Posts for tag: Running
Whether you’re training for your very first marathon or preparing for your 10th, it’s important to begin your training program on the right foot. A lack of experience coupled with the repetitive impact placed on the feet and ankles during a long run can produce enough stress to cause hairline fractures and other debilitating foot injuries.
Many foot problems seen in marathoners are caused by the repetitive pounding over the months of long-distance running. With some people, injury is triggered by the abnormal foot biomechanics, and in others it is because of poor training. During a 10-mile run, the feet make about 15,000 strikes, at a force of three to four times the body's weight. Even if you have perfect foot mechanics, injuries and pain are often unavoidable with this amount of stress.
To prevent injury during training, it’s important to pay close attention to your feet. When increasing mileage, avoid doing so too quickly. The increased forced can make your feet more susceptible to stress fractures.
Basic tips for training include:
- Follow a training schedule that is appropriate for your experience level
- Start easy and increase your mileage slowly
- Stretch and warm up properly to reduce strain on muscles, tendons and joints
- Choose appropriate footwear based on your foot structure, function, body type, running environment and training regimen
- Never ignore pain. If the pain gets worse with reduced exercise and rest, stop training and visit your podiatrist
Aside from stress fractures which often occur from overtraining, additional foot problems you may experience include:
- Toenail problems, including ingrown and fungus
- Heel pain, such as plantar fasciitis
- Achilles tendon and calf pain
- Toe pain, such as bunions
- Shin splints
Before you start training, our practice recommends visiting a podiatrist for a complete evaluation of your lower extremities. Our office will examine your feet and identify potential problems, discuss training tactics, prescribe an orthotic device that fits into a running shoe (if needed) and recommend the best style of footwear for your feet to allow for injury free training all the way up to your race day. It is especially important to come in for an exam if you have already started training and are experiencing foot or ankle pain.
Training for a marathon is hard work. It takes time and dedication. At our practice, we offer special interest and expertise working with marathoners to ensure good foot health throughout your entire training program to help you achieve your goals.
If you're a runner, it goes without saying that your feet take the brunt of the punishment. In fact, for runners the feet are more vulnerable to injury than any other part of the body. Luckily, both long-distance runners and casual joggers can improve their performance by paying extra attention to their feet and taking steps to prevent common foot problems. Poor fitting footwear is often the source of many foot problems caused by running. A visit to our practice can help you determine the best shoes for your foot structure.
A Runner's Roadblock
While many running-related foot injuries can result from a fall or twisted ankle, most running injuries are caused by overuse, meaning the majority of runners experience foot and ankle pain because they do too much for too long. Runners should be aware of the signs of foot problems that can slow them down if not treated promptly. Common foot and ankle injuries experienced by runners include:
Achilles Tendonitis: Achilles tendonitis and other calf-related injuries are prevalent in runners. Poor training, overuse and improper footwear are the three most common reasons for this condition. A sudden increase in distance or pace can strain the muscles and tendons in the foot and ankle, causing small tears within these structures that result in pain and inflammation. Appropriate shoes and training are the most important steps to preventing Achilles tendonitis. Conservative treatment includes rest, ice, stretching and sometimes orthotics or physical therapy.
Heel Pain: Runners develop heel pain more than any other foot-related injury. Plantar fasciitis is the most common cause of heel pain, the result of placing excessive stress on the ligament in the bottom of the foot. Rest, stretching and support are the best ways to ease the pain and inflammation. Reduce your mileage and avoid hill and speed workouts. Stretch before and after you run, and ice your heel after each workout. Special splints and shoe inserts from our practice may also provide support and relief for your heel pain.
Stress Fractures: Stress fractures are small cracks in the surface of a bone. Runners generally notice gradual muscle soreness, stiffness and pain on the affected bone, most often in the lower leg or the foot. Early diagnosis is critical, as a small fracture can spread and eventually become a complete fracture of the bone. Stress fractures are typically caused by increasing training more quickly than the body's ability to build up and strengthen the bone.
If you have symptoms of a stress fracture, you should stop running immediately and see a podiatrist. This injury can keep a runner off the track for several weeks, and is not an injury that you can run through. Depending on the severity of the stress fracture, a cast may be necessary.
If you experience chronic foot pain from running, make an appointment with a podiatrist. Leaving foot injuries untreated could result in more serious conditions, ultimately keeping you from your best performance. Keep in mind that these are not the only foot ailments caused by running, and when at-home foot care isn't effective, you'll need to be evaluated by a podiatrist. As in most cases, prevention is the best medicine. Good footwear, proper training and recognizing a problem before it becomes serious are your keys to staying on the road and avoiding foot injuries.
Finding the perfect running shoe can be a difficult task. A good running shoe can maximize your performance but a bad one could plague you with injuries. There are many factors that go into purchasing the perfect shoe.
There are generally 7 categories of shoe construction and knowing a little about these categories will help you make a better choice. Neutral shoes have a good blend of flexibility and stability. Flexibility shoes offer more shock-absorption. Stability shoes offer high stability and cushioning. Motion-control shoes provide rigidity and stability. Trail running shoes offer increased toe protection, outsole traction, stability and durability. Cushioned shoes are those with little support but more shock absorption. Lightweight shoes come in varying degrees of stability and cushioning.
Arch type is very important in choosing the correct shoe. Do you have a high-arched foot, one that supinates? If your feet do not roll enough, the legs absorb extra shock. Runners should seek added cushioning but not extra support. Flat-footed runners often overpronate; their feet roll inward more than the ideal amount, increasing the risk of injury. Added cushioning and support can help. The normal arched runners have a natural rolling of the foot after impact that dissipates shock. You have a little more leniency as far as shoe choices.
By understanding the parts of a shoe you can make informed choices about which running shoe is best for you and your feet.
Running shoes are formed on a last. Running shoe last patterns are important for stability. Straight lasts are built along the shoe’s straight arch to provide maximum stability. Semi-curved lasts are molded straight toward the rearfooot while having some curve toward the forefoot. This provides stability and flexibility. Curved lasts are built to curve from the toe to the heel.
Consider your weekly mileage. Are you running more than 32 miles, less than 18 or somewhere in between? Those running high miles may need to invest in a shoe with increased durability. Next, you must consider your BMI. Heavy runners need the added cushion and control. Remember to replace your shoes every 500-600 miles.
Running shoes are changing rapidly. The major shoe companies roll out new designs twice a year. Many offer midsole air, gel, and tube chambers; springs; recoil plates; Gore-Tex and other membrane fabrics; breathable liners and mesh outer fabrics; and better support and stability.
Do your homework, study the shoe reviews and discuss with your doctor.
The following are some of the ways my patients have described the pain from a neuroma: “It feels like I’m stepping on a pebble,” “I feel like my sock is wadding up under the ball of my foot,” “I feel a burning pain between my toes,” and sometimes “my 3rd and 4th toes are numb – is it diabetes?” Well, it’s not diabetes (in most cases). It is most likely a common condition called a Morton’s Neuroma, something we podiatrists treat daily.
What exactly is a Neuroma?
It’s actually a bit of a misnomer. It is not a tumor at all. It is in fact a swollen, inflamed nerve located between the bones at the ball of the foot. It can be between the 2nd and 3rd toes or the 3rd and 4th toes. The nerve can actually become so enlarged that it pushes the toes apart when you stand up (called a Sullivan’s sign). It is seldom found between the big toe and 2nd toe or between the 4th and 5th toes.
Who gets it?
Mostly adults, but occasionally I have seen it in teens. Women are more likely to suffer from a neuroma. Perhaps due to the shoes they wear. High heels can cause the foot the slide down in the shoe and compresses the ball of the foot in the toe box. Participating in high-impact athletic activities such as jogging or running may subject your feet to repetitive trauma which can also lead to a neuroma. Foot deformities like bunions, hammertoes and flatfeet can also be predisposing factors.
So, how do we diagnose it?
In most cases, clinical findings alone are sufficient. A positive mulder sign is when the doctor squeezes the ball of the foot with one hand, while concomitantly putting pressure on the interdigital space (on the bottom of the foot between the two metatarsal bones) with the other hand. A click can be felt as well as pain in most cases. An ultrasound and/or MRI can also be used for diagnostic purposes, but the neuroma can sometimes be missed with these imaging studies.
How do we treat it?
A custom orthotic with a metatarsal pad included to relieve pressure from the neuroma is usually the first line treatment. Steroid injections can also be very helpful to decrease the inflammation. Another kind of injection called a sclerosing injection (alcohol based) can also be used to deaden the nerve. These injections are usually given in a series (every 10 days or so – anywhere from 5 to 10 total). If conservative care fails there are also surgical treatment options. There are two kinds of surgery for neuromas: one releases the ligament compressing the nerve and the other involves removing the nerve. Happily, most people recover with conservative care alone and do not need surgery but if conservative care fails surgery can be a welcome relief from the constant pain.