Dr. Guillermo Contreras // #FitnessAthleteFriday // www.ptonice.com 

In today's episode of the PT on ICE Daily Show, Fitness Athlete faculty member Guillermo Contreras discusses the why behind the footwear recommendations they make and why minimalist footwear may not be the best choice for many fitness athletes to start with as well as how proper footwear can have an added benefit of improved strength, hypertrophy and fitness

Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog

If you're looking to learn from our Endurance Athlete division, check out our live physical therapy courses or our online physical therapy courses. Check out our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.

EPISODE TRANSCRIPTION

INTRODUCTIONHey everyone, Alan here, Chief Operating Officer here at ICE. Before we get into today's episode, I'd like to introduce our sponsor, Jane, a clinic management software and EMR with a human touch. Whether you're switching your software or going paperless for the first time ever, the Jane team knows that the onboarding process can feel a little overwhelming. That's why with Jane, you don't just get software, you get a whole team. Including in every Jane subscription is their new award-winning customer support available by phone, email, or chat whenever you need it, even on Saturdays. You can also book a free account setup consultation to review your account and ensure that you feel confident about going live with your switch. And if you'd like some extra advice along the way, you can tap into a lovely community of practitioners, clinic owners, and front desk staff through Jane's community Facebook group. If you're interested in making the switch to Jane, head on over to jane.app.switch to book a one-on-one demo with a member of Jane's support team. Don't forget to mention code IcePT1MO at the time of sign up for a one month free grace period on your new Jane account.

GUILLERMO CONTRERAS Here we go. Good morning, fitness athlete crew. Good morning, PT on Ice Daily Show. Welcome to the PT on Ice Daily Show and the best day of the Fitness Athlete Division of the Institute of Clinical Excellence. Super happy to be with you here this Friday morning. fitness athlete footwear. And that's a little teaser there. Hopefully you get excited for that. Before I start jumping though, I want to say anybody headed to Reno, Nevada, in Reno, Nevada for the ice sampler, have an awesome time. Have an epic time. A little bit of FOMO not being able to be there, but hope you all have a wonderful time. Take so much out of that weekend. It's such a great weekend. So much to learn. So many to learn from. And I've done this topic in the past. I've talked about my shoe recommendations for fitness athletes, whether it be the Rad One Trainer, the Strike Movement Trainer, the Nano, the Metcon. I've gone deep dive almost too long into episodes with that in the past. And today's actually a more of a, let's call it a response, a response PT on this episode, discussing why we don't, or why I don't personally recommend barefoot in the fitness athlete, whether it's the level one or the live course, we get asked, hey, what are your thoughts on barefoot shoes? Or why aren't you recommending minimalist shoes to allow the foot and the ankle to naturally do what the foot and ankle should be able to do? And this is where we're going to dive into, right? This is the topic I'm discussing because we know there's different shoes out there, right? I have somewhere in front of me right here. This would be a minimalist shoe, right? This is a zero drop shoe. it allows the foot display so a really nice wide toe box. It allows the foot to move naturally, allows the ankle to move through a broad range of motion. Why is that foot, why is that shoe wear not something we recommend to the majority of fitness athletes? to explore that full, broad range of motion that we wanna see with squats, squat cleans, wall balls, air squats, you name it. Why is that? when we look at shoe wear, we know that there's aspects to it, right? There's the forefoot, there's the midfoot, there's the heel, and we have something called a heel drop. And the heel drop, essentially, I'm gonna grab another pair here, is the amount of drop a four millimeter heel drop from the back of the shoe to the front of the shoe. That means that when I put this shoe on, my heel is lifted up just a little bit, just about four millimeters difference. What that does for me as an athlete, when I am squatting, is that it gives something we like to coin a dorsiflexion buffer. on board so that when I squat, I have maybe a little bit more available ankle dorsiflexion range of motion for me to squat with. When we take that away, when we go into that minimalist where we have a flat, fully flat shoe, if I am limited at all in ankle mobility, ankle dorsiflexion, that shoe is not going to allow me to have as much anterior transition to that tibia. it's then going to reduce the depth with which I can get into my squat, or it's going to push me into some more funky motor patterns, what we call the immature squat pattern, where my shin moves forward, but then it stops, which means my hips can't go any further without me losing balance or falling backwards, which means my torso needs to dive much further forward, which leads typically to a significant increase in stress on the posterior We're going to increase the loading, uh, the, the, the, the torque on the hips and the posterior chain when we significantly limit that anterior translation of the tibia. We know that from research, right? We know that it's no longer recommended or should be recommended to teach to restrict amount of increased stress to the lumbar spine, the posterior chain, and the hips when we do that with a very minimal decrease in stress to the knee. If you look at the data from the research, it's about a 53% decrease in the knee. 1,000% increase in torque to the low back, hips, and posterior chain, right? That's a huge trade-off. Whereas if we allow that tibia to translate forward, that knee to move forward, it allows for a more upright torso, a more vertical descend into that squat, and improved motor pattern there. So all that to say, when we give minimalist footwear, and we don't know what the individual's mobility is like, or we do know, like, hey, I know this person has really stiff ankles, And what we see both anecdotally and pretty much everywhere is that the ankle is one of the most difficult joints in the body to create mobility. And it can take years to improve ankle dorsiflexion range of motion. If you don't believe me, you can talk to our COO, Alan Fredendahl, uh, who's been working on ankle dorsiflexion for darn near a decade now, probably. And he's, he's doing much, much better now, but it's, it's been a journey for him to try and improve his ankle dorsiflexion. that athlete's ability to sit deeper into that squat with that more mature vertical squat pattern. And when we're talking about CrossFit or fitness athletes, that means that we're limiting the squat, including the back squat, the front squat, the overhead squat, squat cleans, squat snatches, pistol squats, wall balls. There's all these movements where we want to have a vertical torso, a more upright torso when we're performing it or receiving And when we take away mobility from the ankle, we restrict that motion because we're saying you need to go barefoot at all times to really work on it. You need to work on your mobility. Okay, you're not gonna go to depth until you can have better ankle mobility. We are significantly reducing that athlete's ability. to improve, strengthen the knees, strengthen the hips, strengthen the trunk because they can't load that barbell as much. We're reducing fitness level because now they're doing less work in the same amount of time as maybe their counterparts in the same classes or following the same programming and such. So we use the shoe to allow for that dorsiflexion buffer to allow for a deeper squat. We also recommend TO Slide a pair of VersaLifts, of heel lifts underneath the insole, they sit in there. Now instead of a four millimeter, maybe they have more like, I believe VersaLifts are eight millimeter or so. So it'd be like a 12 millimeter, which is, it's pretty high up, right? But it gives so much more mobility in that ankle to allow them to sit deep into a squat with good mechanics, with good motor pattern, and really, really hit the deep ranges that are gonna allow them to train a greater amount of the glute max, a greater amount of their quad to a broader range of motion, right? powerful hip extender that most people don't realize only really gets targeted when we're hitting those deep ranges below parallel to the squat. Again, this is not me saying barefoot or minimalist shoes aren't for nobody, right? There are individuals who have fantastic mobility in their ankles, great mobility in their hips. By all means, if they want to wear a two millimeter heel drop like Vans or Chuck Taylors, or do you want to wear a New Balance Minimus or the, I think the Xero, X-E-R-O, whatever those are. Those are fine for those individuals if they have the adequate prerequisite mobility in their ankle, their hips to be able to perform these movements are really good quality patterns. But for those of us who might have a limitation in the hip or limitation in the ankle, we have should be recommended. right? The two I have right in front of me, right? The strength movement, his trainer, four millimeter heel drop. This is someone who maybe has pretty good hip mobility. Um, and they can make up for a little bit of lack in ankle mobility with that, but they still have more than like 10, 15 degrees of ankle dorsiflexion. Um, me personally, I have like 30, 35 degrees of ankle dorsiflexion. I have decent hips. These work really, really well for me. These are my favorite training shoe for They fit more true to size than they used to. This has, uh, the rad one trainer, um, has a seven millimeter heel drop. Uh, and it is much larger. It's different. The heel is really good for lifting. It's good for Metcons. I have a lot of people at our gym who love these shoes. Uh, really high recommend these for those who maybe need a little bit more ankle dorsiflexion buffer or limited in their ankle mobility because of that. And one I don't have with me right now, if you have more of Um, and you don't like your toes display a whole lot, uh, tier T Y R their tier one trainer has a nine millimeter heel drop. So the biggest heel drop and they just standard training shoe that you can find. And that is the one I recommend to my individuals who like, Hey, I have horrible ankle mobility. Um, I always struggle to hit squatting full depth without my either my ankles kicking in or my going up on my toes. What do you recommend? Um, that's uh that's tier one trainer um excuse me first ones are called oh i'm sorry these are the uh strike movement haze trainer strike movement haze trainer so there is a strike movement right there uh strike movement without any vowels in the movement um so the haze trainer uh good quality shoe really really solid uh great for med cons i love them for weight lifting as well um and again nice and like a wider toe box not too wide but not too narrow at all either so really comfortable i love these for So hopefully that answers your question. And if you're looking for the evidence, right? Like, oh, well, like you gotta be able to use your feet. You gotta be able to use your ankles. In 2022, a study from the Journal of Strength and Conditioning Research came out on the effects of footwear and biomechanics of the loaded back squat to exhaustion in skilled lifters. So these are people who are already lifting, who probably already have really good mechanics and strength and everything on board. And they made one group lift barefoot or minimalist as barefoot style shoes. One group had to lift in like heel elevated shoes. And what they found was there's no difference more in like a novice athlete or beginner athlete or maybe people who maybe don't have that same mobility but in these skilled lifters people have been doing it for a while there was no significant difference in that either shoe reduced joint loading or improved joint range of motion for them they already had the adequates on board so the reason I even always emphasize, more than anything else, in the level one, in the live course, when people ask about shoe wear, about are we going to restrict someone from squatting until they have adequate ankle mobility, do we give them a shoe like this, is this okay, or do we give them a minimalist shoe right away, and if they can't do it, do we let them do it? It's always and, not for. I'm going to recommend something like a Rad1, and if they need it, a Rad1 with a heel insert, a VersaLift in there, while they work on ankle mobility, while they work on their hip strength, to work on their squat, to continue being a part, a participant in their CrossFit class, in their group fitness class, without needing to worry about scaling every single time, without needing to worry about modifying every movement every single time, and then they are also going to continue working on their ankle mobility diligently to get to a point where maybe they can take that heel insert out and they feel really comfortable here, and they can move to something like this, and then they can move to minimalistic. That is their end goal. It's always and, not, or with this type of If you want to learn more, if you want to ask this person live and really have a debate with me one-on-one, we have courses coming up where you can meet us on the road, where you can talk all things shoe. Like I love talking shoes. I love talking footwear, worn them, almost all of them. Love doing it.

SUMMARY But we have courses coming up. Our CMFA online level one just sold out. So if you've been looking to take an online level one course with Fitness Athlete, we are not having another one until fall of 2024, but you can sign up for that now. So if you want to register for that now, this course always sells out. We always sell out before we start the course. We have a course in the fall. You can sign up now. You can wait until the summer to sign up whenever you want to. Our next level one one if you've taken the live course and you just have the level two to finish up your CMFA cert or if you just want to continue down the path of that CMFA cert we have CMFA level two starting up in September uh on to a year. So again, if you're looking to get that certification, if you're looking to learn more about Olympic weightlifting, programming, modification, even some business type things, check out the level two CMFA course on September 3rd. That one also always sells out before it starts. So if you're looking to take that, sign up sooner rather than later. If you want to hit us up on the road, you're looking where we're at. CMFA Live is going to be on May 18th and 19th in two different locations. Proctor, Minnesota. I believe Joe Hnisko will be leading that one up in Proctor, Minnesota. And then that same weekend, I'll be hanging out with Mitch Babcock in Bozeman, Montana. That is, again, the weekend of May 18th and 19th. And that's all we have right now in May. And then June, on June 8th and 9th, you can hang out with the barbell physio, Zach Long, in Raleigh, North Carolina. And then on June 22nd and 23rd, we have the first ever annual Fitness Athlete Summit. You're going to see every single faculty and TA and every member of the fitness athlete crew. You have Mitch, Zach, Joe, myself, Kelly, Jenna, Tucker. We're all going to be coming together in Fenton, Michigan at CrossFit Fenton for an epic weekend, more fitness and fun and sweating and learning than any course you've ever done in your career. So we would love to see you at the Fitness Athlete Summit on June 22nd and 23rd. I believe it's about 45 minutes, an hour, something like that away from Detroit.

null: So quick flight in. You can also

SPEAKER_00: to fly into Flint, I believe, which is a shorter, even shorter drive from there. But we would love to see you there and have you join us for the Fitness Athlete Summit in June of, June 22nd and 23rd. Gang, thanks so much for tuning in this morning. Have a wonderful weekend. Again, if you are at Sampler, have an absolute blast. Enjoy yourself for me as well. And we will catch you on Monday for the PTNX Daily Show.

OUTRO Hey, thanks for tuning in to the PT on ICE daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you’re interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you’re there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.