High heel shoes: the new fashion faux pas

This just in from the Wall Street Journal Fashion Section: high-heeled shoes appear to be very yesterday.

According to the article published last week entitled, “Are High Heels Dead?”, there’s been a strong trend toward low flat shoes like sneakers that may lead to a lasting change in women’s footwear. For example, this Spring, high-heels were nowhere to be seen on the fashion runways.

Rejoice!

As the woman who first discovered the link between high-heeled shoes and knee arthritis back in 1998, I couldn’t be happier. If you never saw it, for giggles, see this clip on ABC’s 20/20:

I have to admit that my feelings have been a little hurt all these years that fashion didn’t immediately change with that discovery. Come on, you’d think that something as medically important as knee arthritis would trump fashion, but it didn’t. Until now! Ha!

I’d like to think that our OESH La Vida has had a little something to do with this recent shift in fashion. Yes, I designed OESH with health in mind, but guess what? Our La Vida has become, gulp, a fashion statement and we are getting requests to, gulp again, feature them in fashion shows. (When we actually accept a request, we’ll let you know.)

Of course, you OESHers don’t need Paris or the Wall Street Journal to tell you that your La Vidas are fashionable. Thank you for posting on social media outlets and sending us pictures of your wearing them at weddings and other fancy occasions. Please keep posting and sending pictures because healthy is and forever will be fashionable.

D. Casey Kerrigan, Mary K. Todd, Patrick O. Riley. Knee Osteoarthritis and High-Heeled Shoes. The Lancet. 1998:351(9113):1399-1401.
D. Casey Kerrigan, Jennifer L. Lelas, Mark E. Karvosky. Women’s Shoes and Knee Osteoarthritis. The Lancet. 2001:357(9262):1097-1098.
D. Casey Kerrigan, Jennifer Lelas Johansson, Mary F. Bryant, Jeniffer A. Boxer, Ugo Della Croce, Patrick O. Riley. Moderate-heeled shoes and knee joint torques relevant to the development and progression of knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2005:86(5):871-5.

Children in a Shoe Factory?

When I set out to make healthy shoes, a fellow physician friend of mine said, “Casey, knowing you, you’re going to hate those sweat shops and you’re going to want to do something about it.” Indeed, I did hate every shoe factory I visited (and believe me, I visited a lot of them). I didn’t need to be a physician to realize they are a violation to everyone’s health not just the person wearing the final product.

The rest of the story, as they say, is history. I built my own factory, become an expert in materials, computerized machinery and 3-D manufacturing and re-defined what a shoe factory should be.

The major benefit of building the OESH Factory is that it allowed me to design, develop and make shoes with the most sophisticated and superior sole materials that just couldn’t have been done any other way. Along the way, OESH has built a reputation for not only making the healthiest shoes, but for setting an example for what innovative technology applied to manufacturing can do.

This year we’ve had so many requests from educational groups and organizations for tours of the factory that we’ve sadly had to say “no” to the large majority. If we did not, there would be no time left to make all those wonderful La Vidas! But when we do give tours, I love it. This is so different from when I used to give tours of the hospital, trying my best to inspire children to become physicians. No matter how hard I tried, there was a lot of yawning.

This time around, I can show them things they really seem to like: shoe parts, a computerized milling machine, 3-D printers, hydraulic press “monsters,” an injection molding machine that I explain is basically a huge, fancy hot glue gun with a lot of accessories, and a computerized machine that cuts through six inches of steel with just water and sand (like how the Grand Canyon was created). There is no yawning. There is a lot of touching, which for the most part is okay. (They LOVE the warning sign on one of the machines that depicts fingers being cleanly sliced off.) I tell them I’m a physician by training, and somehow, they seem far more interested in becoming a physician than the groups I used to give hospital tours to.

Science and medicine is not abstract. They are fascinated with my research using 3-D motion analysis and force plates showing the effects of shoes on forces in the body. More so than if I were to to go over that same research in a hospital tour. They easily connect the dots on how a shoe must be designed so as to help not hinder the body.

A lot of them have experience with 3-D printers. Their schools typically have one or ten of them lying around. They immediately relate to a new way of manufacturing shoes using computers and 3-D manufacturing. In fact, they seem proud that they’re learning new technologies that their parents may not know too much about. It’s easy for them to envision making shoes in an entirely different way than what’s ever been done. And they get the whole sustainability thing.

Children in a shoe factory? Heck yeah! As long as it’s OESH’s.

8th graders from Buford Middle School, Charlottesville, Virginia

8th graders from Buford Middle School, Charlottesville, Virginia

Beating Knee Pain & Everyone Else

Last year, when I started working at OESH, I sent my mom a pair of La Vidas from our first production run. She had always been an avid runner but a couple years ago she started getting bad knee pains which prevented her from running as much as she liked. I sent her that first pair hoping they would help her knee pain and in fact, not long after, she was out running again. She was back to running about 3 miles a few times a week and ever since has been doing any 5K she can find. Her goal is to complete at least one 5K a month. This brings us to a couple weekends ago when I had gone back to the Eastern Shore of Maryland to visit my parents. My mom was running in the Chester River Crab Chase 5K in Chestertown, MD the following morning so I decided to join her. We got up early, put on our OESH La Vida 2.0 (I wore rococco, she wore her fiji) and headed out to the race. She received first place in her age group as I received second place in mine. This is not the first time she has won first place in her age group as she is always sending us pictures of her first place winnings. It is great to see her back in the running game and healthy as ever! Way to go Mom!

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Featured Speaker at the Maker Faire

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“A maker is a person or thing that makes or produces something.” Historically a maker does metalworking, woodworking, and/or traditional arts and crafts, but more recently the term “maker” has become synonymous with being engaged in engineering-oriented pursuits such as electronics, robotics, 3-D manufacturing, and the use of CNC tools. Insofar as OESH, unlike any other shoe company that we are aware of, employs all these latest high tech methods to make shoes, we qualify as modern-day makers.

In fact, it was quite an honor to be featured at the Maker’s Faire in Charlottesville, Virginia this weekend. Right alongside one of the most famous makers of the United States, Thomas Jefferson.

In about 20 minutes I jam packed all there is to know about OESH and the future of shoe design and manufacturing…from my research that informs the design of shoes to the futuristic, high-tech engineering, including 3-D design and CNC tools that we’ve been using to make OESH shoes. As it was a fairly technical crowd, I expected some technical questions. I didn’t get any. Rather, I got the “why don’t you make shoes for men?” The answer is, “Sorry guys, women first. (But if you’re a size 10 or smaller, go for it – just order two sizes bigger.)”

My talk was followed with an act by a Thomas Jefferson masked impersonator. Funny…no one asked him why the things he made (like the University of Virginia) were only for men.

Onward!

A Game of Catch – A Good Read

In the spirit of being back to school, I thought I’d hit you with one more OESH book review.

Every once in a while, I’m lucky enough to come across a great book that might not have the visibility we’re usually afforded with excellent literature. But A Game of Catch by our friend and daughters’ middle school English teacher, Proal Hartwell (at the Village School in Charlottesville, Virginia – the nation’s first all girls middle school), is too good to stay in the shadows for long.

A Game of Catch

 

 

Broadly speaking, not enough “readable” fiction has been able to bring across the turbulence and confusion of the American generation raised during the Vietnam War. Separating Catch from the pack is the absence of anger and the abundance of compassion in its central characters (Will on the left and Joe on the right).

 

 

 

However, without a master lighting up the manuscript, any book stops out at fiction, which isn’t necessarily literature. It’s in the hinge of this story that you know that you are in the capable hands of an artist. And when Joe Washington’s father visits an otherwise bleached Church congregation, it’s worth listening to the actual words of our author, as the minister “Dr. Taylor, tried to continue his reading, but faltered, aware that the real lesson was in the church and not on the page in front of him.”

From there, the story only gathers more heft. And grace.

You can get your own copy, right here.

Onward!

1:59 The Sub-Two-Hour Marathon is Within Reach – Not just a “Guy” Book

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Anyone who has ever run a marathon, is thinking of running a marathon or is even just thinking of someone who is thinking of running a marathon, will find this book an excellent read. Written by Phil Maffetone, with Bill Katovsky, friends of mine from the Natural Running Center, it’s packed with interesting facts (did you know that the Marathon has only recently been 26.2 miles?) and sensible but not commonly given advice for long distance training.

Phil predicts that soon, probably within the next few years, someone will break the two-hour barrier for running a marathon. (Currently, the official world record is two hours, three minutes and 23 seconds.) The person who does it first may become as famous as Roger Banister became for breaking the four-minute mile barrier when he was a student at Oxford University. Personally, I admire Roger more for becoming a brilliant physician. That’s another story, but speaking of fellow multi-talented physicians who change the world’s thinking, Phil Maffetone is one of these. Phil is not only a physician (and musician), he’s been a long distance training coach for many years, for many people, some of whom, without mentioning names, have been pretty famous.

Have you ever been told by a well-meaning coach, “No pain, no gain?” Thankfully, Phil provides medically sound arguments why that is not such a great idea. Rather, you need to listen to our own body. Phil discusses exactly how one goes about this “listening,” monitoring your resting heart rate when you first wake up in the morning, for example. He gives advice about how hard to train and for how long. He also gives advice for running form, nutrition, (provides a few recipes even), sleep and footwear (it should come as no surprise that he is not a fan of heavily cushioned, “supportive” running shoes). The book is meant to help anyone, not just an elite marathoner, run faster and more efficiently, with fewer injuries.

Phil talks about why he thinks Kenyans and Ethiopans are winning most marathons today and why he thinks that trend may not continue. Counter to common belief, he believes their success has little to do with genetics but is more largely due to their environment, which is changing.

Phil predicts that a man will be the first to run a marathon under two hours. BUT, he also predicts that soon after, a woman will break the two-hour barrier. The gender gap in world record time for the marathon is smaller than it is for shorter races. We women have a number of genetic and physical attributes that make us quite suitable for long distance running. The current woman’s world record is 2:15:25, set by Paula Radcliffe in 2003. Back when Roger Banister was running in 1954, Paula’s marathon time would have been THE world record, men and women included.

Mostly, the book is inspiring. I’ve run a number of marathons in my life, the first one when I was 15 years old and probably, at the time (1977), the fastest (and only) woman my age in the race. Although I run every day, I haven’t run a marathon for awhile, and wasn’t thinking of running one anytime soon…until I read this book. If and when I do, I’m counting on there being a lot of women my age to run with.

OESH Meets Autodesk Fusion 360

 

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We’ve just begun an exciting partnership with Autodesk, the world leader in 3D design software, to help take their latest CAD/CAM (computer-aided design/computer-aided manufacturing) software called Autodesk Fusion 360 to a new level. Simultaneously, they’re working with us on a new project that I can’t wait to share in the next coming months.

First I need to mention that most shoe companies don’t use 3D design software. Shoe designers typically design a shoe pattern in two dimensional drawings and leave the more sophisticated 3D modeling, engineering, and manufacturing to folks overseas. Can you imagine?!

When I was a department chair at the university, I must have been the only physician with 3D design software installed on my computer. First I learned a CAD program called Solid Works, which is what my engineering colleagues were using. That was good for designing a lot of engineery things we used in the laboratory but I soon realized I needed something more to model the complex organic footwear components I envisioned. Eventually, I mastered a CAD program called “Rhino 3D,” which is what my university architect friends swear is the best thing since sliced bread. It really does allow one to design beautiful organic yet scientifically based creations like, um, our basic OESH shoe form, illustrated above.

For the last few years we’ve been using a number of CAD/CAM programs including Rhino 3D, each helping us with a specific design or manufacturing task. For example, one program allows for designing REALLY organic shapes while another program allows us to write our own code. On the CAM side of things, we’ve been using a software package called “Visual Mill” to operate our CNC (computer numerical code) milling machine and another CAM program that is specific to cutting with our waterjet saw.

And now we’ve brought in our new CAD/CAM friend, Fusion 360, along with its brilliant development team, who look to be as visionary about 3D design and manufacturing as we are about shoes.

OESHers LOVE the Back To School SALE, now extended through 9/7/14!!!

OESHer Email #21Life at OESH continues to be incredibly active. I think we’ve all been amazed at not only how much manufacturing we can get done, but how much fun it is to do the manufacturing, too. Not to mention the designing of all-things-OESH, which is the overarching thought behind the super products you enjoy.

A virtuous circle, you might say.

Since the beginning of the month when we first emailed everyone on our OESHer Priority Email List a discount code for the Back to School Sale on any of the six La Vida v2.0′s, it has been CRAAAAAAAAAAAAAAAAZY busy while we’ve filled all the backorders.

Of course, the first thing we did when we finally caught up this week, was in looking at one another, we said “let’s go for it!” and thusly, WE’VE EXTENDED THE SALE until Sunday September 7, for the entire BTS week beyond Labor Day.

As we mentioned before, if you’re not on our list or know someone else who would like to take advantage of this opportunity to clip a significant amount from the sticker price (ongoing for another week-plus), we’d encourage taking a look-see at our La Vidas and writing to service@oeshshoes.com for the discount code. Which we will be happy to provide you.

Viva La Vida!!!

Thinking Outside the Boundaries

Who knew that making shoes would involve cutting so much metal? Recently, we cut all new slats for our Waterjet Saw. Slats are the long, sleek metal pieces that lay in the tank and hold the material about to be cut. I know, quite ironic that we cut slats on top of slats to make new slats. Anyway, we had about 10 slats in the tank which was sufficient but decided we needed more to maximize our cutting area. The problem was that the metal came in 4 x 8 sheets however; our cutting area is not that large. Therefore, we did what we do best here at OESH, put on our thinking caps and thought of a way to complete the unthinkable. We figured that with one cut here and an eleven degree cut there we could maneuver the piece to the exact angle where we could make perfect cuts for the slats.

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Waterjet Saw cutting slats from metal sheet.

After much brainstorming of how to cut the slats ourselves, we ended up with 35 new ones which, as you can see, was well worth the extra work! Bring on more cutting!

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The Science of Yoga

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Yesterday, I did a yoga session with a friend at the Charlottesville Hot Yoga Studio, which is just around the corner from the OESH factory. The 90 minute session was terrific in all aspects, including making me think about the biomechanics of the poses we did. Every day, I do a modified Warrior Pose/Lunge Exercise, as I demonstrate above and describe here along with my scientific rationale.

I’m one of a number of people who’ve studied the biomechanics of various yoga poses with a 3-D motion and force plate instrumented laboratory and in 2005, my research team and I published one of the first studies of the effects of yoga on walking here. That work led me to become a peer-review expert on yoga, being called upon, for example, to evaluate research proposals on yoga for federal funding.

Studying the biomechanics of walking and running led me to yoga much like it led me to make shoes. I found in our laboratory several things that had never been noticed before. The specific discovery leading to yoga was an isolated reduction in peak hip extension at the end of stance that consistently occurred in various pathologies and as we age (as I further describe and give references for, here). That finding could very well help explain why many of us get low back pain and have difficulty maintaining balance as we get older.

One of the ways I looked to improve this walking abnormality was yoga. I knew there to be several yoga poses that stretch the hip into extension, including the Sun Salutation and Warrior Poses. I hypothesized that yoga, which typically includes one or more of these stretches, would improve peak hip extension during walking. Indeed, that is what we found. We performed a preliminary study in healthy elderly subjects, which led to studies in other populations.

Of course yoga includes much more than just one or two poses that stretch the hip into extension. But at least we had a biomechanical foundation for understanding some of yoga’s physical effects. Which I believed was important to advancing our understanding of yoga, as well as exercise in general. It took time to get the powers-that-be interested in funding studies on yoga. On one extreme, there were the traditional Western trained physicians and scientists who didn’t understand yoga enough to be able to study it. On the other extreme, there were some outspoken yogis who believed that there was nothing about this ancient and unique mind-body practice that needed proving.

Meanwhile, yoga has exploded in popularity. And more and more people have turned to yoga for exercise and relaxation, as well as relief of bone, joint, and muscle-related pain. And in 2012, William Broad published a book “The Science of Yoga: The Risks and Rewards” that gave pause to many would-be yoga doers as well as put a whole new scrutiny onto yoga teachers. In his book, Broad brought to the public the many health benefits of yoga but also, a number of injuries that have occurred with yoga. While the book caused controversy in the yoga world, I believe much good has come out of it, including an appreciation for biomechanical research which has led to not only safer, but more effective poses.

George Salem, Ph.D. and his research group at the University of Southern California (USC), have been studying the biomechanics of a number of yoga poses in the healthy elderly population, described here. George is a former classmate of mine from UCLA where I received a Masters of Science in Kinesiology. For several years now, George has been studying yoga poses at USC using the same 3-D motion and force plate analysis techniques that I used at Harvard and at UVa. That type of analysis has allowed George and his team to evaluate for any given yoga pose, what muscle groups are stretched and strengthened and which ligaments and joints might be overstretched or over stressed, predisposing to injury.

George and his team have shown that several yoga postures aren’t working on the joints and muscle groups in the way that many yoga teachers had thought they were. They’ve also shown that some poses that were thought to decrease stresses to joints, actually increase stresses to joints. Their research has improved the practice of yoga, helping yoga teachers make modifications to a number poses. Most importantly, their research has led to the general recommendation that routines of poses always be tailored to an individual based on his/her musculoskeletal limitations.

With this research at hand, this is the current advice on yoga given by the American Academy of Orthopedic Surgeons:

“The American Academy of Orthopaedic Surgeons (AAOS) believes the rewards of basic yoga outweigh the potential physical risks, as long as you take caution and perform the exercises in moderation, according to your individual flexibility level. These rewards include improved strength, balance, and flexibility, as well as improved sense of well-being. Yoga may also be beneficial for certain bone and joint problems like carpal tunnel syndrome, tennis elbow, and arthritis.

Be aware that whether yoga enthusiasts are just stretching or assuming specific positions, serious muscle damage and related injuries can result if they do not take the proper precautions, especially for people with pre-existing musculoskeletal ailments or conditions.

According to the U.S. Consumer Product Safety Commission, there were more than 7,369 yoga-related injuries treated in doctors’ offices, clinics, and emergency rooms in 2010. Common yoga injuries include repetitive strain to and overstretching of the neck, shoulders, spine, legs, and knees.

There are many things you can do to help prevent yoga-related injuries.

  • If you have any medical conditions or injuries, speak to your doctor before participating in yoga.
  • Work with a qualified yoga instructor. Ask about his or her experience and credentials.
  • Discuss any known illness or injury with your yoga instructor prior to the class so that he or she can recommend pose modifications.
  • Learn what type of yoga you are performing. There are hundreds of different forms of yoga, some more strenuous than others. It is important to learn which type of yoga will best suit your needs.
  • Select the class level that is appropriate for you. Beginners should start slowly and learn the basics first — such as breathing — rather than trying to stretch too far.
  • Wear appropriate clothing that allows for proper movement.
  • Warm up thoroughly before a yoga session — cold muscles, tendons, and ligaments are vulnerable to injury.
  • If you are unsure of a pose or movement, ask questions.
  • Know your limits. Do not try positions beyond your experience or comfort level.
  • Keep hydrated by drinking plenty of fluids, especially if participating in Bikram or “hot” yoga.
  • Listen to your body. If you are experiencing pain or exhaustion while participating in yoga, stop or take a break. If pain persists, talk to your doctor.”

My personal experience doing yoga has only reinforced my appreciation for having a good yoga teacher who understands current biomechanics research. The teacher I had yesterday appropriately told us not to do anything we didn’t feel comfortable doing. And when we did a pose called the Pada Hastasana where an experienced yogi can bend down to put his/her hands under their feet, he enforced that it wasn’t necessary to get our hands all the way to the floor but rather it was important to keep our backs straight. Even if that meant for some, getting our hands down only as far as our knees. Doing that pose in this modified way stretches the hamstrings without stretching the small ligaments running along the back of the spine.

I can’t speak for each of the numerous yoga studios and teachers who may or may not be in-tune with current biomechanics research. But yesterday, leaving the Charlottesville Hot Yoga Studio, I felt better. More relaxed, happier. In a way that was different than after I go for a run. And all day today, I’ve been thinking much more about my posture and my movement, which is always good!