WHAT SHOES TO WEAR FOR FOREFOOT PAIN

Do you have forefoot pain or pathology and you’re not really sure what shoe you should be wearing? There are numerous foot pathologies that you could have, however we are going just zero in on a few today, such as bunions, first metatarsal joint arthritis, neuromas, and plantar plate tears.

Before we get into details about each, let’s just go over some quick anatomy.  The forefoot includes the phalanges (toes), the five metatarsals, and the connective tissue.

Now, let’s jump right into our foot pathologies and what feature in the shoe you should be looking for to accommodate for your pain.

  1. 1st MPJ arthritis:

This 1st metatarsal phalangeal joint is also referred to as the great toe. This is caused by the joint jamming too early in the gait cycle or an inflammatory reaction.  If you have arthritis in this toe and it is either painful and or limited in mobility, then the most important feature for your shoe will be a more rigid midsole. Secondly, you’ll want a wide toe box so that you have room for your toes to splay properly.

midsole

2. Bunion:

A bunion occurs when we lose stability in the metatarsal cuneiform joint (first ray). The first metatarsal will swing out and create a valgus position on the great toe. With a bunion, you definitely want a wide toe box. Because a bunion is caused by a lack of stability in the 1st ray, this often indicates that the foot is likely an unstable, everted foot type. In this case, a stiff heel counter in the back of the shoe will help control the foot so that it does not overpronate.

heel counter

3. Neuroma:

A neuroma is a scarred or fibrotic nerve often between the third and the fourth metatarsal. The nerve rubs on the fascial tissue and then becomes fibrotic.  This typically occurs from a loss of stability in the foot and/or compression in footwear, among other things such as injury. What will be most important with acute symptoms of a neuroma will be a stiff midsole. If the midsole is flexible, and you have an active, painful neuroma, you will continually compress the nerves at toe-off in your gait. So when your foot is more irritated, a stiffer midsole with a wide toe box will be most beneficial. 

toe box

4. Plantar plate tear:

The plantar plate is an extension of the plantar fascia that runs horizontally across the joints. A plantar plate tear can be very painful, and you’ll want to immobilize the tissue for a period of time. In this case, once again, you’ll want something more rigid in the midsole. During an acute injury, you will want to immobilize the tissue for a period of time, therefore utilizing the rigid midsole.

In certain circumstances depending on the level of forefoot pain and pathology and how it’s affecting your quality of life, a forefoot rocker is frequently recommended. If someone has advanced great toe arthritis, whether it’s fused itself or a fusion surgery has been performed, a rocker bottom shoe can be very helpful.  It can be added to the shoe or there are actually shoes that you can purchase with this specific feature.

Now for your bonus! The more cushion you have in your shoe, the more impact force you will have through your body. Picture yourself walking outside barefoot. Imagine how you would walk–your pace, your intention, your impact.  Now picture yourself doing the same walk in high cushioned shoes. Think about the difference in how you would interact with the ground. You will strike the ground much harder because you do not have the same sensory input that you would have if you were walking barefoot. 

When you have pain that is affecting your quality of life, shoes can be part of the solution, rather than part of the problem.

If you’d like to schedule a free 15-minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schedule. We’d love to help you get healthy again!

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What To Eat To Improve Your Nerve Health | 10 NUTRIENTS

Do you suffer from nerve pain? Whether it’s sciatica, median nerve tension, carpal tunnel, thoracic outlet syndrome, chronic nerve pain into the hands, or maybe it’s even chemotherapy-induced or diabetic neuropathy? It’s important to address the root causes of any nerve pain, and most importantly, optimize your nutrition so that you can improve your nerve health.

Here are 10 different nutrients that you can consume through foods or supplementation that can optimize your nerve health.

1. Vitamin B12

This is important for the myelin sheath, which is surrounding the nerve. It’s been shown that even high doses of vitamin B12 can potentially repair damaged nerves. Good sources of vitamin B12 are yogurt, fatty fish such as salmon, cod, and sardines.

2. Vitamin B6

We need vitamin B6 to be able to absorb vitamin B12. Rather than supplementing with B6, which can potentially cause damage to the nerves, you can get this through your foods. Good sources of vitamin B6 are tuna, salmon, chicken, and spinach.

3. Vitamin B1

This is important for our muscular system and nervous system. It also converts carbohydrates to energy in the form of ATP which is our energy source. This is something that we only get a small fraction of through the metabolism of it so this is something you could supplement with, in addition to getting it from foods. Good sources of vitamin B1 are navy beans, other forms of beans, green peas, and sunflower seeds.

4. Vitamin B2

This is necessary for the absorption of B6 and B12. Good sources of vitamin B2 are soybeans, spinach, almonds, and asparagus.

5. Antioxidants

This can be powerful to optimize the myelin sheath and prevent any damage to the nerve. Good sources of antioxidants are berries such as blueberries, blackberries, or raspberries, dark leafy greens, fatty fish, and walnuts. Try to eat a rainbow every day!

6. Ginger

This can be a powerful anti-inflammatory agent. Try using a couple of teaspoons in hot water or you can incorporate it into salads, soups, and stews. It is very helpful for nerve inflammation and pain.

7. Omega 3

This is important in repairing the myelin sheath that the nerve is wrapped in. Good sources of Omega 3 are fatty fish, walnuts, and flaxseeds.

8. Water

We are made up of 70% water. All of our nerves, bones, ligaments, and connective tissue is inside of our lymphatic system which essentially is water. It’s our aquarium. We want to make sure that we are well hydrated so that our nerves can function at their peak.

9. & 10. Magnesium and Potassium

Magnesium helps the nervous system to relax where potassium is helping to transmit those signals or messages efficiently. Good sources of potassium and magnesium are pumpkin seeds, quinoa, and fresh fruit.

These ten nutrients may not eliminate your nerve pain, but they can definitely help optimize your nerve health. Remember, you always want to get to the root of the issue.  You want to look at this from an integrative perspective and recognize that the nutrients that you are consuming or not consuming are going to impact how you are recovering from your nerve injury.

If you’d like to schedule a free 15-minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schedule. We’d love to help you get healthy again!

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4 REASONS YOU SHOULD RECONSIDER NSAIDS

Do you have arthritis and you’ve been told by your physician that you should be taking some kind of anti-inflammatory and/or pain medications? You’ve maybe settled on Ibuprofen, or perhaps you have tried some prescription medications. Well, let’s talk about why we may want to reconsider.

Let’s start by saying that osteoarthritis is an inflammatory condition. It is important to recognize all the potentially inflammatory triggers that could be impacting your pain and function: food, bugs, toxins, trauma (both physical and emotional), and hormone dysfunction. Let’s not forget the movement compensations over many years that are also contributing to your painful patterns. It is not simply that you have poor genetics, or you played football when you’re younger, or you hurt your knee many years ago. Those may play into it but they are definitely not the only driver and you do not need to be debilitated by your pain and function. There are many negative side effects of NSAIDs.

1. Impacts the GI System

It can significantly impact your GI system. It can affect the lining of the GI system, even in the stomach, and can contribute to GI bleeds. Now let’s remember that 70 percent of your immune system is in your gut. If you are negatively impacting your gut lining by taking NSAIDs regularly, then you are impacting your ability to regulate inflammation. Remember, osteoarthritis is inflammatory.

2. Linked to Heart Issues

NSAIDs have been linked to more heart attacks, strokes, and other heart-related conditions.

3. Affects Kidneys

It can impact your kidneys and the blood flow to the kidneys.

4. Decreases Pain Threshold

Your pain threshold is lower. So, what may have just been a little bit of pain, such as a one or two out of 10 is now a five or six. This is because you cannot manage or process pain as you could before with chronic NSAID use.

This goes without saying but physical therapists are the best way to improve your overall function, decrease pain, and help you to do exactly what you want to do. Please reach out to us we would love to help you. Also focusing on things like breathing, yoga, meditation, all of the things have been shown to help with being able to manage pain more effectively.

I know that you think I might suggest ice or heat, but we’re going to ditch those. Neither one of them is going to have a positive or therapeutic impact on your arthritis. It may feel good, but it is not doing anything to help. When you’re using ice it’s decreasing blood flow to the area creating vasoconstriction, so it does not decrease inflammation despite what people think. Also, heat can potentially bring a little bit of blood flow to the area, but it’s such superficial heat that it’s very minimal. Although it might feel good once again it is not necessarily doing anything to improve your function. You want to try to move as much as possible because that has been shown over and over again through research that is the most effective treatment for arthritis.

If you need help on your journey to better health, contact drarianne@themovementparadigm.com to schedule a FREE 15 minute virtual consultation.

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WHY DO YOU HAVE CRAVINGS | 4 reasons

Did you ever wonder why you get cravings and why these cravings can be so overpowering they prevent you from sticking to your nutrition plan? There are four key reasons for cravings.

1. Dopamine response

You may have heard someone say they’re addicted to sugar or you may even be addicted to sugar. Sugar can cause a dopamine response, just like it can with things like alcohol, drugs, or cigarettes. This can cause a neurochemical and biochemical response in the body, therefore attributing to cravings. Think of it as a feed-forward mechanism.

2. Gut bacteria

We have a trillion different bacteria in our gut that all like different things like fiber, carbohydrates, and fat. When we don’t give them what they want they get pissed off. These specific bacteria are, in essence, seeking out certain foods so it’s important that we have a diverse healthy diet filled with lots of antioxidants and phytonutrients. If we feed it with exactly what it needs and wants, we won’t have cravings for other things, perhaps like carbohydrates, salt, or sugar.

3. Habits

You may go hours and hours without eating and without checking in with your body, and then all of a sudden, you are starving. This is a perfect example of how your habits and not being internally aware of what you need can attribute to your poor eating habits and choices. This will impact the cravings that you have for sugar, carbohydrates, and energy-rich foods that are giving you a quick burst of energy because you have let the tank stay empty way too long.

4. Blood sugar

This is really imperative in making sure that you are decreasing cravings. Let’s start with the basics. Every four to six hours you should be eating unless you are hungry. Now there are some exceptions if you are doing intermittent fasting. If there is already some existing blood sugar dysregulation, that would mean that you probably have to eat a little bit sooner than that, but ultimately that is our goal. Now to do that, we have to have a balance of nutrients; a protein, a healthy fat, and a fiber source. If we’re getting these balanced meals every four to six hours, then we should be able to keep our blood sugar stabilized. If you happen to just wake up, eat a bunch of sugar and carbohydrates such as oatmeal with honey and blueberries, our blood sugar is going to go way up, and then crashing down. Then, you will crave carbohydrates. So, make sure you are consistently incorporating a protein, a fat, and a fiber source in each of your meals to optimize your blood sugar control and prevent cravings.

In essence, being able to regulate cravings is within your control 100 percent. There are lots of ways to address it. Even if you have some preexisting health conditions, like insulin resistance, or dysregulation of your blood sugars, etc.; this could impact your cravings. However, try to work on these key fundamental things so that you can decrease your cravings and ultimately feel your best.

If you need help on your journey to better health, contact drarianne@themovementparadigm.com to schedule a FREE 15 minute virtual consultation.

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What is SIBO?| Is this the cause of your digestive issues?

Have you heard about SIBO (small intestinal bacterial overgrowth) or perhaps you’ve been diagnosed with IBS (Irritable Bowel Syndrome) but you don’t know what to do about it? You may be wondering  if this is the cause of your digestive issues? Is this what’s making you feel so terrible? Let’s start by saying that SIBO is very complex and there is not one easy roadmap to treat SIBO. It is really important to understand what it is, the anatomy behind it, the risk factors, some of the symptoms that you could experience, and most importantly, the underlying causes. SIBO is exactly what it sounds like, an overgrowth of bacteria in the small intestine. It is not necessarily an imbalance between the good and bad bacteria, although it can be pathogenic, it is in essence, an overgrowth. The small intestine is meant for digestion and absorption of nutrients, where the large intestine is meant to house our beneficial bacteria. When we have a backflow of this bacteria into the small intestine, that’s when we can begin to overpopulate and have an overgrowth.

Let’s go over some brief functional anatomy so that you understand what’s happening. When you start chewing your food, you produce salivary enzymes to help begin the digestive process. The food is then passed through our esophagus, i.e. the food pipe, into the stomach. The stomach begins to produce hydrochloric acid (HCL) to break down the food even further. We have our gallbladder that releases bile to help break down the food moving into the small intestine. Our pancreas is also releasing enzymes to help further break down this food. Once the food moves into the small intestine which is 18 to 25 feet long, so it’s not small, digestion and absorption of nutrients occurs. The small intestine connect into our large intestine. There’s an ileocecal valve that prevents any backflow. From here, we then move the food into our rectum for waste removal. We can think of the large intestine as the house for the good bacteria and our storage for waste and excretion.

What symptoms can you have with SIBO?

One of the most frequent complaints is bloating. This is when the gases build-up from the bacteria eating the food. When the gas is releases, it causes pressure or distension in the abdomen. The small intestine is not made for any kind of buildup. When this buildup occurs and we’re not able to process it or digest it properly, this is when you can begin to have symptoms of nausea and acid reflux. The other two symptoms that are very common are constipation and/or diarrhea. You may have both and it could be alternating, or you could gravitate more towards one or the other. This can often be referred to as SIBO-C or SIBO-D. In addition to all the common digestive complaints associated with SIBO such as constipation, diarrhea, acid reflux, cramping, and abdominal pain, you can also have other health issues. This can range from skin issues to significant fatigue to anxiety or depression, and the list goes on.

What are the risk factors for SIBO?

1. Disease states. That can be an autoimmune disease or any other chronic disease that can be a driving factor.

2. Surgery. Specifically abdominal surgeries that create adhesions from scar tissue. This can impact the motility of the small intestine.

3. Medications. This can be any kind of pharmaceutical drugs or antibiotics that you may have been taking, chemotherapy, etc. All of these can drive SIBO.

Now, what are the underlying causes of SIBO?

This is often much more difficult to figure out, and sometimes requires a lot of investigation. The underlying cause essentially is when the system fails. When this protection mode and the normal process of digestion is not happening the way that it should. This can happen for various reasons.

1. If we do not have the appropriate amount of stomach acid in the stomach to be able to begin to break down food properly.

2. If there is an enzyme deficiency, which means that you do not have the capability of being able to break down food and absorb the nutrients.

3. The immune system. Seventy percent of the immune system is in our gut specifically in the gut-associated lymphoid tissue (GALT). You can appreciate that if this system begins to fail and our immune system becomes more heightened, this can be an underlying cause of SIBO.

If you have IBS or have chronic digestive issues, you may look into this as a possible cause. You can get tested for SIBO here.

If you need help on your journey to better health, contact drarianne@themovementparadigm.com to schedule a FREE 15 minute virtual consultation.

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How to do an elimination diet

Have you been experiencing fatigue, chronic pain, allergies, sinus issues, depression, anxiety, bloating, cramping, abdominal pain, diarrhea, and/or constipation? Or maybe you just aren’t feeling your absolute best? If so, you might want to consider the elimination diet. The elimination diet is the gold standard for uncovering food sensitivities and food intolerances that are frequently overlooked as a major contributor to a whole host of inflammatory conditions. It’s been used by allergists and registered dietitians for decades and is currently used frequently in functional medicine.  It can be extremely valuable in finding information.  It uncovers foot triggers that can help you determine what foods are best for you…and of course, what foods are not. There is no one-size-fits-all.  Everyone is unique.

What does the elimination diet do?

The elimination diet helps to decrease inflammation, identify food triggers, reduce intestinal permeability i.e. leaky gut., decrease inflammation, reduce toxic burden, and it is high in phytonutrients and it is not calorie restrictive. If you have already been diagnosed with leaky gut, autoimmune, or any other inflammatory condition (nearly 90% of all conditions), then this would be something that is highly recommended to initiate a gut healing protocol to remove these potentially inflammatory foods. It is not a calorie-restricted plan, so it is not meant to be a weight-loss diet. Instead, it is meant to be an “information diet”, which means it is not a forever plan. This diet is comprised of all whole natural foods, there’s nothing processed. You are eliminating all of the potentially inflammatory foods. Some of those foods include coffee/tea, alcohol, corn, soy, peanuts, processed meats, red meat, gluten, dairy, and so on. (See below) You would be eliminating these foods for at least four weeks.

What foods do you eliminate?

  • corn
  • dairy
  • gluten
  • eggs
  • peanuts
  • white sugar
  • shellfish
  • soy
  • beef
  • processed meats
  • pork
  • coffe, tea, chocolate

How to prepare

For this to be successful, it is vital to have a preparation period. One to three months’ preparation time is recommended to prepare for it so that you can just go into it with ease. The last thing you want it to do is to create stress, ie. Inflammation, on your body.  You’ll want to make sure it is the right time in your life and things are relatively calm. It is extremely challenging to eat out when you are on the elimination diet. Lastly, it’s often easier if you slowly work out one to three foods at a time and find replacements for them before you begin. You want to be fully prepared, which is why it is strongly recommended to work with a professional to guide and support you through the process.   

How to reintroduce

The reintroduction phase is the most important part and many people fail to do this. They sometimes get frustrated and eat something that has multiple inflammatory triggers like pizza that includes gluten, dairy, and tomato sauce. Then, they don’t feel their best and don’t really know why. Was it gluten? The dairy? The tomato sauce with all the preservatives? This is why it’s really important to do a very careful and systematic reintroduction of foods. To give you an example of how that looks, you would do the elimination diet for 30 days. Then, on day 31 you choose a food that you really want to bring back into your life. Let’s say it’s eggs. So, what you would do is have eggs on day 31 in the morning and in the afternoon. You would wait four days, and you would see what kind of symptoms or adverse reactions you may have. A food reintroduction tracker is very helpful for this information. You might have nausea, bloating, abdominal pain, joint pain, etc. If you have negative or adverse symptoms within that four-day window, then eggs, right now, are a ‘no go’. You would wait at least three months before you reintroduce them again. This might mean that your gut needs more time to heal or that eggs are never going to be part of your diet. You can then make a conscious decision to include this in your life knowing the effects it has on you, or now that you have that information, limit or eliminate it. The goal is to find this information, so you know exactly what is helping you feel your best. That means having energy and living with vitality, versus feeling like crap every day, but not really knowing why.

Summary

The elimination diet is extremely valuable when you’re dealing with multiple medical symptoms. It is very challenging for many because they don’t realize just how many of the foods they are consuming on a regular basis. Most people need a lot of support and guidance through the process.  So, again I strongly encourage you to reach out to a registered dietitian or functional medicine doctor to help you through this process.

If you are interested in feeling your best and you need help, reach out to schedule an appointment to get you started on your journey.