When and How Often to Replace Your Orthotics

An orthotic is a vital piece of equipment for those who wear them. They provide support and comfort when running and playing sports. They also help people get through their day outside of sports and exercise.

One of the biggest misconceptions is that orthotics should only be used for exercise and athletics. This couldn’t be further from the truth! The function of an orthotic is to provide support to the foot to allow the lower extremity to work more efficiently. For that reason, wearing them only for exercise puts you at a disadvantage.

Muscles have memory and enjoy consistency. If you only wear an orthotic for exercise, that only accounts for 10% of your day…maybe even less! Think about it this way: Let’s say you could only use your car 10% of the time, but you had to walk the rest. You’d be pretty tired, right? So think about your feet and legs only being allowed to work at peak performance for that same short time.

To make it easier to wear an orthotic throughout the day, they can be made to fit an athletic shoe, dress shoe, women’s high heels, western boots…anything where the heel is closed in. For those who enjoy a more open shoe, some sandals, such as Bite, can accommodate an orthotic. Other sandals, such as Birkenstock and Naot, can be custom made with an orthotic built in.

There are many factors that determine the useful lifetime of an orthotic. The first is the material the orthotic is made from. In my Houston podiatry practice, the orthoses we fabricate are made a firm plastic material. Because this material is durable and wears very little, the orthotic generally lasts about four to five years. Softer materials, such as cork, leather, and foams, will deform with time and has a much shorter lifespan of one to three years, depending on how it is constructed.

Another factor is your activity level. A marathon runner is harder on their feet than a “weekend warrior.” The foot is dynamic and must change with every step and manage forces. So the foot changes with time and those who are more active notice quicker and more dramatic change. This will require a change in orthotics sooner, simply because of a change in mechanics.

Finally, there are other issues that will cause an orthotic to be replaced. A major joint replacement, such as a knee or hip, will alter the mechanics of the lower extremity significantly enough to warrant a new orthotic. Generally, I wait six months for the joint to “settle in” until I move forward with evaluating for a new orthotic. Many women see changes in their feet and mechanics during and after their first pregnancy. This will occasionally require a reevaluation for new orthotics.

And let’s not forget about our household pets. If your puppy chews up your orthotic – we’ll need to replace them then too!

Paula Radcliffe Wins NY Half Marathon after Recovering from Bunion Surgery

Former, and possibly future, Olympian Paula Radcliffe won the New York Half Marathon on Sunday. This is her first race since the New York Marathon in November and also her first after recovering from bunion surgery. She will assess her progress in the next few days to see if she will pursue the World Championships Marathon in Berlin.

This is great news. One of the most common concerns my patients have when considering bunion surgery is whether or not they will be able to return to running, triathlons, or any other athletic activities. I'm pleased that I'll be able to point to Ms. Radcliffe as someone who recovered from bunion surgery and rehabilitated several other injuries and has been able to return to a world-class level.

One treatment that is likely helping her at this point is a custom orthotic. An orthotic is a custom insole that supports and stabilizes the lower extremity. It balances the mechanics to remove the forces that deform the foot and cause a bunion. An orthotic allows the foot to work at it's most efficient and prevents a recurrence of the bunion. I hope that Paula's doctors have her in a custom orthotic so she can continue to pursue her goals.

Black and Blue Toenails From Running

Many runners have been surprised to take off their socks after a run to notice that one or more of their toenails is turning black and blue. Many times the bruised toenails can look much worse than they are, but there is actually a simple explanation for this condition.

If a runner does not wear shoes that fit them properly then their feet are able to slide in their shoes. This can occur if running shoes and too big because the foot will slide around in the shoe and bang up against the front edge. This can also occur if shoes are too small because the toes begin to jam up against the front of the shoe. This is why it is so important to get shoes that fit properly in order to prevent the toes front hitting the front of the shoe to hard.

If the nails are turning black and blue from the toes hitting up against the front edge while running don’t be alarmed. The color change is from micro lesions under the nail from where tiny capillaries have broken. If you notice this discoloration the best way to get rid of this is to stop running in the same shoes that caused this condition.

Most of the time the discoloration does not cause much discomfort, however, the nail can become infected if it is not kept clean so make sure you wash around the nail to prevent infection from occurring. Sometimes if there is enough bleeding under the nail pressure can build which will cause discomfort. If the nail starts to become painful, then you will want to go to get evaluated by a podiatrist. The pain either signifies infection or pressure build up from bleeding under the nail, both of which can be easily treated by a podiatrist.

A bruised nail does not automatically mean that you will lose the toenail. If there is substantial bleeding beneath the nail and a podiatrist relieves that pressure quickly, then the nail can reattach to the nail bed. Otherwise, the prolonged trauma from the pressure can cause the nail to detach and a new nail to begin forming and growing. If that occurs, the original, damaged nail will simply fall off when the new nail has progressed. As long as the nail comes off with no pain or bleeding, there should be no concern.

Bruised nails are a common sign of running shoes not fitting properly. If this occurs, get new running shoes. Your best bet is to visit a specialty running store, which has staff trained to properly assess your needs to recommend the right shoe for you and to ensure that shoe fits properly. If you have any pain with the injured toenail, be sure to get in to visit your podiatrist.

Training for a Half Marathon

Half marathons are a very popular length race to run. For those runners who are well trained, hard-core athletes the half marathon has its appeal because it can help train them for a full marathon. Many training schedules include a half marathon as one of its long runs in order to help get an athlete in prime condition for a marathon. In fact some marathons will even take half marathon times for qualification for a starting corral.

For other runners who are maybe just getting into running, very young or very old, or people who don't have as much time to train, a half marathon has an appeal for an entirely different reason. For the beginners a half marathon is seen as a reachable goal. Many new runners may be overwhelmed by how far a marathon is, but the option of running a half marathon seems to be a much more feasible, yet still respectable goal. For those people who fall into the category of being very young or very old, a half marathon is a popular option to prevent them from getting injured by attempting to run a full marathon.

Whether you are the well trained athlete, the beginner, or on either end of the age spectrum there are some things about training for and racing a half marathon that apply to all runners. First, always pick a training schedule that is right for your experience level. There are many free training programs out there that range from beginner to expert. It is important to use these schedules in order to know that you are not over working your body too quickly and making sure you get the right amount of rest that your body requires to replenish its essential chemicals. Second, it is important to always stretch before and after each run to help prevent injuries from occurring. Third, remember that the more that you run the more you must eat and drink to compensate for the extra calories and sweat you’re burning. Lastly, make sure you have a good pair of running shoes that give you the right stability and support you need to sustain the number of miles you will run throughout your training and race.

Half marathons are a great length because they allow people of all running abilities to participate. As long as the runner follows a training schedule, stretches, and takes care of their feet they will have a healthy and successful race.

Running While Pregnant

There are many dedicated female runners who become pregnant and are faced with the decision of taking the next 9 months off from running or continuing to run while pregnant. There are varying opinions out there about how much exercise a woman should or should not do during pregnancy. This can be confusing for a woman who is looking for a clear cut answer. The reason for the ambiguity is that there is no absolute “yes or no” answer to if a women should continue to run during pregnancy. The answer depends on the health, level of running a women usually does, and difficulty of pregnancy of the women.

One thing that most experts on this subject agree on is that women should stay active during their pregnancy as long as they do not overexert themselves. If you are a long distance runner, then you are going to need to tone down your training schedule because any stress or strain you put on yourself will also be put on your child. It is also important to remember to never let yourself become overheated because when you overheat so does you baby. If you live in hotter climates, such as Houston, then you are going to have to consider moving indoors for your runs. Runners do love, and even depend on, their routine. Pregnancy, however, requires some of your routines to change.

There are also many side effects of pregnancy that may limit a woman from running certain speeds, distances, or even running at all. During the first trimester, women commonly feel morning nausea which may prevent those who are used to running in the morning from continuing their morning running routine. During the second and third trimesters, the feet also can become swollen which can prevent women from running. Women should not attempt to run away the swelling in their feet because this may overwork the heart as it attempts to pump the excess fluid against gravity while also keeping up with the stress of running.

Running is a very important part of many women's lives. It is important for pregnant women to know the facts about running while pregnant in order to keep their body and their baby’s body safe. It is also important to communicate with your doctor and podiatrist about running during pregnancy so that they are well informed of your physical activity during pregnancy so they can best inform you of any side effects you may experience.