... Weighing In On Some Evidence for Forefoot Strike vs Heel Strike

In 2010 I wrote :There appears to be a continuum of preference for barefoot running related to a runner's efficiency and abilities. Certainly runners that have grown up running barefoot in areas where it is more prevalent, like Kenya, have been conditioned to run more efficiently barefoot than more industrialized countries. Beyond that elite athletes are exceptional in their foot musculature and would have an easier time in general running barefoot than others. A word about zealots on both sides of running barefoot vs shod. Some will experience cognitive dissonance when their point of view is challenged. This means that when presented with evidence contrary to their point of view they will tend to deny it or reframe the evidence as if it was part of their argument all along. We should remember this, otherwise we are no better than the iconic Dr. Zaius who held both the posts of both minister of science and defender of the faith, a conflict of interest that does not seek out answers, only support for our own preconceived views. It turns out for the answers are very individual and may not be what we expect. Podiatrist and biomechanics guru Kevin Kirby,DPM brought two important papers to my attention in a recent conversation. The small studies done by Kumala and Rooney independently suggest that forefoot running may offload the knee but not during the adaptation phase if you are a heel striker and heel strike running is easier on the ankles, My own take on previous claims made by Dan Lieberman that we were born to run barefoot(approaching forefoot strike)based on anthropological research was that it was not relevant to modern running. There will be more research forthcoming.

Blood Sport

I thought for election day I would post a throwback to our other blood sport besides politics. Those of you old enough, remember the original movie Rollerball. Jonathan E. was the modern day gladiator who was eventually coerced to give up the game as the individual was not that important in modern day "Futopia" In some way are American pasttime the NFL has drifted a little closer to that reality. Looking the other way while doing whatever one feels like is apparently common place in our real American pastime the NFL but other sports are not immune to this culture either. Our institutions ultimately have to vote thumbs up or thumbs down to looking the other way.

The Evolution of Performance Socks and Compression Sleeves

An Evolution of Socks and Compression Sleeves: From Simple Support to Injury Prevention Socks have always been a critical component to the modern athlete’s wardrobe. Recently the consumer sports medicine marketplace has begun to offer a number of sock designs to help prevent and treat injuries. Back in the late ‘70s, the confluence of the running boom and a robust economy in the '80s inspired sock manufacturers to start thinking about ways to improve sock construction and design. Interest in sock research and development led to advancements in four areas: wicking materials, materials with decreased friction, pressure management and compressive support. Recently, compressive sleeves in the ankle and shin have spun off from the core sock business as additional sock related garments to help with injury prevention and workout recovery. In order to examine the characteristic of sock materials, one must first understand the difference between "hydrophobic," which refers to wicking water through the fiber, and “hydrophilic,” drawing water to the fiber. These terms can be used conjointly when describing the fluid dynamics in socks as some fibers have characteristics of both components. The key is that whatever sweat or moisture is produced needs to be moved away from the foot, whether it is wicked through the fiber or drawn into it. The coefficient of friction increases with moisture on the skin, therefore blisters are more likely to occur on socks that do not provide moisture management. When combining hydrophobic qualities and mechanical fiber qualities, the fibers that wick moisture are, from best to worst: CoolMax®, acrylic, polypropylene, wool, cotton. If you are using high-grade materials, a two-layer system can be more effective with CoolMax®, a polyester fiber, as the outer layer. CoolMax® has its roots in the concept writings of DuPont scientists in the ‘20s. Dacron, a precursor polyester fiber was later modified and renamed CoolMax®, which is unique in its four-layer hydrophilic construction. Acrylic is a material that has good heat retention and hydrophilic properties, only slightly less than CoolMax®. Acrylic is another less costly material used in many wool blends for higher performance and durability. Polypropylene is a cheaper material that is hydrophobic and used in some sports synthetic socks. Nylon, by contrast, is hydrophobic, and normally blocks the moisture. Today, there are moisture treatments that can change the aqueous nature of some fibers, like nylon, making them hydrophilic. Although this can be an expensive process, Polypropylene is a cheaper material more frequently used by manufacturing companies who supply discount sporting goods items. Also, spandex, the fiber used to optimize fit and stretch, is quite critical to sizing. Most higher-end performance or Diabetic sock products will offer multiple sizing as compared to cheaper brands. Wool is one of the oldest natural fibers used in socks and offers excellent wicking properties in product lines such as Smartwool. One of the downsides is that it wears out more easily. Therefore, some companies, like Darn-Tuff, offer lifetime warranties for their combinations. Smartwool extends a performance guarantee but stipulates that reasonable wear will not be covered. Assuming you have a properly fitted shoe, the sock is the first layer of defense against skin injury. There have been attempts to use double-layer socks for anti-blister effect but adding a second layer can generate excess heat, which, in turn, produces more sweat. The problem with accumulating moisture in wet material is that it collapses. This is important with so-called performance socks. The extra friction and shear protection they give requires that the terry padding or layers stay relatively dry. It has been studied and proven by Dr. Richie, et. al., that moisture wicking, properly padded and/or layered socks prevent blistering and skin injury in runners. Doug Richie, DPM, outlined the seminal work of Veve regarding the reduction of pressure with padded socks in his CME paper, in 2008. Thorlo sports socks were studied, along with experimental socks and reductions in pressure were noted in both. Donaghue and others demonstrated durability in pressure management of Thorlo socks. There has been little credible research done on anti-microbial properties in socks. It is generally accepted that these treatments and fibers create a healthier environment for the foot. But, the EPA heavily regulates the technology involved in this process and the standard of proof for benefit is too costly for most companies. Dave Higgins, former president of Thorlo, is the designer of the FS6 Plantar Fasciitis Sleeve and other compression sock brands. He has been in the sock development industry for decades. He and Doug Richie collaborated on diabetic sock development in the early ‘90s and are recognized as inventors of the Diabetic Sock marketplace. Higgins’ current company, ING Source, has partnered with Darco to distribute the FS6 in the Podiatric market. The idea behind the FS6 Plantar Fasciitis Sleeve is to create an orthopedic product that provides both support and pain relief to heel pain and Plantar Fasciitis sufferers. This is achieved by keeping a consistent stretch across fascia. It can also be used to treat Achilles tendonitis and ankle sprains. Introduced in the fall of 2012, it makes up 35% of all orthopedic appliances sold. Since June 2013, the product has been the top-selling orthopedic appliance in running shops across America. At the Running Expo in Austin Texas, it was crowned "New Product of the Year.” Mel Chrestman an outdoor and running sales representative notes that there were almost 20 new sock and orthopedic manufacturers at the Expo. Compression support sleeves and socks are the third innovation that has evolved in the sock industry. Zensah makes a compression leg sleeve geared at athletes for quicker recovery from calf problems and shin splints. Zensah is more fashion forward than most, offering an array of vivid, bright colors. Other brands are also quickly growing in both general health and sports market. The FDA regulates the formula for the compression gradient in compression socks. However, only some companies have chosen to manufacture their products within FDA guidelines. Garments are tested on a CMD100 Compression Tester for compliance to FDA standards. The test equipment is calibrated to the British Standard for medical stockings. This does not mean that non-standardized socks will not work but they may be less effective or, in the worst case, create a tourniquet effect. The FDA also expects companies to abide by approved manufacturing practices. ING Source’s FS6 and its Calf Sleeve, CS6, are both FDA registered and targeted more for medical market use. There has been a trend by runners, most notably marathon champion Paula Radcliffe, to wear performance compression socks and sleeves. Pro teams including the NFL also use compressive performance socks. Matt Werd, DPM, a seasoned Ironman Triathlete and past president of the American Academy of Podiatric Sports Medicine, notes that about 1 in 10 triathletes use some form of compression sleeve or sock. He occasionally uses compression socks in training but generally refrains from using them in competition because of the heat created by knee high compression socks, particularly in warmer weather climates. He has tried Herzog, a company based out of the Netherlands. He notes that leg and arm sleeves are frequently used for temperature regulation in endurance training and competition. Sigvaris and CEP are two major manufacturers of performance socks and sleeves. They have recovery socks rated at 15-20mm HG and performance socks rated at 20-30 mm Hg. The research on the efficacy for socks is limited. One small study, by Kemmler et. al., showed increased maximal load with use of the compressive socks. The study conceded that there could have been placebo effect but a pre-questionnaire showed hesitancy to wear compressive socks which would seem to lessen a placebo effect. The evaluation of lactate and lactic acid as an indicator for muscle fatigue in studies is controversial. Kravitz's article summarizes the new thinking:" Lactate production is ACTUALLY A CONSEQUENCE of cellular acidosis and NOT the cause of the acidosis. More blatantly, lactate production actually RETARDS ACIDOSIS. Lactate is a temporary ‘neutralizer’ or ‘buffer’ to the cells elevated accumulation of protons during high-intensity exercise. Since increased lactate production coincides with acidosis, lactate measurement is an excellent ‘indirect’ marker for the metabolic condition of the cell." The development of socks from garments to injury preventative socks and orthopedic sleeves has made the discussion even more relevant for podiatric sports medicine practices. Most sock companies require large inventory to become a vendor. Compression sleeves do not require the same inventory and have less size skews than socks making stocking easier. The medical grade companies have a broader range size skews and many will allow smaller orders as a healthcare provider. These products have become excellent tools for assisting patients perform better and help in injury prevention and recovery. Chrestman, Mel- Interview 2013 Higgins, Dave – Interview 2013 Kemmler, W., von Strengel, S., Kockkritz, C., Mayhew, J., Wassermann, A., & ZapF, J. 2009, “ Effect of compression stockings on running performance in men runners”, Journal of Strength and Conditioning Research, Vol 23, No. 1, pp. 101-105. Naylor PE. Experimental friction blisters. Br J Dermatol. 1955;67:327-335. Parker, Tim _interview 2014 Richie, Jr Douglas H., D.P.M. Socks & Your Feet Socks: Hosiery -Essential Equipment for the Athlete Vercruyssen,F., Easthope, C., Bernard, T., Hausswirth, C., Bleuzen, F., Gruet, M., et al. 2012,“The influence of wearing compression stockings on performance indicators and physiological responses following a prolonged trail running exercise”, European Journal of Sport Science, Vol. 1, pp. 1-7. Werd, Matt, D.P.M. (interview) 2014

Catching or Crashing on the Wave of New Sports Medicine Technology: PRP and other Cell Therapy

Platelet Rich Plasma (PRP) has its advocates as a viable treatment option, but it lacks evidence shown in clinical studies substantiating these claims. There is very little difference between placebo and treatment groups. The PRP disposable kit costs approximately 250 dollars per kit. Skeletal muscle has a greater regenerative capacity than tendon and ligament. There is also the cost of the centrifuge (approximately 10,000 dollars) needed to spin the blood down. One small level 3 evidence study showed comparable results to cortisone injections for plantar fasciitis after three months using VAS scores. As with lasers, PRP has not yet established strong efficacy for musculoskeletal use. One disadvantage of PRP is that the potency of the cells is dependent on the age of the patient. Stem cell harvesting from adipose tissue and bone marrow may be the next progression in regenerative technologies but there are no large trials to support the theory at this time. Finally, amniotic tissue is being investigated and used for musculoskeletal injuries. Amniotic tissue has the advantage of possessing very young cells, which are pluripotent (able to differentiate into all three germ layers). The price of ¼ cc of tissue ranges from $500-$750. One plantar fascial injection uses ¼ cc. One small study, that had Charles Zelen, DPM as the lead investigator, showed some promise versus control for an eight week follow-up for plantar fasciitis.

Catching or Crashing on the Wave of New Sports Medicine Technology

There are a number of new technologies in the sports medicine space that promise to get you back in the game more quickly. How do you as the patient know what to believe? One important question is “Does the technology provide long term relief”." If the patient has shown noticeable improvement immediately after prescribed treatment but returns to symptoms after activity, they will be left unsatisfied with the treatment. David Armstrong, DPM, MD (University of Arizona) adds that it is difficult to cut through the noise around many technologies. It is expensive to run good quality studies and smaller companies rely on 510k status to cover like technologies. On the other hand, he believes some potential good technologies never see the light of day. The other question to ask is how the natural progression of the acute or chronic injury compares with the improvement noted after intervention. One example is heel pain. Studies have stated that there may be as high as 90% conservative improvement with heel pain. Specialists obviously will get the recalcitrant cases. The argument can be made that continuing a trajectory of failed treatments will cost more money than an intervention that will cure the problem earlier. For example, there are about 1 million patient visits for plantar fasciitis alone in the United States with an estimated cost of $192 million to $376 million dollars. The average time for resolution for plantar fasciitis is about 18 months. Look for part 2 on this topic Thursday.

Brave New World Of Regenerative Medicine

It's a brave new world of regenerative medicine. David Armstrong DPM, MD has a lecture devoted to replacement parts. Another type of regenerative medicine is using cells to repair injuries. With appropriate cell signaling organs can be created from cells. Amnion cells are being used to help heal injuries. They are more potent than stem cells derived from our own bodies because they are not worn down with age. Industry studies, including one with Dr. James Andrews as a secondary author, that are double blinded have shown some promise injecting these substances into injured area like the ankle and plantar fascia as well as arthritic joints. Dr. Andrews is the consultant orthopedic surgeon to NFl teams with tricky knee injuries like RGIII's. Stay tuned!

On Breathing & becoming a Lifetime Learner

While in upstate New York, I took a class on healing Thai Chi. The instructor mentioned that we should be breathing in through the nose and not the mouth in practice because it restores more oxygen to the brain than mouth breathing which is more of a fight & flight mechanism.I thought , wow I never new that and I have been doing yoga a while now. it reminded me that you can never stop learning if you want to optimize your well being and your ability to help others. I watched a sales presentation on lasers once and the video had the standard doc in the white coat behind a bunch of books stating that 100% of his patients improved with the laser. I started getting this "Amway brain wash"Danger Will Robinson" feeling wash over me and had an impulse to take my own flight from the program. When the sales rep spoke to me regarding my hesitation with the studies he said a bit exasperated "Well, Dr. Pearl, you're a unique individual - you're a Lifetime Learner and sometimes you just have to pull the trigger. I suppose being called a Lifetime Learner isn't such a bad thing.

The Extra Discretionary Effort

In my match at the pitch today in front of thre Washington Monument I had a realization. We play White Jersey's versus Dark Jersey. The White Jersey team consists of the lower skill level player but the team that hustles more. I probably epitomize that giving it all you got as much as anyone out there but I also figured out that you have to stay disciplined about the timing of that discretionary effort. You can't go all out at once and burn out. You have to be disciplined( i.e. not chasing the ball, playing your position) about maintaining focus and continuing to put the gas pedal down to succeed. In the end it might be that extra five percent of discretionary effort that decides the outcome of the match or applied to a larger context your health and your life.

Could Modern Laser Medicine Prevent Jozy's Hamstring Injury?

It's widely accepted that dehydration is the number one source of muscle cramping but what about Jozy Altidore's hamstring strain in las weekend US - Ghana game. According to Brazilian Doctor Ernesto Leal Jr. low level laser therapy decreases muscular fatigue. He measured CK and C-reactive protein levels which were lower after laser therapy administered to volley ball players preemptively than those that did not get the laser pulses. These are markers for muscle breakdown in the blood. Peak performance load was also increased. The study was relatively small but did suggest some benefit. Currently the Brazilian soccer team uses laser therapy as part of their injury recovery regimen but US Soccer preferred to stick to what they have been doing. I would not say that laser would have stopped the Altidore's hamstring strain- the field conditions were very humid. It may hsve decreased the damage and quite possibly may add something more than the conventional e-stim and ice to the recovery. sometimes cutting edge treatment can does just that- it gives you an edgd and that can be the difference in world competition.

Recovering Outside the Box

Injuries are not fun . In order to keep fit you can do other activities while you recover. I recently hurt my achilles tendon playing soccer and have been swimming, doing yoga and using a speed bag to get some cardio. I try to swim underwater the length of a pool as another means to help keep up my cardio that is less taxing on my body than sprinting injury or no injury. Usually, unless you are spinning hard or doing lots of hills biking is ok with an achilles tendon injury. People underestimate how helpful your core can be in helping to recover from injury. Because we function as a unit in sports a strong core can help prevent slumping while running or worse not sustaining a twisting motion and having the force create an unstable moment in the back, knee or ankle. Part of sustaining training is keeping it interesting and this applies to recovering as well. Gary Hall Jr. used to go spear fishing to break up the monotony of pool laps. Coaches are always trying to think up creative games durin practice and you can apply the same philosophy to recovery.

Putting on Your Own Oxygen Mask First When Facing Injury

We all face daily decisions of taking care of yourself versus doing other things vying for our attention. When recovering from injury you have to put the necessary time in. I am nursing an achilles strain and I went to yoga this morning versus continuing to play soccer through a persistent injury. Part of the key to getting better is the recognition that "playing through" an injury is going to prolong the healing in most cases. You have to tell yourself the charge you get from competition is muted to begin with because you are playing guarded when you are hurt. It is tempting to think that you can play and rehab but unless you have youth,genetics and luck on your side it is not sustainable. I got injured in part because I had not went to my usual twice a week yoga regimen with consistency, In fact for my almost half century old body I need to commit to yoga a minimum of every other day, The structure and pacing of a class in more valuable than doing it on your own but there is nothing wrong with supplementing your classes with 20 minutes on your own when time does not permit. It is also helpful to cross-train with other activities such as swimming or weights when recovering from overuse injuries in the lower extremity.

The Skinny on Lasers and Toenail Fungus

People have been fascinated with lasers going way back to the iconic image of James Bond being nearly split in two in the movie Goldfinger. Goldfinger was the first blockbuster movie ever. It could be argued that this brought the idea of lasers as being cutting edge into the American psyche. Lasers have been used in medicine for everything from zapping off warts to whitening teeth, and now for treatment of those ugly, thick fungal toenails. Sports like running, skiing, and soccer increase your risk of getting toenail fungus. This is because you sweat inside a closed shoe or boot results in subjection of your toenails to repetitive microtrauma. The laser helps eliminate the fungal spores that lie deep within the nail. The treatment should be only part of a regimen for a pesky problem. The FDA requires language to specify that the skin must be treated at the same time using the one laser that has been recently approved for nail use. The reason this is necessary is because the same spore that can infect the nail can infect the skin. Utilizing the laser as an adjunct treatment with either the oral or topical treatment is most effective. The laser helps eliminate the fungal spores that lie deep within the nail. Similar to laser teeth whitening, serial treatments are a part of the process. It is also important disinfect the areas the fungal spores reside, so the nail does not get reinfected. There are now ultraviolet lights to do this. Lysol is not a great idea because you are subjecting your skin to strong chemicals, but there are other more safe disinfection sprays for shoes available. Health insurance does not cover the cost of this treatment. The treatments are administered once a month over three months and do not require anesthesia. You don't have to hide your feet.

Vibram will deposit $3.75 million into an escrow account and those funds will be distributed to those valid class members who purchased a pair of Vibram FiveFingers between March 21, 2009 and the date of the first dissemination of summary settlement notice or class notice, whichever is earlier.

There's a rock band called Five Fingers Death Punch and this news may fit that bill. Vibram will deposit $3.75 million into an escrow account and those funds will be distributed to those valid class members who purchased a pair of Vibram FiveFingers between March 21, 2009 and the date of the first dissemination of summary settlement notice or class notice, whichever is earlier according to a Runner's World Report. I had joked about selling the minimalist trend short and this most certainly will take some steam off the minimalist running shoe surge. I think strider drills and their use have a place but the Vibram Five Finger was over-hyped and now they are paying the price.

Flexible Shoes Cause Running Blues

Here is another example of a running shoe that is too flexible. While not being one itself, the minimalist shoe movement has encouraged more mobility in running shoes. This patient is a recreational runner who runs several days a week. He developed achilles tendonitis and bursitis over the course of the last six months running with this shoe. Here is the picture of the ultrasound. The arrow indicates the micro tear in the achilles and bursitis.

Treating Early

Bob Marley loved playing soccer. He had a recurring sore nail on his right foot that kept falling off that was thought to related to playing soccer at first. The nail bed was slow to heal. He was diagnosed with acral melanoma in 1977 and was advised to A. Have the toe amputated or B. have the foot amputated. The cancer was stage 3/4, the most deadly. Bob decided to let it be and then many months later have the lesion cut out and a skin graft placed on it. By the time the cancer had affected him physically it had already metastasized all over his body and it was too late to treat him. He died in 1981. If he had had at least the toe amputated on detection he would have extended his life probably for at least several years. A dark spot under the nail particularly in a darker pigmented person and particulary if it extends back to the cuticle is not something to be taken lightly.

Nike Free not Always Mantle Worthy

The latest casualty on the shoe circuit is the Nike Free. A patient this month had pain on the outside of their foot at the end of his marathon. It turned out he had a tear on his peroneous brevis muscle that was visualized on ultrasound. I advised him to take 2 weeks off and reevaluate. He had trained without consequence in the shoe but reached a break point at race pace after mile 20. Stay tuned for how to detect injuries in real time with diagnostic ultrasound and you can see the injury.

Hype the Shoe, Take Two Aspirin and Call me in the Morning

So it's not just the minimalist shoes that get runners in my office. Here's the bottom lugs one the over-hyped Newton's. The idea here is it accentuate the "Pose" method or Forefoot running. I had a runner come see me yesterday who had been doing fine in the Saucony Ghost and was swayed into trying these out. The problem with the shoes is the crease line and lug distribution put a hot spot near the common location for a neuroma between the heads of the third and fourth metatarsals. She had not developed a neuroma yet but I saw swelling on my ultrasound that could develop into one if she continued with the Newton's. to much distribution to the forefoot. I told her to go back to the Ghost and and take some time to let the swelling reduce. Hype is what sells. Reality is the lesson.

Minimalism Shoes: Overdone and Running on Empty

5 years ago the minimalist running shoe was at it's infancy. Now the trend is overdone. If minimalist shoes were a stock I'd sell them short. That's not to say most people need running shoes that are built like a tank or have soles like a snow tire. After Chris McDougall's book Born to Run the seed was planted for the Vibram 5 finger and the Nike Free.now there are dozens of choices that are available. The minimalist movement also was further hyped by the culture of crossfit. If you are a podiatrist like I am you would see first hand the injuries that are direct results from these shoes. My introduction to minimalist shoes came when my friend Jay started running barefoot. He will be the first to tell you that barefoot and running in minimalist shoes are not the same thing. We also agree that running barefoot or in minimalist shoes require a lengthy transition. 5 years ago I started to blog about it and that led to an interview in the Baltimore Sun which was then noticed by an MSNBC producer and I ended up being part of a panel interview by Dr. Nancy on barefoot running. Now the trend is running on thin treads. If you are lean and fit it's one thing but for much of the rest of the running populace there is no doubt in my mind that you increase the odds of sustaining plantar fasciitis, achilles tendonitis and stress fractures, especially in the metatarsals. Runner's World has pronounced the trend cooling over the past year.http://www.runnersworld.com/minimalist-shoes/more-support-for-slow-transition-to-minimalism A recent article showed that runners had more injuries with minimalist shoes.One small study showed equal numbers of injuries with a neutral shoe vs. minimalist shoes but the numbers were small. Larger studies are difficult to conduct because controlling the variables of runner's body type and training. I don't put much stock in Dan Lieberman's claims off small studies of elite runners at Harvard. He's not the one seeing the runners outside the lab hobble into our clinics.

Top 3 Olympic Memories Contest

Top Winter Olympic Memories contest will be extended to the end of the Olympics as many of us are just getting into the spirit! Prizes include some fashion/function boots from Soles, snuggly Winter Slippers & insulated Sole sport insoles. To qualify for entry send your top 3 to Arlingtonfoot@gmail.com and like our page Arlington Foot and Ankle on Facebook. James Hess is the top Olympic memories contestant so far.... 1) 1980 US Hockey victory over CCCP, 2) Eric Heiden 1980 -- winning 5 golds in speed skating at every distance -- in my mind among the greatest athletic accomplishments ever -- like winning the 100 meter dash and the marathon in the same week 3) Franz Klammer's downhill win in 1976 4) Dorothy Hamel's gold in 1976 Olympics 5) Norwegian XC skier Bjorn Daehlie's Classical 10K Pursuit gold medal over Thomas Algaard in the 1992 Albertville games 6) Bill Demong's Gold medal along with Johnny Spillane's silver in the same event in the Nordic Combined in 2010 Vancouver games . First ever medal for an American in this event -- gold and Silver. If I thought more, I might come up with something obscure.

3 Favorite Winter Olympic Moments Contest

# 1. Improbably after stumbling in two previous Olympiads and touching his hand to the ice in the 500m in the 1994 Lillehammer Games Dan Jensen came up with Gold in his non-signature event the 1000 meters. I like this as my number one moment because he found a way to win when he was on the verge of going down as one of the all time choke performances in the Olympic games-this despite being understanably shaken in his first Olympiad shadowed by his sister's death. Instead he came up with one of the all time clutch performances on his last skate. # 2. still get goosebumps... #3. After over a decade drought for the US in the Men's Alpine Ski Team Champion on the Podium Ted Ligety took Gold in the combined at Lillehammer at 21 in what was supposed to be Bode's Games.

What Makes an Epic Ski Lesson Part ll

I had a chance to ski with Damien Oliphant yesterday and continue our conversation on what he does to facilitate his student's development and make his lessons special. One thing we discussed was his take on what a skier needs to be successful. "You have to have two basic big box items. I call them your 'Skier Toolbox', all the things you know how to do on and with your skis, and your 'Skier's Sense', knowing the places and situations to use the different things in your toolbox. Together those things things keep you safe, help you be as efficient as possible and have the most fun. My goal as an instructor is to help you hone your skills with the tools you already have, add the tools I see you are lacking and train you to recognize which of your tools are best suited for different situations you may face." Doc for Jocks: Do you use the thousand steps drill in your lessons? I've been a big fan of it and I know it is one of Bill Deitrich's (Adaptive Ski School Director at Whitetail) go to drills. Damien: I have used Thousand Steps. My focus though is always on skill development vs drill execution. Most important for me are the specific movements or actions I'm trying to foster with any given drill. If I don't see movements I'm looking for, how can I help the student take small steps, toward proficiency? With that discussion on the lift, we took it to the snow. During our run, Damien noticed I was rushing through my leg steering. I was using up all my available movement at once at the top of each turn which caused skidding through the bottom half. Damien: Ben, when you're skiing the tree line, hunting the best kept snow, you have to trust that moving with your very well designed skis. Progressively steering your legs through a smooth arc will keep you in the zone and is the most efficient way to go. Let the skis do what they are designed to do . If you rush through the movements, you end up doing a LOT more work, talking a much more bumpy, skiddy ride AND missing out on the most fun part of each turn. Some situations require you be more tactical. In some of those cases, throwing your boards sideways to get out of trouble is totally acceptable. I just want my default to be moving as silky smoothly as possible. I want to be skiing when I'm 90. My legs and joints probably won't make it that long if i'm throwing them sideways and jamming the brakes in every turn for the next 50 years. With that I took a shadow run with Damien so I could follow his tracks. He cued me by telling me to enjoy the falling sensation in the fall line that makes skiing fun. He also had me focus on more progressive, continuous motion. Damien: Think about when you take a clover leaf to exit a highway. If you spun your steering wheel to the side all at once, you would roll your car. Instead you steer the wheel a little at a time progressively around the turn. Use the same thinking when steering your legs though each turn. Within the run on Limelight I actually had a couple of turns that felt just right and I thought in that moment "So this is what it must be like to be Damien" -if only for a couple of turns! In between turns Damien shared with me his thoughts on lesson groups and clinics. Damien: I like to deliver the highest quality learning and recreation experience I can for my guests. For me that is most successfully achieved in private lessons, 1 on 1 and small group settings(3-5 students max). I feel much the same about my own skiing and teaching development. I learn best in 1 on 1 or small group settings. I seek out learning environments that best suit my needs and make the most of my invested time. When I need information, I reach out to a small circle of people I trust for input and feedback. I take every opportunity to ski and spend time with PSIA National Team members. Small things I have picked up from Eric Lipton, Matt and Jeb Boyd have been great for me as a skier and teacher. My friend, Stan Wilkes (PSIA Eastern Dev. Team) has always offered good insights . My first ski teaching mentor, Tom Riford (PSIA Eastern Examiner), who took a chance and hired me at Whitetail 19 seasons ago, has been very gracious to allow me to shadow some of his PSIA event and ITC groups. His mentorship, encouragement and willingness to share his vast knowledge base have been invaluable to me throughout my time as a ski pro . The road from 18 year old fresh faced hack to seasoned professional skier has been long. The spirit, passion and hard work that started in 1994, shadowing my mentors , watching video, absorbing technical information, training all night after teaching 4 and 5 year olds in SkiWee all day, inline skating to cross train in the summer, is still a big part of what drives me today. I think sharing that with my students is what has made the Ski with D experience success

What Makes an Epic Ski Lesson

So what makes an epic ski lesson? After an great evening of twilight skiing I sat down with Damien Oliphant, The "D" of Ski with D, and talked about what he does to make his ski lessons special. Dock for Jocks (DFJ): What features do you think think make your lessons unique? Damien: I first try to establish a comfort zone for my students. I have to understand their concerns, fears, physical strengths and limitations. likes/dislikes, etc. People have to feel good about your interaction and trust you to take good care of them before they will really follow you. If a student trusts you, they invest in your opinion and value your confidence in them. A trusted expert's confidence in their capacity and ability is often the first step to greater personal trust and self confidence. The confidence to experiment and take small risks that push the edge of our comfort zone is a big difference between a skier who makes progress and one who doesn't. Most decent ski teachers understand the mechanics of teaching feet to turn left and right. The great instructors understand how to mitigate the situational and mental speed bumps or road blocks that keep a skier from performing and mastering those mechanics. Beyond that I fully believe in providing the highest level of service and attention to my guests needs possible. I anticipate my guest's needs and do all I can to fill any void before they are aware it exists. Skiing at it's best is a luxurious experience. People come to us to escape the the detail management that fills their regular days. I take on all those things so they can focus on enjoying their experience and making the most of a fantastic day on the mountain. DFJ: What is your favorite breakthrough moment with a student? Damien: I skied with a lovely woman one day a couple seasons ago. Before we headed out she described herself as a 'VERY nervous skier" making wedge turns on easy green terrain. On our first chair ride. She explained she skied to pass the time while her son skied in his classes every week. I asked about what made her nervous. She mentioned injury to herself and others, etc. I reassured her all that was natural and not to beat herself up for the good instincts that were working hard to keep her safe. I explained my job was to give her tools to ski in control so she could minimize her fears. We skied one assessment run on a short green trail. She was in pretty good balance and her steering was good but the fear and tension was all over her body. The muscle tension was impeding her ability to move the ways she needed to. Classic case of fearful brain getting in the way of a capable body. We took another chair ride and talked about anything other than skiing. At the top of the run I asked her to take her skis off. "Just take it all in and enjoy the view." Right away a smile washed over her face and I watched her tense body begin to relax. She said "I've never seen this before." I told her I knew she hadn't because she had only been looking at her feet. I told her views like this are a huge part of why I love to ski so much and to take a moment before each run to take it in. We stood for a minute or two in silence appreciating the freshly fallen snow covering the valley. Then it was time to make some turns. We clicked back in to our skis and were off. Right away she was a completely different skier. Renewed energy and relaxed fluid movements made for some really beautiful turns. She was skiing well and really enjoying herself. We took a few more runs over the course of our hour together and tweaked a few things but our greatest break through came about 15 minutes into the lesson when we stood to enjoy the view and found her enough joy to offset her fears. At the end of the lesson she gave me a big hug and thanked me. She told me before coming to ski that day she had decided it would be her last day on skis. She just wasn't enjoying it. She was going to continue to bring her son for his classes but would just bring her laptop and work while he skied. By the end of our time together she'd not only changed her mind but was so excited she wanted to go buy her own equipment! I have a lotta great success stories but this one is my favorite. I always smile when I think of her. DFJ: What is your favorite go to drill for your students? Damien: I really like combining two drills (patience turns and J turns) to make one that's been really successful for me. I call them Patience Js. When I choose an exercise I make sure it has a direct connection to skill development. I've found one big obstacle to effective skill development is skier's not understanding the relationship between turn shape and speed control. If we can't manage speed consistently we are always on the edge of control. That's not a good place to be if you want to learn anything new. Students on the edge of their control envelope spend they're time on skis hanging on for life. You can't learn new skills when all you're energy is focused on survival. I have had great success with the Patience J. It really gets students in tune with what good turn shape feels like and how it allows them to control speed. Once we build that platform the sky is the limit. DFJ: Do you practice yoga and meditation? Damien: Yes I do both from time to time. Not enough of either. I'm also experimenting with movements from ballet. The flexibility and leg rotation in the basic ballet positions are great for skiing.

Cueing it up for 2014

Cueing can take the form of coaching or instruction and professional advice. It can make all the difference. The reason people don't learn a movement pattern like skiing ,golf or even a yoga pose as well from a video is that you don't have the feedback from a professional instructor. The same holds true when you are recover from a complicated injury. The level of injury needs to be assessed whether it be with an X-ray, an ultrasound or an MRI so that you have a reference point of where you are and where you are going. The successful outcomes are attained by those that stick to the protocols and safe training methods. This coupled with tenacity to stick to a training schedule that builds in progressive movement patterns will develop your goals into reality for 2014!