Improve The Timing Of Foot Pronation To Eliminate Plantar Fasciitis

Blog post by: Dr. Lev Borukhov, PT, DPT

Plantar fasciitis can be a painful and limiting injury. It often affects the bottom of your foot between the heel and arch. Plantar fasciitis is usually described as a sharp pain in the morning as soon as you get out of bed. Most people will modify their gait ( the way they walk) by walking on the outside edge of their foot to decrease pain. Over time that compensation my result as a heel spur. Plantar fasciitis is thought of as an overuse injury but the cause is unknown.

Plantar fasciitis symptoms include:
• Pain with walking especially in morning
• Pain with walking after sitting

Physical therapist treatments for people with plantar fasciitis should be custom tailored to their specific functional limitations. At Therapydia we use an individualized approach to every patient. One of my favorite approaches to treat plantar fasciitis is to look at the timing of the foot when it pronates and supinates. I commonly find a discrepancy between what should happen and what is happening.

Your foot begins to enter pronation when your big toe lands on the ground after you heel strike. If your foot doesn’t get to pronate then the shock absorbing properties that are innate to the foot structure don’t get a chance to take place which may lead to plantar fasciitis-like pain.

plantar fasciitis pronation kona

The foot enters supination to give itself rigidity for a stable platform to push off from. If the foot doesn’t supinate properly or in time it may mean that you are pushing off a pronated foot which could cause some pain in the plantar fascia area.

plantar fasciitis supination kona

So speed up or slow down these steps I like to use little foam wedges. In this video we are using wedges to speed up pronation.

In this video we are using wedges to speed up supination of the foot.

Pronation is a normal foot motion and helps to absorb shock on the foot, knee, hip and back. However, over pronation stretches the plantar fascia leading to plantar fasciitis. By improving the timing and positioning on each step, you can eliminate plantar fasciitis pain. There are many other treatment modalities that physical therapists utilize to treat patients with plantar fasciitis. Most treatment plans are tailored to the patient and their specific functional deficits. Give us a call if you’re experiencing heel-related pain and we’ll work with you to create a custom treatment plan for your needs.

3 Cross Training Exercises For Runners

If you’re a runner training for a big, or little, race, cross training is important to keep you injury free. If you just started to run and are going from couch to 5k, or a general training plan to run your first half marathon or marathon, you might want to swap out a running day with a cross training day to make sure that you don’t get an overuse injury.

Single Leg Deadlift with a Row

single leg deadlift runner
• Feet hip width apart knees should be soft, hold the kettle bell handle in your hand.
• Hinge your hips as you lower the bell
• When you’re as parallel to the floor as you can be, bring your elbow up to your side.
• Lower the bell and use your hips/ gluts to bring your self vertical again. your focus should be on balancing on the foot thats on the ground.

Walking Lunges with Medicine Ball

walking lunges with a medicine ball

• Hold the medicine ball close to your torso
• Take a lunge forward with your left leg and rotate the ball over the leg.
• In one movement bring the ball back to center and bring your right knee in the air to get into position to lunge over your right leg.

1.5 Kettle Bell Swings

1.5 kettle bell swings
• Stand with one leg in front of the other with enough space between your legs to swing the Kettlebell.
• Your back heel should be off the floor
• Swing the bell back towards your butt and use your hip to thrust it forward around mid chest level.
• Remember to switch to do the other side.

Try these to weed out those weak links so that you can be a bulletproof runner.

Running With A Physical Therapist

running form kona physical terapy

Written by: Stephanie Colasanti, DPT & Tyler Patrick, DPT, OCS, ATC, CSCS

An estimated 10 million in the US run and it is fast becoming the most popular form of exercise. From the cardiovascular improvements to stress relief to losing weight, it’s no surprise that many people pick up running for its health benefits. With the popularity of running increasing, so has the rates of injuries from running. In fact, a whopping 82% of runners will get injured at some point. This could range from relatively minor symptoms to major game changers that  can cause you to halt all of your running goals. Although it may seem like the repetitive nature of running would lead to injury, there is no evidence that running is actually bad for you. Now this comes with a disclaimer….with the right type of training and form, your body should be able to withstand the forces in running and get stronger from them, injury free!

That’s where we come in. As physical therapists, we generally see people after they get hurt, which is extremely frustrating for us. With the right guidance, runners of all ages and skill level could benefit from a screening and assessment to PREVENT injury or even unlock performance potential.

What Happens During a Run Analysis

To decrease run-related injuries and improve your run times, a physical therapist will examine the following:

Muscle strength (muscles provide the force to allow movement)
Muscle length (allows your joints to move through their full range of motion)
Joint mobility (joints create movement between bones)
Ligament integrity (ligaments help keep joints together)
Running form/movement

Problems with one or multiple of these could lead to excessive wear and tear and possible injury. A physical therapist will examine all of these bones, joints, muscles, as well as how they interact with each other during movement. From your spine, all the way down to your big toe, we will make sure that everything is working the way it should in order to keep you out of that 82% or help manage that nagging injury that prevents you from unlocking your full running potential. By assessing your musculoskeletal makeup and movement patterns, you and your PT will have information on your unique biomechanics and develop a custom treatment program based on those findings.

For a little bit of insight and to get you started at home, here is one of the things we would take a look in a running assessment: hip flexor flexibility.

Hip Flexor Assessment For Runners

Hip flexor tone/tightness is a common issue that we find in people because we have made a life that allows us to sit for everything. Sitting causes your hip flexors to be in a shortened position and leaves your hips and legs tight and your glutes inactive. Why does this matter for running? Tight hip flexors limit the ability of your leg to go behind you (hip extension). Running requires a great deal of hip extension to generate the force to propel you forward. Tight hip flexors can also cause your back or knee to take more stress than it should. If you have less than 10-20 degrees of hip extension (or hip flexor flexibility), the range of motion required for normal walking/running, you will increase your chances of injury due to stresses placed on your low back and knees.

To assess your own hip flexor tightness, lay down on the edge of a bed, then bring both of your hips up towards your chest:

assess hip flexor tightness physical therapy

Allow one leg to fall down with your knee bent slowly. You have iliopsoas (hip flexor) tightness if your thigh is not parallel to the table/bed:

hip flexor runners

You have rectus femoris (hip flexor/knee extensor) tightness if your lower leg is not straight up and down:

hip flexor tightness assessment

If you find that you have some tightness, here are a few stretches that will get you started on improving your flexibility.

2 Stretches For Tight Hip Flexors

Lunge Hip Flexor Stretch

couch stretch runners

Couch Stretch
lunge hip flexor stretch runners
Perform each stretch for at least 30 seconds, but preferably 1 minute. Do this about 3 times on each side daily. Contract your butt muscles on the leg where the knee that is down to prevent your pelvis from tilting forward. Also, work on your breathing to sink into the stretch during the exhale.

Get started on your flexibility and come see one of us down at Therapydia for a running assessment, as well as an individualized program that will prepare your body to handle the impact of running.

Stay tuned for the remainder of our running series! We will be discussing shoes, as well as some tests and corrective exercises that should help you unlock your full potential!

How To Properly Warm-up Before Your Workout

side lunge warm up stretch

By Jaime Granchelli, PT, DPT

Yes, it matters. It’s actually kind of a big deal. If you’re not physically warm before you hit your workout, you’re not ready. Muscles don’t like to be asked to move and do work under load and tension when they are cold. Cold muscles also have a higher chance of being strained or even torn.

Why Stretching Isn’t Enough

What muscles prefer is to be warmed up gradually from smaller to bigger range. Kicking your foot up on a bench and hanging in a passive hamstring stretch for a few minutes isn’t going to cut it. Sure, this will help lengthen the muscle but simply gaining more range from sitting in a stretch doesn’t mean that muscle is geared and ready for dynamic movement. In order to achieve more range, your muscle has to relax itself and is technically shutting down. When you hold a stretch for a period of time without involving movement, you’re actually shutting your muscle down even more and goes against exactly what you’re trying to accomplish.

Furthermore, this relaxation of the muscle is shutting down it’s natural responses that are necessary for power and force generation. A 2014 Journal of Strength & Conditioning Research study found that 60 seconds of four different static stretches resulted in substantial decreases in jump height and power compared to not stretching at all. In another 2014 study by the Journal of Sports Medicine found that an upper body static stretching protocol negatively affected peak jump force. With all that said, sitting in a passive stretch after your workout is a great addition to your cool down routine since you will be done putting those muscles under load and going into “shut down mode”, so to speak, and it won’t be detrimental to performance and/or health of the muscle.

Customize a Warm Up Routine For Each Activity

So, how should I warm up for my walking program?… my triathlon training?… surfing? Does it matter?

Warming up doesn’t have to be fancy, but it should be deliberate. Start by easy walking, jogging, biking, or swimming. Then, gradually start to open up your stride or pick up the pace as you feel your body warming up and engaging. Once you’re warm, play around with all those bounty drills we did in P.E. class or high school or college sports: lunges, side lunges, squats, jumping jacks, fire hydrants, regular or knee push ups, soldier kicks, high knee jog, inch worms. These can and should cater to what exercise you’re about to perform, as well as, where you tend to be tight. If you know you are about to do a shoulder intensive workout, the shoulder and arm take priority over hip and leg drills. If you feel you have tight hips, make sure to do some drills that loosen them up. Lastly, depending on what sport you’re warming up for and what skill demands you may require, start honing into more sport/skill specific movements. Tap into muscle memory and get them activated.

Below is a lower body warm-up routine you can do before your next workout!


low body warm up exercise routine


2 rounds of:

  1. 10 Squats
  2. 10 Lunges (5 each leg)
  3. 10 Side lunges (5 each leg)
  4. 10 Fire hydrants (5 each leg)
  5. 20m High knees Jog

Change The Way You Move At Work

Therapydia Work Injury Treatment

Developing an ergonomic and workplace injury doesn’t just have to do with heavy lifting or bad posture at a desk. Even if you’re moving around on your feet all day, you may still be at risk for developing some repetitive movement injuries. If you work in the service industry, you may feel like there’s no way to avoid certain tasks that may be contributing to daily aches and pains. We usually move without thinking—which may not be the best thing if we’re moving in a way that strains our bodies. Our bodies tend to do better with more neutral movements. Unnatural movements like constantly lifting, reaching, or holding objects on a daily basis may overexert your muscles and lead to injuries you probably didn’t even know you were developing. A lot of employees within the hospitality and service industries are at risk for sprains and strains, simply from moving the wrong way. Even quick breaks to stretch and walk around can make a huge difference. Beyond that, you can be at top level performance at work without having to worry about those constant aches in your neck, shoulders, arms, and back.

If You’re At The Front Desk

If you usually work at a workstation or behind a desk, keep to general ergonomic tips about adjusting your desk space. Keeping your body as relaxed as possible is critical for this type of environment. Unnatural positioning when using your mouse and keyboard can potentially cause carpal tunnel in your wrists. It also puts you at risk for tennis elbow, which causes the muscles and tendons around the elbow to become inflamed. Just moving your mouse and typing on your keyboard the right way makes a huge difference.

Tips For Your Mouse, Keyboard, & Computer:

• Place pressure on the palm of your hand, don’t hold mouse too tightly
• Keep mouse and keyboard at elbow height
• Type with straight wrists
• Keep your computer screen at eye level

Tips For Your Chair:

• Keep thighs horizontal with room for knees under desk
• Keep neck and shoulders relaxed
• Don’t stoop forward, keep to good posture

Taking the time to relieve neck and shoulder tension could prevent any postural misalignments that could occur in your upper spine. One way to release tension throughout your entire spine and chest area and also improve posture is to stretch backwards. Counter a long day of hunching forward and flexing your spine with a quick break.

Quick Stretch Break:

• Get to a comfortable standing position
• Keep your feet hips-width apart
• Bring your hands up over your head with palms facing forward and thumbs hooked
• Begin to bend gently backwards
• Remember to breathe deeply as you do so

After sitting for a long time, this could be a good way to extend your posture. If you have back pain related to stenosis, remember that you should avoid bending backwards altogether.

Serving Is More Strain Than You Think

A lot of service industry jobs involve being in strenuous positions for most of the day. If you think about it on an ergonomic level, there’s a lot you personally can do to minimize the amount of stress you’re putting on your muscles and joints. Our bodies move and function the best way in natural positions. Carrying trays, plates, or bottles of beverages aren’t exactly the most natural ways for your body to hold weight. Waiters and waitresses have to contend with carrying a lot of weight balanced on one arm, which has the potential for injury.

How To Hold A Tray:

• Keep your position as neutral as possible
• Keep hand firm but relaxed on bottom of tray, don’t tense your fingers
• Keep your wrists straight and upper arm vertical
• Hold the tray as close to your body as possible
• Balance the tray on both your arm and hand
• Alternate which arm you use so you don’t overuse one arm
• Carry fewer plates at a time, ask other servers to help with larger orders

Pain because of these repeat movements might be felt in the the wrists, elbows, or shoulders. This might eventually put a server at risk for developing an overuse injury such as carpal tunnel, bursitis, or tendinitis around a joint. Servers are at risk for carpal tunnel symptoms progressing to the elbows as well as the wrists because of the way they hold heavy trays. Doing some wrist stretches during breaks can help relieve built-up tension in your wrists, your elbow, and general forearm musculature.

Quick Stretch Break:

• Extend your arm forward, hold your hand straight out, palm down
• Use the opposite hand to grab the back of the hand and the fingertips
• Pull the hand towards your trunk
• To stretch other side, flip your palm over and repeat the movement
• Hold for 10 seconds on each side

Pouring & Shaking

For servers or bartenders who work with heavy jugs, coffee pots, or bottles of beverage—keep to general tips about how to hold weight.

How To Pour:

• Hold jugs, pots, or bottles close to your body when carrying them
• When pouring, move the glass or cup as close to you as possible
• Don’t overreach with a full jug

For bartenders, they also have to worry about reaching for heavy bottles of premium liquor and constantly shaking drinks filled with heavier ice (which is similar to the motion of a baseball pitch). With all that shaking, they’re at risk for tendinitis in the elbow or the shoulder. If you’re a bartender, thinking about the way you shake is critical. You need to get the maximum impact from the way you’re shaking, but don’t let it impact your body as well.

How To Shake:

• Keep your shoulders and wrists as flexible as possible
• Stretch when you can
• Focus on which muscles you’re putting the most force on
• If you feel more pressure or force in one area, direct the pressure away
• Switch hands when shaking, vary your shaking routine

A common injury bartenders are prone to is shoulder tendonitis. Doing some external shoulder rotations to strengthen the muscles of the rotator cuff around the shoulder will help strengthen and stabilize your shoulder joint.

Quick Workout Break:

• Lay on your side with the knees bent and a dumbbell in the upper hand
• Start small with the weight if you’re just starting out
• Bend the elbow to a right angle
• Keep the upper arm supported on your side with the dumbbell hovering in front
• Rotate the shoulder to pull the lower arm and dumbbell up
• Pull so the they are level with the top side of your body
• Slowly return down to the starting position

Keep Moving, Stretching, and Walking

Remember to take as many breaks as you can. If you’re on your feet all day, invest in good shoes that have some arch support and aren’t too pointed at the tip. Most servers or front desk workers have to stoop forward to speak with customers all day, which puts strain on their lower back. Comfortable shoes can go a long way in helping decrease lower limb and lower back pain. Get up, move around, throw something away, go to the bathroom, take a quick walk around your office space—whatever you can do. If you’re working the front desk, make sure you take the time to relax your hands. Be mindful of which positions feel awkward or uncomfortable when going through your work day, chances are, there’s a way to correct your movement to make it more natural. That way, you can avoid the aches and pains that come along with your specific job duties.

Preventing Injuries: What Surfers May Not Know

Therapydia Treat Surf Injuries

Feeling sore after getting out of the water? It may not be entirely obvious that you may be developing an injury somewhere in your body. Feeling any type of tightness or nagging aches in your shoulders or knees may mean that you’re not moving correctly when you’re on the water. Most surfing-related injuries could be prevented by knowing how to better engage certain parts of your body. Surf injuries lead to a progressive downgrade of a surfer’s performance since those aches and pains get in the way of how well you surf.

If you do feel some aches after getting out of the water, you may need some help with how you move. You may not have known how to use certain muscles to allow you to get the most out of your surf routine.

Don’t Cheat By Rotating Through The Knees

Surfing requires significant range of motion and stability across many major joints. Many surfers start developing injuries when they get stuck in a specific movement pattern. To start with, knees can take a beating when surfing. If your knees are feeling sore, you’re not going to produce as powerful of turns. As a surfer, it’s critical to have a healthy knee joint and quality strength throughout the muscles of the legs and hips. When surfing, your knee can get into some awkward or unnatural positions that put too much strain on your knee joints. Relying on just your knees to produce the force you need to make those turns can cause pain in your knee joint. These issues could range from damage to the cartilage, ligaments, and tendons around your knee joint to having your knee joint start to misalign.

Activate Above Your Knees

Consider moving throughout your entire body as you cut and turn through the waves. One solution to help your knees out would be to rotate through your shoulders and trunk (i.e. chest and ribcage). Flowing from turn to turn involves leading with your shoulder and hips. When leading into a really tight turn, it’s especially helpful to utilize your hips. Getting low and staying balanced while tube riding also requires a lot of hip, knee, and ankle flexibility and strength. Surfing creates tight hip flexors (i.e. muscles surrounding your hips) because straddling the board keeps those muscles contracted for long periods of time. Having tight hips can restrict how well you rotate during a turn. When this happens, it goes back to that knee pain. You’ll compensate for the force needed to turn by using your knees, which will strain them. Better hip flexibility and strength can also help with the fundamental squat position, you’ll see better stability and more lower body control while you’re out there surfing.

Those Achy, Creaking Shoulders

Surfer’s also have a high risk for overusing and putting too much strain on their shoulders. When surfing, you’re constantly pulling your shoulders forward in the water. Over time, this becomes a habit and you begin stretching and irritating the muscles around your shoulder. Paddling also strengthens certain muscles in the shoulder while weakening the rotator cuff muscles (i.e. muscles around upper arm and top of shoulder). This leads to a type of injury called shoulder impingement, which occurs when you constantly compress the rotator cuff tendons of your shoulder with a lot of overhead movement (i.e. paddling). Strengthening the muscles that surround the back of your shoulder will take the stress off of those overused muscles in the front. Working on balancing the pressure across your shoulder muscles will prevent any inflammation or pain that may come from having your shoulder impinged. Paddling also takes a lot of power and flexibility coming from your back and core. If you consider how your entire body moves when you paddle, you’ll put less stress on certain parts of your body and begin to utilize major muscle groups.

Surf With Your Whole Body

While some moves may require the use of certain muscles more than others, it’s important to have strength and flexibility across your body. Surfing is as dynamic of a sport as it gets—moving on open water is anything but simple. Your body has to punch back against the force of the waves while also moving well. Each wave will have an effect on your board and ultimately on your body. Working through your movements and figuring out the cause of your pain will help you move your best—and surf your best.

Right Workstation, Wrong Posture

chair posture ergonomics

Did you finally buy that top-end office chair only to find out that your neck and back still hurt during the day?

High end office chairs often come equipped with contoured lumbar support which is fine, but truth be told; the best lumbar support comes from you supporting yourself with your own muscles.

The quickest way to stop hurting yourself at work is to lift your chest, slightly tuck your chin back and gently feel the muscles of the low back lifting the pressure up off your sit bones.

Standing is better than sitting – however bad standing can still result in many of the problems found with sitting. Your muscles are designed to lift the pressure off of more delicate structures such as joints and cartilage. Your muscles can help protect your delicate joints but only if you consciously use them.

Using Technology To Help Chronic Back Pain: A Physical Therapist’s Thoughts on Lumo Lift

lumo lift back pain posture

I was fortunately gifted a Lumo Lift a few weeks ago. Lumo Lift is a small device that clips onto your shirt and it uses subtle vibrations to remind you to straighten up when you slumping into poor posture. You can also customize your experience—from a 3 second vibration delay to 10 minutes— set goals, and track your physical activity through the Lumo Lift App. I instantly took it out of the box, downloaded the app and followed the simple setup instructions. I wore the Lift all day for three consecutive days and tracked my steps per day and posture. Then I passed off Lumo Lift to one of my patients suffering from chronic low back pain.

Why Exercise Isn’t Always Enough For Back Pain

I often tell my patients that they need to incorporate a systems based approach to stopping their low back pain.  Specific exercises are important to gain the flexibility, strength and coordination needed to facilitate proper posture with sitting, standing, bending, sports performance, etc.  However, my professional opinion is that exercise alone does very little to keep lower back pain from reoccurring.  

Ultimately most chronic back pain cases persist because patients are constantly causing irritation to their lumbar spine without realizing it. Poor posture is the number one cause of back pain. Bone spurs and disc bulges are now largely believed to be predictable responses to the way we distribute forces across our spine.  Research tells us that sitting in a chair and slouching puts a lot of pressure on our spines. Not surprisingly, most patients with back pain say that sitting causes more pain than standing.  

The Patient’s Result

My patient with low back pain wore the Lumo Lift for five days and very surprised at how often he was falling into poor postures. He believes that the gentle vibration from Lumo Lift has in fact decreased his lower back pain and made him more mindful of his positioning.  

I plan on continuing to send patients home with Lumo Lift.  I always tell my patientsit only takes one unfortunate episode of slouching or bending over the wrong way to set off an episode of acute back pain.  

Lumo Lift seems like an easy, consumer friendly way to help reinforce proper static seated and standing postures.   

Traits of Physical Therapy Patients Who Beat the Odds

physical therapy recovery program

Over the past five and a half years of treating patients for 40+ hours per week, I have seen several patients beat the odds – by a lot! These folks were given very low expectations from neurologists, orthopedic doctors and even other physical therapists.

Sometimes their gains seemed to defy what the science taught us to be possible. What causes such incredible outcomes? Is it great therapy? No, I can’t accept such credit. There seems to be some golden, intangible thread that allows these patients to beat their prognosis. I have tried to read between the lines when working with these patients to better understand what they seem to know and learn how to teach their incredible skills to other patients.

What 4 traits do these patients have in common?

1. The ability to suspend their disbelief: The ability to take one step and a time and be process orientated instead of end goal orientated. The ability to suspend judgement on one’s condition or situation.

Why is this important?: Simple logic – if you don’t swing the bat, you can’t hit the ball. Every great modern accomplishment by humans was initially thought to be impossible. Someone always has to be the first to do what has never been done.

2. Setting intentions is foundation of luck: No you can’t magically speak yourself into getting better after suffering a major physical trauma. However, if you intend on getting better, you are more likely to ask important questions and surround yourself with healthcare providers who are talented enough to help you on your journey.

Why is this important?: Dr. Wayne Dyer says it best with his book “The Power of Intention” that if you intend to succeed then success chases you instead of you chasing it.

3. The ability to put stress in it’s place: A powerful exercise that we teach our patients to do is to set a timer and let yourself worry about your aliment for no longer than 10 minutes per day. During those 10 minutes it is okay to cry, wring hands, complain, etc. After those 10 minutes, turn the stress switch to the off position and focus on how the exercises, information and hard work will help your situation improve.

Why is this important?: Stress in small amounts can be a catalyst and cause incredible motivation. Stress in large amounts bogs the body down and disrupts mental focus needed to accomplish difficult challanges.

4. Assembling the right team: Working with therapists and physicians that mesh well with your personality.

Why is this important?: Rehabilitation needs to be a constructive team effort. Undergoing therapy can be a long process that is incredibly trying mentally and physically. Therapy works best when patient and therapist personalities compliment each other instead of disrupt each other.

Giving credit where credit is due: During one of my student internships, I was fortunate enough to be mentored by Steve Schall of Norfolk Physical Therapy in Virginia. I once asked Steve why he would create incredibly lofty and unlikely goals for patients. Steve answered simply:

“I’m not going to be the one to place limitations on anyone”.

Why a Former Pro Contest Surfer Is Taking a Surfing Lesson

I started surfing frequently when I was 12 and I spent all of my teenage years either surfing or skateboarding. During my 20s I was fortunate enough to obtain surfing sponsors that brought me to wonderful surfing destinations all over the world and supplied me with the best equipment. I surfed many times in professional and invite-only events for both shortboarding and longboarding and even performed well in novelty events such as tandem surfing and stand up bodyboarding. When I wasn’t surfing, I taught surf lessons to newcomers and up and coming surfers with high aspirations.

When I turned 24, I stopped surfing in contests, voluntarily dropped most sponsors and committed myself to the Doctor of Physical Therapy program at Old Dominion University. I imagined that after graduating, I would work full time as a physical therapist but still continue to compete in a few B-list professional contests in Hawaii and do this until I was in my early 40s. But then I had a change of heart…

For the Love Of Surfing

Now at age 32, I am in the best physical shape of my life. Being in the health and wellness field has changed my view of what it means to be at my highest personal athletic performance. Rather than trying to prove myself in professional events, I am surfing for it’s own sake and learning new novel forms of the craft.

Today, I spend my time body surfing large waves and stand up paddling smaller surf in addition to riding a short modern board. I have realized that in order to keep outperforming my 20 year old self, I have to surf smarter and I need to seek out new ways of learning about my technique flaws. There are many learning curves in surfing and getting feedback from friends and other surfers or watching replays captured by Solo Shot / GoPro can help you identify performance gaps that are holding you from the next level.

Physically speaking – surfing in not a difficult sport. Cognitively speaking – surfing may be the single hardest physical activity out there. I believe that most surfers would most greatly improve their performance not through better equipment or finding better waves, but simply spending more time in “deep practice”. The Talent Code by Daniel Coyle speaks volumes about the concept of “deep practice” or in other words increasing your cognitive awareness of what makes someone a better performer. The idea of being process orientated rather than goal orientated. For me, I made the switch of being goal oriented (wanting to win contests) to being process oriented (deeply analysis of technique).

Now instead of worrying about contest results, I focus on timing, exact positioning of my back arm during turns on the wave, breath control when flying down a big wave, etc. As author Daniel Coyle pointed out, learning exact techniques and then spending time repeating and deeply analyzing techniques allows for your body to create more myelin. Myelin insulates nerve fibers, increasing the speed at which impulses are conducted. The more myelin – the faster you can fire nerve impulses / correct mistakes and perfect techniques.

In speaking of technique corrections, many of us saw the video capturing John Florence fracturing his ankle. John Florence is highly regarded as one the best surfers in the world with excellent technique in any conditions. Back in 2013, he was surfing in Australia and performing a routine maneuver when he broke his right ankle. While most of the surf media chalked this injury as a “freak accident”, it is noticeable within the video as to exactly what happened.

Watch his back leg, notice how his hip-knee-foot are not in alignment. If he had pushed his back knee outwards during the aerial rotation it would have most likely avoided the excessive ankle torque that caused the fracture. Basically, instead of his hip pushing outwards to bring the knee and ankle in alignment, his body instead used his knee and shin as a fulcum to destabilize and fracture his back ankle.

Even hearing John’s own explanation of the injury – it doesn’t sound like he had yet figured out that these injuries don’t have to happen. My advice to John would be to practice keeping hip-knee-ankle stability on land as to make proper positioning of his back leg flawless – then slowly translate that positioning into actually riding waves. Because there is so much to think about when riding a wave, proper ergonomic alignment in surfing should be practiced deeply on land and then added into actual surfing.

Movement science can be multi disciplinary. Often I have worked in conjunction with surfing coaches to better a surfer’s performance. A surfing coach can teach the athlete how to add speed, power and flow (contest judging criteria) into their surfing. A physical therapist is better suited though to help an athlete understand how to better command their body and avoid injury while trying seemingly dangerous maneuvers.

From Instructor To Student

Next summer I am finally taking my first surfing lesson. Twenty five years after my first surf session in Cocoa Beach beach I am going to Northern Costa Rica to work with a performance coach. I look forward to finding new ways to accelerate my learning curve. The best athletes are the best because they never stop learning (and figuring out how to avoid injury).

I will be attending the Surf Simply resort in Costa Rica. After listening to many of their podcasts it is apparent that the coaches are truly surf scientists. If there was such a thing as a PhD is surfing, these folks would deserve the title of “Dr.”.

Whether you are a surfer, an athlete or just someone who wants to achieve better balance – never stop learning and know that most injuries are truly avoidable if you have adequate command and understanding over your body.