"Summer Foot" and Flip Flop Pain

I just had a friend text me and ask a very familiar question for this time of year. “Ian, my feet and shins are killing me. What can it be?” After a couple of questions back and forth trying to E-heal my friend, I simply asked how old her shoes were that she was walking in. She texted me back, “I don’t know, 3 months? Why does that matter?” I went on to explain how footwear can affect someone with a lot of walking if they get old, but her shoes were well within the realm of normal. After a little bit of a pause, she texted back again. “Um, I haven’t worn those in about a month, I’ve been wearing flats, and flip-flops to walk in.” Ta-Da, we figured out the root of the problem.

I know, I know, it’s summer time and we have all been waiting months to free our feet from the confines of shoes. Those perfect little flats that go great with that outfit. Those flip-flops that are so easy to slip on. Those bedazzled sandals that are just killer when you go out. I get it...but your feet don’t. I have started to evaluate more and more “summer foot” (that’s my phrase, not medical at all) in the clinic lately because of the nice weather. So what is summer foot and how do you fix it?

Summer foot is any pain in the foot associated with wearing horrible footwear. Some people get plantar fascitis, some get ankle pain, some get toe and bunion pain. No matter where the pain is, it is all from the same root cause - poorly supportive footwear that leads to bad alignment of the foot and ankle, and pain. You might be thinking, “Ian, not everyone gets summer foot though – why is that?” Well, not everyone has the same type of foot. Some people have a normal arch (they are the lucky ones) which allows them to wear unsupportive footwear without an issue. If you are like most of us though you have either too low of an arch (pronated) or too high of an arch (supinated).

If you have too low of an arch you will get more benefit from strengthening your foot and hip. Try these exercises:

They will help to strengthen your foot, and hip, and give you a little more arch support when you wear those summer shoes.

If you have too high of an arch, you aren’t as lucky as your low arch counterpart. A high arch means you have a very stiff bony structure. Although that is how you are built, you will still get some benefit from stretching your ankle and hip. Try these stretches to loosen your muscles and take some pressure off your arch:



The best way to make your feet feel better in the summer months is to wear those flats and flip-flops sporadically. If you do find yourself wearing them more than you should and your feet start to bother you, try the exercises. Hopefully they help you get through the nice weather with a pain free flip-flop tan.

You're Already Behind on Your Golf Season Prep

It’s getting to be my favorite time of year, golf season. The PGA tour is starting to heat up with bigger tournaments and people are already talking about The Masters. In New England, we’re starting to get glimpses of nicer weather. It can also be one of the most frustrating times of year for me professionally though. Why you ask? Now that the weather is getting nicer, I’m starting to get golfers calling saying they want to get ready for the upcoming season. It is great that people are looking to get better, and I love helping my golfers. The problem is that the season starts in two weeks. Where were you for the past 3 months when you couldn’t play golf and were stuck inside? The truth is, you already missed the boat if you truly want to be ready for the start of the season. Fear not though my golfing friends, there is still plenty that you can do to improve your golf game for next season.

What are the two most important things to focus on? Good mobility and good stability. Simple right? What that really means is you need good mobility of your hips, ankles, shoulders, and neck. For stability you need strength in your core, chest, hips, and shoulders. That is just to develop a good foundation. If you really want to hit the ball farther, you need to work on power development. That is a whole extra level of strength and speed training. Are you starting to see why you need at least 3 months to make a change in the off season? I’m going to do my best to simplify it for you to get you up and running for the season. Just remember that next season you need to call me in December, not March.


The biggest restriction that I see in amateur golfers is shoulder turn – most don’t have enough. This restriction places a lot of strain on your back and shoulders. It can also limit the power you can produce in your swing. My favorite way to improve shoulder turn is the open book exercise. Perform 10 repetitions, with a 3 second hold, twice a day.


Most amateurs are seriously lacking in the stability category. The reason is, most people sit all day at their job and then during their commute to and from work. The glutes and abdominals are the two big players in producing stability. The unfortunate thing is that when we are sitting, both of these muscles are taking a break. That means that in a normal work day the two most important players in producing stability in the golf swing are on vacation. I’m not telling you to quit your job and find one that doesn’t require you to sit all day. I’m just trying to give you an idea of what an uphill battle it is to build the proper stability that is required in the golf swing. One of the best exercises to help increase both glute and abdominal strength at the same time is the bridge with kick. Perform 3 sets of 10 repetitions, twice daily.

Performing those two exercises will get you started on the right track. It isn’t ideal but it’s better than nothing. The take home message? Golf season doesn’t start in March or April. It really starts 2-3 months before that. Make sure you get started a little bit earlier next season to make it your best. Happy golfing!

- Ian at OrthoCore

5 Essential Home Gym Exercises

A little while ago we covered some essential home gym equipment. While the general reasoning as to why they are essential was explained, now I would like to go over some of the exercises you should make sure you’re doing with each piece.

There are many others we won’t cover today, but these specific exercises are some of the most important in any training program, and your equipment will allow for them to be done effectively.

1.    Dumbbell Bench/Chest Press – Okay, this is a little bit of a cheat as we’re going to focus on 2 pieces of equipment here. But this exercise is a major part of why you needed both weights, and a sturdy bench or stability ball. This is a major pushing motion that anyone should be able to do with appropriate weight. Since many people can’t do a push up, the bench press is a great way to build strength in that muscle group until they can. This can be done with either a bench or the stability ball like so. 

2.    Dumbell Front Squat/Goblet Squat – Here’s one of the other reasons you needed weights. Squats are a great motion for your entire body, not just your legs. But to get the most out of your squats, you’re going to need to move some weight. Sooner or later you will adapt to bodyweight squats and they won’t challenge your legs, core, and back the way weighted squats will. Enter the dumbbell front squat. A simple way to challenge yourself at home.

3.    Suspension Trainer Inverted Rows – It is worth whatever you paid for your suspension trainer to do this one exercise alone. If pull ups and chin ups are the king of bodyweight pulling exercises, then inverted rows are queen. This movement will do wonders for developing back strength, bicep strength, grip strength, and core strength. Very few people can do a pull up. This exercise is the next best bet. It’s easily modified for beginners by having a bend in the knees. The more parallel you are to the ground and the straighter your knees are, the tougher it gets.

4.    Band Overhead Press – Many people (myself included) have some kind of previous shoulder injury or current shoulder pain. Motions that push and pull overhead can be very tricky sometimes to perform pain free with weights. Luckily resistance bands are very forgiving on the joints. If pressing overhead with weight bothers your shoulders, give this variant a try. In fact, even those of you with strong shoulders should be able to challenge yourself with a band pressing routine.

5.    Lat Rolling – Your foam roller will be key in mobility and flexibility of many muscles. But one of the biggest will be your lats. That big thick muscle on each side of your back. It’s an incredibly thick and powerful muscle and can prove difficult to stretch more than just the outermost portion. The roller will attack them deep beyond the spots you can normally hit with static stretching. Beware, this is usually the rolling exercise that clients feel the most tightness and related pain while doing. Start with about 30 seconds each side until you loosen up and build some tolerance to it.

So you have it! 5 basic, but key exercises for you to incorporate into your routine with all of your fancy new home gym equipment! Practice these until you’re comfortable enough to add weight or increase the amount of sets and reps you perform. If you have any other questions on exercising in or out of the gym feel free to contact me at AdamD@OrthoCorePT.com.

-        Adam at OrthoCore

Making Time for Physical Therapy

Let’s face it, nobody has enough time anymore. It’s the number one reason that we hear from our patients as to why it takes them so long to get started on a rehabilitation program. Once people do start on a program, they finally commit to getting better. The thing that makes us crazy, though, is when people throw all of their hard work away by not sticking with their program once they are discharged. Why do patients fall off the wagon once they are done with treatment? Time, not enough time.

We’re here to offer some solutions for people who are looking to stay on top of their program and stay pain-free especially during this busy holiday season.

1. You don't have to do every single exercise, every single day.

Rehabbing from an injury is a huge commitment. You usually have to go to PT 1-2x/week for about an hour per visit. When you are not at PT you have "homework" that you are supposed to do at least once per day. It all starts to add up. Patients think that once they are discharged they need to keep up with the pace of doing everything once a day. Add that to everything else that people have to do during the day and it starts to get overwhelming

We always try to educate our patients that rehabilitating is different from maintaining. When a patient is rehabilitating, they are working on correcting whatever strength, flexibility, or motor pattern issues that are leading to their pain. It takes more repetitions to make those changes, and that’s why we usually ask the patient to perform their program daily. 

Once they make those changes and are now pain free, the patient transitions to the maintenance phase. During the maintenance phase patients only have to perform the exercises 1-2 times/week. What a relief! Think of all that extra time you will have on your hands. 1-2 times/week is all that is needed to maintain that new strength and flexibility you have worked so hard to obtain. 

2. You don’t have to do all the exercises at once. 

Most patients’ rehabilitation "homework" consists of at least 5-6 exercises that you are supposed to do multiple repetitions of. That can add up to a lot of time in one sitting. Instead of trying to carve out a block of time to perform the whole program you can do each exercise at least once per day. If you have a free couple of minutes, do one of the exercises. If your program consists of some exercises that have you lying down you have two opportunities during the day where you start and end in that position (yes, we’re talking about sleeping, people!). Take a little extra time to do those exercises when you are already in the starting position. That way you can get to the whole program throughout the day, rather than feeling like you need "extra" time to perform the whole thing at once. 

3. You probably don't have to do every exercise on your program for the rest of your life. 

If you feel like your program is really extensive by the end of your rehabilitation, you are probably correct. If you truly feel like you can't do every exercise then be honest with your therapist. We always try to work our programs around what the patient is willing to commit to. Sometimes that is only two exercises. If that is all you can commit to, it just means you have commitment issues and that’s fine (…or is it?). In all seriousness, we would rather give someone a couple of exercises that will highlight the biggest areas of dysfunction vs. a program that is aimed at fixing everything that they won't stick to.

4. Pain sucks, so why would you want it to come back?

It drives us CRAZY when patients come back with the same injury. This drives us up a wall because the typical answer as to why their pain returned is because they didn't stick with the program. It’s like failing a test that you have the answers to. 

One of the best ways that we've found to keep people on track is setting a schedule. Set reminders on your phone, place sticky notes around your house, whatever reminders you need to stick to the schedule. That will give you the best opportunity to stay on track and live pain free!

The 5 Essential Home Gym Requirements

I’m often asked what the best home gym equipment is. Even today I was asked by a new client if he should get weights for his home. Many people, whether due their budget or schedule, choose to work out at home rather than in a gym that requires a membership. This is totally doable, the issue is however that your home often isn’t equipped anywhere near as well as your local gym. However, you would be surprised how much equipment at the gym is either unnecessary or non-essential to strength training.

So to save you some space (and hopefully some money), here are my top picks for home gym equipment.

1.    Weight Bench/Stability ball – Okay, I’m cheating a bit by including two items here. But in this case they’re both going to be used for the same thing, that thing being a surface for free weight exercises. A stability ball can be substituted for many exercises requiring a bench. You can bench press, overhead press, dumbbell row, seated row, and split squat on a stability ball. Using a stability ball will also add an extra element of core training (hence stability ball). Stability balls are also easier to store than a bench and allow for unique core exercises and squats that can only be done with a stability ball. However a solid bench will be better for overall strength. While it will be bulkier, it will provide a more stable surface for training with heavier weights (allowing you to really focus on strength), and will assist in many lower body exercises such as step ups and box squats that a stability ball cannot. So take your pick as to which suits your home and goals best.

2.    Adjustable Dumbbells- So your ultimate goal usually in home training is to save money and space. The best way to do this is focus on dumbbell training over barbells. They’re easier to store and won’t also require a squat rack to train with. There’s all manner of adjustable dumbbells. Vinyl sets sell for pretty cheap, often going from 5-25lbs for $20-$30 a set. There’s the standard spinning screw lock dumbbells which can come in sets of anywhere from 25 to 100lbs. These are usually a more affordable way to lift heavier weight, just always be sure to check that the screw is fastened tight. Then there are the more expensive and popular brand name sets. These each offer their own strengths and weaknesses too and come in sets that range from anywhere to 45lbs, 55lbs, 75lbs, 90lbs, 120lbs, and even 165lbs! The set we have at OrthoCore I chose for its durability and design. They were a pretty penny but they are shaped like traditional dumbbells, and made from interlocking iron plates and flat steel screws. When my studio was smaller, this allowed me to use dumbbells from 5-120lbs and take up incredibly little room. So find a set that fits your goals and budget!

3.    Suspension Trainer- Some people refer to these as “TRX”, however the name of the piece of equipment is a suspension trainer. TRX just happens to be a popular brand for this equipment. However, the TRX is pricey. The clinic at OrthoCore and my old studio uses a variant that is just as versatile and more than half the price. A suspension trainer is great for the way it challenged stability in the rotator cuff when you use it for inverted rows and for suspended pushups. It can also be used for a number of unique core exercises. The reason I like them the most is for their ability to help people learn squat and lunge technique by doing assisted versions of them on the suspension trainer. This is especially useful for people with poor ankle and hip stability.

4.    Resistance Bands- I don’t use resistance bands much anymore now that I train at OC Performance. But they were invaluable to me at my old studio and when I trained clients in home. The reason is that they best allow simulation of cable machine exercises. Seated rows for example, won’t be possible without either a machine or by hooking a resistance band around something that you can use to pull it from. By putting resistance bands at different heights, they can be used to simulate cable rows and presses, overhead presses, chops, twists, deltoid raises, arm isolation, and so much more. Resistance bands come in all sizes and tension levels so you can perform entire workouts with them if you so chose. I would save them for specific exercises, however, as resistance bands will wear over time and you never have an exact idea of how much resistance they are actually giving you.

5.    Foam Roller- With everything I listed above, you actually have enough equipment now to perform hundreds, more likely thousands of exercise variations that target the entire body. But how are your muscles feeling? Are they tight in some areas? Do you get knots and trigger points in them often? If you don’t, you’ll start to now that you’re strength training regularly. Stretching will help, and like certain exercises, all you’ll need to stretch is your body and know how. But to really help mobility and to work through tightness, you’ll want a good foam roller. Foam rollers attack area in the muscle deeper than a lot of static stretching will hit. This is especially important for big muscles like your lats, glutes, calves, and quads. Your lower back will love it too. Add a tennis ball to your roller to hit the small spots like under the shoulder blade.

So there you are! That’s all it takes to have your own home gym. Now obviously, more standard equipment will make your training experience even better, but say you want to be ready for days you can’t make your gym, or you’re stuck inside due to the weather, this will be more than enough equipment to give even an Olympic athlete enough to challenge themselves with. Make sure you have a good surface to exercise on too, even if it’s just a yoga mat. If not, a basement or garage setup may be ideal to prevent damage to the floors as you jump around and drop weights everywhere.

But no matter where you set up your personal training space, just make sure you don’t let all of these items gather dust. These pieces of equipment are investments in your health, so use them to make sure you have a good healthy return from them.

Keep an eye out for our blog with great exercises for this equipment!

-        Adam at OrthoCore