decrease your risk of developing depression.[4]
- Don't drink too much! Excessive caffeine consumption can cause anxiousness and irritability. Drinking too much coffee can also interfere with your ability to have a good night of sleep after you make it through the day.[5]
- Opt for coffee over energy drinks. An 8 oz. cup of coffee typically contains more caffeine than the same serving size of most energy drinks.[6]
- Stay hydrated. Drinking enough water is important to maintain your body's natural functions, and dehydration can actually make you feel even more tired.[7]
- Chew ice. The physical act of chewing keeps your body awake, and ice comes with the additional benefits of being refreshing and hydrating.[8]
- Take a snack break during the day. Snacks high in protein and vitamins, like nuts or fresh fruit, can help give you an energy boost between meals when your body starts to drag.[9]
- Take a nap, if you can. Even just a brief 15-20 minute nap can boost your energy levels and leave you feeling more alert, awake, and able to perform at work.[10]
- Don't nap for too long. Napping for more than 30 minutes can lead to increased grogginess after waking.[11]
- Remember that you may feel groggy for about 15 minutes after waking. It might be a good idea to drink coffee immediately after a nap.[12]
- Eat a hearty lunch. Your body needs most of its calories in the morning and afternoon. Give yourself the fuel you need when you need it most.[13]
- But be sure to make healthy food choices. Overdoing it on calories or sugar at lunch can leave you feeling more tired in the afternoon.[14]
EditStaying Active - Get in a light workout. Even a short, brisk walk can help wake you up and give you the energy you need to make it through the day.[15]
- Spend some time in the sun. Experts have found that being immersed in natural light can increase wakefulness and make you feel more alert as you go through your day.[16]
- Change your environment. If possible, work with the windows open to allow fresh air to enter, and try listening to music to keep you going.[17]
EditManaging Your Time - Make a list. Plan out everything you need to do during the day, and arrange them in order of importance. This will help you remember everything you need to get done. It will also give you a sense of capability and provide you with a visual reminder of both what you've accomplished and what tasks remain.[18]
- Work efficiently. Aim to get your most challenging or complex tasks done earlier in the day, when you have more energy.[19]
- Reward yourself with a break. Disengaging from homework, studying, or work projects for a short period of time can improve productivity by making you feel more refreshed and recharged, and it can motivate you to get through your next set of tasks.[20].
- Return to your normal sleep schedule. After pulling an all-nighter, it's important to return to your regular habits. Go to bed around the time you normally would, or perhaps a little earlier than usual, and set your alarm for the same time you would normally wake up.[21]
- If you are so tired you can barely keep your eyes open, (which is totally normal for this situation), splash yourself with water, dunk your head in a tub of ice water, or slap yourself really hard. These may not be very enjoyable ways to keep yourself awake, but they will do the trick.
- Listen to loud music, preferably with headphones.
- To keep yourself awake early in the day, drink an energy drink or have coffee with your breakfast, even soda, anything with caffeine.
- Put red stop signs or warning signs around couches and beds so you remember not to lay down and rest, trust us, if you lay down and start relaxing you will doze off into slumber land and wake up around 5pm. This will ruin your sleep cycle!
- Dance around the room or play a board game that's lengthy like monopoly to keep you up and focused.
- When in the late afternoon (4-5), when you start getting very tired, make hyphy mud. Mix 3-4 teaspoons of instant coffee into a cup with Pepsi or other pop. Take 1 or 2 big gulps at first then sip the rest slowly over the next hour. That should keep you awake just long enough that when you crash, you're ready to get a full sleep.
- Try getting warm, or take a warm shower. The warm water will help you relax and take your mind off of it. Or try a mixture of a hot watered bath/shower then to a cold one. It will awaken your senses and increases alertness.
- Don't drive if you're sleep-deprived.
- Avoid staying up all night if you work in an environment where drowsiness could pose a risk to you or others.
- "Microsleeping" is fine as long as you have an alarm or someone to wake you. Be careful as it can make you sleep longer than intended.
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