Intro Jason Nichols is the Director of Inspired Orthotic Solutions or I.O.S as it is more commonly referred to in Martin St Brighton, Vic. Ten years ago, he graduated with a Ba.App.Sci (Prosthetics & Orthotics). He has such a diverse background ranging form prosthetic limb replacements, shoe designing and the complicated world of orthotics and bracing. He has worked with Miles Stewart, Australian Triathlete, X- Terra Champion Jodie Mielke (Purcell) to name but a few. I.O.S. orthotics have travelled the world servicing the feet of athletes across the Lava fields of Hawaii, depths of cold of the Antarctic, Patagonia, North Pole on the fairways of the PGA and WPGA as well as the worlds No1 female squash player. Many other professional and semi professional feet in other sports such as Cycling, Soccer, AFL, NBL, Rugby Union / League, Table Tennis and Badminton have been successfully treated. We are proud founding sponsors of the St Kilda Cycling Club. We will continue to support community based sporting clubs. We also sponsor are large number of varied sports people to allow them to reach their atmost potential Main Page For those looking for an alternative to conventional HARD orthotics, Inspired Orthotic Solutions of Brighton offers the perfect solution: Flexible, semi-rigid orthotics that feature a far superior level of comfort whilst still providing the support needed. If you have been suffering pain in your knees, feet or back, it could simply be due to an incorrectly aligned lower limb, restrictions around the joints, inflammation around tendons, or poorly fitting footwear. IOS has the latest technology in walking gait analysis using the new FOOTMAXX system to show where these painful problems originate and how they can be treated. IOS manager and orthotist Jason Nichols, is offering a free assessment to enable people to find out if they need orthotics and to get advice on correct shoe choice. Poorly fitting footwear can twist or squash the foot into an unnatural position and over some time, have debilitating consequences. Orthotics can help anyone looking to reduce pain, stop the injury cycle, or just to relieve tired aching feet after standing for long periods of time. For a FREE consultation and Shoe advice please call IOS on - 9596 1944 or drop in to 144 Martin Street, Brighton. Services I.O.S offer a FREE foot assessment and shoe advice Biomechanical assessment of running gait Review of cycling position and efficency Orthotics can help anyone from Children to the Elderly. If your child has foot pain, flat feet, knee / hip pain , problems running, walking, sporting injuries, Growing Pains, , or ankle problems, orthotics may be able to help. The advantage of treating Children, is that their structures in and around the foot are still growing, therefore we may be able to correct the irregularities. Early Diagnosis is of key importance to give the best possible out come. I.O.S prides itself on offering the most upto date and technically advanced orthotic treatment available.However we try to avoid precsibing orthotic devices, and offer several other treatment regimes which can give suitable relief and correction to our clients. Products Appointments are required to allow adequate time for assessment and fitting. The range of services offered include: -Foot Orthotics ~ Custom and `Off-the-Shelf ` Prescription, Rigid and Semi-Rigid. -Fracture Casts -Soft Bracing for knees, elbows, ankles etc. - Advice on shoe choice -Orthopedic Footwear ~ Custom-made for children and The elderly, Anti-Varus shoes, Customising & repairs. -Calipers & A.F.O's -Custom bracing; for fingers, wrists and hands. -Back braces ~ Custom body jackets, Lumbar Sacral Corsets. -Surgical Stockings for Lymphoedema. -Gait Assessment for professional sports people in running and cycling. Contact us If you wish to make an appointment for a FREE Foot assessment or shoe advice, appointments should be made only by telephone. Please call (03) 9596 1944. E - mail - Jason@ios.com.au Fax # (03) 95968573 Location We are located at !44 Martin St BRIGHTON, Victoria, Australia, (directly oppisite the Gardenvale Train Station ) Melway Map reference 67 F 7 Please insert a map Links www.skcc.com.au www.icetrek.com Our Star Althletes Kevin Muscat - Captain of the Australian Soccer team, and star player for Rangers United Miles Stewart - Trialthlete - World champion Luke Bell - Trialthlete Jodie Meilke - X Terra Trialthete based in *** Johno Hall world duathlon Champion Nathan O'Neill - Cyclist , Australian Time Trial Champion 2002 Johnie Clarke - Cyclist Trent Lowe - Cyclist Sarah Fitz-Gerald - World No. ! squash player Eric Phillips - Adventures - Treked to the South / North Poles FOOT FACTS · The foot is an intricate structure containing 26 bones. Thirty-three joints, 107 ligaments, 19 muscles, and tendons hold the structure together and allow it to move in a variety of ways. · Your feet mirror your general health. Such conditions as arthritis, diabetes, nerve and circulatory disorders can show their initial symptoms in the feet - so the foot's ailments can be your first sign of more serious medical problems. · Any diabetic patient with evidence of loss of sensation should be started on a comprehensive foot care program, beginning with a Footmaxx gait and pressure analysis test. · There are times when you're walking that the pressure on your feet exceeds your body weight, and when you're running, it can be three or four times your weight. · Walking is the best exercise for your feet. It also contributes to your general health by improving circulation, contributing to weight control, and promoting all-around well being. · Women have about four times as many foot problems as men; lifelong patterns of wearing high heels are the culprit. The orthotic you have been given is designed to support, correct and accommodate your foot. The orthotic, however, also needs some help. Cleaning · Wipe with warm soapy water. · Towel dry, leave in open area overnight, away from sunlight. · DO NOT put in oven, microwave, washing machine, dryer.or in front of the heater · If delamination (un-glueing) of orthotic occurs, IOS should be contacted for repair. Wearing-In Period · The IOS foot orthotic is designed to work with the natural motion of the body and hence facilitate natural gait. However, in a small number of people, a wearing-in period may be necessary. · If a wearing-in period is required, remove and replace the orthotic within the limits of comfort, until the orthotic can be used continuously for the whole day. Do not allow small red spots to turn into blisters. PLANTAR FASCIITIS ("HEEL SPURS") Pain on the sole of the foot at the heel, or sometimes midway in the arch is a relatively common condition and can be treated simply. Pain results from the strain of the major ligament of the foot (plantar aponeurosis) which normally occurs at the attachment point of the heel. It commonly strikes on arising from bed in the morning or after resting in a chair. Inflammation at this point aggravates the surrounding area; this in turn can stimulate bone growth causing a "bone spur". The continual pull of the ligament contributes to the inflammation and a chronic condition becomes apparent. The strain can be caused by a variety of reasons; resticted range of motion in dorsiflexion (calf tightness), excessive pronation, and/or poor footwear. Treatment: · Injection of anti-inflammatory drugs (such as cortisones) into the heel OR oral anti-inflammatories. · Application of localised heat by ultrasound for pain relief. · Direct massage into the specific area and calves. · Surgical removal of the "heel spur". · Increasing the dietary intake of minerals. · The use of supportive heel cups. · Orthotic management: application of foot orthotics can increase the overall weight-bearing taken by the foot and, in turn, can directly unload the area by allowing relief under the heel and restricting pronation. · A series of stretching exercises to free up the ankle joint. · The use of a plantar fascia night splint. Any combination of the treatments listed will be used to decrease the discomfort experienced. Please refer to this sheet to remind you of your individual regime. Any further questions or problems please contact me on: 9596 1944. Shoe Reviews ASICS DS - TRAINER Weight 280 gm R.R.P. $210.00 This is version VII of the DS - Trainer and seems to get better as the years roll on. So what makes this shoe so good? - Its weight less than 300gms -Durable enough to run any distance up to marathon -Proven and used by a vast number of athletes (see results of runner usage in the Aust. Iron man) The midsole of this shoe is SpEVA.® This is Asics' new material, which improves the return rate after compression and gives increased longevity to the midsole. Outsole materials give a balanced combination of hardwearing lateral heel section in Ahar ® right and the forefoot covered in DVO Sole ®, which is both light and grippy. The heel counter is firm and a terrific shape for comfort, the mid foot is well supported with a well-designed duo truss shank, and this feature decreases weight and adds necessary strength to this area. In conclusion, if you're racing Hawaii, or competing in those important speed sessions, then this is the shoe for you. BROOKS - HYPERION Weight 360 gm RRP $ 210.00 In my practise we see many foot types, git patterns and running shoe usage, rarely does a shoe cover so many variables. Principally a training shoe with a perfectly balanced neutral ride. There is no dual density in the midsole; this omission allows your legs and feet to dictate its natural progression. The upper fits the "typical' Aussie foot, wide forefoot and narrow heel. The heel counter is firm and well shaped while the tongue is well padded and comfortable; nothing fancy but extremely functional. One of the other features of this shoe is a very cool window to the rear foot section of Hydro-flow giving outstanding comfort to the heel. As previously mentioned this shoe suits a variety of feet and uses, and gives a support without changing your natural gait. Shoe Advice So what is the best shoe for your foot? The one that best suits your individual circumstances. Not much help Huh? Well everybody's foot is different in width, length, volume, shape, your weight, not to mention biomechanics, the use of orthotics, muscle and bone development, running style, running surfaces, your weight, frequency of running and any prior injuries. Pretty exhausting list of variables, each important to your choice. SO HOW DO YOU FIND OUT??? The best is of course go and get yourself assessed by a foot specialist; do make sure this person has and is dealing with sports people within your chosen sport. This person should assess you as to any biomechanical abnormalities you may be suffering, advise on flexibility issues, possible specific strengthening exercises, prescribe orthotics if needed, hints on treatments available to you for pre-existing injuries and how to avoid them in the future and discuss your footwear needs. Armed with this newfound knowledge you should be bursting to get some new running shoes. Other options for advise is your coach, specialist runner / triathlon / shoe store each of which will give you an idea of what you need; if in doubt get a second opinion. FITTING All going well you'll soon be standing in your favorite runner shop armed with a list of either specific shoes or features needed in your shoe; either way plan to take your time. Try everything, even those you weren't meant to try, this will hopefully give an idea what does fit and suit you. The reason on why I say to try on many shoes is that particularly when you have a specific list of shoes some of them won't be available while there will be new shoes just released which may suit you to a tee. New Runners were at one stage released just twice a year while now they can make it on the market at any stage, its very hard to keep up with what hits the market and what's no longer available. Try both the men's (generally a wider fit) and women's (generally a narrower fit in the heel and proportionally wider but shallower in the toe box) as they can give a completely different feel, That's one of the best things about today's runners they're nearly all Unisex. Give some feedback to the fitter as this information may give them some clues as to what to fit you with next. SIZING Allow about 1cm between your big toe and the end of the shoe when standing. This last point is very important as your foot can change considerably when fully weight bearing. Volume in the toe box is also important; too much, no stabilization in the forefoot too little increased discomfort for your toes. Having problems feeling the distance? If there is a removable sock liner take it out and stand on that, not a bad idea Huh?? Is this little fitting advice perfect no, What if I have different size feet? This shoes longest point is in the middle of my toes while this one is more over to my big toe? See what I mean its never quite as easy as it all seems at first, it will however put you in the right ball park be guided by your fitter. REMEMBER THAT THE NUMBERS ON THE BOX MEANS THAT THE NEXT NUMBER IS BIGGER THAN THE ONE YOU HAVE ON AT THE MOMENT. Shoe sizes can vary across the board as much as 11/2 sizes so please don't settle on the shoe size that you've always had. Your feet do change both size and shape as you go through life, always, always get yourself measured, please be guided by the numbers on the box, don't ever take them as gospel. TESTING Try going for a short run in the store, watch to see that your foot isn't swimming in the shoe or that the heel is sliding, if it is, start again with the next pair. If all else fails contact your foot practitioner. REMEMBER * Shoes that fit poorly or chosen incorrectly can cause a multitude of problems, best to get yourself assessed as to the suitability of the shoes in question. If they need to be retired they make excellent dog chew toys (just mind they don't choke) or if in good condition off to charity. * More isn't necessarily better, just because it costs more, has the latest and most features on it won't make it necessarily the best choice for your foot. There has been a wonderful study by Dr Marti in Switzerland on over 5000 runners training for a 16km-road race. Some of the findings were surprising, the cheaper the shoe the less likely they were injured during the training period. Simple basic designs can work wonderfully don't discount the cheaper models because they're cheaper, it may be the perfect model. BASE ALL OF YOUR DECISIONS ON WHAT WORKS BEST FOR YOUR FOOT. * Don't worry there is a shoe out there for your foot. Bike Position There is a wonderful saying used when setting up a bike, "Fit the bike to the person rather than the person to the bike." In this and the following edition, we will try to cover as much ground on this subject to allow you, the reader, some insight into the complexities of this all too misunderstood subject. Even if you're not the one to set your bike up, you should be armed with the latest information to discuss with your chosen bike 'setter,' giving them some helpful clues as to what works for you and what doesn't. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ First and foremost, let me stress that there is no one set of rules that will work for everyone all of the time!!!! The guidelines that I am going to set out, are just that, guidelines! However one needs a place to start, and what is to follow will give you just that. 1.GETTING STARTED You have a bike, now ask yourself 'is it the right size?' This is the place to start. You cannot get the perfect bike set-up on a bike that's either too small or too large. There is always the grand art of 'adjustment', applied to the seat, the bars and head stem, however this has its limits. The table below will give you an idea if you're starting in the right place. Remember it depends on the many variables and the result given in this table may be different to the size you truly need. The only way to get the perfect size is to actually have a qualified experienced person have a look at you whilst riding. A similar table can be found in back issue of Australian Triathlete Vol. 2 Issue 6 . To use this chart you must first accurately measure your lower limb. Firstly, find a bump about 10 - 15cm below the crest of your hipbone and in the middle of your thigh. Once found, push inwards a little and get an idea of exactly the dimensions of bone protuberance, known as 'the Trocanter'. Mark this spot, or better still get a friend to, then measure to the ground. Reading this off the chart will give you an approximate of which frame size to look for. Is it really that easy I hear you cry. NO!! There are many variables that change the dynamics of this procedure. For example, what if your upper body is longer/shorter than the standard? Or if your arms are longer/shorter than the standard? These variants and many others, can move you're your frame choice up or down the list, or even push you toward buying a custom made frame. Table 1 Leg length Seat tube length 84 -86 cm 51 -52 cm 86 -88 cm 52 - 53 cm 88 -90 cm 53 - 54 cm 90 -92 cm 54 -55 cm 92 -94 cm 55 - 57 cm 94 - 96 cm 56 - 58 cm 96 - 98 cm 57 - 59 cm 98 - 100cm 58 -60 cm 100 - 102 cm 59 -61 cm 102 -104 cm 61 -63 cm Too hard to find that elusive hipbone? Want another way? Get yourself into a pair of knicks, stand on a hard flat surface with your back against the wall, place a book between your legs (make sure you don't have shoes on) and mark a line where the top of the book is. The book represents the seat. Try this exercise a couple of times and average them. This little equation has been around since Noah was a lad and has some flaws to it, but it's a place to start. ( see Picture 1) Inseam (cm) x 0.65 = frame size ( or there abouts) Many frame manufacturers have different ways of giving sizes to their frames. Some bikes get measured 'centre of the seat tube to the head tube', while most measure from the top tube to the centre of the bottom bracket. Take a tape measure along with you if you are unsure, check, check again and ask questions. Nothing is as easy as it first seems. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2.FRAME ANGLES. Yes the jury is still out on this one too; steep or shallow? It's a big ask. Quintana Roo were one of the first manufacturers to bring in a very steep seat tube angle and to purpose build the 'Tri Bike'. What followed were some of the most popular bikes ever produced for triathlon - Cannondales' R700 and Treks' 5000 series amongst others. Being in a very forward position does put more weight on the front wheel of the bike, particularly on a standard road frame geometry, and can reduce stability. Its not just the geometry of a frame that can affect your choice of seat angle; you must take into account the inseam length, saddle choice/position, stem length, torso length etc,etc as they are all contributing factors. The complete geometry of their bikes have been changed to reflect this and to allow an easier way to reach an aero position. The question is 'does it work?' For some people it's the best discovery since sliced bread. Others will argue that it can put more strain on the Quadriceps over longer distances, therefore not allowing an efficient run off the bike, or indeed efficient pedal stroke. This discussion could go on and on, however, there is only one way of knowing what works. Borrow some bikes and try them and ask loads of questions. It may take some time to work out what's best for you, but my tip is to think conservatively and try not to load up the front wheel too much, this will only succeed in making your bike unstable. For everyone person that says steep angles are bad, there'll be somebody which will say they're great. In regards to seat angles, one of the areas which hasn't been discussed is flexibility. The tighter your hamstrings, gluteals and lower back the more restricted you will be in getting to a 'good' aero position. You may be able decrease your frontal area more so on a 'steep bike', however this doesn't hold true for everyone. There is a measurement which can give you some idea as to a possible seat tube angle; its called Q (see Picture 2). It is worked out by dividing the kneeling inseam by the standing inseam. The longer the thigh is, the more relaxed seat angle needs to be, to allow efficient pedaling action. Remember, there are many other factors that can dictate angle, so again try and ask as many questions as possible. Q Angle 0.45 75.0 0.46 74.5 0.47 73.5 0.48 73.0 0.49 72.5 0.50 72.0 3.Crank length. The crank gives you advantageous leverage and as a result there has been research into the area of the correct length.. However, no real correlation or pattern has been drawn from these findings. Most studies found the cranks you use, if tested, will give you the most power; yet this is all due to familiarity and very little else. Some studies found very short cranks (150cm) were the most efficient and powerful over flat courses, a point to ponder. Other research found, particularly in the aero position, if the cranks were too long it restricted just how low your upper body could go. This gets slightly more complex when looking at pedaling technique; are you a grinder?, slow revs, big power stroke? Try a slightly shorter crank to maybe get you to spin a touch quicker (increasing your cadence). Longer cranks need more power to move them and can put more stress through the knee joint. Contradictory to this, with some riding styles, degrees of muscle strength or type of course, a longer crank can work very well. As an example, let me compare a 170 to a 175 crank. There is only a 5mm difference, however, spun once and your knee has gone through an extra 1cm of movement. Taking this further, if you're spinning at100rpm over a 2 hour period, how far extra would your knee move now? Try 12,000 extra cm!!! This could prove to be a big aggravating factor to an already existing knee complaint. Try using the below chart to give you the ball park to start from. Inseam Crank Length <70 165 - 167.5 71 - 74 167.5 - 170 75 - 84 170 - 172.5 85 - 88 170 - 172.5 89 - 91 170 - 175 >91 172.5 - 177.5 4.Seat height. This is one of the most important measurements so as to allow efficiency of your pedal stroke. 'Too low' and the full use of your musculature will be underused as well as putting strain on your knees. 'Too high' and your pelvis will rock from side to side on the saddle and many muscles will be stretched. Here's a good place to start: 1.0883 x INSEAM = seat height NB: This measurement is a 'ball-park' figure, however if you point your toes excessively or have long feet, it may need to be increased. Conversely, short feet and a flatter foot position when riding, will need it lowered. Ever changed pedal systems or shoes and wondered why you felt a little bit different?. Different pedal systems and shoes give different heights between the sole of the foot and the centre of the pedal axle. The closer to the centre of the axle, theoretically, the greater chance of power transfer. Shimano and their new Durace/ Ultegra /105 pedal system, in combination with their Carbon sole shoe, gives a very close sole to pedal axis, the Time pedal also gives an excellent result. This difference may take a while to notice but yields good returns. This little bit of information however goes against the flow of the European Peleton as most riders, 80%, use a Look type pedal. Conclusion what works for you, works for you. Seat Forward? Seat Back? Where does the seat go? Firstly make sure the seat is horizontal. This is an extremely important factor as it can strain wrists, arms, shoulders, lower back etc. Too low at the front and your body will slip forward on the seat putting more strain on your shoulders and hands. Too high at the front can load the very sensitive perineum area and in turn lead to long term internal problems such as urinary track infections, especially prevalent in females. The measurement of where the seat should be, is generally taken in relation to the bottom bracket. Again, remember there are many myths and legends about where the seat should be and each has its merits, but all must be checked for you personally and in relation to your riding style and anatomical lengths. ~Movement of the seat should only be undertaken after it has been adjusted and set into a horizontal position. ~Place the bike on a level surface (normally in a wind trainer or the like) and have the cyclist sit on the bike. ~Now move the cranks to the 3 o'clock / 9 o'clock position and have a look at the front of the shin, just below the kneecap. You should see a small bump on the shinbone. This is known as the Tibial Tuberosity (it's the attachment point for Quadriceps tendon). ~Run a plumb bob from this point and let it hang down between the frame and the pedal. Where does the string lie? Forward of the axle of the pedal, or behind it? Either of these positions could be correct depending on your particular pedaling style, muscular strength and anatomical dimensions. Generally, when the going gets tough, most people tend to drop their heels and, in turn, the Tibial Tuberosity will fall behind the pedal axle. Of course the opposite is true if your heel raises. Other relevant influences include short or long feet and long Femur to Tibial length. Confusing huh? The only way to truly know where to position your feet is seek proper advice. Try these changes and then go for a ride a few times. On a well set up bike, both the Quadriceps, Hamstrings, Calves and Gluteals/ITB should be working in unison. Your pedal stroke should be smooth with no real sticking points and you should feel relaxed in your upper body and arms. Some people feel a significant change for the better while for others it can take a while to get used to. The most important part of any bike setup, particularly if being done by another person is giving/getting feedback. Communicate with this person whom you are placing so much trust in; good, bad or indifferent, as this will ultimately give you the best result. Next month we'll take you through a complete set-up, from start to finish, even discussing cleat position 'Til next time.