Waterloo Chiropractor, Waterloo Physiotherapist, and Massage Therapist (RMT)

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June 2021

The quest to give a more complete view of strength training and endurance sports continues!

In my first two articles in this series, I discussed the impact of strength training on your ability to consume oxygen (no major impact) and the impact on running economy.

In the article on strength training and running economy, I explained how 8-12 weeks of 2-3 sessions/week is required to see any change.  Heavy weight, low rep exercises seem to trump plyometrics and high rep exercises.   On top of this, masters and female runners are more likely to be responders.  I also discussed how simply running more, if you are a low volume runner, should be the first step in trying to get faster (of course there are other benefits to strength training if you are thinking beyond speed). 

Now, since there are so many multisport athletes who read this column, I thought I would address how strength training impacts cycling economy specifically.   Surprisingly, the relationship isn’t quite as clear!

Intuitively, you’d think it would almost be the opposite in the minds of most- that strength training would be more helpful to cycling than to running.  It kind of makes sense to speculate that cycling requires more powerful, larger muscles to smash big gears, while running requires light legs and next-level cardio.  Therefore, lifting weights should help cyclists more, right?  Wrong!

When we look at studies like THIS ONE, we see that cycling economy isn’t something that’s nearly as difficult to develop as running economy.  As studies like this one show, runners with no cycling training tend to have pretty good cycling economy, while cyclists have horrible running economy.  Cycling economy isn’t hard to train, but running economy is!

That’s also why we see that V02max is a great predictor of longer cycling event performance, while V02max does not do a great job of predicting running performance.  

So when we look at the studies on strength work and cycling economy, we get mixed answers. 

Click HERE to read the rest on the Run Waterloo magazine.

Wanted: Physiotherapist Associate 

We are looking for the right physiotherapist to join our growing team.

Hours: 10-20 hours/week or more if desired.  Flexible in terms of days and times. 

We are hoping to find an evidence-based therapist with strong work ethic, who works well independently, is motivated, possesses good people skills, and has a keen interest in the science of injury management with a focus on active care.  Acupuncture is an asset. 

We are also hoping to find somebody who values patient care above all else, and is easy to get along with and contributes to our positive work environment.  We want a great teammate! 

Learn more about our clinic and club we are associated with: www.drdelanghe.com www.health-performance.ca

Included:

  • Jane practice software
  • Full time reception during regular office hours
  • Access to office after hours 
  • Your own treatment room 
  • Access to gym space for 1-on-1 sessions 
  • TENs and acupuncture needles 
  • Payment: Percentage split with ceiling 

Send Resumes to: info@drdelanghe.com

Dear Patients,

It’s time for an update.  As many of you already know, our staff is contributing to Canada’s dwindling population growth!

We’re excited to let you know that Dr. Sean and his wife are expecting their first child in early August, while physio Sayaka and her husband are expecting their first in September.

That being said, we want to make sure you all are taken care of during this busy time. 

What this means for office hours:
(1) Dr. Sean along with reception will take the first week of August off with reduced hours in August.  

  • If the baby comes as expected, no changes will be made.  
  • If the baby comes at a different time your appointment will have to be moved accordingly- we apologize for any inconvenience this may cause! 
  • During the time Dr. Sean is off, physio and RMT will still be available at the clinic if you are in pain and cannot wait.
  • We will also have an emergency chiro available- details TBA. 

(2) Physio Sayaka will be taking about a year off closer to September.

  • We have high standards! If the right person comes along to cover her mat leave, we will bring them on board.
  • Otherwise, full time hours with Dr. Sean, RMT and occasional hours with physio Kayla will be available to keep you in one piece in the meantime. 


As always, you can book online, call (519) 885-4930 or reply to this e-mail if you you need to reach us. 


Yours in good health,


Dr. Sean Delanghe 

waterloo physio sayaka tiessen


By: Waterloo Physiotherapist Sayaka Tiessen

No, I’m not talking about this season’s hottest Balenciagas, and I’m not even going to get into the carbon plated shoe thing. (Side note: a lot of interesting studies about their efficiency have come out, as have some important discussions about equity in sport.)

We are going to just have a straight talk about your running shoes – what to look for when buying, how to screen for lemons, and injury considerations. Get ready to nerd out!

What to look for when buying

  1. What is the purpose of the shoe you are looking for?
    • A trail shoe for grip and stability? A plush road runner for pounding the pavement? A racing flat or track spike to break the speed of sound? Know what you are looking for to help narrow your search.
    • Stability shoe or neutral? Or dare I say, minimal? This is a complicated question and one where I would look at your previous shoe history and maybe stay within it, unless a change is recommended by your health professional. For example, I know people with pancake flat feet who were put into a stability shoe and it caused more problems for them, so having flat feet DOES NOT mean you need a “motion control” shoe. If you have orthotics, you should go with a neutral shoe 100% of the time so that it can function the way it should. Perhaps get your feet checked out by your health provider if you are in doubt.
  2. Shop when your feet are the largest, and bring anything you typically would have on your feet when you run
    • Your feet tend to get a smidge larger as the day goes on, so plan your trip to your local running shop for the afternoon or later in the day if you can.
    • BYOS – bring your own socks, specifically the types of socks you would wear while running. This will give you a much more accurate feel for the shoe and fit. If you wear orthotics, an ankle brace, or special heel lift in your runners, bring them!
  3. Brand loyalty is ok to a point, but keep an open mind (unless you are sponsored, which I am not).
    • Most companies will tweak their models with each new iteration – new foam! a different upper! a whole new last! There is no guarantee that a shoe will be the same from year to year, meaning it might not provide the same type of ride.
PXL_20210519_135101285.jpg
4. COMFORT IS KING- No matter how much you try to convince yourself, the shoe will not become more comfortable over time. Don’t ignore hot spots, rubbing, and sliding. These will become your nemesis. See how your foot sits on the insert. This is a fun trick I learned from listening to Chris Johnson, a PT legend in the running field. Just take the insert out and place your foot on it. What do you see? If your foot oozes way beyond the borders of the insert, it might be too narrow. In this photo, you can see that my foot is a bit wide relative to the insert, meaning my toes are going to scrunched together once in the confines of the shoe. I have wide feet and finding a shoe that fits is a tough quest, but some brands do fit wider than others (Altra, New Balance to name two).

How to screen for lemons

Sometimes life gives you lemons, and that’s ok if you know how to screen for them to avoid being saddled with a pair of defective shoes. You might get some odd looks if you try these in the store, so bring the shoes home, and in a reasonable, non-Hulk manner, put them through their paces.

The video posted below is a sequence of tests developed by physiotherapist Bruce Wilk. Some of my favorites are:

  1. The Break Test: This is to see if the shoe breaks at the level of the toes and not in a weird place like the mid foot. It shouldn’t be overly stiff either. This does not apply to minimalist shoes as they will fold up like a piece of origami.
  2. The Twist Test: Mostly looking for symmetry here
  3. The Rock Test: This is to see if the shoe is sitting evenly on the surface. Press straight down and apply a bit of a rock left and right. Does one shoe start tilting a lot?

WATCH MORE HERE.

What if I’m injured?

There are some footwear considerations when it comes to dealing with injury. I will mostly be talking about drop, which is the height difference between the heel and the toes. Most shoes will describe the drop in mm. Below are a few considerations about heel-toe drop and how it might play into injuries. These are generalizations, so take it with a grain of salt!

Zero Drop (aka a flat bottom, not necessarily no cushioning. Remember, we are talking about the difference in height between the heel and toes)

  • Places more stress on feet, ankles, and the Achilles, so if you have any issues in these areas, it might be best to avoid this type of shoe.
  • Good if you are dealing with knee issues, or have a stiff first toe because the shoe won’t bias you into slight extension.
  • If you are new to zero drop shoes, it is important to gradually introduce them into the shoe rotation because you will probably get tight calves when you start using them.

Regular Runner with a Drop (the vast majority of shoes)

  • Places more stress at the knee, so if you have cranky knees, consider avoiding this type of shoe.
  • Good if you are dealing with an Achilles injury, or plantar fascia pain because it will put your posterior chain on some slack.

Cushioning or Barefoot/Minimal?

  • Cushioning is best if you are: recovering from an injury (notably any bone stress injury, plantar foot pain), have osteopenia or osteoporosis, are new to running, or are planning on doing the vast majority of your runs on pavement*.
  • Barefoot is something you can work towards if that is what you are interested in. I know people that love the tactile sensation that going more minimal gives them. *you can run in barefoot/minimalist shoes on pavement, but you must give your body time to adapt to the stress.

THE TAKEAWAY?

The most recent studies suggest the best shoe for you if the shoe that FITS, meaning you won’t subconsciously change your gait to avoid that nasty blister on your toe. I know you love that hot new colourway from (insert whatever brand here), but if it has a weird break pattern, or it feels uncomfortable in the shop, it is highly unlikely to EVER be comfortable. Take it from me – I have made that mistake a few times in my career.

Give this post a share with anyone you know who is eyeing up a new pair of kicks. Live in the Kitchener-Waterloo area, dealing with a running injury and want to get a plan in place? Book your appointment here.

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