British marathoner Paula Radcliffe lately has been plagued by injuries. In fact, she had to pull out from this weekend's London marathon after breaking a toe. She since has had bunion surgery and is hoping the realigned foot mechanics will end her long stream of injuries. After running the marathon for the Beijing Olympics just four months after breaking a leg, she is focused on her 2012 goal of medaling in the London Olympics, her home city.
A bunion is an enlargement of the great toe joint. It, however, is not from a growth of bone, but rather a shifting of the first metatarsal bone due to unstable mechanics. The forces causes the great toe to shift towards the second to and the metatarsal bone to shift out of alignment. Bunion surgery, when necessary, realigns the relationship of the bones, but does not alter the underlying mechanics that caused the bunion in the first place. If left uncontrolled, the bunion can return over time and can even require a second surgery.
The best way to balance the lower extremity is with the use of a custom orthotic. An orthotic redistributes the mechanical pressures, permitting the feet to function as a more stable unit. This allows for more a more efficient gait in walking and running. It also helps to moderate the deforming forces that caused the bunion in the first place.
In 2012, Paula Radcliffe will be 38 years old. It is not unheard of for a woman of 38 to win Olympic gold in the maraton. Constantina Dita of Romania won the Beijing marathon this past summer at the same age. Lets just hope that Paula is able to rehabilitate and resume her training, injury free, while taking all the necessary precautions to allow her body to function at peak performance.
Monday, April 27, 2009
Friday, April 10, 2009
Treadmill Running...Just Slow Down!!
I was reviewing the post about Madonna falling off of her treadmill and started thinking of the multitude of injuries I see due to the perceived safety of a treadmill. True, the surface of a treadmill does absorb shock, but there is a major natural pitfall with using a treadmill.
When you run - for real, with real forward progression - you are in control. As you tire, what happens? You slow down, of course! Not so on a treadmill. We typically set a speed and stick with it the whole way, for better or for worse. Some can maintain that steady pace, but most can not. As we tire, we'll naturally shift the upper body forward and the running gait will be more unnatural. What will happen? The anterior muscle group of the lower extremity (the front of the leg) will be overworked, as will the Achilles tendon. Then comes the pain...shin splints most commonly along with Achilles pain.
So what do you do to stop it? Well, just slow down! Not by a lot...every so often, maybe after the first third of the run or walk, lower the speed by 0.2 mph. This will allow for the natural fatigue of your body.
If you wait too long and start to feel some discomfort, drop the speed even more, by as much as 0.5 mph to even a full mph. Then, depending how you feel, slowly increase your speed. If the pain persists, be sure to visit your podiatrist sooner than later.
A treadmill is not meant to be a passive experience. Be sure to listen to your body and make appropriate adjustments along the way.
When you run - for real, with real forward progression - you are in control. As you tire, what happens? You slow down, of course! Not so on a treadmill. We typically set a speed and stick with it the whole way, for better or for worse. Some can maintain that steady pace, but most can not. As we tire, we'll naturally shift the upper body forward and the running gait will be more unnatural. What will happen? The anterior muscle group of the lower extremity (the front of the leg) will be overworked, as will the Achilles tendon. Then comes the pain...shin splints most commonly along with Achilles pain.
So what do you do to stop it? Well, just slow down! Not by a lot...every so often, maybe after the first third of the run or walk, lower the speed by 0.2 mph. This will allow for the natural fatigue of your body.
If you wait too long and start to feel some discomfort, drop the speed even more, by as much as 0.5 mph to even a full mph. Then, depending how you feel, slowly increase your speed. If the pain persists, be sure to visit your podiatrist sooner than later.
A treadmill is not meant to be a passive experience. Be sure to listen to your body and make appropriate adjustments along the way.
Sunday, April 5, 2009
It's Just a Step To The Left...
No, this isn't doing the "Time Warp!" I'm more interested in my runners who come in complaining about foot, ankle, shin, knee, or hip pain ON ONE SIDE. Here in Houston, TX we have major drainage issues, so all of our streets are banked.
So when runners come into my office, they have done online searches and have a million reasons why they are hurting. They have bought all sorts of supports and liniments to make them feel better...but they don't seem to work. They come in complaining of their IT band hurting, or some shin splint pain on one side and expect me to run a whole barrage of tests to tell them in a high-tech way why they hurt and how to solve it. Then, after I listen to them, I ask the most important question:
What surface are you running on?
Invariably I'll hear an answer that they're running on the side of the road, or another similar uneven surface. I watch as they brace to hear a lecture on how "asphalt is a terrible surface" or "never run on concrete." Instead I ask my next question:
Where on the road do you run?
This is a loaded question...I know pretty well that they're not running in the middle of the road (if they were, there would be bigger problems than limb pain). They're, of course, running harmlessly on the side of the road. A-ha!!
When someone runs on the side of a banked surface, like the local Houston roads, they are essentially creating a leg length difference. This will cause the two feet to function very differently. One limb is going to compensate by attempting to lengthen and the other is going to shorten. A significant imbalance will result and can cause a variety of pains. My great wisdom for these runners?
Take a step to the left...
That's all? That's what they came in for? Well...yes. Sometimes a simple change makes a huge difference. By running on a more even surface, it allows for a more stable and even base and doesn't overwhelm the mechanics. My advice is to not take time off. Nurse the injury with ice and some anti-inflammatory medication, and be more aware of where they're running. I ask them to call me in a week to tell me how they're doing.
The results are amazing! A small adjustment like this causes the lower extremity to even up and makes a huge impact on the biomechanics. The pain gradually improves with essentially no time away from training!
So when runners come into my office, they have done online searches and have a million reasons why they are hurting. They have bought all sorts of supports and liniments to make them feel better...but they don't seem to work. They come in complaining of their IT band hurting, or some shin splint pain on one side and expect me to run a whole barrage of tests to tell them in a high-tech way why they hurt and how to solve it. Then, after I listen to them, I ask the most important question:
What surface are you running on?
Invariably I'll hear an answer that they're running on the side of the road, or another similar uneven surface. I watch as they brace to hear a lecture on how "asphalt is a terrible surface" or "never run on concrete." Instead I ask my next question:
Where on the road do you run?
This is a loaded question...I know pretty well that they're not running in the middle of the road (if they were, there would be bigger problems than limb pain). They're, of course, running harmlessly on the side of the road. A-ha!!
When someone runs on the side of a banked surface, like the local Houston roads, they are essentially creating a leg length difference. This will cause the two feet to function very differently. One limb is going to compensate by attempting to lengthen and the other is going to shorten. A significant imbalance will result and can cause a variety of pains. My great wisdom for these runners?
Take a step to the left...
That's all? That's what they came in for? Well...yes. Sometimes a simple change makes a huge difference. By running on a more even surface, it allows for a more stable and even base and doesn't overwhelm the mechanics. My advice is to not take time off. Nurse the injury with ice and some anti-inflammatory medication, and be more aware of where they're running. I ask them to call me in a week to tell me how they're doing.
The results are amazing! A small adjustment like this causes the lower extremity to even up and makes a huge impact on the biomechanics. The pain gradually improves with essentially no time away from training!
Wednesday, April 1, 2009
Running Stores Know Runners
I had an opportunity to sit down with the store manager and shoe manager of Luke's Locker, a specialty running store here in Houston. The partnership between a good running store and their clients is a vital one. They're the ones that stay on top of the new shoe styles, monitor changes and "upgrades" and can best identify when a shoe is not appropriate for a particular runner.
Staying on top of changes in running shoes is tough. Most shoe companies will "upgrade" a shoe as often as twice a year. Why the quotes? Well an upgrade may end up being an entirely redesigned shoe with a new last but with the same name. While it may have been the right shoe for you at one time, it no longer may fit right once it was updated.
Most podiatrists are unable to keep up with the constantly changing variety of shoes. Since I see lots of runners, triathletes, and other athletes, I do my best to stay abreast of changes, but I often refer to the experts. A specialty running store has knowledgeable managers who educate their salespeople as to the appropriate shoes for foot types. Some even bring in podiatrists and other experts into their stores to run workshop for their sales staff and even for their customers.
A properly fitting shoe is vital to foot health in general, but especially if you're involved in an exercise program. Proper shoes can not solve all foot problems (otherwise I'd be out of business) but they're an important step to providing the environment that will be most helpful in healing many foot issues.
To learn more about how running effects the feet, visit www.tanglewoodfootspecialists.com
To find a location for Luke's Locker, visit www. lukeslocker.com
Staying on top of changes in running shoes is tough. Most shoe companies will "upgrade" a shoe as often as twice a year. Why the quotes? Well an upgrade may end up being an entirely redesigned shoe with a new last but with the same name. While it may have been the right shoe for you at one time, it no longer may fit right once it was updated.
Most podiatrists are unable to keep up with the constantly changing variety of shoes. Since I see lots of runners, triathletes, and other athletes, I do my best to stay abreast of changes, but I often refer to the experts. A specialty running store has knowledgeable managers who educate their salespeople as to the appropriate shoes for foot types. Some even bring in podiatrists and other experts into their stores to run workshop for their sales staff and even for their customers.
A properly fitting shoe is vital to foot health in general, but especially if you're involved in an exercise program. Proper shoes can not solve all foot problems (otherwise I'd be out of business) but they're an important step to providing the environment that will be most helpful in healing many foot issues.
To learn more about how running effects the feet, visit www.tanglewoodfootspecialists.com
To find a location for Luke's Locker, visit www. lukeslocker.com
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