Here’s what I have to say.

I don’t care about your herniated disc.  Or your torn labrum.  Or the arthritis in your neck.  ~Me

Please don’t take this to mean that I don’t care about you or the sufferring you’re going through right now.

It’s just that I don’t care what your fancy pictures (x-ray or MRI) look like or what you’ve been diagnosed with by someone else.

All of this “not caring” talk is somewhat facetious.  The fact that the structure of your body is not ideal does tell me something about your body.  However, it’s one small piece in the puzzle.

The Research on Herniated Discs

In a 1994 study by the New England Journal of Medicine, researchers sent images of 98 “healthy” (no symptoms) backs to two neuroradiologists, asking for a diagnosis.

Only 36% of the SYMPTOM-LESS individuals had clean MRIs.  That means no herniations (see the red and green arrows in the image above), sequestrations, extrusions, dragons, or monsters present.

52% had a bulge at least one level.

27% had an extrustion.

1% had an extrusion.

Conclusion: 80% of healthy and symptom-less individuals had MRIs that a doctor diagnosed as a problem.

Let me summarize the research: I don’t care about your “herniated disc.”

What Does An MRI Do?

In a report done by the Radiology Society of North America in 2007, imaging has two roles.

1. provide accurate morphological information (what the structure of the spine looks like)
2. influence therapeutic decision making

No one denies that imaging such as MRIs successfully accomplish #1.

The problem is with #2.

“Any study looking at the natural history of degenerative disk disease, prognostic value of imaging, or its effect on therapeutic decision making will be confounded by the high prevalence of morphologic change in the asymptomatic population.”  [the boldness is mine.]

The MRI is very successful at taking a picture of the joints of the body.

Again, this is only a small piece of the puzzle.

As a small piece, I normally refer out for an MRI in these situations:

• when treatment is going nowhere.
• serious trauma to the low back.
• lower extremity numbness/tingling that is not provoked by musculoskeletal movements.
• lower extremity numbness/tingling/weakness that has lasted more than a month.
• serious “saucerization” of the low back (more on this in another blog post.  “Saucerization” is a fancy way of saying that the lumbar spine has been damaged and the muscles at specific levels won’t relax and stretch, either due to spasm or adhesion.)

In the above cases, an MRI can help let the doctor know if treatment should begin/continue or if surgery is the right solution.

Here’s What I Do Care About

Conventional wisdom tells you this equation :

Your symptoms (PAIN) + Your images (MRI) =

• “Don’t squat” OR
• “Don’t exercise” OR
• “Don’t live your life” OR
• “Let’s cut you open” OR
• “Here, take these highly addictive painkillers.”

This equation is merely a moment in time.

At this moment in time, you’re in pain with a certain amount of structural change to your body (as evidenced by the MRI).  The “answer” part to the equation is trying to protect you based on what conventional wisdom knows.  Doing specific movements will only increase the amount of pain and damage done to the structure of your body.

But come on.  How are you supposed to use the toilet bowl when the doctor says you’re not allowed to squat?

I care about these factors:

• the amount of bubble gum (or scar tissue) in between your muscles, ligaments, nerves, and tendons.
• the strength, endurance, flexibility, and stamina of your muscles.
• the amount of inflammatory foods you are consuming, such as grains, dairy, and processed foods.

That bubble gum that God put in your body is directly responsible for your muscle inflexibility and indirectly for your relative muscle weakness.  [ie. When you squat, you can't stand back up.]

For scar tissue help, find a proficient Integrative Diagnosis provider , Active Release Technique provider or Graston provider.  It is my personal opinion that an Integrative Diagnosis provider is the best musculoskeletal pain specialist that you can find.  (Dr. Brady, founder of the “Integrative Diagnosis” curriculum, demands excellence.)

Your muscle capacity [or ability to do work, as measured by strength, endurance, flexibility, and stamina] can make a PAINFUL BACK WITH STRUCTURAL DAMAGE symptom-less.

For fitness help, find a Crossfit affiliate or reputable personalt trainer to help you.  (Please note: In my experience, not all Crossfit Coaches are created equal, just as it is with lawyers, doctors, and accountants.  Crossfit can cause serious damage if done improperly.  I’ve personally witnessed a handful of my patients cause permanent damage and therefore need surgery, by sloppy form with unexcusable coaching.  Seek out the best).

Inflammatory foods decrease the symptom threshold for musculoskeletal pain.  Put simply, diet is the #1 premature killer of Homo sapiens and their dogs, who are fed weird brown pebbles (aka “dog food”) or the humans’ left-over pasta.

If the pasta isn’t good for you, what makes you think it’s good for the dog?

For dietary/nutritional help, check out my gurus:

• Diane at Balanced Bites - general education of Paleo foods
• Dr. Alex Rinehart - specific education of actual nutrients, complete with blood testing

Take Home Message

1. An MRI is a helpful piece of information.  But it means nothing without the other details.
2. 80% of chronic pain is caused by a) weakness and b) bubble gum.  Cover your bases.
3. An inflammatory (non-Paleo) diet is MUCH more dangerous than a herniated disc.  Back pain stinks, but dying stinks worse.

There.  A nice, healthy dose of perspective.  : )

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Northern NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He loves to help people in ANY way he can. Please reach out to him if he can be of a service in any way. It doesnt hurt to ask.

What do you dream of?

Being with your perfect husband or wife?  Having the perfect family?  Living on the beach or up in the mountains?

Working three days a week?  Losing fifty pounds?  Having a pain-free life?  Creating a cardboard arcade?  World peace?

Whatever it is …

Are you pursuing your dreams?

I hope so, because I can’t imagine a world without dreamseekers.

Not only that, but your health depends on it.

Pursue Dreams to Be Healthy

Your dreams are a reflection of who you are.

Being true to yourself gives your mind levity and allows you to go to sleep each night, knowing you showed up today exactly as you were meant to.

Following your dreams is a necessity to a healthy life, allowing the stress of a conformed life to fall to the wayside.

We all know of a person, perhaps a family man, with a wife and kids at home to support, struggling to make ends meet, who died in his 40′s of a heart attack.

Was it worth it?  Hustling just to make another dollar?  Yes, if this victim was pursuing his dreams.

But I’d bet that he conformed to society’s pressures and was not the type that should be working as much as he did.

Because your dreams talk to your heart too.  They tell you that your efforts are exactly in the right place and will be rewarded for your courage by your dreams manifesting in reality.

Enter: Caine and His Arcade

Caine is a 9 year old boy who created a cardboard arcade in East Los Angeles.

He didn’t have very many customers (count: zero) in the beginning of his dream pursuit.

But he continued to build: arcade soccer, claw machines, with tickets, fun passes, prizes, and all the rest.

And finally, his dream became a reality.

Watch the ten minute video below.

I hope it inspires you to remember your dreams.  Life’s too short to forget them.

What do you dream of?

Support Caine’s Scholarship Fund here.

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He loves to help people in ANY way he can. Please reach out to him if he can be of a service in any way. It doesnt hurt to ask.

What do you live for?

Who do you live for?

Sometimes, when you forget the answers to these questions, the universe has a way of reminding you.

Date: Friday, March 16, 2012.

My mom leaves me a text message: “Call me ASAP.”

Over the phone: “Pop-pop couldn’t speak.  He’s in the hospital.  He has a brain tumor.  They don’t know if it’s malignant or not.  They’re operating in the next few days.  He might die soon.”

Wow.  OK.  Contemplation begins.

Life flashes before my eyes.

The universe knocks on my head a few times: “Heyy there!!  Anyone home?!  Are you doing what you’re supposed to be doing?  Are you worrying about being ten minutes late to an appointment or how many chores you have to do?  Does that stuff really matter to you?”

A Text Message as a Sign

Before I received that text message at 10:14 PM to be exact, I’d spent the day with almost twenty of the most passionate, engaging, loving people I’ve ever met (Thanks Jonathan Fields).  They were so engaging that life took the form of butterflies in my stomach, throughout my bloodstream, and fluttering within the lenses of my eyeballs for the previous twelve hours.

I had already remembered what life was about: the love and the humanity.

But walking home, my thoughts wandered to the doldrums of the following week: the multitude of unimportant tasks.

So the text message came.

It reminded me about the answers, reinforcing a truth of the universe: “Without humanity, nothing matters.”

A Not-so Serious Life

Life isn’t as serious as your mind makes it out to be. ~Eckhart Tolle

Date: Sunday, March 18, 2012.

I drove to visit Pop-pop at St. Peter’s Hospital in Central New Jersey.

As I’m driving, I begin to dread the situation that I will find him in.

I enter the hospital doors and I think to myself: “Wow, hospitals suck a lot.”

Think immediate energy depletion.  Serious disease and imminent death has that effect on life.

I walk up the stairs to the oncology wing.  I hear beeping machines and see older gentleman walking gingerly with the help of nurse’s aids.

Finally, I enter Pop-pops door.  He sees me…

[LOL!] ~Pop-pop

“What the F?”  I think to myself.

The guy is about to get his skull cut open and he’s laughing up a storm.

Apparently, he was happy to see me.

Not-so serious, but very real.

I ask him questions, some of which, are more important than the others (particularly #6 and #7):

1. How was your day?
2. How bad is it?
3. When are they operating?
4. Did Mom cry?
5. Did you cry?
6. How’s your spirit?
7. Are you scared of death?

He starts talking to me about his neighbor in the hospital room, a Hindu man named “Kiran,” which apparently means “ray” in English.

I ask Pop-pop, “Do you think that means ‘ray’ as in ‘a ray of light’?”

“I think it means much more than that,” Pop-pop answered.

I understood what he meant.

Kiran, hearing us talking about him as if calling to him through our subconsciousness, comes over to talk to interrupt my conversation with Pop-pop.

In broken English:

“Don’t worry grandson.  What is name?  Chris.  Ok Chris.  Don’t worry Chris.  There is no material.  There is only mind.  I meditate for him.  He be fine.”

Kiran continued to passionately explain how in this reality, you can do anything you want in life.

But in order to do anything, you must love both yourself and others.

“When you love and live in the present, the universe is your’s.” ~Kiran

3 Lessons On Humanity

Pop-pop has not been operated on yet. 

But looking right back at Kiran’s dead-certain stare, the feeling washed over me that, he’s right. 

Pop-pop will be fine.

What did I (re-)learn this past weekend?

1. Love and other humans come first.
2. You can do anything you want in life.
3. Humbly observe: you never know where you might see a sign in the form of a text message or a “ray” of light.  ; )

Can you see the signs?

When is the last time you saw a sign that brought you back to your own humanity?

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He loves to help people in ANY way he can. Please reach out to him if he can be of a service in any way. It doesnt hurt to ask.

They (the creators of quotes) say “the eyes are windows to the soul”.

If that’s the case, how well do you know your own soul?

Go to a mirror.

Look into your own eyes.

Appreciate your beauty, your integrity, your heart, your realness.

No, you’re not done after 5 seconds.

Look into your eyes for a solid 5 minutes.  Talk to yourself.  Say “I love you (insert name here).”  Tell yourself what you love about yourself and what you’re grateful for.

Your purpose is to try to understand who you are.

When you start to feel the inevitable tingling in every limb, ahhhhhhhhhhhhh ….

Now you’re touching your soul.

Can you see how almost unimaginably powerful you are!

You might be saying to yourself, “That’s stupid Chris.  I’m not doing that!”

Or perhaps you tried it and found it really awkward.  It will be at first.  But it gets easier with practice, just like anything else in life.

But please do it, because Chris loves you!

Let me know what you learn?

If you don’t know how to turn on your own power, follow the lead of this little girl.

If you do this everyday, you’ll find your confidence and security in who you are radiating aggressively out of your soul, like an old man at a deli trying to send back soup.  (Sorry, had to use the George Costanza quote.)

Then you’ll be able to see your life’s big picture, and how beautiful your creation is from an endpoint perspective.  And that you can do anything good, yeah, yeah, yeah, yeah.

What do you love about yourself?

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He loves to help people in ANY way he can. Please reach out to him if he can be of a service in any way. It doesnt hurt to ask.

Somebody asked Dale Carnegie if he spent his time learning as much as he could about the world.

His answer was essentially this:

 Why would I waste my time trying to learn everything about the world?

There is no way I can be an expert at everything.

That’s why I build a network of people who are experts in their fields.

In this way, indirectly through my network, I AM an expert in everything.

My expertise is in fixing musculoskeletal pain.

I leave the rest to the experts.

When it comes to nutrition, I have three resources that I always ask questions:

1. Dr. Dennis Lesniak of Crossfit 716 in Buffalo, NY.
2. Dr. Alex Rinehart of the NJ Nutrition Center.
3. Diane Sanfilippo of balancedbites.com.

Whenever I get an opportunity to learn more about a subject that has changed my life and continues to change the lives of my family, friends, and patients, I pursue it.

Practical Paleo with Diane Sanfilippo

This past Saturday, March 3, 2012, I attended a “Practical Paleo” Seminar with Diane Sanfilippo at Brazen Athletics in Fairfield, NJ.

As humble observers, it is important to learn as much as we can about moving reality so that we may be able to change our reality and circumstances.  We don’t necessarily need to own the “why’s” behind our actions, but we need to know people who do.

Here are the home-run hitters for me from Diane’s seminar:

1.  Transparency: Body weight is not relevant.

I’m more interested in your long-term health and reducing disease conditions than I am about you losing a few pounds.  Sorry.  ~Diane Sanfilippo

Within the first thirty minutes, Diane told us her weight.  Out of respect for her, I won’t put it here.  But I was awed by her willingness to share this usually embarassing information.  This action shows her true intentions, which are to reduce disease conditions and not just have you lose a few pounds.

2.  Reality: This paleo stuff works.

“This is not a religion.” ~Diane Sanfilippo

There is a lot of dogma out there behind this Paleo bandwagon.  Unfortunately, people discredit the Paleo-diet for being a buzzword right now.

The reality is, though, that this Paleo stuff really does change lives.

It changed Diane’s.  It changed mine.  It changed at least 5 people’s lives from Crossfit Morristown.  And it can change healthcare in the United States and other affluent societies.

You heard it here first.

3.  Cholesterol: Cholesterol is nothing to be scared of.

Cholesterol is a precursor for three things:

1. Steroid and sex hormones
2. Vitamin D – actually a hormone.
3. Bile - used to digest fat.

Your cholesterol levels are independent of how much cholesterol you consume.  And when you don’t consume cholesterol, your body makes it anyway.

Take home: There’s no reason to be scared of egg yolks folks.  It’s not uncommon for me to eat 6 egg yolks/day.  You should do the same.

4.  “The Pregnenolone Seal” – Stress first, sex second.

The Pregnenolone Seal occurs when you experience so much stress that no sex hormones are made.

If you have a low sex drive or are having trouble conceiving a child, you are a victim of this pathway.

5.  Familial hypercholesteremia: Genetic high cholesterol.

“High cholesterol does NOT run in your family.

A bad diet and lifestyle run in your family.” ~Diane Sanfilippo

Well said Diane.

6.  Horrible Sleeping and Carb Cravings:

“Have you ever had a bad night of sleeping and craved carbohydrates the next day?” ~Diane Sanfilippo

As I mentioned when I discussed Endless Summer Syndrome, human beings are meant to sleep when it’s dark out.

When is it dark out?

It is dark for about 8-10 hours in the summer and 10-12 hours in the winter.

Yes, you read that correctly.  No, you’re not sleeping enough.

See how good you feel after sleeping for 10 hours in the winter.

7.  Spot reducing fat:

“How do I get rid of the fat from my triceps or inner thighs?” ~Struggling gym-goer

As I always tell my patients, everyone has six-pack abs.  Some people just have them hidden under a bunch of fat.

You can have the biggest triceps in the world and if there’s fat on top of it, you won’t be able to see it.

Increased fat on the triceps, inner thighs, or chest is a sign of high estrogen levels, caused by an inflammatory diet.

It just so happens that the Paleo-diet is also an anti-inflammatory diet.

8.  Every disease has a cause:

Many people are told by their primary care physicians that their disease condition is “idiopathic.”  That means “we have no idea what is causing your symptoms.”

“How scientific is it that any condition is idiopathic?” ~Diane Sanfilippo

Medical doctors may not know directly what causes a disease.

But when humans start eating, moving, and thinking according to what their genes require, disease conditions miraculously (and sarcastically) disappear.

Just because any healthcare practitioner does not know what is causing your symptoms does not mean it can’t be fixed.

Where Should I Spend My $1000?

If a patient comes to me who is in chronic pain, sedentary, and ridden full of disease, and they have only $1000 to spend on one type of care, where do I send them?

My choices are:

1. Me (of course) to get them out of pain.  Why wouldn’t I take their money?
2. Pay for an annual gym membership, probably at a Crossfit gym.
3. Pay for the highly qualified experience of a Paleo-ish nutritionist and spend the rest of that money on organic vegetables and grass-fed meat?

I’d choose #3 every time.

Diet is more important than manual therapy and exercise.  Your foods literally make you.  Do you want to be made out of twinkies, pasta, or spinach?

Popeye was onto something.  I wonder if he was one of Dale Carnegie’s experts.

Thank you Diane, for being one of mine.

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He loves to help people in ANY way he can. Please reach out to him if he can be of a service in any way. It doesnt hurt to ask.

Writer’s Note: I was recently in Atlantic City in a club, dancing with a few friends. I was not sober. In the club, I had an epiphany. I stopped dancing and just stood there. Deja vu, kind of. The last time I was in that club, I was not sober either. It was the last time I saw my cousin before he committed suicide. It’s amazing that I remembered it, because I want to emphasize how “not sober” I was. 

I believe it happened for a reason. The epiphany occured so I could share this speech, which I gave to my Toastmaster’s Club. I believe that what is written here can change the world … and will.

Some parts of what is written below might read funny because it was intended to be spoken, not written. Please overlook funky grammar.

Please also realize that as I was scared to share my depression post with you out of fear of judgement, I’m scared to share this with you, as I was scared to give this speech to live people. Because I’ve found that running into my fear rather than away from it as incredibally empowering, and wanting to lead by example, I share what is written below.

For those of you don’t know me, I used to burn myself with coat hangers that I’d heat on the stove top. I wanted to hurt myself because I thought it was my right and I wanted to feel alive. You see, I come from a subconsciously self-destructive family. We seem to want to harm the bodies that allow us to exist. With my self-inflicting tendencies, my Uncle’s mentioning of wanting to shoot himself at times, and my cousin’s downfall, I’ve discovered that keeping myself above the happiness threshold to be of paramount importance.

Mr. Toastmaster, Fellow TM’s, and Honored Guests, I’d like to share some of the things that I’ve learned about love and happiness with you why its important to let these energies breeze into your living rooms or any other space you may be occupying.

Lesson 1: People need to be touched. Not sexually for any of you SICKOS in the room.

Seriously, even dogs and cats, just need your hand tugging at their fur.

Touch has become a genetic requirement for emotional health.

Being touched tells your brain that you are loved. Love gives you the social support to share the burden of everyday life, whether that’s finding shelter, hunting and gathering food, finding a mate to spread your genes, or working a 9 to 5 in 2012. In today’s world, it saves you from the intolerable hopelessness of being alone.

Touch, is a way in which you can create an ocean breeze, loving suttly from one person to another.

Lesson 2: Love buffers pain.

As a chiropractor, I’ve realized that alot of physical pain is caused by the mind and spirit. Many people don’t talk to anyone about what is hurting them and this torment brews internally.

Here is a little experiment to try. Next time that YOU and ANY OTHER HUMAN BEING you observe is spiritually sufferring, that means they’re depressed, sad, or not happy, try this.

Set aside 15 minutes to give your unbiased, focused attention. Sit with this person. [Kneel next to person in front row.] Look at her right eye (her giving eye) with your left eye (your receiving eye) to set it up so that she subconsciously wants to unload her burden in your company. Put your hand on her knee, shoulder, or hand, using the power of touch. [Put your hand on her hand.] Mimic her posture or gestures to create repoire. Remember that there is no other thing or person in the world at this time but who you are sitting with. It’s complete blackness, and she is all that exists.

Then say with intent …

“These 15 minutes are YOUR’s. Tell me …. what’s wrong.”

Then, wait for a few moments until she realizes you’re serious. When she still hesitates, here is what you’ll say next:

“I’m sorry, but if you smell anything funky, I just farted.”

Next, you’ll both laugh, and her guard will be down. Finally, the floodgates will be opened and she’ll unload her burden and talk. As you emotionally remove the spiritual knife at her side, all you want to focus is on feeling her suffering.

Your goal is put yourself in her shoes, so that you come from a place of compassion, so that she knows, she is not alone. Not to put her load on your shoulders, but to acknowledge what that burden is as it falls to the ground. And when you’re done, hug her. And tell her, “I feel you, you’re not alone, and I love you.” Follow that with “Again, I’m sorry, I shouldn’t have eaten those beans.”

This type of spiritual engagement between two beings is like a twister carrying a slap in the face. Now we’re starting to feel alive.

Lesson 3: Plants flower. But humans flower too.

Love was always there, as evidenced by the nurturing that mammals give to their offspring, but more recently, love seems to be expanding, or flowering if you will.

[Pull out rose from brown paper bag.]

Land plants have been around for approximately 425 million years, but the earliest fossil of a flowering plant is dated about 125 million years ago. With the flower, a new level of beauty has been seen. And every time that an organism recognizes a flower’s beauty, completely enveloped in its infinite existence and unbound presence, a person comes back to their true existence, and that is of love, to love, and in love.

Pay attention. Can you see the way the world is changing? The economy was and continues to be down. Low skill jobs are hardly needed, requiring a higher level of intelligence in order to make a living in this world. As we evolve in intelligence, people begin to support more and more of their communities, understanding that the whole is more important than the individual. That love, in the words of Paul McCartney and John Lennon, is all you need.

Grand Finale

The intraearthly whirlwind of wanton love is not about Chinese dumplings (wontons). That 15 minute conversation would result in one heck of a fart storm if that were the case. But about a movement (not a bowel movement), but a social movement that has no motive or provocation or reason for showing up. Love, like the storm that was Hurrican Irene without any apparent cause, is gathering momentum, gusting whispers and sweet nothings to every passing soul and spirit. I see more and more people touching others. Sharing suffering. Looking at one another’s eyes. Listening with their undivided attention. Observing flowers (even the machoest and gassiest of men like myself). Making the world a better place.

If this whirlwind continues to spread, and people continue to flower, can you imagine what the world would be like?

Next time you picked up the coat hanger off of the stove top, the whirlwind would come through, and someone would be there to listen to your pain, and you’d put the coat hanger down.

You would make the time to go to Atlantic City with your cousin, who reached out to you for weeks, before he committed suicide.

Instead of thinking about the twenty chores you have to do today, you’d actually finish the conversation with the person who is desperately seeking someone to talk to about their bad day.

Gandhi didn’t say we should talk about the change we want to see in the world, he said to be it. Don’t you think it’s about time we stop talking about making this world a better place, and start being it?

The whirlwind is expanding. Keep it moving. You just don’t know whose life you might save. Mr. Toastmaster.

[Give flower to woman in front row]

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He loves to help people in ANY way he can. Please reach out to him if he can be of a service in any way. It doesnt hurt to ask.

What are your thoughts on Vibrams, Inov-8s, or Nike Frees?

You’re not supposed to wear orthotics, are you?

Shouldn’t everyone run and walk around barefoot?

Why do my ankles hurt when I run barefoot or when I run with $200 pairs of Nike “Fluffs”?

In this post, I will address some of these questions.

Writer’s note: Please keep in mind, this information comes from the perspective of a doctor who deals with acute and chronic pain, and takes it as his responsibility to get and keep people out of pain.  This perspective may be different than your runner who took up barefoot running without problems, strength coach, or other hippie type who all have their own motives and beliefs.

The Barefoot Theory

Whenever discussing movement, diet, mindset, beliefs, behaviors, or any earthly idea at all, it helps to put it into context so that you have a framework of thinking that governs where the idea belongs in your brain hierarchy.

Benjamin Franklin looks like an idiot when flying a kite in a thunderstorm.  But when you find out that in the context of figuring out how to prevent buildings from burning down by lightning strikes, suddenly Ben’s actions make sense.

People have been walking around barefoot or with nothing but a piece of cloth on their feet for millions of years.  Just like the Paleo Diet works because we eat the food that our genes evolved with for millions of years, so did our feet evolve to not need so much support.

We wonder why when we start sitting in chairs for eight hour days or wearing shoes that the human body has never seen before the past forty years why so many people suffer from musculoskeletal pain?

Ideally, people should be barefoot or wear shoes that resemble being barefoot in order to be healthy, with a multitude of scientific reasons as evidence.  And your kids should never wear any type of fluffy, expensive shoes if you want them to turn out to be super babies.

Anything you can do to live in congruency with your genetic requirements will cause you to be healthier and happier.  Any healthcare intervention that does not take into account evolutionary biology should not be trusted.

We’ll address the caveats afterwards.

The Science of Being Barefoot

We’ve all heard the principle:

 Use it or lose it. ~ God.

Being barefoot asks our body to do more work (more load).

Tom, Dick, and Harry (when dissecting the human body in chiropractic school, these were the names we used to remember the muscles of the deep calf) are going to do at least their 9-to-5 job, and likely be asked to work overtime.  Tom is Tibialis Posterior (the highlighted muscle on the right), Dick is Flexor Digitorum Longus (just to the left of highlighted muscle), and Harry is Flexor Hallucis Longus (just to the right of the highlighted muscle).  All of the miniature intrinsic muscles of the foot will work overtime too.

But it is largely Tom, Dick, and Harry’s job, when on the flat ground, to keep the arch up vs. flat footed.  This is in opposition to conventional wisdom, which states that it is those muscles right underneath the arch.   It’s the calf is responsible for whether someone is flat footed or not!

To confirm the importance of these muscles, in anecodotal studies, when tibialis posterior is torn, the arch completely collapses.

Tom, Dick, and Harry will do their job as long as their asked, before they burn out.  : (

When they burn out, a variety of conditions can fall upon us such as:

• plantar fasciosis
• achilles tendonosis
• Tom, Dick, or Harry strain or otherwise known as “shin splints”
• Gasctrocnemius or soleus strain
• Peroneus longus or peroneus brevis strain
• Tibialis anterior or extensor digitorum longus strain
• Hip flexor strain (with the calf’s inability to push off when walking or running, something has to compensate, and it is often the psoas, iliacus, or quad)
• 1st toe metatarsalgia or “John Bunion“
• “Ankle weakness” (which is what I experience from scar tissue in my Tom, Dick, and Harry)

The Pathophysiology of Vibrams (layman’s terms: “how your foot pain develops”)

Another earthly principle for you:

The only healthy posture is one that is always changing. ~The humanly Stu McGill

Going through kindergarten, high school, and college sitting in chairs with nice “fluffy” shoes diminishes our capacity to do work significantly.

Capacity is diminished because of two problems:

1.  Adhesion

Remember, we’re not meant to be sedentary. When we are, muscles stop contracting, blood flow stops.  When blood becomes stagnant, toxins build up (How are the garbage men supposed to get though when there’s a traffic jam?  They can’t!), free radicals enter the scene, damage is done, “adhesion” or scar tissue builds to repair that damage.

Short term solution.  Long term problem.

Many people who start running with no or minimal footwear and develop pain have significant adhesion in Tom, Dick, Harry, and the rest of their crew.   Adhesion glued to the muscles is like breaking the right leg of Tom, Dick, and Harry.  You want your guys to have both arms and both legs to work and not be handicapped.

You can roll out the deep calf with a lacrosse ball.  This can make it less painful to run.

But the only solution to this problem is getting rid of the adhesion in Tom, Dick, or Harry by finding a licensed ART or MAR provider.  Graston or any instrument assisted technique will not be able to penetrate to the proper depth because the gastrocnemius and soleus are more than an inch thick.

2.  Weakness

Load your body close to what it can ultimately handle.  Let it be damaged.  Let it recover.  Then load it more.  Repeat. ~Mother Nature

You won’t realize how much you use your calf and foot muscles until you try barefoot standing or running.

The tricky part is to know when you’re doing too much.

The key part is this: ramp up load (amount of running or standing) slowly. 

With no adhesion present, and you slowly and gradually increase load, then Tom, Dick, and Harry will gradually get stronger without incidence.

And you can run barefoot successfully.

For example, if you run 10 miles a week total in Nike “Fluffonator” Max 95 with a big and bulky heel, Tom, Dick, Harry, and the rest essentially have part time jobs.

Running 10 miles a week in “Fluffs” and too quickly transitioning to running 10 miles a week in Vibrams, Innov8′s, Nike Free’s, or barefoot is like going from working a 20 hour work week to a 40 hour work week, if not a 60 hour work week.

Your lazy, just graduated brother from college just can’t handle that much work!

Exit “Crutch”, Enter “Load Management”

Me – “Dr. Brady, why would I ever want to use a lifting belt when doing deadlift, an orthotic when walking or running, use a chair when sitting, or even a bed when sleeping?  Why wouldn’t I just deadlift 600 lbs, run barefoot all of the time, sit on a physioball at work, or sleep standing straight up like a Conehead?  Aren’t these all just “crutches”?  Why wouldn’t I always ask my muscles to do as much work as possible?  ”

Dr. Brady – “Stupid question Chris. [Just kidding, he didn't say that.]  No, they’re not “crutches”.  They’re “load management” devices.

Every movement you do has a limiting factor that prevents you from doing more work.

For example, say you’re doing a deadlift or just picking something up off the floor, perhaps your capacities look like this:

• Your legs can lift 300 lb.
• Your shoulders can lift 300 lb.
• Your ankles can lift 300 lb.
• But your low back can only lift 200 lb.

While the rest of your body can lift more weight, your low back is going to prevent you from lifting any more by rounding over and possibly even getting injured at 200 lb even though the rest of your body can handle it.

You can circumvent this solution by managing the load on your low back by wearing a weight belt and actually giving the rest of your body a workout.  This way, you won’t be limited at 200 lbs and can increase the load up to 300 lbs.

Back to the barefoot conversation ….

If you have:

• a) adhesion: aka “scar tissue” aka ”bubble gum” aka “super glue” in your calf and foot that you can’t get rid of
• b) overload: your job or life activities require that you load your calf and foot alot, then an orthotic as a load management tool is a good idea.

For example, as a chiropractor, I tend to stand all day.

When I started wearing sole support orthotics, I experienced a great amount of comfort and much less fatigue and achiness in my deep calf and foot.  The orthotic decreased the load on my calf/foot so that it didn’t exceed capacity and I had no symptoms.

To Vibram or Not To Vibram

Long story short:

1.  Sound Theory: I agree that ideally, we’d all be walking or running around barefoot or in minimalist footwear.  Unfortunately, this is reality and not everyone can do this without messing themselves up.

2.  Experiment: In minimalist footwear, increase activity slowly.  Add a mile or two every couple of weeks and notice how your body responds

3.  Stretching: Either before beginning to run in Vibrams or meanwhile, increase ankle dorsiflexion range of motion.  Kelly Starrett uses a band, which is the most effective way to make sure you’re stretching Tom, Dick, and Harry, and not giving yourself an ankle impingement caused by the posterior ankle ligaments.

4.  Orthotics: Generally a good idea if you tend to run or stand alot and are worried about calf health.

In my experience, I’ve found that wearing orthotics throughout the day and working out with minimalist footwear or barefoot is a good strategy for load management of the legs and feet.

5.  Pain: If pain sets in,  find a licensed ART or MAR provider and back off the running.

When it comes down to the ultimate question.  The answer is clear: “Yes … and no.  It depends.”

As always, if you have personal questions, feel free to ask.

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He practices out of Guerrilla Fitness:Crossfit Morristown.

On a February 14, an old man boarded a bus, carrying a dozen roses.  A young man made room for him to sit, saying “Somebody’s going to get a beautiful Valentine’s Day gift.”  The old man smiled and nodded.

After a few minutes, he noticed that his young companion was still gazing at the roses.  “Do you have a girlfriend?” he asked.

“I do,” said the young man.  “I’m on my way to see her.  I’m bringing her this.”  He held up a Valentine’s card.  They rode along in silence for another few minutes until the old man rose to ge toff the bus.  As he stepped out into the aisle, he suddenly placed the roses on the young man’s lap and said, “I think my wife would want you to have these.  I’ll tell her I gave them to you.”

He then turned and left the bus.  As the bus pulled away, the young man looked out the window to see the old man enter the gates of a cemetary.

Moral of the story:

You never know where the opportunity to love another might come.  Whether boyfriend/girlfriend, husband/wife, son/daughter, friend, or even stranger.  When you give love, it seems to magically come back to you.

Can you imagine being happy without feeling loved?

I can’t.

Feel mine then.  From me, a wish that you may have a very Love-filled Valentine’s Day.

Love always,

Chris

Note: The story is courtesy of Dan Millman’s book, Living on Purpose.

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He practices out of Guerrilla Fitness:Crossfit Morristown.

If I had it my way, I'd put Abe on the $1,000 bill, because he's worth way more than $5.

When trying to master life on Earth in order to be as healthy and happy as possible, it can be helpful to learn how other humans fail and succeed.

Why not learn from the best then, right?

And to celebrate his birthday today, we’ll learn from Honest Abraham Lincoln.

When I do good, I feel good.
When I do bad, I feel bad.
That’s my religion.
~ Abraham Lincoln

Does morality and the choices you make every day have to get more complicated than that?

I don’t think so.

Man, I love you Abe.

Be sure you put your feet in the right place, then stand firm.
~Abraham Lincoln

Courtesy of akeg

Does your thumb hurt?

Then you may have a “painful thumb”.

Yes, that’s the medical diagnosis ….

Why I Hate “Arthritis”

I’m sitting at breakfast as I watch a woman grab and massage her thumb in pain.

Being always curious, I ask her what’s wrong.

“My thumb arthritis is acting up.”

I think to myself “Oh is it?”

A few treatments later, her pain is miraculously (and sarcastically) less.

If her pain were truely caused by “arthritis” which I define as “bone smashing into bone” pain, her pain would have lessened a small amount or not at all.

But in her case, there was a noticeable, 30% reduction in symptoms only after three visits.

Because my treatments don’t address the “arthritis” or shape of the bones at all, the diagnosis is mostly wrong.

The Most Common Musculoskeletal Condition in the Body

Adhesion (or “scar tissue” when caused by trauma) is rampant.

An adhesion is a think bundle of connective tissue caused by two processes:

1. trauma.
2. repetitive contraction most often caused by overuse.

In regard to #2 from above, you might imagine where all of the texting with our thumbs is going to lead the 300,000,000 people in America and the rest of those around the world.

Adhesion is problematic for a few reasons:

1. It causes tightness and restricts range of motion.
2. It causes weakness within the muscle (or other tissue) that it is present by not being able to handle the muscle’s work and thus, underworking.
3. It causes weakness in synergistic (muscles that do the same motion) muscles by overloading them and thus, overworking.

With adhesion causing much of the tightness and weakness around the world and a lack of practitioners able to diagnose and treat the problematic tissue, we all might wonder why the most common musculoskeletal condition in the body is actually the least commonly diagnosed.

The Answer To Your “Painful Thumb”

Too many people complain about their fixable medical conditions without getting results from them for me not to address these problems.  The truth is that all of these are (mostly) fixeable:

• thumb pain
• plantar fasciosis
• achilles tendonosis
• medical epicondylosis
• lateral epicondylosis
• wrist pain
• big toe pain (otherwise known as “painful big toe” or “arthritic big toe” if you must)

And there are more.

Please realize that just because your pain has not been fixed before does not mean there isn’t an answer.  Remember, you can’t hammer a nail with a screwdriver.

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He has been trained under the Integrative Diagnosis system for “clinical excellence”.  He practices out of Guerrilla Fitness:Crossfit Morristown.