Monday, November 22, 2010

(Almost) Happy Feet: Steps for plantar fasciitis recovery & good shoes

I still have plantar fasciitis (PF) in my left foot but I'm finally seeing progress again. This is since the disasters earlier this year that have pushed back the healing process.  In January I tried running a few miles (2 to 4) per my doctor's okay after having my PF foot immobilized in a cast for a month (in October'09) followed by three months of physical therapy and a cortisone shot (November thru December'09). I ended up with a calcaneal contusion (bone bruise in my heel) and plantar fasciitis all over again. While riding my road bike in May, I got hit by a van and between the road rash, an infected abrasion on my ankle, bashed up hand, and whip lash from hitting the pavement that day, I wasn't able to train or do the PT exercises for about 8 weeks. Argh! So, 2010 will not be my fondest year.  After doing core and strength workouts in the gym with an athletic trainer beginning in July and getting the foot treated by running injury specialist chiropractor once a week in mid-October this year, the PF is finally getting better. And, I'm finally starting to much feel better physically and mentally.

If you are suffering from plantar fasciitis, I have a lot of empathy for you. Don't ignore that heel pain! I did two years ago and that is how I got into this situation. I've had to deal with this running injury off and on since December 2008. Finally, it's starting to go away. Here is what is working for me...

Plantar Fasciitis Recovery Steps That Seem to Be Working –Finally:
  1. Sleeping with a Strassburg Sock night splint on my PF foot; By keeping the foot stretched in a dorsaflexed position, it allows the damaged fascia tendons to heal in a stretched position that prevents re-tearing every time my arch flexes down when I walk or run (Earlier this year I wore the Swede-O Thermoskin night splint with good results but had to stop after a bike accident since its thick ankle strap irritated the road rash on my left ankle) - every night
  2. Stretching the Achille's tendon every day (and calves and hamstrings) for 30 seconds each day- 1x/day
  3. Core and strength training (upper and lower body) in the gym to develop better running posture and prevent re-injury - 2x/week
  4. Foot strength training with toe-towel pull and other exercises from recommended by my physical therapists, chiropractor and the book Injury Afoot by Patrick Hafner* - 2x/week
  5. Increasing circulation to damaged fasia tendons to expedite healing and optimal tissue alignment (while breaking up the twisted scar tissue) with deep tissue massage, ultrasound or rolling my foot on tennis ball (followed by 10min ice treatment) - 3-4x/week
  6. Cardio workouts in the pool, on an elliptical machine or on my road bike - 2x/week
  7. Good chiropractic therapy by a sports injury specialist at Wilson Chiropractic Clinic in Ventura. This place was recommended to me by someone who had plantar fasciitis and recovered from it (I don't receive a benefit by mentioning this place and haven't told my chiropractor about this post) - 1x/week
  8. Think positive thoughts (thinking positively lowers one's stress hormone levels which enables healing)
  9. Eat highly nutritious foods: A fresh organic fruit smoothie on most mornings followed by a low-processed carbohydrate diet mostly nutrition-rich whole foods (fruits, vegetables, dairy and nuts)  in meals I prepare for my family at home from our local grocery store and CSA farm basket from Ojai 
  10. Wear good shoes: I wear my regular shoes with custom orthotics or the anatomically designed comfortable Kuru shoes** or stylish FitFlops (Both of these footwear companies make shoes that come with anatomically supportive arch supports and heel pads, and they are, honestly, the most comfortable shoes I have ever worn.* ) I had to get rid of all my sandals and flip flops that didn't have arch supports.:(

Weekly Workout Time: Those ten steps translate into a half hour to one hour workout per day– about 5 hours a week. That should be do-able for most people. As a busy parent, who is in a graduate program and who works part-time, this is all I have time for now. This is about half to a third of the time I normally would like to workout each week (10 - 15 hours). Wouldn't that be nice.

Motivation: I try to workout first thing in the morning before I take the kids to school. Also, I register each workout on my free account. Stressing about staying on track with my workouts on is self-motivating and allows me to see progress and trends with workouts the past year.

Full Disclosure:

I promoted several products in this post. For full disclosure, below are the details about my experiences with the two products that I have received free for this review and my relationship each.

*You can find plantar fasciitis recovery and strengthening exercises in the book Injury Afoot: 30 things You Can Do to Relieve Heel Pain and Speed Healing of Plantar Fasciitis by Patrick Hafner. The book is clearly written and features photos of every stretch and strength training exercise recommended by podatrists to recover from plantar fasciits. The author has a degree in kinesiology and has recovered from PF himself. I bought my first copy on and reviewed it earlier this year on a post about minimal shoe and barefoot running. The author Mr. Hafner contacted me after reading my post and offered to send me a free copy. The exercises in the Injury Afoot book worked for me except that I put off wearing good shoes and a custom orthotic the first year. Now, I know better.

**Kuru Shoes sent me a pair of their Halcyon model in October to review on this blog. I wore them at our kids cross-country meets for a few weekends and they are the most comfortable shoes that I have ever worn. They were even more comfortable on my feet than my running shoes with my custom orthotics. I asked a few parent friends what they thought about my free comfy Kurus and here is what they said:

"They look funky...With shoes I don't care what they look like. It's all about comfort for me." ~ Physician and mother of two very speedy little girls on the cross-country team.

"Well, they're earthy looking. I'm not a real earthy person." ~ Local race director and multisport retail store owner

"They're, uh, kind of funny looking. But I like 'em!" ~ Local catering business owner

"You didn't buy those, did you?" ~ Hubby

Oh well, so the particular model they sent me won't be found in a fashion magazine but at least they allow me to walk pain free and are good for my PF recovery.

When recovering from chronic plantar fasciitis (or "plantar fasciosis" as one of the several foot specialists I've seen has called my particular chronic case), the key is doing something every day to help the healing and prevent re-injury. After spending hundreds of dollars on medical care for this running injury, what seems to be finally working is doing basic stuff consistently: Deep tissue work followed by ice treatment, daily stretching, wearing a night splint each night, cross-training and wearing good shoes.

Sadly, I can't walk around barefoot anymore. And running in minimal shoes--at least in the near future-- is out of the question. But I really don't care. I would wear clown shoes if I thought it would help me run again...Really!

Wednesday, October 27, 2010

Social reproduction of two ex-Ironman triathletes: Why our kids like sports

Our family has fun working out together.

This morning, after the kids and hubby left for school and office, I was thinking what a wonderfully wacky and athletic family we have.  Our kids, a 14-year old son and 11-year old daughter, actually wanted to get up at dark-thirty (in multisport terms that means "pre-dawn" which was 5:15 this morning) and hit the gym with their parents.  This isn't every morning and usually my son sleeps in until the last possible moment before school or friends or sports drags him away from dreamland. I asked him why he wanted to get up so early. It was still dark! "It would be a fun way to start the day," he said. "The jacuzzi and a swim just sounds so good right now." Similar response from our daughter: she likes to get her workouts "done in the morning." She's been running regularly since last Thanksgiving and she joined the local club cross-country team this Fall.

Our kids think that running and working out every day is normal.

I think that is so cool.

But why do they like sports so much when some of their friends seem to be allergic to sea water, "hate running," and couldn't stay on a skateboard un-assisted for longer a second?

Pierre Bourdieu, a French anthropologist,  said the goal of a family, culturally speaking, is "social reproduction". Whether it is our conscious intention or not, our kids repeat our lives in one way or another.

Social reproduction: Praxa and doxa

In An Outline of a Theory of Practice, Bourdieu’s ethnography of the indigenous Kabyle tribesmen of Algeria, Bourdieu explains his materialist (socioeconomic) and post-modern social theories within the context of interpreting Kabyle cultural practices (Bourdieu 1977:vii).  In particular, Bourdieu makes a decisive break from his French structuralist predecessors by analyzing the human agency and strategy behind the practices of his Kabyle informants, or, what Bourdieu calls their culture’s assembled practices or praxis. Bourdieu believed that “society is constructed by purposeful, creative agents” who create their culture “through talk and action” (Erickson 2008:187). He believed that a cultural group or a society is united in “systems of relationships" and praxis and that have a natural order or "orthodoxy" that is promoted by the dominant group or authority. He calls this cultural authority, it's doxa (Bourdieu 1977:169).

Our family is a prime example of what happens when two athletic ex-Ironman triathletes have kids.

Our family praxis is based on working out together. There are usually workout clothes and sports equipment somewhere on the floor of our house, water bottles on the kitchen counters, HEED and Cytomax tubs in the cupboards and wet suits and beach towels drying in the tree by the backdoor. We "play" every day. Nearly, every day since they were born our kids have seen Mom and Dad leave the house for a run, swim, bike, surf or do some other physical activity, alone or with friends. By watching us, they've learned that working out is fun and makes them feel good afterwords. With friends, it's like a playdate. Soccer, rugby, swimming, taekwando, running, and junior lifeguards, our kids have been on a competitive team of some kind since kindergarten. When not competing, they are usually doing some sport just for fun like surfing, playing around on their skateboards or riding their bikes around town with their friends. Working out is just part of our family's daily praxis. It is a part of our daily routine like brushing our teeth is in the morning.

Our kids have seen their mother push herself to try qualify for Boston and have their seen their father race the Big Sur Trail Marathon with the flue. (He survived fine thank goodness. We figured he scared the flu right out of him with that run--the old "in-hospitable host" theory of flu recovery).  They have also seen their parents go back to school and take entrepreneurial risks so they can be more competitive professionally and happier personally. We have had set-backs, been injured, and have bad days like everyone else, but pushing ourselves physically and mentally is a positive value in our family's doxa.

If all of that sounds too good to be true, I don't blame you for thinking that.  But how did we get our kids to join us working out? How did we get them to not rebel against a parental and cultural hegemony that extols a healthy and athletic lifestyle?

They gotta wanna

I think it is, in part, just as Bourdieu said: social reproduction. Our kids are only mirroring what we are doing every day. If they saw us read, compose songs, drink a lot of beer with our friends, or work longer hours instead of working out in the outdoors--they would probably seek and mirror those behaviors instead.

But I also think their choices are due to our high expectations and use of constant positive re-enforcement.  We don't make them go running with us because it's healthy, we encourage them because it's fun. We ask them to just give a sport a try for one season, and if they don't like it, they don't have to do it again.

The key is for us to encourage our kids to try new things, to  do their best, and to have fun.

Our daughter just started running regularly last year. Before that she really wasn't in to sports. It was our idea when she was younger that she try soccer, Junior Lifeguards, and taekwando. Now, it's her idea to go running and workout at the gym.

Our son got into soccer,  taekwando, and running, initially, because it was our idea. Now he runs and plays rugby because it is his idea. We tell our kids, "Just try it for one season. Do your best. If you don't like it, you don't have to do it next year." If they don't like a sport, that's fine. It is important that they know that we are on their side.

It is also about those old fashioned words of parenting that I remember hearing when I grew up: "Just try it," "Don't quit," and "Do your best."  With the grueling cross-country races our kids have been enduring lately, our advice has been even more empathetic, "I know it's hotter than hell out here and it sucks. Just do your best." and "Don't listen to that guy.  Just do your best."  And, most importantly, and simply, "I'm so proud of you."

The key for me is to make sure our kids' main motivation is internal. They have to want to do well to really excel and be true competitors. They have really believe in themselves. As my old Masters swim coach in San Diego used to say, "You gotta wanna."  Empathy coupled with high expectations are important values in our family doxa.

Old School

My childhood experience was not particularly athletic. As an admittedly non-athletic artist and family iconoclast who preferred books and horses to bicycles and health clubs, my single-parent mother  couldn't relate to my desire to run the trails after school when I was a teenager. Or, to learn surfing, on my own, when I was 19. My mom didn't even know how to swim. But to her credit, she always encouraged me and cheered me on  at dozens of cross-country races in high school and drove me to many a 5K and 10K race on the weekends. She allowed me to hang out at the beach, it seemed, nearly every single weekday, during the summer. She even bought me my first triathlon racing bike, a Specialized Allez, when I was in college. I rode that bike all over San Diego country in my twenties and decorated it with my product sponsor's stickers. I heard "I'm so proud of you" a lot from her when it came to racing.

I'm an old school runner and triathlete. When I started racing, it wasn't cool for girls to be a competitive runner. It was unusual. I was the only girl I knew to enter the first Los Angeles Marathon in 1986. My college training buddies were a Phi Delt and a Sigma Chi who were in my advanced running class. I think I was the only girl in that class, too. That first marathon was only two years after the first Olympic woman's marathon ever at the 1984 Los Angeles Olympics. I did my first triathlon in 1987 as one of the few women in my age group and one of the few people who even knew what a triathlon was it seemed. I taught myself how to swim freestyle in Mission Bay in San Diego – trying to keep up with my roommate who grew up with a pool. Eventually, I found my way to the slow lane and some coaching at a local Swim Masters club in La Jolla. On the bike, I would train Dave Scott-style, usually alone, with a ziplock bag of Fig Newtons, a baked potato or a PB&J, stuffed into a fanny pack for long road rides and a bottle of water.  My training pals were usually athletic college students or young people trying to make money in the outdoor sports industry.

It's an endurance sport culture

Nowadays, there are packs of brightly colored and jerseyed road cyclists all over our local highways each weekend morning. Nearly every town has their own running club, triathlon team and local Masters swim program.  Most of the multisport athletes, it seems are middle aged professionals. The doxa of American sport culture has changed since the days when I was a kid. Marathons, triathlons, and lately long-distance trail running ("racing ultras") have gone mainstream (Helliker 2010).  Today there are about 1.2 million triathletes in the United States, up 51% from 2007, and according to last Sunday's New York Times article, a third of them are men in their 40s (Gardner 2010). A few weeks ago, the Boston marathon sold out in less than eight hours. The proportion of women racing marathons have grown from 10% of the field in 1980 to 41% in 2009 (Running USA 2010). "Marathoning has soared in popularity in the United States. In 1976, 25,000 Americans finished marathons, according to Running USA. Last year, there were a record 467,000 American marathon finishers," according to The Boston Globe on October 18th (Pepin 2010).

Our kids are turning out athletic like us. And, it appears to be national trend. Those wacky multisport events called "triathlons" and long-distance races we did in our younger years are conventional now. "Training for Ironman is the new golf!" an old Ironman training pal and multisport retail shop owner told me the other day, rolling his eyes.

I'm so grateful that both of our kids like doing endurance sports.  It has been so fun to workout together--as a family. I'm going to enjoy it as long as it lasts.


Bourdieu, Pierre, 1977 An Outline of a Theory of Practice, New York, NY: Cambridge University Press, Pp.248.

Gardner, Ann Marie 2010 "Triathletes, Swim, Bike and Run for Youth," New York Times, October 24, 2010, R12.

Helliker, Kevin 2010, "Making marathons even tougher," Wall Street Journal, August 17, 2010; Retrieved on October 26, 2010, from:

Pepin, Matt 2010 "Boston Marathon sells out in a day," The Boston Globe, October 18, 2010; Retrieved on October 26, 2010, from:

Running USA 2010 "Running USA's Annual Marathon Report," Running USA; Retrieved on October 26, 2010, from:

Friday, July 16, 2010

5 Steps to heal plantar fasciitis (after getting hit by a car)

It's been exactly two and a half months since my last blog post about treating plantar fasciitis and it is with great disapointment that I must report that MY HEEL STILL HURTS. And, you know that really sucks and I'm tired of blogging about it and it's not entirely my fault (or my heel's fault) and I wish to God that I could blog about being CURED of plantar fasciitis, instead.

(Sorry about the all-caps words. I just wanted to get my point across that if you are tired about this topic of mine, I am very, very tired of it.

If you are new to plantar fasciitis and are looking for treatments that work, please see my earlier post: "5 Steps to Heal Plantar Fasciitis: Cloud Care from Running Twitter Friends" or go see a physical therapist or athletic trainer who specializes in healing running injuries – or a podiatrist– with good references from runners. If I learned anything from this year of chronic plantar fasciitis pain is that getting a good reference from a runner is key. I didn't a year ago. And, I still have plantar fasciitis.

The reason why I haven't written earlier is two-fold and related:
  1. I got hit by a car while riding my road bike on May 15, 2010
  2. I had to stop doing my "5 Steps to Heal Plantar Fasciitis" after the accident
Because of the accident I have not been able to follow the "5 Steps..." for the past eight months. Before the accident, according to my orthopedic surgeon foot specialist on my last visit in mid-February, I had a calcaneal contusion and still had plantar fasciitis – but it was going away. I was getting better and was advised to keep doing what I was doing and to gradually build up my running mileage from jogging a block, to a mile, to two miles, etc. Two months of doing this, on my first road ride since December,  I got hit by a car. :(

However, I believe my "cloud care" steps to get rid of plantar fascitis came from real people who really recovered from plantar fasciitis.  I found them at my Twitter account @MultisportMama by posting a tweet: "How did you recover from plantar fasciitis?"

So, that being said, here are the 5 Steps to Heal Plantar Fasciitis that worked for other people*:
  1. Stretch (gastrosoleus/calves/hamstrings): Increase flexibility by daily stretches and by wearing night splint when sleeping

    (From the accident I had road rash on my legs and elbow from hitting the pavement and a puncture wound that got infected on my left ankle. That means I could not wear a night splint. Consequently, my arch stiffened up while sleeping and I experienced heel and arch pain with the first foot step out of bed each morning. Sound familiar? The night splint was really helping me keep the fascia loose before the accident.)

  2. Strength train: Heal raises, towel pulling with toes, core workouts, etc

    (After the accident I had to stop weight training for about 6 weeks because of my right strained wrist and hand, a wicked cervical (neck) strain from my helmet hitting the pavement, and a strained left shoulder. I couldn't carry anything in my right hand for weeks and, doing push-ups, pull-ups and using free weights were just not possible.)

  3. Increase circulation: Get deep tissue massage, Rolfing, ultrasound in the affected area or by rolling your foot on tennis or golf ball each day

    (With a banged up body trying to heal itself, the idea of causing more muscular and tendon pain with deep tissue work seemed like a bad idea the first few weeks after the accident.)

  4. Wear custom orthotics

    (Yay! The one thing I could do consistently-- except that week when my foot swelled up with an infection from the heel wound--was wear my new custom othotics. They relieved some of the pressure on my arch but I can honestly, say that used alone without the other four healing methods, didn't work.)

  5. Cross-train: Swim or bike

    (My bike was trashed and I'm still waiting for the insurance settlement to get it fixed. With the road rash and a seeping icky infected punture wound on my left heel at that, swimming was out of the question for a while.)

Now, it's eight weeks since the bike accident.  I've made an appointment with a podiatrist recommended by a running friend. In the meantime, I will be back at the "5 Steps to Heal Plantar Fasciitis" again (with the exception #1's "wear a night splint" since the abrasion on my heel is still sore and number 5's "bike"). Barring any other ridiculous miss-fortune (with my luck lately, who knows?), I will post a status report on the results of the 5 Steps to Recover from Plantar Fasciitis. Believe me, I'm motivated get running again. :)

QUESTION: How did you recover from plantar fasciitis? Please let me know by posting a comment. I may try it. If it works for me I will happily sing your (or the product or services you used) praises right here. Please, only first person experiences.

Best wishes and health and have a great injury-free summer!

:) A

*The 5 Steps To Heal Plantar Fasciitis methods have been validated by peer-reviewed medical research that I have access to as a graduate student. The latest research suggests increasing flexibility, circulation and using orthotics and anti-inflammatories to help that crummy little fascia tendon heal itself. The medical research and Runner's World running experts also suggest supporting the arch during the healing process. They also recommend  s-l-o-w-l-y working up to barefoot or minimalist running if you are injury free. However, with plantar fasciitis, barefoot and minimalist running like a Tarahumara (as mentioned in the book Born to Run by Chris McDougall), running in minimalist shoes like Vibrams and running on the beach are definite no-nos. It puts additional strain on an already strained arch.

Wednesday, April 28, 2010

Eccentric Exercises for plantar fasciitis & patellar tendonitis (runners knee)

After six months and hundreds of dollars spent treating my running injury under a conventional doctor's care who proscribed solely the treatments paid for by my insurance company has failed, I'm trying unconventional methods. By "unconventional" I mean therapies that are not paid for by my insurance company.

To find these therapies I crowd sourced therapy advice from runners, cyclists and multisport athletes on Twitter. I coined the term "cloud care" to describe my new medical care system that involves free outcome-oriented advice from injury-recovered athletes. Basically, it's asking people what worked for them. The old "conventional" care system, based in large part on what my doctor figured that my insurance company would pay for,  I now like to call "crappy care." I posted the results of my survey on a previous post titled "5 Steps To Heal Plantar Fasciitis".

Since my last post, I've discovered three basic tendon/fascia healing principles:
  • Increase circulation: Rolfing, deep tissue massage, PRP,  and "tennis ball therapy"
  • Increase flexibility: Stretches specific for the injured tendon/fascia
  • Increase stress gradually: Stress the injured area to facilitate tissue repair and regrowth
    Notice how these principals do not include many of the ones proscribed by crappy care: Cortisone, immobilizing the injured area with a cast, daily intake of ibuprofen and icing. What I'm not saying is that these treatments don't work. They just didn't work for me and they cost me and my insurance company a lot of money. In defense of crappy care: the physical therapy and proscribed flexibility, stability and strength exercises did help my injury recover. However, due to poor management of my case, a stress fracture went undiagnosed and the foot pain became worse at month five of crappy care.  Also, I just could not afford more PT after over 20 visits at $40 co-pay each. Below are some links to online sources about some "unconventional" (e.g. not paid for by insurance) therapies that have really worked according to athletes. They are treatments you can do at home for free (with the exception of the deep tissue massage/Rolf Therapy and the PRP therapy).

    Cloud Care Healing Therapies for tendon/fascia injuries:
    1. Rolfing–Rolf Integrative Therapy
    2. Eccentric exercises and tendonopathy treatment research:
    3. Eccentric exercises and stretches that worked for by Sigfús Víkþörðson a cyclist who suffered from patellar tendinitis (runners knee):
    4. PRP (Platelet Rich Plasma) blood therapy to oxygenate fibers with little blood circulation such as tendons, fascia, ligaments to induce faster tissue repair and recovery:
    5.  (concerns about PRP)
    6. Eccentric exercises (strength training by lengthening muscles/tendons) for plantar fasciitis:  (scroll down half the page to "Problem: Plantar Fasciitis...")
    7. Stretches and more strength training with eccentric exercises for plantar fasciitis:

    Please let me know what works for your tendon injury by making a comment or sending me a tweet @multisportmama. I think more people should know what really works–even if it's not blessed by the insurance companies.

    Here's to hitting the trails, roads or courts again soon!

    :) A

    Monday, April 19, 2010

    5 Steps to heal plantar fasciitis: "cloud care" from running Twitter friends

    I'm still hopping around on one foot. After more than a year of painful plantar fasciitis heel pain in my left foot (since December 2009) and months of not running (since June 2009) and medical care, this cursed injury has still not gone away.

    It's hard to have an identity of "Runner" and not be able to run. Having a cheerful and fit ultra runner girl friend who moved in across the street recently just put salt in the would.

    Me: "How did your 50K training run go in San Diego last weekend?"
    Ms. Ultra Runner: "Oh fine. I'm really not very sore at all. *laughs * It was a tough run though. The wheels came off at about mile 20 but I managed to get it together and finish..."

    Dang! I so wanted to be her. Dang! She's so happy and looks so fit...Dang! I want to run again...Dang! Dang! Dang! (Can you tell I'm missing my daily running fix? :/ )

    So, out of frustration (and desperation) I looked for some sports injury advice from my @MultisportMama followers on Twitter. Here's their advice in a nutshell:

    5 Steps to Get Rid of Plantar Fasciitis That Worked
    1. Stretch (gastrosoleus/calves/hamstrings), wear night splint to take load off foot tendons/fascia
    2. Strength train (heal raises, towel pulling with toes, core workouts, etc)
    3. Increase circulation with deep tissue massage, ultrasound or rolling foot on tennis ball
    4. Wear custom orthotics (I'm waiting for a pair to get finished now)
    5. Swim or bike (Don't run and cross-train instead)
    How is that for some open source "cloud care"? It was free. It actually worked for other runners. It's based on first person evidence. It's current (meaning it is not based on some study done 20 years ago or a book). And, there is no financial incentive for them to sell me over-priced products and services that don't work.

    To give credit where credit is due, here are some of running Twitter friends who kindly gave me the advice (and agreed to share their tweet names in time for this post):


    Do you remember those $700 toilet seats from back in the 90s? That's how I feel about the insurance-inflated prices for stuff I have in my medical system. The $250 co-pay for the MRI, the $40 co-pay ($150-$212 cost to insurance) for "therapeutic exercises and ultrasound therapy" twice a week, the $20 ($53 cost to insurance) felt heel pad shoe inserts, and waiting 10 weeks for Anthem to approve the MRI so I was getting the wrong kind of treatment for months (getting PT for plantar fasciitis and not a stress fracture).  I think our medical system has some inherent conflicts of interest. I mean when my orthopedic surgeon foot specialist is part-owner of the medical and physical therapy clinic providing me with advice, products and physical therapy, it benefits him financially when I buy as much care as my insurance will approve. So, for example, the stress fracture in my heel-- the "calcaneal contusion"--that didn't show up in my X-Ray-- went untreated for three months before the doctor requested an MRI. Then it took 10 more weeks for the MRI to get approved (thanks Anthem). In the meantime I'm continuing with the same regime of physical therapy for plantar fasciitis and asked to walk on my foot--even though I had a stress fracture.

    The current medical system is a game based on wrangling profit from the patients by both the care providers and the insurance companies.  In this system I only get as much care as my insurance company allows my doctor to proscribe. My doctor only proscribes as much care that the insurance company will approve to pay. That care is not based on needs of my running injury. It's based on what each side can get away with. That is not good outcome-orientated care. That is not good medical care. That is crappy care.

    At this stage of the game, I'm sticking with my running Twitter friends' advice (see above). As far as I'm concerned, it's outcome-orientated care devoid from any profit incentive or conflict or interest.  I will do another blog post about their collective "5 Tips to Get Ride of Plantar Fasciitis That Worked" in mid-May. It will be a status report on how my new social media/sports injury "cloud care" system is working. If those "5 Tips..." actually worked for me.

    Hopefully, by then I won't have to hop on one foot anymore.

    Happy Trails!

    Monday, February 8, 2010

    Illnesses Linked to Industrial Foods, Part III (Discussion & Resources)

    This is Part III, the final part, of my report on the link between chronic illnesses and industrial foods consumption that I researched for a graduate-level class on social evolution taught by an archeologist. My goal was to discover and describe the markers (or in non-archeological terms "physical evidence") that are found in the human body that indicate habitual industrial food consumption. In populations that consume mostly industrial foods, the markers are mostly chronic diseases, dental deformities and some contaminated food borne infections.


    Today’s global market and industrial economy drives the demand for cheap, calorie-rich but nutrient-poor processed foods. This is not just in the United States. Industrialization has transformed commodity grains such as corn, wheat and rice into “inputs” to create profitable “outputs” through industrial production and globalized commerce all over the world. In the United States, the government promotes the industrial food system with government subsidies, which in turn fosters more surplus grain production and consumption. The unintended consequences of the industrial food system are scary:

    1. Industrial foods have taken over most American’s diet and are making people sick

    2. The centralized industrial food system is based on an unsustainable reliance on fossil fuels and non-reproducing genetically modified plant species that require annual seed purchases, fertilizers, herbicides and irrigation water to ensure productivity and distribution

    3. The industrial food system is resistant to change as it is integrated with the American industrial economy, cultural identity and political structure.

    4. The industrial food system does provide enough food for the current U.S. population with 14.6% of American households “food-insecure” in 2008 (USDA 2009).

    The industrial food system is integrated in our industrial culture and economy. Mainstream consumers “show little interest in a new food economy that might require them to pay substantially more for food (to cover it’s external costs) or to eat substantially less of something they enjoy (such as meat) (Roberts 2008:272).” The current rise in health care costs due to the epidemics of obesity, Type 2 diabetes and heart disease demonstrate this. The structural barriers of the working and middle class “time famine” and lack of access to affordable nutritious foods are other roadblocks to shifting to a sustainable and nutritious food production system (Pollan 2009a).

    However, with cultural change and political will, a new food system that is safer and healthier is possible. As the demand for non-industrial foods increase, their availability at affordable prices increase. You can help change the food system by voting with your dollar. If you can't grow or prepare your own foods (most people can't) then support local organic farmers, heritage or non-GMO (non-genetically modified) varieties of plant and animal foods, and humane non-industrial animal husbandry food products. It is up to you. It is only your health...


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    Tuesday, February 2, 2010

    Illnesses Linked to Industrial Foods, Part II ( and health linked to non-industrial foods)

    This is Part II of my report on the link between chronic illnesses and industrial foods consumption that I researched for a graduate-level class on social evolution taught by an archeologist. My goal was to discover and describe the markers (or in non-archeological terms "physical evidence") that are found in the human body that indicate habitual industrial food consumption. What I found out was that in populations that consume mostly industrial foods, the markers are mostly chronic diseases, dental deformities and a few other pathalogies.

    Research Results

    “The way we eat has changed more in the last fifty years than in the previous ten thousand,” according to industrialized agriculture expert Eric Schlosser in the documentary Food, Inc. (Kenner 2009). Up until the past 200 years or so, most people lived relatively strenuous lives and subsisted on whole foods they foraged or produced themselves. When there was inadequate food, birth and survival rates either decreased to keep a population in equilibrium with the local ecology’s carrying capacity or there was societal collapse. Nowadays, the United States, the “leading industrial power in the world,” has longer life expectancies, longer daily work hours requiring little physical exertion and more affordable and abundant unhealthy convenience foods. This is resulting in both less access to nutritious foods and healthful physical activity and greater access to calories and unhealthful chemicals and food borne pathogens. Together these factors are making more and more Americans sick.

    The United States relies on a fossil fuels-based and centralized food system that is highly resistant to change. Less than 0.6 percent of Americans are involved in producing their own food by farming, forestry/hunting or fishing (CIA Factbook 2009). In the United States where 60 percent of the adult population works in non-physically demanding service jobs, “restaurant bills account for 48 percent of spending on food” in 2008 according to National Restaurant Association (Bunker 2009; CIA Factbook 2009). The industrial diet most Americans eat is characterized by refined flours and food processed for increased profitability, shelf life and convenience instead of nutrition. Much of the industrial diet is “nutritionally worthless” (Pollan 2008:108). These foods often contain high proportions of simple carbohydrates and fat that are “energy rich and nutrient poor” according to Bruce Ames, a nutrition researcher at Children’s Hospital Oakland Research Institute in California (Wroth 2009).

    Self-contained societies devoid of chronic diseases

    Self-contained societies that consume solely whole foods that they produce themselves seem to be devoid of chronic diseases, dental crowding and feedlot produced food borne pathogens such as E. coli 0157:H7. Epidemiologists call these communities “cold spots” for these illnesses of their rarity (Miller 2008:17). Medical doctor and nutrition researcher Daphne Miller traveled and documented the cuisines of “cold spots” for chronic diseases and published them in a nutrition self-help book titled The Jungle Effect (Miller 2008). She documented the correlation between diet and health in self-contained societies where chronic diseases such as obesity and Type 2 diabetes, heart disease, and breast and colon cancer are rare to non-existent (Miller 2008). Dentist and medical researcher Weston Price found many traditional self-contained societies in the 1920s and 30s, some of them are located in isolated European communities in Switzerland and the Outer Hebrides Islands, that didn’t suffer from chronic diseases and dental problems that were currently endemic in the United States and industrialized Europe (Price 2008). Both researchers documented a link to the diets and these illnesses (as opposed to inherited genetic traits or socioeconomic factors) by tracking the onset of these chronic diseases in genetically and economically identical populations of decedents or relatives who became sicker and exhibited dental problems once acculturated to industrial foods (Miller 2008; Price 2008).

    The diets of hunters and gatherers and early agriculturalists reveal dietary markers in the human skeleton and dentition. A Paleoepidemiological study of genetically continuous human remains of Native Americans in Georgia for about 3,500 years (2200 B.C. – A.D. 1150) by Clark Spencer Larsen, of the Southeastern Massachusetts University, shows a decrease in maxillary bone growth and an increase in nutritional stress, infectious diseases and dental caries with the shift from hunting and gathering to corn agriculture (Larsen 1981). Studies of other pre-European contact dentition remains of Native Americans show an increase in the frequency of dental caries with the consumption of “highly-processed stone ground” flour derived from maize (corn) or gathered acorns (Schollmeyer 2004). The presence of dental caries in the teeth of acorn gathering hunters and gathers in California and mandible and dentition bone growth decreases in agriculturalists (that were once hunters and gathers) in Georgia show that dental pathologies stem more from diet than anything else (Larsen 1981; Schollmeyer 2004).

    To be continued...

    I will post the conclusion of my report at in a few days with the cited references. Thank you and I wish you good health.

    Friday, January 29, 2010

    Illnesses Linked to Industrial Foods, Part I

    Why is it that chronic deseases such as heart disease, Type 2 diabetes, and some cancers, dental crowding, and E. coli 0157:H7 infections have been increasing in industrialized countries (Dowdle 2009; Pollan 2008; Schlosser 2001; Wroth 2009)? Have technological advances in medicine and public health resulted in longer life expectancies and more age-related illnesses? Or, are these illnesses somehow linked with the industrialization of societies and industrial food production? Are these chronic illnesses correlated with an increasingly globalized food market that delivers exotic and out of season foods to ethnic groups that have not physiologically adapted to them? Or are these chronic diseases a product of over-population and insufficient food that is nutritious? Are the ever-more densely populated and urbanized industrial societies exceeding their carrying capacities for providing affordable and nutrient rich foods?

    This report is from a research project I did in 2009 for a graduate level class called Social Evolution taught by an archaeologist. My goal was to discover and describe the markers (or in non-archeological terms "physical evidence") in the human body that indicate habitual industrial food consumption in populations. What I found out was that in populations that consume mostly industrial foods, the markers were mostly bad.

    Chronic diseases, formerly known as “Western diseases” or “modern diseases,” are common industrialized countries such as the United States, Australia, Canada, Japan and countries in Western Europe. They are common in all populations acculturated to industrialized foods (CDC 2009; Kenner 2009; Pollan 2008; Price 2008; Roberts 2009; Schlosser 2001). In the United States where industrial food production and consumption predominate, chronic diseases are the leading causes of death and disability. They account for 7 out of 10 deaths among Americans each year according to the United States Centers for Disease Control (CDC 2009). Chronic diseases such as obesity, Type 2 diabetes, heart disease and some cancers are believed to be diet-related diseases by medical researchers (CDC 2009). Interestingly, chronic diseases are non-existent to extremely rare in non-industrialized and pre-agricultural societies (Miller 2008; Price 2008). Fossil remains from the Cro-Magnun period “show none of the diet-related chronic diseases that plague us today,” according to Neil Mann, an expert of paleonutrition at RMIT University in Melbourne, Australia (Roberts 2008:8). The only evidence of earlier peoples suffering from obesity and heart disease are the upper-class elites in early civilizations such as Ancient Egypt and Han China (Buck 1975; Rose 2009; Winslow 2009).

    Human populations all over the world have physiologically adapted to a diversity of diets based on locally available foods and environments. There is no single ancestral diet that is optimal for everyone (Naban 2004:55). Some diets are entirely vegetarian and adapted to local wild and domesticated plants. Other diets are entirely carnivorous and adapted to local sources of animal protein prepared in a traditional manner. Most diets are a combination of both. But what humans have not adapted to, it appears, is the industrial food diet. The industrial diet features a high proportion of calories produced from grains. Grains are commodity foods that are easily produced, traded and stored with commercial profitability as the goal rather than nutritional value (Pollen 2008:10). “Grain is the closest thing in nature to an industrial commodity: storable, portable, fungible, ever the same today as it was yesterday and will be tomorrow,” says journalist and food activist Michael Pollen. He adds that, “Since it can be accumulated and traded, grain is a form of wealth…throughout history governments have encouraged their farmers to grow more than enough grain… (Pollen 2007:201).” In response to food surpluses, changes in diet were induced politically by elites to encourage further consumption of wealth-building commodity foods such as sugar and tea in Victorian England (Mintz 1985), corn derivatives such as high fructose corn syrup in modern day America and the consumption of maize in Inka empire (Hastorf 1990).

    In fact, the key correlate between the development of early civilizations and the concentration of political power in the hands of a few was their ability to produce, store and control commodity food surpluses. According to anthropologist Bruce Trigger, it was “the upper classes’ ability to ensure that farmers produced substantial agricultural surpluses and that most of these surpluses be at the disposal of a small ruling group” that helped early civilizations develop, and, eventually, what that gave rise to the Industrial Revolution (Trigger 2003: 395).

    This report is a review of illnesses linked to the consumption of industrial foods by looking at their prevalence in the populations that consume them. Or, in other words, looking that the dietary markers in populations that consume industrial foods.

    The sources of data in this paper include ethnographic research of the diets of both industrial and non-industrial or self-contained societies, where access to industrial foods is limited, and medical and dental studies. Material evidence of food production and dietary markers are from ethnographic and archeological research.

    Definition of Terms

    Researchers and journalists have used many different terms to categorize processed foods commonly eaten in the United States and chronic non-infectious diseases. To make my explanations more clear about the correlation between chronic illnesses and food produced by the industrial food system I will define my terms.

    Industrial foods

    Instead of referring to refined and processed foods made from access to cheap commodity grains such as corn, wheat or soy as “fast food,” “modern” foods or “Western” foods as some researchers do, I use a generalized term “industrial foods” because it describes their key differentiating feature: their industrial method of production (Price 2008; Pollan 2008; Schlosser 2001; Weber 2009). Industrial food production is a mechanized system in which “inputs” of capital “in the form of seeds, fertilizers, pesticides, machines, fuels, and research” are expected to deliver a predictable income from “outputs” such as grain, meat or processed foods made from them (Roberts 2008:25). The main “hallmarks of the industrial food system,” according to Joel Salatin, a third-generation sustainable farmer in Virginia are these:

    · Centralized food production and processing

    · Mono-speciation (growing only one species on a piece of land)

    · Genetically modified plant species that require artificial fertilizers and herbicides and can not adapt to fluctuations in the environment

    · Confined animal feeding operations (also known as feedlots or CAFOs for “centralized agricultural feed operations;” These generate huge concentrations of animal waste and methane –a significant source of green-house gas emissions)

    · Chemicals that end in “cide” (Latin for “death) such as herbicides and fungicides

    · Ready-to-Eat packaged convenience foods

    · Long-distance transportation based on fossil fuels

    · Externalized costs that hurt the economy, society, ecology and human health (Salatin 2009:189).

    Most of the food consumed in the United States is produced by the industrial food system. “For all intents and purposes, the traditional farm has vanished,” according to journalist and industrial food system expert Paul Roberts in his book The End of Food (Roberts 2008:23).

    Self-contained society

    A “self-contained society” in this paper means any society that is either not industrialized or is not involved with an industrialized economic system by purchasing or consuming manufactured commodity foods. I use the term “self-contained society” instead of referring to self-contained population that produces it’s own food as a “non-Western” or ”pre-industrial” society as do some researchers (Mintz 1985; Trigger 2003). Self-contained societies are societies that produce their own nutritious food in adequate quantities and in environmentally sustainable ways.

    Chronic Diseases

    Chronic Illnesses are obesity, Type 2 diabetes, heart disease and cancer (CDC 2009a). These are also known as “Western diseases” due to their early prevalence in Western Europe and rarity in non-European or Euro-American societies until the last hundred years (Pollan 2008). It was once believed that only Westerners suffered from chronic diseases until British doctor Denis Burkitt and other Western researchers in the early 20th Century observed that non-Westerners were also suffering from these diseases once they adopted a diet of refined and processed foods (Pollan 2008:91). The diseases seemed to occur with the introduction of sugar, refined flour, and processed “store foods” that contained high concentrations of fat or sodium (Pollan 2008:91). Chronic diseases are also known as “modern diseases” due to their significant increases world wide in the past 50 years (Miller 2008:15).

    Illnesses traced to industrial foods

    The industrial food system’s over-abundance and centralized production have some unintended consequences. Chronic diseases, food borne illnesses and dental crowding have been linked to the consumption of industrial foods. All three of these have increased significantly in industrial societies where people are acculturated to industrial foods.

    Chronic diseases

    “Chronic diseases—such as heart disease, cancer, and diabetes—are the leading causes of death and disability in the United States. Chronic diseases account for 7 out of 10 deaths among Americans each year,” according to the U.S. Centers for Disease Control (CDC 2009a). Today, heart disease is leading killer worldwide (Winslow 2009:A5). As the most lethal chronic disease some believe it is an unavoidable consequence of modern times. However, the upper classes in early civilizations such as Ancient Egypt suffered from heart disease, too. A team of archeologists and medical imaging specialists has recently found out that seven of the eight mummies, determined to be older than 45, they examined from the National Museum of Antiquities in Cairo, had obvious symptoms of heart disease. The “artherosclerosis looks just like it does in our modern-day patients,” cardiologist Randall Thompson said (Winslow 2009:A5). Today, due to industrial food production, high-calorie and high-sodium diets combined with a sedentary lifestyle, are now the provenance of commoners (Pollen 2008).

    “Every year, cancer claims the lives of more than half a million Americans. Cancer is the second leading cause of death in the United States, exceeded only by heart disease,” according to the U.S. Centers for Disease Control (Centers for Disease Control 2009c).

    “The United States has the highest obesity rate of any industrialized nation in the world,” according to food activist Eric Schlosser (Schlosser 2001).” Obesity is a growing problem in the United States. “More than one third of U.S. adults—more than 72 million people—and 16% of U.S. children are obese. Since 1980, obesity rates for adults have doubled and rates for children have tripled according to the U.S. Centers for Disease Control and Prevention (Centers for Disease Control and Prevention 2009b).”

    At least “23.6 million people in the United States (7.8% of the total population) have diabetes. Of these, 5.7 million are undiagnosed,” according to the U.S. Centers for Disease and Prevention (Centers for Disease Control and Prevention 2009d). “If current trends continue, 1 in 3 Americans will develop diabetes sometime in their lifetime, and those with diabetes will lose, on average, 10–15 years of life,” according to the U.S. Centers for Disease Control and Prevention,”(Centers for Disease Control and Prevention 2009d).

    Food borne illnesses

    “Some 5,000 Americans die and 325,000 are hospitalized annually as a result of food contamination.” according to a 2009 news brief about food safety in Time Magazine (Time 2009:57).” Food borne illnesses traced to large-scale factory farms and CAFOs has increased significantly “with some of the biggest recalls in U.S. history occurring in the last few years (Schlosser 2009: 14). E. coli 0157:H7 is a particularly lethal strain of bacteria produced in the gut of a corn fed feedlot cow didn’t exist until 1980 and by 2005, 15 years later, was responsible for 73,000 illnesses and 2,000 hospitalizations (Frenzen 2005; Pollan 2006:82). Centralized meat production has brought new epidemics into the food system from pathogens that didn’t exist before the industrial food system: camphylobacter, lysteria, E. coli, salmonella, bovine spongiform encephalopathy, avian influenza or bird flu (Salatin 2009:188).

    Dental crowding

    Nearly two-thirds of Americans suffer from some degree of dental crowding or malocclusion caused by insufficient alveolar (tooth arch) bone growth that is related their diet diet (Rose 2009). “In contrast, most of modern society’s ancestors naturally had ideal alignment without malocclusion and their third molars were fully erupted and functioning (Rose 2009).” Recent research on relatives who consume industrial foods and those show don’t indicate that refined foods cause these pathologies and not inherited traits (Rose 2009). Dental researcher Weston Price believed that the increasing incidence of dental crowding and tooth decay that he saw in the 1920s was due to “poor health” caused by the consumption of nutritionally inferior produce grown with artificial fertilizers, factory farmed meat and processed foods made of refined grains and preserved foods (Price 2008:xxiv).

    Next week, in Part II of Illnesses Linked to Industrial Foods, I will post several explanations for the increase of chronic disease, dental crowding and E. coli infections in the United States and other industrialized countries. In Part III next week I will post my research results and my references.

    Thursday, January 7, 2010

    Stop running (or not) & lose weight by changing your diet

    I believe that our bodies are adapted to mobility (such as walking or running) and surviving periods of food scarcity. Faced with running each day (or nearly each day), our body's metabolism adapts and slows down becoming more efficient with it's caloric fuel. I have a friend who complained to me that she runs hilly trails every day and she feels chubby. I've experienced the same thing, when training for a marathon, after awhile my weight plateaus and I will actually gain weight if I eat too many junk food carbs.

    Science research (and personal experience!) supports that we crave ingredients that are rare in nature: sugar, fat, salt.So after a period of time, running every day and eating carbs with higher-than-found-in-nature levels of sugar, fat and salt may often result in weight gain or at least, no weight loss.

    If you cut your carbs from refined grain sources and add weight training to increase your muscle mass you can increase your metabolism and burn through those excess calories. Follow that up with a decrease in your sugar, fat and salt consumption and I think most people will see the results with a more muscular and lean physique in about a month. This is because they are approaching weight loss on two fronts: increased calorie absorption through increased muscle mass-induced metabolism gains and reduced calorie intake from less nutritionally "empty" calories. Basically they are making their bodies less efficient in fuel consumption--like a big engine SUV. Increasing muscle mass is like increasing the size of one's engine. I tried this strategy and it worked better than I had expected. I even stopped running due a running injury (plantar fasciitis and hip bursitis) so I was working out less--just weight training for three months-- and I still lost weight.

    On September 28, the day after I did the Sprint of the Carpinteria Triathlon, I got a cast on my foot. My plantar fasciitis, in spite of not running and daily stretching, arch supports, night splints, ice, tennis balls and other arcane treatments, was getting worse, not better. For the month of October I could not run, bike or swim--nothing but weight train. I was feeling chubby, and pretty bummed about my situation until I applied my nutrition research on myself.

    Being my own test subject I radically changed my diet to exclude processed foods and industrially produced foods. By "industrial foods" I mean non-organic produce, genetically modified produce and animal products, animal products produced from CAFOs (Concentrated Agricultural Feeding Operations) and anything already prepared. I've been eating solely organic, mostly locally produced produce from a local CSA (Community Supported Agriculture) program. "CSA Program" is fancy name for a basket of fresh produce that I pick up each week at a local farm). For protein I get lot's of nuts, beans, organic dairy products and free-range poultry products. I haven't baked my own bread yet but I am making my own corn tortillas from scratch to avoid preservatives. By eating these foods I am getting nutrition-dense food and avoiding the big three industrial food additives that are bad for my health in excess: sugar, salt and fat. The organic foods are more costly, but not eating out anymore and not buying energy bars or other processed foods is really saving me money. The cost to our family food budget of the non-industrial diet is significantly less than with our usual diet.

    I've been researching various diets and native foodways and sports nutrition for a while as an anthropology graduate student (see my foodways research on triathletes and marathon runners in an earlier posting here). I noticed that native populations that consumed their traditional foods did not suffer from chronic diseases that are the number one killers in the United States: heart disease, obesity, Type 2 diabetes and some cancers. Yet, healthy and physically fit triathletes and marathon runners still seem to suffer from heart disease and some cancers. After a bit more anthropological research I've found that it's not genetics, it's the industrial diet that is the root cause of these chronic diseases. I've come to the conclusion that if you avoid processed foods and don't eat anything made of refined grains (no store bought bread, no pizza, no pastries, muffins, burger buns, flour tortillas, white rice, corn chips, crackers, pasta,etc.), you will be healthier and feel better. In addition to the refined grain foods I have been avoiding processed packaged foods such as frozen foods, canned foods, nutrition bars, or any beverage made with corn syrup such as Gatoraid and sodas. Following my "non-industrial diet" in just one month caused a weight loss of about 3-4 pounds. The refined grains have nearly no nutrition (so you're just adding fat calories) so why do we continue to eat them? It's culture and tradition. Pre-race meals of pasta dinners, nutrition bars and food supplements during racing and a group Saturday morning runs followed by coffee and muffins. I think the traditions of consuming industrial foods is killing us.

    For three months (October thru December) I weight trained three times a week and stuck to my whole foods/no refined grains non-industrial diet and lost 5 pounds since September. I'm 5 foot 9 inches and I began at 139 lbs and now weigh consistently at 134 lbs. This is with no cardio workouts. Crazy, huh?

    I'm easing back into running again, with short runs of 30 minutes a week focusing on my gait and stretching a lot before and after. The heel pain from my plantar fasciitis is officially gone. (Woohoo!) I'm going to try to stick to my non-industrial diet and see if I can sustain it with increased running mileage and the need for more carbohydrate energy. If the Kenyans and the Tarahumara can run fast for hours on a traditional non-industrial diet, why can't I?

    I should start a diet plan...