Sometimes it can feel like you need a medical degree when shopping for shoes. Though many footwear companies now provide an arsenal of information on their running and hiking shoes, detailing features designed to match nearly every foot variation known to humans, most people don鈥檛 actually know what their foot type is.

I get it: I had to get rid of the running shoes I’ve been wearing for quite some time, which means I have to hunt for a new pair. But I鈥檓 fuzzy on the details about my foot type, arch style, and toe shapes, which makes it difficult to figure out if the听pairs I鈥檓 interested in will be a good fit or not. I think my foot is 鈥渘ormal,”鈥攚hatever that means. But I鈥檓 not sure. And听I know I鈥檓 not alone in this either.听Podiatrists and physical therapists say they field questions about how to figure out foot type very, very often.

Whether you鈥檙e like me, on the hunt for a new pair of athletic shoes, or just want to stop feeling stressed while searching for sneakers, experts say having baseline knowledge about your feet can help. I interviewed three podiatrists and a physical therapist who specialize in foot health for details on how to figure it all听out.

Why It鈥檚 So Hard to Find Shoes That Are Actually Good for Your Feet

鈥淪hoe companies often market their products based on 鈥榝eatures鈥� they can promote and not necessarily what鈥檚 best for the feet of the shoe shopper,鈥� says , a podiatrist based in Long Beach, California. People are left wondering about which type of shoe will improve and maintain their foot health.

A good podiatrist will measure your feet, look at your foot structure, check your muscle strength, see the range of motion of your foot joints, and watch you stand and walk.

The variety in footwear is overwhelming, too, says , a podiatrist and foot surgeon in New York City. 鈥淭here are so many shoes out there,鈥� he says. 鈥淚t鈥檚 daunting to go through the search.鈥�

4 Foot Traits to Know Before Buying Shoes

There are a lot of terms you鈥檒l come across while shopping for a performance shoe, but they can generally be broken into four major categories: gait style, toe shape, foot width, and arch type. To help you wade through the confusion, here鈥檚 a brief breakdown of some of the more common terms you may come across as you shop, which will help you determine where you land in each category.

1. Identify Your Gait Style

Your gait is your style of walking, Schaeffer explains. It鈥檚 typically broken into these three categories:

• Overpronated: Overpronation is what happens when the foot rolls excessively inward during movement, says Graves. A person with overpronation will look like their ankles are turning in slightly while walking, says , a podiatrist based in Bloomington, Illinois.
• Neutral: Also known as a 鈥渘ormal鈥� gait, this is a style of walking or running where the foot doesn鈥檛 excessively roll inward or outward when you move, explains Graves. 鈥淚n general, the stride will appear to be the typical heel-to-toe gait with no obvious shifting of a patient’s hips up or down,鈥� says Lockwood.
• Supinated: Supination is essentially the opposite of overpronation鈥攊t happens when feet excessively roll outward during movement, Graves says. 鈥淭his will look like patients are walking on the outside of their feet or even tip-toeing instead of that normal heel-to-toe gait,鈥� Lockwood adds.

How to Determine Your Gait Style

Now that you鈥檙e familiar with each gait, you have a few ways to nail down your walking style. Some performance shoe stores will have a treadmill where a salesperson can look at your gait to provide insights into your foot’s movement when you walk or run.

But Schaeffer says you can also try to do this at home by recording yourself walking and looking at the results.

Which Shoes to Look For

For neutral gaits, opt for shoes that are cross-trainers; for overpronation, look for stability shoes; and for supination, look for a cushioned shoe, Lockwood says.

Here鈥檚 the thing: while you may see footwear companies talk up the importance of proper footwear for overpronation and supination, actually having problems with either is rare, says Milica McDowell, a physical therapist.

Footwear companies will often steer people with overpronation or supination toward a stability shoe. Still, unless you have severe overpronation or supination, you may not need a specific shoe designed for this, McDowell says.

2. Determine Your Toe Shape

Schaeffer breaks down common toe shapes this way:

• Egyptian: This is the shape most people think of with a foot, where the big toe is the longest, with a descending order of toe length.
• Roman: With this toe type, the first three toes have a similar length.
• Greek: Also known as 鈥淢orton鈥檚 toe.鈥� This is when the second toe is longer than the big toe. (Some research suggests nearly 30 percent of the population has this toe shape.)
• Celtic: This toe type features a large big toe, a long second toe, and the third toe is slightly shorter.
• Germanic: People with this toe type have toes that are all about the same length.
• Peasant: This toe type features broad and square-shaped toes.

Figuring Out Your Toe Shape

Toe shapes are most helpful in determining the length of your shoe. 鈥淭he rule of thumb is to use the longest toe to judge the appropriate length of the shoe,鈥� Graves says. 鈥淪ometimes people only look at the big toe, which is not good if the second toe is longer.鈥�

Your toe shape may also impact the width of your shoe鈥檚 toebox. 鈥淲idth is usually a bigger concern when all of the toes are about the same length,鈥� Graves says. 鈥淢ost shoes taper to a narrower shape toward the toes, which can make things tight for this toe type.鈥�

Which Shoes to Look For

Ultimately, if any toe is longer than your big toe, Schaeffer suggests considering a bigger shoe size or a wider toe box.

To find a longer shoe, go up a size. When you鈥檙e searching for shoes with a wider toe box, look for a label that specifically states it has a wide toe box or a D width, Lockwood says. (An E width is extra wide, she points out.) Looking for a more rounded toe box versus a V shape can also help, says Lockwood.听

Brooks is known for providing wider toe boxes, along with New Balance, Lockwood says. Consider the or , both of which come in wide and extra-wide sizes.

3. Foot Widths

Shoes used to offer foot width options that synchronized with letters, but Graves says this is now rare. Instead, you鈥檒l likely come across these descriptions:

• Narrow: These feet are considered smaller than what is typical across the widest area of the foot.
• Medium or standard: This foot width is considered typical. Most shoes will meet this width unless otherwise specified.
• Wide: Feet that fall into this category are wider across than standard feet.
• Extra Wide: Not all footwear companies offer this size option, but some provide a width that works for听people whose feet exceed a typical wide width.

How to Measure the Width of Your Foot

McDowell recommends measuring the widest part of your foot at home (or while you’re at the store) and continuing to measure it annually. 鈥淔oot length and volume changes in adulthood,鈥� she says. 鈥淲e have a misconception that once you stop growing, your feet stop growing. But there are lots of different reasons your foot length could change.鈥�

Measuring your feet across is still not a perfect science, though. Graves points out that while foot measurements are two-dimensional, feet are actually three-dimensional. 鈥淪ome people have feet that might measure wide, but they鈥檙e flat and bony on top and don鈥檛 take up much room in the shoe. They can probably get by with normal width,鈥� he says. 鈥淥ther people have feet that measure normal, but they鈥檙e very high and thick on top and might require a wide shoe.鈥�

Which Shoes to Look For听

There are width sizing charts, but footwear companies may vary the widths of their shoes, even within the standard categories,听 Schaeffer says. Most big-name companies, like Hoka, New Balance, and Brooks, offer shoes in multiple foot widths. You can check the dimensions of a shoe in the product description for guidance.

But Lockwood also suggests relying on your history with different shoes. 鈥淵ou should go by feel,鈥� she says. 鈥淚f you squeeze your big toe and baby toe in the shoe, you should not feel pain or pressure with a wide-enough shoe.鈥� If this has been an issue for you in the past, consider getting a wider width.

4. Arch Types

Your foot鈥檚 arch is the curved part of the bottom of your foot, which stretches between your heel and the ball of your foot, Schaeffer explains. There are different arch types to consider:

• Normal: Also known as a 鈥渕edium鈥� arch, this is regarded as a standard arch type.
• Flat: Also called a 鈥渓ow鈥� arch, flat arches appear flat or nearly flat on the ground. Sometimes the term “flexible” is used to describe this type of arch. With a flexible arch, the foot arch seems to disappear when someone is standing, but returns when they are sitting, Schaeffer explains.
• High: Also known as a 鈥渃avus foot.鈥� This is the opposite of flat arches. This arch type happens when the bottom of the foot is higher than normal.

Look at Your Footprint to Determine Your Arch

The easiest way to check your arch type is to look at your footprint when you get out of a pool or shower, Graves says. People who have a normal arch will have a footprint that looks like a foot, with a small indentation where the arch is located.

鈥淚f your footprint when you get out of the water looks like only two or three areas are hitting the ground, then you probably have a high arch,鈥� Graves says. 鈥淚f your footprint is a more solid wet spot, then you probably have a low arch or 鈥榝lat鈥� foot.鈥�

Which Shoes to Look For

Some shoes have more arch support than others. If you have flat feet, you鈥檒l likely need a lower arch; those with higher arches may need more arch support, Schaeffer says.

While some shoe companies will specifically talk about their models having higher or lower levels of arch support, more support around the shoe鈥檚 midsole and insole may also provide this. However, Schaeffer says a good insole or orthotic can also help deliver the arch support your foot requires. 鈥淎 shoe is only going to help so much,鈥� he says.

When to See a Podiatrist

Given how complicated looking for the right footwear can be, Schaeffer recommends seeing a podiatrist if you don鈥檛 have a pair of performance shoes you like. 鈥淎 podiatrist can do a gait analysis quickly,鈥� he says. 鈥淔or most people, they would just do that for a co-pay.鈥� A podiatrist can also listen to your foot health concerns and suggest shoe features from there, Schaeffer says.

But Graves says you should definitely consider seeing a podiatrist if you have foot pain that鈥檚 increasing, pain that鈥檚 causing a change to how you walk, foot pain that doesn鈥檛 get better in a day or two, or foot pain that comes with other symptoms like swelling, bruising, and redness.

鈥淵ou should also see a podiatrist if your foot structure seems to be dramatically different from that of other people, you鈥檙e having difficulty figuring out your foot type or the best shoes, you鈥檙e chronically having foot pain or injuries, or shoes just never feel comfortable,鈥� Graves says.

A good podiatrist will measure your feet, look at your foot structure, check your muscle strength, see the range of motion of your foot joints, and watch you stand and walk, he says. With all of that information in hand, you should be able to find the perfect pair of performance shoes for your foot type.

Want more听国产吃瓜黑料听health stories?听.

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My husband cracks his neck multiple times a day. He complains that his neck often feels stiff, which he attributes to the 30-mile bike rides he regularly takes and the uncomfortable sleeping positions he winds up in during the night. So, as a quick fix, he whips his neck from left to right. Pop. Pop. The thing is: I absolutely detest the sound. After all, it sounds like bones smashing against each other. Gross.

In the hopes of resolving this marital issue, I needed to convince him to cool it with the neck snapping. I figured it wouldn’t be hard; I had to believe all that popping was bad for him. But, as a good journalist, I decided to do my due diligence first.

Not to say I told you so, but after lots of research and interviewing sports medicine physicians, I learned that I was right, though not in the ways I imagined. Cracking your neck can be risky and sometimes downright dangerous. Overstretching听your neck joint can also derail your athletic performance听in specific instances.

Fortunately for me, and unfortunately for my husband, I have some great argument ammunition next time I beg him to stop.听Here鈥檚 why cracking your neck may do more harm than good.

What Happens When You Crack Your Neck?

Your neck is also听known as the , and consists of seven bones, or vertebrae, stacked atop one another. When you crack your neck, you鈥檙e popping tiny gas bubbles that have accumulated in the fluid within the spinal joints (these are called facet joints). It鈥檚 the same phenomenon that occurs when you crack your knuckles, says , a sports medicine doctor and president of the .

(FYI: Check out the video below to learn more about what happens in your neck when you crack it.)

When you yank your neck around, those gas bubbles burst and release any pressure that has built up within your joints, says Laker. The gas bubbles pop, creating a sensation of relief, or as my husband says, a drop in tension.

There are a couple of other听less common听explanations听as well.听If you have super-tight muscles, for example, they may rub on top of the joints and bones in your neck, says Laker. If the joints in your neck are extra flexible, say, if you have a connective tissue disorder, that might mean the surrounding tissues and ligaments as securely as they should. When the vertebrae are unstable, the 鈥攖he soft tissue sac that surrounds and protects the joint鈥攃an 鈥減op鈥� on itself.

Neck Cracking Weakens Ligaments

While cracking your neck can provide quick relief, doing so won鈥檛 actually fix the underlying reason your neck hurts. As such, the pain or tension will recur, and you鈥檒l likely repeatedly feel the urge to crack. Some people develop a habit of cracking their neck multiple times a day, says Laker. This is where things can get dicey.

Tissues in the Cervical Region Stretch Out

If you frequently crack your neck (and especially if you鈥檙e putting a lot of force on it by using your hands), you can strain the nearby ligaments and loosen your neck joint.

鈥淥ver time, the soft tissues that hold that joint together are going to stretch out,鈥� says , an orthopedic surgeon at the Hoag Orthopedic Institute in Southern California.

And then you鈥檝e got a new health issue on your hands鈥�, which is a condition that causes your joints to be more flexible than normal. This can make your neck feel increasingly tense or unstable, says Laker. You can get trapped in a vicious cycle where your neck feels stiff, so you crack it again and again, which, over time, loosens the joint and leads to more tension, which makes you want to keep cracking your neck, he adds. 鈥淯ltimately, you鈥檙e making the muscle tension worse because you鈥檙e making the hypermobility worse,鈥� he says.

The risk of increased ligament laxity is greatest in people who already have hyperflexible joints to begin with. Still, this problem can occur in anyone, even those with totally healthy joints and ligaments鈥攊f you crack enough, says Laker.

If you rarely crack your neck, you don鈥檛 really need to worry about laxity, says Laker, but even one-off cracks come with risks. If you put enough pressure on your neck鈥攖hink: one hand鈥檚 on the top of your head and another鈥檚 below your jaw, and you give it a sharp twist鈥攖he disc can herniate and trigger intense pain from the surrounding nerves. This is super rare, though. Out of every ten million neck manipulations, only 听result in some kind of injury.

While Rare, Neck Cracking Can Damage a Critical Artery

The scariest potential consequence of neck cracking is what’s called a vertebral artery dissection, in other words, a tear in an artery. According to Laker, the vertebral artery is a that runs through the bones in your neck that feeds your brain stem and part of your spinal cord. If that artery is injured, you can experience a type of stroke that can lead to permanent . In even rarer cases, it can be life-threatening.

While cracking your neck can provide quick relief, doing so won鈥檛 actually fix the underlying reason your neck hurts. As such, the pain or tension will recur, and you鈥檒l likely repeatedly feel the urge to crack.

The risk is lowest when you consult a professional, such as a certified chiropractor or physical therapist, who is trained to perform neck manipulations in a safe and controlled manner. But, even then, artery injuries can occur with the very best precautions, says Laker. Some people unknowingly have underlying conditions, like collagen disorders or a history of neck trauma from, for example, a sports injury or car accident, that increase their risk. They might not have any symptoms until the injury听occurs. 鈥淚t鈥檚 not a problem until it鈥檚 an enormous problem,鈥� says Laker.

How Cracking Your Neck Affects Performance

The neck plays a crucial role in many sports, and as the states, 鈥淲here the head goes, the body will follow.鈥� To be at the top of your game, your neck needs to move freely and decisively. A less-stable neck can interfere with your posture, breathing mechanics, balance, vision, and energy levels, says Laker. In any sport, being able to scan your environment comfortably is super critical, he adds.

Frequent neck cracking can affect training in the following ways:

• Reduced ability to scan your surroundings: When you ski, for instance, your neck helps you scan your environment and get a feel for the terrain, all while keeping a pulse on nearby trees and other skiers鈥攊f your neck鈥檚 struggling, your ability to traverse the slope may suffer, too.
• Fewer reps at the gym: As for strength training? Increased neck mobility can make it 鈥渄ifficult to perform higher repetitions or do higher loads of exercises using the neck,鈥� says , a certified exercise physiologist.
• Restricted breathing: If you鈥檙e a cyclist, a tense neck can restrict your ability to breathe deeply, says Laker.
• Fatigue and poor posture: Neck pain, which may , can also make you feel fatigued earlier if you鈥檙e hiking or running, McDowell says. And it can impair your posture, she adds, which can throw off your muscles and joints and prevent you from moving around properly鈥攁 skill you need with any sport.
• Increased risk of injury: Neck laxity can also increase your risk of a serious injury, such as cervical spine (which occurs when the vertebrae in the neck shift out of alignment), if you play a contact sport like football or soccer, says Beyer.

Stretch Don鈥檛 Crack

Cracking your neck鈥攅ven though it might feel good鈥攄oesn鈥檛 solve the root problem. If you constantly feel the need to manipulate your neck, see a doctor. They can determine if you have a health condition (such as degenerative disc disease, bone spurs, or arthritis) that may improve with treatment.

Chin Tucks, Head Rolls, and Forehead-to-Palm Presses

If you feel the itch to crack before or after a long ride or big climb, consider stretching your neck instead, advises Laker. He recommends chin tucks (pulling your chin toward your neck) and head rolls (moving your head in a circular motion). Another trick to stabilize and strengthen your neck muscles: put your palm on your forehead and press your head into it.

Heating pads, foam rollers (like this one), massages (even if it鈥檚 with your own hands or an at-home massage device), and a nice soak in a jacuzzi or hot bath are all effective ways to decrease tension.

Finally, consider working with a physical therapist if your neck pain and persistent cracking are interfering with your performance. A solid stretching or strengthening program can keep your neck strong, healthy, and pain-free, says Beyer.

And if you鈥檙e hellbent on cracking your neck? The safest approach is to simply rotate your head from shoulder to shoulder without using your hands, says Beyer. The real concern is when you, or someone else, hold your neck and forcibly manipulate it. That鈥檚 where you can run into trouble.

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In triathlon training, consistency is king. But what if that consistency was a culprit in your latest injury? As all too many of us know, like IT band syndrome, shin splints, and stress fractures often present themselves at the worst times and have been the bane of many great race preparations.

Consistent, repetitive motion with improper running form often causes these injuries. But according to new research out of the University of Florida, you probably don鈥檛 even know your form could use a tune-up 鈥� and your shoes might be the reason why.

The study, published in the journal ,听consisted of 710 runners from various backgrounds. After asking each runner if they were a heel striker, non-heel striker (mid-foot or forefoot strike) or they 鈥渄idn鈥檛 know,鈥� the researchers examined each runner鈥檚 gait with a high-tech slow-mo motion capture system and analyzed their past running injuries.

The results were abundantly clear. Those runners who 鈥渄idn鈥檛 know鈥� their gait pattern had, by far, the greatest likelihood of sustaining a running-related injury.

The main contributing factor to runners not knowing their foot strike, or how their feet were hitting the ground, was the heel-to-toe drop of their training shoes. A higher drop, as well as higher shoe weight, led to less accurate body awareness and a higher likelihood of injury.

Additionally, those runners who changed their shoe type in the past six months were more likely to sustain a running-related injury.

So if shoes are part of the problem, is the solution simply changing them out? Yes and no. Let鈥檚 look at the takeaways and how can you apply them to reduce your risk of injury.

Shoe Choice Matters

As the study highlights, a shoes with high heel-to-toe drop and greater weight contribute to less awareness of foot strike. Opting for a shoe that has a lower drop and weight is an effective way to become more engaged (literally) with the ground and how your foot is interacting at the impact, loading, and takeoff stages of your run gait. A healthy foot will feel the ground, fully load, then utilize its 鈥渇ree鈥� stored energy to push you forward.

A more minimalistic shoe will let the foot function as it should. Further, a large heel-to-toe drop alters how the force of impact is distributed throughout the body. As shown in 听on the effect of shoe drop on joint stress, a higher-drop results in much larger stress at the patellofemoral (knee) joint. Opting for a lower-drop shoe allows the body to distribute stress as it was designed to do, reducing excessive loading to individual joints.

Opting for trainers with a mild drop (4-6mm) and not too much 鈥渃lunk鈥� could be an easy way to become more aware of how you鈥檙e running and stay injury-free.

If you鈥檝e been running in a high heel-toe drop shoe and dealing with injury, it might be worth trying a different shoe. Just remember, as with any change, to progress gradually into your new shoes to allow the body time to adapt. Start with one to two runs per week, and slowly progress over four to five weeks until you can wear your new shoes full time.

Self-Awareness Matters More听听

Yes, the type of shoes you wear can be a culprit in running-related injury, especially if they blunt the signals your body needs for good running form. This study clearly shows that enhanced body awareness while running, particularly when it comes to foot strike, leads to lowered injury risk.

Becoming more cognizant of how your body is moving and how your foot interacts with the ground is a free way to decrease your risk of injury. Yes, it鈥檚 nice to listen to music or zone out with a podcast during a long run. However, it鈥檚 likely worth it to zone in to the task at hand now and then to ensure you鈥檙e moving well.

One helpful tip is to run in front of a mirror on a treadmill so you can watch yourself run in real time. It鈥檚 easy to adopt poor running mechanics without realizing it, especially when fatigue sets in. Unlike the friendly spectator yelling, 鈥淟ooking good!鈥� at mile 23 of the marathon, the mirror doesn鈥檛 lie.

The best part about working on your running form is that it will help you develop movement patterns that make you stronger instead of more likely to get injured. More importantly, it might even help you actually look good at mile 23!

The post Are Shoes with High Heel-to-Toe Drop More Likely to Cause Injury? appeared first on 国产吃瓜黑料 Online.

As an endurance athlete, I spent the better part of my twenties training for and running ultramarathons. My body was resilient, productively absorbing 60- to 100-mile training weeks and races just as long, and I thought that would continue indefinitely.

Then, over the course of nine months, I developed intermittent but often excruciating sciatica, nerve pain that originates in the lower back and radiates down the leg, and eventually, as a result of changing my running gait to compensate for this pain, a torn hip labrum. I expected rest鈥攖he do-nothing, on-the-couch type rest鈥攖o eventually heal me, but the pain persisted. I saw massage therapists, chiropractors, acupuncturists, bone and joint specialists, and nerve doctors. No one had a clear answer and no treatment worked.

It was at this vulnerable moment, in 2020, that I discovered the Knees Over Toes Guy. Ben Patrick, a then 30-year-old based in Clearwater, Florida, posted videos of himself on Instagram performing scroll-stopping feats of circus athleticism without any apparent discomfort: springing from a stationary deep squat up to dunk a basketball; where, from a standing position, he drops his knees out forward to touch the ground. These exercises put a remarkable amount of pressure on very vulnerable joints.

In nearly every video, Patrick shares that he has had three knee surgeries, and doctors told him he would never be able to squat or play basketball without pain again. But through an unconventional鈥攁nd some might say dangerous鈥攕trength training protocol, Patrick was not only able to effectively eliminate his pain, but he says he was able to increase his speed and vertical jump to well beyond his youthful PRs. His message was that anyone can achieve that same ability and resilience. But in order to do so, you鈥檇 have to forget most everything you鈥檝e been told about strength training.

The internet is rife with fitness hucksters and overpriced, overcomplicated training plans, but Patrick seemed different. As I read the hundreds of comments under his videos, I was struck by how universally positive everyone was, with sincere-seeming testimonials for his online program, gratitude for introducing them to these unconventional movements, and encouragement towards users who shared their stories of chronic pain.听I was also impressed by the numerous physical therapists . Desperate to regain autonomy over my athleticism, I decided to give his exercises a try.

Over the last four years, Patrick has exploded in popularity, going from a trainer and gym owner to an online fitness mega-personality with 2.4 million Instagram followers. Patrick, who declined to speak with us for this article, has shared his origin story on many podcasts, including the mega-popular Joe Rogan Experience, which has 14.5 million followers on Spotify and 17.6 million on YouTube.

As an obsessive youth basketball player, his passion for the sport and penchant for grueling drills (he would frequently perform 1,000 daily layups) led to painful, fragile knees. His teammates nicknamed him Old Man. After Patrick underwent those three knee surgeries鈥攖he first while he was still a teenager鈥攈e discovered the late, famed Canadian strength coach Charles Poliquin, who preached a style of strength training where each rep is taken to its stretched end range. The priority is not just the amount of weight you can lift, but the body’s ability to move into deeper positions while doing so. (Poliquin was noted for his Seussian soundbite: 鈥淪trength is gained in the range it is trained.鈥�)

Patrick adopted Poliquin鈥檚 training techniques and not only eliminated his chronic knee pain, he says, but began to redevelop his athleticism. At age 23, he was offered a full-ride scholarship to play D1 basketball at Eastern Florida State College. Now, as a trainer, he proselytizes this training philosophy through his unsubtly named app and online coaching business, Athletic Truth Group.

Part of Patrick鈥檚 success can be attributed to his origin story and his social media savvy: his videos are short, attention grabbing, and feature practical training advice. With the bracing sincerity of a youth camp counselor, he talks directly to the camera, appearing trustworthy and capable. But the other part is that this style of training鈥攚hich Poliquin pioneered and Patrick champions鈥攊s, by historic standards, radical.

If you have ever spent time in a weight room, you鈥檝e likely been warned that your knees should never go past your toes in a squat. Instead, you should push your butt backwards and stop when the upper and lower leg form a 90-degree angle. Failing to do so will put too much pressure on your knee and cause injury.

This is only half true. Squatting with your knees over your toes does put pressure on the joint, but that pressure may actually help you avoid injury.

鈥淭endons, cartilage, ligaments鈥攁ll those things will toughen up to load,鈥� says Erik Meira, a physical therapist and rehab specialist based in Portland, Oregon, who works with NBA and NFL players. For most athletes, especially those in endurance sports, injuries occur in the connective tissues of the joints. Tendons, while quite different in composition than muscles, still operate under the same principle: to get them stronger, you must use them in a mildly stressful manner, then back off and let them recover.

鈥淜nees over toes is something that has been vilified for a long time as causing pain to the front of the knee,鈥� says Meira. 鈥淭he reality is it will cause pain if you鈥檙e not conditioned to take that kind of load. But the best way to condition yourself to that kind of load is to get used to positions like that.鈥�

Patrick has taken this philosophy鈥攖hat bending your knees under progressive load will make them healthy and strong鈥攁nd applied it to other vulnerable parts of the body including the ankles, hips, lower back, shoulders, and elbows. In a way, Patrick’s protocol could be seen as a gym routine structured entirely around proactive physical therapy: he identifies problem areas and develops strength and range of motion in the local musculature and connective tissue.

It is a tremendously appealing proposition to many endurance athletes, who are traditionally averse to the gym. Here is a style of strength training that doesn鈥檛 prioritize muscle mass, is singularly focused on avoiding pain, and will allow you to fully express yourself physically outside of the gym.

In 2020, I was one of many impressionable scrollers transfixed by Patrick and his message. Without much to lose, I dedicated myself to 16 weeks of his program through the app. The first cycle, a full-body general protocol called Zero, was easy. I did repetitive, progressive bodyweight exercises鈥攕ome familiar, some novel鈥攖o strengthen mind-muscle connections and expose my joints to new movement patterns. Then, four weeks later, came Dense, where you take these same and other similar exercises, add weight, and perform many sets to condition your joints through repetition under manageable load. Four weeks after that, I moved on to a back-specific training program.

The most significant movement for me in this block was the , which you perform on a forward-angled, hip-high bench that allows you to hinge forward from the hips and directly strengthen the lower back muscles. This was terrifying, as I thought putting my injured back in that exposed position would only hurt it further. But this is precisely what this program is trying to teach: safely training in a vulnerable position creates resilience in that position.

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鈥淭he most important part of rehabilitation is graded exposure,鈥� says Mike Istraetel, the popular online fitness commentator who holds a doctorate in exercise science. 鈥淵ou want a little bit of irritation, then back off and heal up鈥� The biggest mistake people make in a gym is assuming a degree of fragility to their body.鈥�

And while Patrick emphasizes the importance of developing strength in tendons themselves, there鈥檚 also another factor at work. 鈥淭endons take up to nine months, if not more, of consistently loading to heal and grow stronger,鈥� says Matt Klein, a rehabilitation and movement science professor at George Fox University. 鈥淏ut patients can have an acute decrease in pain [when they first start training the injured joint] and that鈥檚 not because the tendon has changed. That鈥檚 because their perception of pain鈥攁 fear response鈥攈as changed.鈥�

Meira explains that fear activates our nervous system and sends us into a dysfunctional 鈥減rotective mode.鈥澨� 鈥淲e see this a lot with low back pain,鈥� Meira says. 鈥淎n individual starts to fear taking load and their back gets weaker. Then they 肠补苍鈥檛 take more load, then they fear it more, and they end up in a downward spiral where their back is made out of glass.鈥�

With this mindset, I performed small reps at first, barely leaning forward a few inches, then the next time I went a little deeper, and so on until months later, I was doing 20 full range reps. Eventually I started holding a weight to my chest as I leaned forward, taxing my low back further. And an amazing thing happened: my sciatica went away. Gone, vanished. The insidious nerve pain that for years鈥攍iterally years鈥擨 tried to roll, massage, stretch, and rest away, finally disappeared. All it needed, it turned out, was to get stronger.

鈥淭he biggest mistake I see with athletes is resting for wellness,鈥� says Meira. 鈥淟et鈥檚 say the front of my knee gets sensitive when I run. I think I鈥檓 going to stop putting any load on it and let that heal. Then once it heals I鈥檒l go back to what I鈥檓 doing. But when I鈥檓 resting it, the front of that knee isn’t getting any stimulus, so it鈥檚 not learning to take load. It鈥檚 being de-conditioned to load. Being overprotective is often what gives us issues.鈥� This is ultimately Patrick鈥檚 message: to heal your body, you must use your body.

鈥淭en years ago we still had a postural fear model: you should not put your knees over your toes because that鈥檚 going to cause you knee pain; you should not slouch because that鈥檚 going to cause you neck pain,鈥� says Klein. 鈥淭he current evidence suggests that the perfect posture is the one you鈥檙e in for the least amount of time. Move. People are going to be slumped forward and extended and everything in between. Your body is meant to move in these ways. If your body is having trouble in a position, train in that position more.鈥�

As I progressed through the program, it became evident that there are only about two dozen total exercises that Patrick repeatedly prescribes. If you’ve never performed these movements, the app鈥攚hich coaches you through proper form鈥攊s invaluable. The back extension machine was revelatory for me and got me out of pain and back to the sport I love.

But as I rebuilt my running body and tried to progress deeper into his program, I ran up against his one-size-fits-most approach, an unfortunate and necessary limitation of mass-marketed fitness programs. For instance, deadlifts, which Ben prescribes, still hurt my back no matter how gentle or light I went.

No program will serve as the answer to everything, says Klein. 鈥淚 think [Patrick] is helping a lot of people,鈥� he says. 鈥淏ut I also think it can hurt a lot of people.” Klein points out that athletes should only try these training protocols after taking the time to pursue an accurate diagnosis with doctors and physical therapists鈥攖o ensure they’re treating the right thing.

After two years, I stopped following Patrick鈥檚 program through his app, but his philosophies have fundamentally changed how I think about exercise. Now, four years since I began his protocol, running is still my priority, but I only run four days a week instead of six. Strength training two to three times a week is non-negotiable. Each session is full-body and joint-focused, and at least half of the exercises I perform are ones I learned through his program. I haven鈥檛 gone a week without a back extension in two years. But the most important thing the Knees Over Toes Guy has taught me is as simple and radical as this: to keep athletically progressing and doing what you love into your thirties and beyond, you have to get strong. Spending time in the gym is a real-time fight against aging.

Despite the reduction in my running volume, I鈥檓 still getting faster, winning races, and setting PRs. But the thing I鈥檓 most proud of: I鈥檓 doing it all without pain.

The Knees Over Toes Philosophy

Strength Train

If you are injury-prone, aging, or looking to maximize your body鈥檚 potential, you MUST strength train. Full stop. Two or three times a week is ideal, but once a week is better than nothing. Perhaps this is obvious, but it bears repeating to strength-shy endurance athletes.

Measurably Strengthen Vulnerable Areas

Identify the muscles that support your body鈥檚 most vulnerable areas and train them unyieldingly. For ankles, this means targeting your calves (encompassing both the soleus and gastrocnemius) and tibialis anterior, the oft-ignored muscle on the front of the lower leg. For knees, it鈥檚 mainly quads and hamstrings. And for hips and back, well, it鈥檚 your hip flexors and back muscles. Do this in a manner that you can measure, such as weight lifted or reps completed, and work to improve those metrics. This is in contrast to many other runners鈥� strength programs, where you鈥檒l likely find complex kettlebell swinging workouts, yogic core stability routines, or resistance band 鈥渁ctivation鈥� drills. There鈥檚 nothing inherently bad about these exercises, but they fail to give you a way to measure their progress. They are also inefficient at genuinely strengthening the muscles and tendons that do the most for you.

Build Balance

Nearly everyone has practiced squatting. But when was the last time you did the opposite鈥搕hat is, lifted weight up off the ground with your legs instead of lowering weight toward the ground? Over time, certain exercises have become popular while their counterbalancing movements have not. Most athletes train their calves but not their tibialis anterior; their squat but not their hip flexors; their abs but not their lower back. To be a high-performing pain-free athlete, you must train both sides of the body, and both sides of any joint.

Regress

If pain pops up, as it is bound to, do not stop training that area. Instead, regress the movement (e.g. less weight, smaller range of motion, and/or fewer reps) to the point where you feel no pain. But do not cease to use that area of the body entirely. Pain is bad and you should never work through pain鈥攂ut motion is lotion.

Length Through Strength

Static stretching is not the panacea for health that it was once thought to be. However, the mobility (i.e. range of motion) of your joints and muscles is incredibly important and is correlated with healthier tissue. So how do we reconcile those two truths? We work to lengthen while strengthening. This means that for every exercise, you should be feeling a stretch at the top or bottom of the movement, and you should perform every exercise with the greatest bend in the targeted joint that you can achieve without pain. (Often, this means starting by lifting lighter weights.)

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For some athletes, taking pain relievers like Tylenol (acetaminophen) or Advil (ibuprofen, an NSAID drug) to ease muscle soreness after a hard workout is second nature. However, while pain relievers may have their place in lessening discomfort, pain can also be an important signal from the body that you鈥檝e overdone it.听So, how do you know when to take an occasional Advil for an achy knee and when to see a professional for help?

You Can Treat Minor Aches with OTC Medications; Injuries Require Special Attention

One of the most common reasons people feel sore after a workout is due to delayed onset muscle soreness, or DOMS. This can feel like tenderness in the muscles, stiffness, or mild swelling.

For instance, if you had a tough leg workout, you might spend the next few days walking funny up and down the stairs. You can still exercise when you experience this kind of soreness as long as the tenderness doesn鈥檛 affect your movement. However, if you 肠补苍鈥檛 properly execute an exercise without shifting form, then it鈥檚 wise to take it easy.

It鈥檚 always important to warm up before a workout, especially if you鈥檙e feeling muscle fatigue. This can decrease the chance that your soreness will get in the way of your routine.

, a doctor of osteopathic medicine and听迟he director of the Center for Sports Medicine at the New York Institute of Technology, says that this kind of soreness is typical and shouldn鈥檛 be cause for concern. 鈥淎fter exercising, our muscles are inflamed,鈥� he says. 鈥淚f there鈥檚 no larger injury, this is normal and healthy. When the muscle heals after inflammation, it becomes stronger.鈥�

In cases such as this, you can take an anti-inflammatory (such as ibuprofen) until DOMS subsides. Take note, however, of how often you鈥檙e doing this. Dr. Reuben Chen, a board-certified sports medicine physician, says that DOMS isn鈥檛 necessarily reoccurring, and thus you shouldn鈥檛 need to be popping pain relievers after every workout. In fact, as you progress in your physical fitness, DOMS should go away completely within a few weeks to a month.

鈥淚f there鈥檚 occasional swelling in the knee joint, for example, then taking an anti-inflammatory would be appropriate,鈥� says Chen. 鈥淏ut if you notice the need to take an anti-inflammatory every time you exercise because of swelling and pain, then it鈥檚 time to seek professional help.鈥�

Is It Muscle Soreness or an Injury?

To differentiate between injury and DOMS, you should pay attention to how the painful spot feels when you move around. With DOMS, the pain should lessen when you warm up and move your body.

Injuries, however, usually become more painful with movement. Instead of soreness, an injury will feel like localized sharp pain and bruising that doesn鈥檛 go away.听

What Is the Best Pain Reliever for Soreness After a Workout?

Chen makes it clear that while NSAIDs can be helpful for short-term pain management, continuous use can be dangerous. shows that long-term usage can impair healing, make someone more prone to injury, and create health problems down the line. He adds that if you really need a pain reliever, it might be best to take Tylenol, which has been shown to produce fewer GI issues in the future.听

鈥淭ry some other over-the-counter medications, like Tylenol, about 30 to 60 minutes before you hit the gym,鈥� Chen advises. 鈥淎lso, be sure to consult with your doctor on any OTC meds you take and stay hydrated by drinking fluids before and during any workout.鈥�

Other Pain Relief Treatments for Sore Muscles

Chen, who has a background in traditional Chinese medicine, also recommends considering some Eastern medicine modalities for managing aches and pains. He adds that acupuncture is a beneficial holistic pain reliever alternative.听 suggests that it鈥檚 effective at treating various forms of pain, including osteoarthritis and myofascial pain syndrome.

鈥淢odalities like controlled breathing, ice, and osteopathic manipulative medicine (OMM), are safe, inexpensive, and effective ways to reduce pain,鈥澨� Zwibel says. 鈥淭hey also empower patients by allowing them to feel more involved in their own care.鈥�

Food, as we know, can often be the best medicine. Turmeric, for example, has been for its anti-inflammatory effects on irritable bowel syndrome, psoriasis, atherosclerosis, and other diseases.

Hydrolyzed , , and also have anti-inflammatory properties. The good thing about these options is that you can consistently take them, unlike NSAIDs that, over time, with your heart and kidneys.

Overall, it鈥檚 best to avoid regular use of pain relievers like Advil and Tylenol after a workout to ease sore muscles and try alternatives first. But if you need to occasionally take the edge off muscle aches and soreness, Tylenol is the best option.

Most importantly, remember to listen to the signals your body is giving you. If that aching isn鈥檛 clearing up or seems more sharp and pronounced, it鈥檚 time to see a doctor.

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When your lower back or glutes flare up painfully after going too hard trail running over the weekend, your default instinct might be to add some extra stretching to your routine or schedule some time with your massage therapist or chiropractor.听 If the pain is excruciating, you might even consult with a sports medicine doctor.

But there’s another accessible and effective treatment option for aches and pains. One that has only limited side effects and that’s been practiced for thousands of years.

It’s acupuncture. And although the mechanisms through which acupuncture works in the body aren鈥檛 fully understood, and there may be a placebo effect in play, research repeatedly indicates that acupuncture is effective at treating various forms of pain, including those related to , the back, and .

Here鈥檚 what you need to know about acupuncture鈥檚 potential role in treating sports injuries.听

Acupuncture and Sports Medicine

is a practice in Traditional Chinese Medicine (TCM) that involves inserting small, thin needles through the skin and often into the superficial layers of the muscle to relieve pain and address health conditions like menstrual cramps, , and arthritis. The points where needles are inserted are pathways, each corresponding to a particular organ or system, along which energy, or qi, is believed to travel. According to TCM, the needle helps unblock meridians.听

From a Western medicine perspective, it鈥檚 believed that the needles stimulate the body鈥檚 muscles, connective tissue, and central nervous system, which can help with recovery from illnesses and pain. 鈥淏asically, what we’re doing with acupuncture is we’re using your body’s inherent means of healing itself,鈥� says , DO, who is a primary care and sports medicine physician and licensed acupuncturist at Houston Methodist.听

Sports medicine acupuncturists specifically treat sports injuries using the same foundations of TCM, but also incorporate functional anatomy, muscle testing, and range of motion testing. 鈥淯sing this approach, I can precisely identify complex injuries and their sources, especially when checking for posture issues during various movements,鈥� explains sports medicine acupuncturist .听

a doctor of Chinese Medicine and licensed acupuncturist who works with the Minnesota Vikings, believes combining TCM and sports medicine really helps nudge the body along on the path to healing. 鈥淭he body wants to be in harmony, it wants to be balanced, it wants to be functional,鈥� she says. 鈥淏ut sometimes it has to be told what to do because it鈥檚 gotten out of alignment.鈥�

Acupuncture is used to treat all sorts of sports injuries, including joint problems, muscle sprains and strains, tight muscles and trigger points, lower back pain, cervical and lumbar herniations, and many other conditions. 鈥淚t鈥檚 just so incredibly helpful because we can treat the whole body effectively in that one treatment,鈥� Patzer says. 鈥淭hose needles are like little magic wands.鈥�

This broad approach means that when treating something like a quadriceps strain, an acupuncturist will also assess and potentially address other muscles around that injury that may be compromised or compensating. 鈥淚f you don鈥檛 treat anything around [the injury], they鈥檙e going to continue to have that quad injury and it鈥檚 not going to heal nearly as fast as if you treat upstream and downstream as well,鈥� Patzer explains.

How Acupuncture Helps Sports Injuries

Here are a few ways that acupuncture can be useful when treating sports injuries, according to the experts:听

1. Reduces Pain

Acupuncture is frequently used to of pain and is increasingly recognized as a non-drug alternative to painkillers. One reason for acupuncture鈥檚 pain relieving effect is that it鈥檚 known to , which can help decrease pain and lift your mood. 鈥淏y boosting the production of endorphins, acupuncture directly counters pain, a primary concern with sports-related injuries,鈥� Menard says.听

2. Decreases Inflammation

Acupuncturists commonly use the practice to reduce inflammation following injuries. Menard explains that acupuncture improves to targeted muscles, fascia, tendons, and ligaments, which helps reduce swelling and repair injured tissues.

A recent published in the journal Nature found that acupuncture can trigger an anti-inflammatory response and suppress inflammation through the involvement of a nerve pathway between the vagus nerve and the adrenals called the vagal-adrenal axis. Other show similar findings, with acupuncture reducing or controlling inflammation by stimulating various pathways that connect the nervous and immune systems, both of which are known to play a role in the body鈥檚 inflammatory response. It鈥檚 important to note that these studies were conducted on mice, which isn鈥檛 always an exact predictor of human response.

Another found that acupuncture may reduce inflammation by stimulating the vagus nerve, which is part of the parasympathetic nervous system and plays a large role in the body鈥檚 stress response.

3. Corrects Muscle Imbalances

Acupuncture can enhance proprioception鈥攎eaning the body鈥檚 sense of its position and movement鈥攂y addressing trigger points and knots in the muscle tissue, Menard says. For athletes, proprioception is really important because it plays a role in balance, coordinating movements, and adjusting muscle activity. When proprioception is low, sports injuries may be to occur

鈥淭hese knots, if untreated, can hinder muscles and their counterparts from functioning correctly, leading to imbalances and further complications,鈥� Menard explains. 鈥淎cupuncture’s ability to identify and treat these points can provide immediate relief, helping athletes regain their proper form and function.鈥�

Patzer compares muscle functioning to a slinky鈥攚hen a muscle is functioning properly it opens and closes like a spring, and that鈥檚 a good thing. But if it鈥檚 pulled too long or locked up too tight, it may not perform at its best. Left untreated, this can sometimes lead to problems with nearby muscles, tendons, and joints. 鈥淲ith acupuncture, I鈥檓 able to help the muscle get that kind of proper movement and function back,鈥� Patzer says.听

Do All Acupuncturists Treat Sports Injuries?

Many acupuncturists may be able to help someone with a sports injury, but if you鈥檙e an athlete and experiencing pain, Patzer says it鈥檚 best to see someone who specializes or is certified in sports medicine acupuncture. If you have an X-ray or MRI results, bring a copy to your appointment to help inform treatment. 鈥淚t’s essential to accurately diagnose each condition to tailor the most effective acupuncture treatment to the patient’s specific needs,鈥� Menard says.

Keep in mind that acupuncture likely isn鈥檛 going to be a one-stop cure for any sports injury that arises, and it鈥檚 often most effective when used in conjunction with other types of treatment. Acupuncturists will even refer patients to other care facilities or professionals, like hospitals, chiropractors, physical therapists, and massage therapists. 鈥淲e work in tandem, ensuring every patient gets the holistic care they need,鈥滿enard says.

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