If your feet hurt...

 

If you are an athlete, your shoes shouldn’t be a fashion statement.  There I’ve said it. 

If you’ve read this column for long or if you have ever seen me professionally for foot problems, then you should know my feelings about your shoes. 

If you walk into my clinic in “shoes” that don’t support your feet, then you’ve probably heard about it from me. If you are wearing those rubbery things that kids wear WAY too much, then you’ve gotten the LECTURE. Or slides. Or (heavens forbid) bedroom slippers (yes, I see that way too often). 

Don’t believe me?  Go to the big box store. 

It hasn’t been too many years since I would send an older person to the shoe store with the instructions to purchase running shoes.  Sometimes they would come back complaining that “those things cost more than my dress shoes!”  Or maybe they said “those things are ugly—I’m not wearing those.”

Yeah, good running shoes cost more than most dress shoes.  And beauty is in the eyes of the beholder.

But here’s the bottom line—those running shoes are probably the best pair of shoes in your closet.  More research has gone into them than anything else you’re going to find in any shoe store. 

If you’re feet hurt, well, you will wear them.  And (surprise, surprise) you will feel better almost immediately.

When I first got out of Physical Therapy school lo those many years ago, we were expected to wear a white jacket, dress shirt (with tie for guys), dark slacks and dress shoes. 

It took a long time before I figured out that those dress shoes that I was wearing every day were killing my feet.  I was quite young back then and not much hurt, but my feet sure did.

And then came the gosh awful shoes that were issued to us when I worked the ’96 Olympics.  Sort of dress shoe looking but with just a hint of running shoe technology thrown in.  I was more miserable than ever.

Along the way, I found that the shoes that I wore for exercise would work in the clinic.  So, dress shoes were the first thing I ditched, in favor of running shoes.  Then came the tie, then the white coat. Nixed the dark slacks.  The uniform became a polo shirt, khakis, and running shoes.

Still is. I don’t need a uniform to demonstrate my professionalism.  That white coat did nothing for me.

So when every kid with shin splints or plantar fasciitis shows up at my office (invariably wearing slides or those rubbery things), they learn (if they listen) that those “shoes” were not meant to wear every day all day.

They might learn that how their foot hits the ground, whether walking around school or competing in a sport, determines the health of their feet and lower legs. They will hear how important it is to take care of their feet.

And if they listen…if they start wearing those running shoes every day…they will find that their problems go away. It really can be that simple.

Pretty good place to be

 

I was an athlete. I was the parent to athletes. And now I’m grandparent to athletes.  I’m here to tell you that that last category is the easiest.  Let’s chat about all three.

I remember my days of competitive sports vividly.  Despite many decades having passed since I was in any game where we kept score other than pickup basketball, I remember details you would think would have been lost to memory.

Most of what I played back then was football.  I played a little basketball but when the high school football coach told me that I could be good at football if I worked at it…well, that was the end of any basketball career.

But I remember it all.  The practices, the Friday nights, the smell of the locker room—I remember it as though it were yesterday.  Going to battle with your friends--it doesn’t get any better than that.  Many of the friends that I still have from high school days are from my high school football team.  Lonnie Hawkins. JL Millsaps.  Mike Bivens.  Greg Cagle. Ricky Alexander. Byron Lawson.

Not all of them are still with us, but the occasions when I’ve seen any of them just makes those memories a bit brighter.

As a parent, I started out determined to let others coach my own kids.  That lasted but a moment.  I have been around sports my whole life, having seen the good and the bad, and I realized that I might be able to coach my kid and yours better than maybe what they were getting.

So I coached.  And supported.  And never missed anything.  One of the good things about being a youth sports coach is that you get to decide when and where to hold practice—that means those things are on your schedule, not someone else’s.

I’m sure I was harder on my own kids than I was on anyone else’s kid, but isn’t that they way it is supposed to be?

I believe competitive sports are a very important part of childhood development.  I do not believe that being on a championship team at age 8 makes a kid a “winner.”  Quite the contrary.

I believe that learning how to be coached, how to work together with others, and how to perform unselfishly are hugely important in childhood development. So, play they must.

I really enjoyed those times.  Road trips with an AAU basketball team. Football practice on the grass beside John Sevier School.  Soccer practice wherever we could find a field.  Those were special.

Ah, but the best gig out there?  Being the grandparent.  You don’t have the angst that comes with being the parent of an athlete. You are granted the latitude to see the big picture-the joy of sport, the development of a child, the rewards found in effort.

Then, on a magical night, it all comes together and your grandchild “gets it.”  They get the importance of teamwork. They get the rewards of a hard fought game.  They get what it is all about.

And maybe, if you’re lucky, you’re there when they hit the winning shot, or when they find that joy in being part of something greater than themselves. That is really a sweet place to be.

ACL Prevention

 

As sports medicine professionals, we are always looking for a way to prevent injuries.  Working with coaches, we work to help our athletes train in ways to both avoid and minimize the impact of injuries.

Strength training, flexibility, and skills acquisition are all tools in the prevention tool chest. More recent techniques such as chaos training and training based on a variety of individualized metrics have made a difference. But there are still almost a quarter of a million ACL injuries per year in this country. 

Studies tell us that for every male that has an ACL injury, 8 females have one. That data can be argued, dissected, and defied, but the bottom line is still that more girls have ACL tears than boys.

I have two friends, Dr. Tim Hewett and Dr. Amy Arundale, who have dedicated their careers to injury prevention, particularly for the ACL.  Both have PhD’s in biomechanics and both have focused exhaustive studies on preventing ACL injuries.

Dr. Hewett created the original Cincinnati Jump Program, which did have some impact on ACL injury incidence, but even he admits that we have all had limited success in the prevention arena.

Dr. Arundale, who works for the NBA’s Washington Wizards, is most certainly considered one of the foremost authorities on preventing ACL injuries but she tore her own ACL, playing Australian Rules Football. 

I’m going to bring this story to a personal level.  Last year, I worked with a young athlete as she rehabbed her knee after ACL surgery.  It was nine grueling months of work. Along the way, we worked diligently on both legs, putting a lot of emphasis on preventing an injury to her other knee.

She got the benefit of everything that I know about ACL prevention--and I have dedicated a large part of my career to understanding the ACL. She returned to basketball in the fall and had no problem with the knee that she had surgery on—it performed at a very high level. Yet, you know the rest of the story.  A few weeks ago, she tore the ACL in her other knee.

So the bottom line is that we just don’t know how to truly prevent ACL injuries.  We can lessen the risk but we can’t stop it. That is frustrating for me.

Because of that frustration, I have engaged several of the leading authorities in the country in an ongoing discussion about what else we might do. One of the common denominators appears to be a narrowed intercondylar notch (you probably need your orthopedist or physical therapist to explain that one).  There isn’t a practical solution for that one.

What don’t we know?  The effect of the menstrual cycle on ACL injuries.  We know that adequate sleep is important but what role does fatigue play?  And how do you deal with that?

Are there training techniques that we just don’t understand yet? We know that how the foot interacts with the ground is important but how best to intervene?

What we do know and which I’ll preach for the rest of my life—it is essential that young kids play and run and move their bodies. Especially girls. And begin sports training by the time puberty hits. Not just playing a sport, but training for that sport.

I’ll admit that we don’t know what we don’t know right now—but we’re looking, searching for every ingredient to the ACL prevention our athletes so desperately need.  

Senior Leadership

 

Senior leadership.  Teams talk about it all the time. But what is it?  And how do you know it when you see it?

Every team needs leaders. I’m involved with a lot of leadership development activities, so I have a lot of opinions about what it takes to be a leader. I also know that there are different kinds of leaders. 

When you think of a leader, what do you think of?  Do you think of the rah-rah leader, the one that is the loudest?  Or do you think about the silent type—the one that forges ahead and leads purely by example?

Effective leadership can be a combination of many things. If we always look for the same thing in our leaders, we are likely to be disappointed.  I will herein declare that everyone is a leader. It might be on your team, your job, your community, or your family. I will also declare that anyone can be a better leader.  Anyone can grow their leadership skillset.

So, what kind of leadership skills do you have?  Maybe put another way, what are your strengths and weaknesses as a leader?

I believe that all effective leadership is “servant leadership.” What that means to me can best be described in quotes and cliches.

“Leaders eat last.” Author and inspirational speaker Simon Sinek even has a book titled Leaders Eat Last.  Effective leaders make sure that others are taken care of before they take care of themselves. Effective leaders put others first.

My Dad always told me “don’t ask anybody to do anything you’re not willing to do yourself.” He started telling me that when I was quite young and it was a lesson well learned—I’ve tried to follow that principle my entire life.  If you want to be a good leader, you never let anyone work harder than you.

Effective leaders display integrity.  Dwight D. Eisenhower has been quoted as saying “the supreme quality for leadership is unquestionably integrity.  Without it, no real success is possible.”

Maya Angelou famously said “people don’t care what you know until they know that you care.” You have to truly care about those that you hope to lead.  Nothing else will work.

Effective leaders are good communicators. Maybe not the rah-rah type and maybe silently leading through their actions, but getting their message across, regardless of how they do it.

John Maxwell has said “good leaders take more than their share of the blame, and less than their share of the credit.”  It’s funny how that works, but know for sure that those that might follow you will do so with great gusto if they truly know that you appreciate their efforts and tell them so.

OK, then how do you extrapolate all that leadership stuff to a sports team? You do it all. Service. Work ethic. Showing integrity. Caring. Communicating. Encouraging.

Be willing to set yourself apart but always be responsible to yourself and to others.

Not a sports fan?

 

I’m a sports fan. That much is obvious. But I’m more of a fan of sports rather than someone that keeps up with their stats and players and all that. Let me explain.

I can’t tell you much about the teams or the scores and all that. Oh, I do love my Clemson Tigers but I can’t tell you all the players and how they’re doing.  I know that Dabo Swinney is the coach and that George Quarles’ son is the assistant to the offensive coordinator. And that we need a good running back and a DB or two.

I can’t tell you which former Tigers are in the pro’s or the team they are on, other than Trevor Lawrence and Travis Etienne (Jacksonville Jaguars).

I rarely sit and watch an entire game, start to finish.  I’m just not made that way. I found the Super Bowl interesting in bits and the only way I knew who won the World Series was when I got a photo of my friend Sue Falson (a physical therapist with the Dodgers) celebrating with the trophy.

I’m definitely not that sports fan that lives and dies based on the outcome of a game.  I don’t listen to sports shows on the radio and I rarely watch sports on TV.

My wife is the true sports fan in the family.  Any time I get behind the wheel of her van, you can be sure that the radio is on and tuned to one of the sports radio shows.

But I am most definitely a fan of sports participation.

I believe in sports for everyone. My rule as a father was that I didn’t care what sport you played, but you had to play something.  For the most part, my kids are raising their own kids based on the same principle. 

Sports participation, in and of itself, is an incredibly important part of growing up. Youth sports teams are not about making future sports stars—they’re about teaching life lessons.

But you’ve heard that here, time and time again.

“Upon the fields of friendly strife are sown the seeds that, upon other fields, on other days, will bear the fruits of victory.” That quote from General Douglas MacArthur speaks to the opportunity to learn and grow from sports participation.

Did you know that over 90% of female CEO’s in this country played sports in high school? They learned valuable lessons in teamwork, rewarded effort, and reliability that they carried into hugely successful careers.

But here’s my dark moment—it has become incredibly expensive to participate in youth sports these days. Golf and tennis have long been dominated by those blessed by parents with healthy incomes, who can afford the costs of being good.

Soccer, baseball, softball, and volleyball have, unfortunately, joined the ranks of sports that are just downright expensive to participate in. Between travel ball and private coaching, the costs can be enormous.

What’s the solution? I believe that if your youngster develops real athleticism, if they play multiple sports, if they play for the love of the game, then they will be successful.  Maybe not in what you think might be their best sport—given the opportunity, a child will find what they’re really good at.

And I don’t care what anyone tells you—no one can tell at 8 that a child is going to be a great athlete. So, save your money, travel to cool places, give your child diverse opportunities, and let them find their way.

Let Them Find Their Way

 

I’m a sports fan. That much is obvious. But I’m more of a fan of sports rather than someone that keeps up with their stats and players and all that. Let me explain.

I can’t tell you much about the teams or the scores and all that. Oh, I do love my Clemson Tigers but I can’t tell you all the players and how they’re doing.  I know that Dabo Swinney is the coach and that George Quarles’ son is the assistant to the offensive coordinator. And that we need a good running back and a DB or two.

I can’t tell you which former Tigers are in the pro’s or the team they are on, other than Trevor Lawrence and Travis Etienne (Jacksonville Jaguars).

I rarely sit and watch an entire game, start to finish.  I’m just not made that way. I found the Super Bowl interesting in bits and the only way I knew who won the World Series was when I got a photo of my friend Sue Falson (a physical therapist with the Dodgers) celebrating with the trophy.

I’m definitely not that sports fan that lives and dies based on the outcome of a game.  I don’t listen to sports shows on the radio and I rarely watch sports on TV.

My wife is the true sports fan in the family.  Any time I get behind the wheel of her van, you can be sure that the radio is on and tuned to one of the sports radio shows.

But I am most definitely a fan of sports participation.

I believe in sports for everyone. My rule as a father was that I didn’t care what sport you played, but you had to play something.  For the most part, my kids are raising their own kids based on the same principle. 

Sports participation, in and of itself, is an incredibly important part of growing up. Youth sports teams are not about making future sports stars—they’re about teaching life lessons.

But you’ve heard that here, time and time again.

“Upon the fields of friendly strife are sown the seeds that, upon other fields, on other days, will bear the fruits of victory.” That quote from General Douglas MacArthur speaks to the opportunity to learn and grow from sports participation.

Did you know that over 90% of female CEO’s in this country played sports in high school? They learned valuable lessons in teamwork, rewarded effort, and reliability that they carried into hugely successful careers.

But here’s my dark moment—it has become incredibly expensive to participate in youth sports these days. Golf and tennis have long been dominated by those blessed by parents with healthy incomes, who can afford the costs of being good.

Soccer, baseball, softball, and volleyball have, unfortunately, joined the ranks of sports that are just downright expensive to participate in. Between travel ball and private coaching, the costs can be enormous.

What’s the solution? I believe that if your youngster develops real athleticism, if they play multiple sports, if they play for the love of the game, then they will be successful.  Maybe not in what you think might be their best sport—given the opportunity, a child will find what they’re really good at.

And I don’t care what anyone tells you—no one can tell at 8 that a child is going to be a great athlete. So, save your money, travel to cool places, give your child diverse opportunities, and let them find their way.

Ready and Able

 

I’ve gotten soft in my old age. I mean, I’ve always been a pretty emotional guy—It’s just gotten worse.

Forget Marley and Me—I’ll often get all emotional because the underdog wins, or the couple made for each other get together. 

I had an episode recently where a young athlete that I’ve gotten close to injured her knee.  She had already been here for long rehab on one knee, only to injure the other one.  I was off that afternoon but came back to examine her knee.

When I walked into our reception area, where she sat distraught, it was all I could do to keep from crying with her.  Truth be known, I did choke up quite a bit and maybe leaked a little bit of tears.

One of the things about physical therapists and athletic trainers (and occupational therapists and speech therapists too) is that we really care about our patients.  And we get quite close to them as well.

Even a surgeon might see a patient just a handful of times, but in rehab, we may see them three times a week for several weeks.  We have more opportunity to really get to know our patients and our athletes. 

I was working a soccer match recently when one of our players was injured.  This happened just a few feet in front of me, and from his scream, I knew it was bad.

I jumped up and didn’t wait for the referee to signal me onto the field.  I was there within seconds of the injury, assessing the situation, and quickly deciding that he had a serious injury. 

Athletic Trainers and Sports Physical Therapists prepare for that moment.  We hate it and when one of our athletes gets hurt, we hurt too. But we are trained to know what to do, we quickly go in emergency care mode, and do what is necessary to protect the athlete and make almost instantaneous decisions.

For this young soccer player, it was clear what to do—immobilize him and call for an ambulance.  All of our schools have an Emergency Action Plan (EAP) and put that into action once an injury calls for it.

First and foremost, we make sure the athlete is stabilized. We either call 911 or have someone trusted to make the call, making sure that they tell the operator that we have a medical emergency and that we will need transport to the hospital.

When it is an event where we have student trainers, the EAP is automatic.  Everyone knows what to do and everyone has a job.  We send someone to direct the ambulance to the entrance and to where they can park to best do the job. We inform the parents of what is going on.

If the injury requires splinting or special equipment, we’ve got that with us.  All of our folks carry a complete array of things we might need, including an AED. 

We work hard to be prepared, to anticipate every contingency, and to execute the plan that is in the best interest of the injured athlete.  School officials understand and cooperate.  Game officials understand and wait patiently. Fans and parents do what they can—pray and hope for a good outcome.

It’s the worst part of the job and yet it’s the most essential part of the job. We practice regularly to be good at what we do. We want to be ready and able.