Worst Beverage in America

• Worst Water - Snapple Agave Melon Antioxidant Water

  
  Sugar Equivalent: 2 Good Humor Chocolate Éclair Bars

• Worst Bottled Tea - SoBe Green Tea

  
  Sugar Equivalent: 4 slices Sara Lee Cherry Pie

• Worst Energy Drink - Rockstar Energy Drink

  
  Sugar Equivalent: 6 Krispy Kreme Original Glazed Doughnuts

• Worst Bottled Coffee- Starbucks Vanilla Frappuccino

  
  Sugar Equivalent: 32 Nilla Wafers

• Worst Soda - Sunkist

  
  Sugar Equivalent: 6 Breyers Oreo Ice Cream Sandwiches

• Worst Beer - Sierra Nevada Bigfoot

  Carbohydrate Equivalent: 12-pack of Michelob Ultra

• Worst Kids’ Drink - Tropicana Tropical Fruit Fury Twister

  
  Sugar Equivalent: Two 7-ounce canisters Reddi-wip

• Worst Functional Beverage - Arizona Rx Energy

  
  Sugar Equivalent: 6 Cinnamon Roll

• Worst Espresso Drink - Starbucks Peppermint White Chocolate Mocha with Whipped Cream

  
  Sugar Equivalent: 8½ scoops Edy’s Slow Churned Rich and Creamy Coffee Ice Cream

• Worst Lemonade - Auntie Anne’s Wild Cherry Lemonade Mixer

  
  Sugar Equivalent: 11 bowls of Cookie Crisp cereal

• Worst Frozen Coffee Drink - Dairy Queen Caramel MooLatte

  
  Sugar Equivalent: 12 Dunkin’ Donuts Bavarian Kreme Doughnuts

• Worst Margarita - Traditional Red Lobster Lobsterita

  
  Carbohydrate Equivalent: 7 Almond Joy candy bars

• Worst Beverage in America - Cold Stone PB&C

  
  Sugar Equivalent: 30 Chewy Chips Ahoy Cookies

The Great Myth of the Core Workout

The Great Myth of the Core Workout

Posted by Brandon M at http://www.liftbigeatbig.com

((Trrrruuust me, deadlifts, overhead squats, turkish getups - your core will be fine (in every sense of the word!)))

Add the word "core" to any form of exercise, and people seem to jump right on it. "Core blaster", "Core fitness class", "Sit on a ball at work to stabilize your core". It is a buzzword that is thrown around so much it has become meaningless. It appears in every fitness dvd and boot camp on the market. Core training seems to have become another example of something that the masses will sign up for in order to get out of doing any real work.

First, let's get started on the flawed training model of these core workout classes. Some of these classes can last up to 60 minutes and focus primarily on stretching, "core" exercises, and breathing patterns--all with the promise that you will have improved posture, better stability and of course, washboard abs.( Who doesn't want those, right?). The first of many problems with these classes is their tendency to focus on concentric and eccentric contractions. In reality, most of the stability in our bodies is isometric.

Another problem with these classes are the claims that it will stabilize your body. Grenier Kaycic has this to say about the complexity of trunk stabilization:

CONCLUSIONS: No single muscle dominated in the enhancement of spine stability, and their individual roles were continuously changing across tasks. Clinically, if the goal is to train for stability, enhancing motor patterns that incorporate many muscles rather than targeting just a few is justifiable. 

The passive human spine is an unstable structure that requires stabilization by the co-contraction of trunk muscles. In the fitness industry, they are often mistakenly referred to as the "core", implying that there is a distinct group of muscles for stabilizing. The transverses abdominis (TrA) is usually the muscle that is being mentioned. While it does play a role in stability, it is a role that is synergistic with every other muscle that makes up the abdominal wall.

A simple way to test the reliability of the stability help that TrA offers is on pregnant women. It takes the abdominal muscle 4-6 weeks to reverse the length changes and undergo re-shortening. Believing the core stability myth, it would seem that a women undergoing the changes of post-pregnancy would have severe lower back pain. Yet the study found that postpartum women women had unexpected speed in their recovery time. How is it possible that the lower back has been strengthened in a time when the abdominal wall is weakened?

The answer is that the relation between the abs and spinal stability has been dramatically exaggerated.

Not to mention that there is no evidence that proves that sitting on a ball at work is going to help improve your spine. If anything, it is going to relax your trunk even more. I'm not sure how it "forces your core to stay tight" as the claims say. You know what would make your back feel better at work? Getting up, walking around, and doing some air squats.

Getting back to the topic of fitness, ab-centric workouts have no place in the training regimen of a serious athlete. Any elite athlete will tell you that to build a strong core (core being everything between your neck and thighs), you have to work the compound lifts. Squats, presses, deadlifts, and the variations of the Olympic lifts will work your core in ways that you have only dreamed. I do abmat & GHD situps  about twice a week, and my core is stronger than it ever has been. This is because I spend the majority of my workouts on compound movements with core exercises as a supplementation, not the main focus of my training.

Look at elite Crossfitters. Have you seen their stomachs? I don't think they spend an hour doing 1/8 crunches on the BOSU ball.  Besides, a 6 pack comes diet more than training.

He uses the crunchercizer X-3000

Elite powerlifters and strongmen are squatting and deadlifting 800+ pounds. You think they are wasting time on those catapult-looking machines in the corner of the gym?

Superman

Stop wasting your valuable time in the gym focusing on your abs. All you have to do is work the compound lifts with excellent form, and your core will naturally strengthen along with everything else you are working. Abdominal definition will come from zoning in on your diet. You can do all the situps in the world and still have a gut if you are eating trash.

Just be a real (wo)man and keep lifting big. Only good things will come from it.

Sources:

Kavcic N, Grenier S, McGill SM. Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine. 2004 Jun 1;29(11):1254-65. 

 Lederman, Eyal. PHD. The myth of core stability.

  Hodges, P.W. and C.A. Richardson, Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine, 1996. 21(22): p. 2640-50.
  Hodges, P.W. and C.A. Richardson, Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J Spinal Disord, 1998. 11(1): p. 46-56.

  Freeman, M.A., M.R. Dean, and I.W. Hanham, The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br, 1965. 47(4): p. 678-85.

Jull, G.A. and C.A. Richardson, Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. J Manipulative Physiol Ther, 2000. 23(2): p. 115-7.

  Richardson, C.A., et al., The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine, 2002. 27(4): p. 399-405.

The Toxic Effect of Sugar

This weekend's 60 Minutes had Dr Lustig on explaining how sugar is a toxin.  It's a good episode if you haven't seen it:  60 Minutes Sugar is a Toxin.  Note the best advocate for sugar is the sugar farmer. I'm sure he knows what the body needs.  :).  But all in moderation - anything in moderation is fine, right?  The problem is the moderation is gone, once you refine sugar it is potent and pure.  NOT the way we were intended to ingest it.  Note the 60 Minutes story's reference to how to block sugar receptors in cancer tumors.  It will take cutting edge science and $billions to allow us to keep over consuming sugar.  This should make any thinking person's head explode.  Invest medical research to allow us to continue to do things we shouldn't be doing?!? 


Dr Lustig got his fame from this youtube video.  Some advice on how to live longer/better and without metabolic syndrome or diabetes or obesity, etc etc..

• Limit sweets, especially sugar-sweetened drinks.  Even the naturally occurring sugars in 100% fruit juice can raise your risk.  Even in the 60 Minutes story the point is made - it'd take 10 oranges to equal that much sugar - and WHO  eats 10 oranges in a sitting??  Well YOU do - one large glass of Orange Juice takes 10 oranges.  Oranges are heathful, but a dozen oranges spike insulin production.  Where's your moderation.  Our parents had it right, a thimble full of OJ is all you need.  

• Recognize that starchy carbohydrates, such as breads, cereals, crackers, and pasta can have the same effect in producing too much blood sugar (glucose).  I don't eat breads, pastas, anything with refined flour.  These have the same insulin overproducing affects.

• Eat whole fruit which contains fructose, but also fiber and micronutrients that your body was meant to have.

• Read food labels for hidden sugars- high fructose and all other corn syrups; refined sugar and artificial sweeteners present in processed foods such as tomato sauce and bread; even maple syrup and honey may be layered onto other sugars.   This is decent advice as long as you know 50 more names for sugar.  All the same molecule, but the multiple words for it allow food labels to look like their ingredients are distributed across more ingredients... they aren't.  You can't pronounce an ingredient you probably shouldn't be eating it!  

To Organic or Not to Organic

(thanks Jason Bolduc for the chart)


Now it kiiiiiills me to use the word 'Conventional' to define factory farmed with pesticides, growth hormones and forced-genetic modifications, etc etc...  But I feel that will change someday soon.


I get the question a lot if organic foods are worth the cost.  If you're concerned with a natural way to get the vitamins you need then this chart shows organic choices make a HUGE difference.  Perhaps replace your 'daily vitamin' budget (and unseen saved health care expenses) with more organic produce.  


Here is a list of the 'dirty dozen' - the worst culprits of 'conventional' foods you should avoid.  (also click the 'clean 15' - safest foods to buy from conventional sources).  Face it, there are untested things in our foods that you shouldn't be ingesting.  Think about it.


We vote with our dollars

Woman Sues for Vibram Five Fingers Not Delivering

'Damaged' woman sues over flatfooted sneakersBy adamg - 3/22/12 - 7:59 amA Florida woman is suing Concord-based Vibram USA over its Vibram FiveFingers sneakers, claiming they not only fail to provide the health benefits the company claims, they can lead to injuries among people who fail to adjust their gait while using them.In her suit, filed yesterday in US District Court in Boston, Valerie Bezdek does not specify how she became "damaged" while using the sneakers, but says she never would have bought a pair if she'd known the truth. She's asking to be named lead plaintiff in a class-action suit that seeks millions of dollars in damages and lawyer's fees.

Since Reebok paid $25m in a suit for misleading consumers there is blood in the water for shoe claims. Note the Ab Lounge, Shake weight and Thigh Master are delivering on all their claims ;).


An aside:  I was helping a friend babysit/host a party of 9 year old girls.  They were all from very successful rich parents, dropped off in Aston Martins and Porsches.  While they were at play one girl says when I'm older I'll work in a zoo, so I can play with animals all day.  The other girl says when I'm older I'll be a lawyer so I can sue your zoo and then I can own it.  Oh yeah well I'll sue you first for... blah blah, on and on.  They knew the American dream at such a young age.  Very 'inspiring', well very telling anyway.  Meanwhile we make fun of the woman who sued McDonalds for making the coffee too hot.  That case had some interesting facts people don't understand, like why was it 230degrees?  Seriously weaponized.  SHE didn't want money she wanted her 24" of third degree burn fixed, they offered $400 for her medical expenses.  The rest spiraled out of control.  But now McDs serves coffee 40 degrees cooler, no longer able to take skin off.  


Sorry, that was serious digression...  Point is, there is a woman who feels that she was misled by Vibram and their advertising.  Her claim is that running incorrectly in these shoes can lead to injury.  

“Indeed, running in FiveFingers may increase injury risk as compared to running in conventional running shoes, and even when compared to running barefoot,” according to a copy of the suit, filed in US District Court in Boston.

'Conventional' a word here which means overly supportive, something that encourages heel striking, and removes propriocetive cues needed in running injury free.  We get the society we deserve, right?   Some more details here.


What are your thoughts?  Return an item you're not happy with or sue?   

Dynamic Warmup Boosts Strength, Flexibility

By Scott Douglas

Doing a dynamic warmup of exercises like leg swings increases quadriceps strength and hamstring flexibility, whereas a warmup of static stretching doesn't produce those gains, according to a study published in the Journal of Strength and Conditioning Research.

Researchers at the University of North Carolina measured subjects' leg strength, power, flexibility and vertical leap, then had them do one of three routines before restesting those measures. Some people did a dynamic warmup, some did static stretching and some did nothing. When retested, those who did the dynamic warmup scored significantly better on quadriceps strength and hamstring flexibility than they had in the pre-warmup test. Those who did static stretching or nothing between the two rounds of tests neither improved nor lessened their strength and flexibility.

This study supports what elite runners and coaches are increasingly doing--using a dynamic warmup to increase muscle activity before hard workouts. Aswe reported earlier this month, some studies find that the traditional pre-run static stretching decreases performance by lowering muscles' ability to contract rapidly and powerfully. Static stretching is best done after a workout as a means of lengthening muscle fibers.

Chocolate Coconut Paleo-Doughnuts!

Follow these steps for great results!

If you’re not a Facebook fan of fast Paleo, click here!

Cooking Steps
I came up with this idea out of a discussion of people’s cheats. Doughnuts were something that came up, and I wanted there to be a better option than running into Dunkin. The carbs in this are mostly starch, with some fructose present in the maple syrup. The fats are mostly MCTs, which your body doesn’t like to store and prefers to burn as fat. If you eat these after a hard workout, the starch will be taken up by your muscles and liver, and the MCTs will be burned for fuel. You will have a very hard time storing them as fat if eaten that way (within reason!).


Yields 20 large or 30 medium doughnuts.
Large doughnut nutrition facts (baked, per doughnut. If you fry then  count that fat.)
450 Calories 24g fat 47g carbs 7.5g protein Medium doughnut nutrition facts.
300 Calories 16g fat 32 carbs 5g protein


Doughnuts

1. In a large mixer or mixing bowl, sprinkle yeast on 0.25 cup warm water and let sit 5 minutes or until foamy.
2. Add 0.5 cup coconut oil, 0.5 cup manna/butter, 0.5 cup maple syrup, 4 eggs, and 1.5 cups water. Mix until smooth. Add 2 cups coconut flour and mix until smooth. Add remaining 4 cups of flour 1 cup at a time. Knead the dough about 5 minutes. Place dough in a greased bowl and set aside in a warm place to rise 2-3 hours or until puffy to the touch.
3. Form the dough into doughnut shaped objects (good luck!) and set aside, covered, to rise again.
4. If frying, heat oil in a large pan. Gently slide doughnuts in with a spatula and cook 30-45 seconds on each side or until they float and are golden brown. Set aside on wax paper.
5. **If baking, bake doughnuts 10-12 minutes at 375 on a cookie sheet or until golden brown.

Topping
You can double or triple recipe if you want to cover the entire doughnut or want extra to drizzle or dip.

1. Combine 1 cup maple syrup, 0.5 cup coconut manna/butter, 4 tablespoons cocoa powder, and 1 tablespoon starch flour in a small saucepan over low heat, mixing with a whisk. Reduce and thicken until whisk leaves definite trails.
2. Let cool until nearly room temperature (or chill in the freezer 5 minutes). Dump shredded coconut into a bowl slightly wider than your doughnuts.
3. Dip one side or fully submerge doughnuts into frosting, then press firmly into shredded coconut for several seconds. No chocolate should be left in the coconut bowl. Set aside on wax paper.
4. Drizzle remaining chocolate over the doughnuts, or use it for dipping!
5. **Suggested substitutions: You could use butter or clarified butter in place of the coconut products, but you’ll be losing the nutritional trickery of the coconut fat. You can also switch up the flour called for to whatever is to your liking.

Can Sprinting Help Your Endurance?

Sprinting for Endurance

Can sprinting improve your aerobic conditioning? Absolutely. Although not exactly common knowledge, in-the-know endurance athletes have been enjoying the benefits of sprint training as a substitute for some of their distance work. And you'll find that sprint work is part of the foundational training of a growing number of champion endurance athletes, especially those following the Crossfit Endurance program.



But is there any scientific foundation for the use of sprints to improve endurance? Again, absolutely. In 1993, scientists studied the percentage of energy pathway contributions during repeated maximal effort sprints. They theorized that although your phosphagen pathway might be responsible for a huge energy contribution on the first sprint, by the later sprints it would seem plausible that other pathways were making increasingly greater contributions. To briefly review: the phosphagen pathway is the responsible for quick, explosive strength over the first few seconds of a movement, while the glycolytic pathway contributes to the next couple of minutes worth of energy, and finally the oxidative pathway takes over for events lasting anywhere from several minutes to several hours.

But what about repeated sprint efforts? Would we see an increasingly greater contribution from the glycolytic pathway, even though the amount of work performed is a short sprint, firmly in the phosphagen's domain?

To test this theory, a group of subjects were tasked with six seconds of sprinting followed by 30 seconds of rest, for ten repeated efforts (a 1:5 work ratio). Any athlete who's run a set of suicides or repeated sprint intervals will attest to the fact that oxygen consumption clearly increases between the first and last sprint - which intuitively means that the body must be shifting from the use of one energy system (anaerobic) to another (aerobic). If we consider the types of conditioning work done at all levels of sport, we find that repeated sprints are a staple of every coach from Pee-wee Football to professional rugby, and every level and sport in between.

This effect can be seen with traditional weight training as well, when we use shorter rest periods between sets, leading to increased oxygen consumption (breathing heavier) and a stress on our oxidative (aerobic) system. So although it's uncommon to think of sprints as a form of aerobic conditioning, there are numerous practical examples of them being used as such.

So what happened between the first and tenth sprint?

What the researchers found was that there was a significantly reduced contribution from the anaerobic energy pathway on the final sprint as compared to the first one. Although they didn't measure the exact contributions of every energy pathway independently, they produced enough data to imply that as the sprinting session progressed, there was a trend towards a decrease in the phosphagen and glycolytic pathways, signifying a likely increase in the percentage of energy being derived from oxidative metabolism.

This data can't be interpreted as a good reason for endurance athletes to ditch all of their long efforts and focus on sprinting instead, but it does give those athletes a good reason to start working in some sprints to their routine.
You'll also note that these charts are given as percentages, not absolute values; although one may talk about "shifting" from one energy contributor to another, the analogy of shifting gears is not apt. We don't shift energy pathways like a car shifting from first (phosphagen) to second (glycolytic); either completely in one gear or another. Instead, the human body is constantly altering the ratio between one energy system to another, and sometimes back, in a fluid series of shifting contributions. So if you're looking to get some of the benefits of aerobic training without putting in endless miles on the road, maybe a set of 10 x 6s sprints is the workout you've been looking for. http://www.vpxsports.com/onlinearticles/default.aspx?unabletolocate=sprinting%20for%20endurance?ref=nf

Making the case for running shoes, a study

Making the case for running shoes, a study


I was glad to see this article come out (with its corrections)  "Making the case for running shoes, a study Link Here"


In summary, the study asks "is barefoot running more efficient"??  Sure it can be considered more efficient because we are carrying less mass on our feet - but if the mass was the same(held constant), would it still be more efficient?  


The way they tested this was comparing O2 use between runners using 150gram shoes and the same runn ers wearing 150gram taped weights on their feet and running barefoot.  These runners are barefoot experienced - so there was hopes of removing that variable.


They were shocked to find that weight bare feet were LESS efficient than wearing shoes.  This is expected to us.  I mean the removal of weight advantage is carved out of the experiment, so the only question is are we metabolically more efficient when barefoot??  I'd say 'who cares'.  If (and this is a mid-sized 'if') we are less injury prone and have years more of lifetime running due to having good form, would 101 breaths in stead of 100 be a worthy trade??  


Why don't you find out and run as shodless as possible to correct your form.  I've NEVER heard a story (Not One) where supportive shoes extended a runner's running career, yet I've heard many testimonials to the contrary.  Testimonials are not science, but they may be indicators of what would happen to you.  We're all an experiment of one.!


Thoughts?  Explicatives? Mints?

Working out on travel

 

I get this question frequently: I need to travel, will I lose my fitness??!?!  

Don't feel like you'll lose fitness when taking a week off.  A vacation can be the perfect time to let your body heal completely and you will be fresh to continue your training when you return.  For many, I suggest to take a week out ten off as a good schedule to keep to prevent overtraining.

The active vacation: If you exercise regularly and you're headed out for an active vacation, like skiing, rafting, mountain climbing, this is the perfect time to USE the fitness you've gained from your normal training.  That's the 'sport/specialty' on top of the fitness pyramid!  If you've been good about the rest of the pyramid, you'll be surprised how good you are at many things that are NEW to you.  This is because you've been hitting many points of fitness simultaneously (both in terms of movements and metabolic pathways).  Training outside your comfort zone prepares you for activities outside of your comfort zone, it's that simple!  Of course you should go out and enjoy your new fitness gains in creative ways.

In travelling for work or over the holidays if you are afraid you're losing fitness; here's a list of exercises that can be done at most hotel gyms. Link: Bodyweight Workout List.  This list varies from no equipment to needing a pullup bar, rings, or a jump rope. If you find that you make the same trips periodically, (for example, the annual Consumer Electronics Show or a quarterly training event) record which workouts/performance and repeat them every trip to track your fitness gains.


How do you workout (or choose a running path) in/near a hotel room?

Happy travels!

Overtraining Continued

After my original post on overtraining here: http://paleorunners.blogspot.com/2012/01/ole-overtraining.html I thought about doing my own little overtraining experiment.  By using what I have at home (Garmin 310xt), I have recorded my Heart Rate while sleeping.  While this may seem OCD, or excessively geek'y you have to remember who you're talking to ;)!  Note, you can benefit from others' obsessive behavior.


Nothing new here that isn't covered in the previous 'overtrained' post except for this example: I pushed myself hard for 5 days straight by running to and from work, running to the gym for some high intensity training and even starting runs with a set of squats or other wise.  There is a race coming up and needed some volume and I was curious about how much repair I would need to do in my sleep.



I think the most important metrics here are average and minimum heart rate.  It would be interesting to track REM cycles and my ability to awaken in between deep sleep.  Sleep tracking for detecting overtraining seems overly rigorous, there are plenty of other markers to look for.  

• Keep the body guessing 
• Occasionally PUSH the envelope 
• Always get plenty of sleep 
• Take ~1 out of ten weeks off
• **most importantly** train to recover and recover to train! 

Stretching out plantar fasciitis

Sing Song: "The Hamstring's connected to the Fascii"  great Video on the subject, click here

 Summary:  “After controlling for covariates, participants (86 of 210 feet) with hamstring tightness were 8.7 times as likely to experience plantar fasciitis (p < .0001) as participants without hamstring tightness. Patients with a BMI >35 were 2.4 times as likely as those with a BMI <35 to have plantar fasciitis.”

Stretching out plantar fasciitis

www.shutterstock.com #6522286

By Katie Bell 

Tight hamstrings play an important role in plantar fasciitis, according to a study published in the June issue of Foot and Ankle Specialist.

“These findings show that while we always consider the tightness of the gastrocnemius/soleus complex and the subsequent restricted ankle motion from this equinus, we also need to consider the role of the hamstrings,” said Jonathan Labovitz, DPM, lead author and associate professor at Western University of Health Sciences, Pomona, CA.

The prospective cohort study included 105 participants (210 feet); 79 had plantar fasciitis, which researchers assessed with palpation, who measured popliteal angle with a tractograph and diagnosed ham­string tightness when the popliteal angle ≤160°.

Without controlling for covari­ates, body mass index (BMI), tightness in the hamstring, gastroc­nemius/soleus, and gastrocnemius, and the presence of a calcaneal spur all had statistically significant associations with plantar fasciitis.

After controlling for covariates, participants (86 of 210 feet) with hamstring tightness were 8.7 times as likely to experience plantar fasciitis (p < .0001) as participants without hamstring tightness. Patients with a BMI >35 were 2.4 times as likely as those with a BMI <35 to have plantar fasciitis.

Researchers at Cappagh Orthopedic Hospital in Dublin, Ireland, first linked hamstring tightness with plantar fasciitis in a study published in the December 2005 issue of Foot & Ankle International. The Western University researchers now suggest that an increase in hamstring tightness may induce prolonged forefoot loading and, through the windlass mechanism, may be a factor that increases repetitive plantar fascia injury.

Triceps surae tightness was not included in the Western University covariate analysis, raising the possibility that hamstring tightness was not actually the cause of plantar fasciitis in patients wth tightness in both areas.

“People who have tight hamstrings are more than likely going to have a tight triceps surae,” said Michael T. Gross, PT, PhD, a professor in the Division of Physical Therapy at the University of North Carolina in Chapel Hill. “The investigators of this study admitted that 96% of subjects who had tight hamstrings also had tight triceps surae. Now there’s a cause and effect. If you can’t get dorsiflexion at your talo-crural joint, this often drives dorsiflexion at other joints and that is going to cause collapse of the longitudinal arch of the foot, loading the plantar fascia with increased tensile stress.”

In people with hamstring and triceps surae tightness and plantar fasciitis it’s not known whether the ankle equinus from a tight triceps surae causes hamstring tightness or vice versa, Labovitz said.

“There is no question that the tightness of the triceps surae will cause flattening of the arch and increase tensile stress on the plantar fascia,” Labovitz said. “The question becomes, are the hamstrings involved in this and, if so, to what effect?”

The timing of plantar fascia loading and hip kinematics during gait raise additional questions about pos­sible hamstring involvement, Gross said.

“When loading is taking place at the plantar fascia, it’s mid to late stance. At mid to late stance, the hip is in extension and even hyperextension.  Even though the knee is extended, extension/hyperextension at the hip will limit the amount of passive tension that could be developed in the hamstrings, so it is a mystery to me how tight hamstrings would cause trouble for the plantar fascia,“ he said.

Labovitz suggested, however, that a little hamstring tightness might go a long way in influencing the plantar fascia.

“The practical application is that since the hamstrings have been shown to be involved and possibly have more influence than equinus due to the longer lever arm, showing greater effect on the flattening of the foot and plantar fasciitis, less restriction is necessary to have the same effect as equinus,” he said.

The researchers suggest that treatment of plantar fasciitis should address hamstring tightness along with equinus and obesity. Night splints, orthoses, and gait retraining have been shown to be effective for managing plantar fasciitis pain but will not address hamstring flexibility, Labovitz noted.

“The hamstrings should be examined and treated,” Labovitz said.  “Stretching is the best treatment for increasing flexibility.”