Forget The Pain, Running Injuries Can Be Depressing!!

Earlier this year I treated a patient who ran the Houston Marathon and jumped right into training for the upcoming triathlon season the following week, against my advice, while nursing a painful case of posterior tibial tendon tendonitits. Unfortunately this approach eventually sidelined him and forced him to scrap the entire triathlon season in order to undergo surgery and recover from his injury. This eventually led to a major case of depression which far outlasted his recovery from injury and almost kept him out indefinitely.

By nature, athletes have an extremely high tolerance for pain and at times tend to view their injuries as a normal part of their training regimen often to the point of ignoring serious symptoms. Posterior tibial tendonitis is a common injury in runners usually resulting from chronic overpronation and overuse caused by the repetitive force and trauma asociated with overtraining. Symptoms usually begin as soreness along the inside of the ankle and/or arch when pushing off and can eventually lead to weakness and severe pain. Left untreated, it can progress to a tear which usually requires lengthy immobilization or surgical intervention causing a major delay in any training regimen. However, if the injury is caught early and treated aggressively, it can be done without any interruption or possibly a slight, brief alteration in the training schedule while avoiding a lengthy delay which can spoil any runner's plans.

In this particular case, my patient underwent approximately 8 weeks of physical therapy, anti inflammatories and forced rest. During this time he became discouraged, angry and unmotivated, even though I recommended cross training to maintain at least some level of fitness so that his return to running would not be so traumatic. He resisted the entire time and even admitted to feeling "worthless" at one point. Once he was pain free, he was still afraid to resume running for fear he would reinjure his foot and it would sideine him again.

About 3 months after stopping running completely to rehabilitate from his injury, he began cycling, swimming and using the elliptical machine gradually. More recently, he resumed running starting at a much reduced distance than where he left off, and he is starting to regain confidence and a sense of self worth.

He now realizes what caused his depression and I have no doubt that he will return stronger than ever. More importantly, I think the lesson he learned and one that all athletes should learn, particularly runners, is not to ignore any injury. No matter how small or insignificant you may think the injury is, it can become significant if it is not addressed early and aggressively. The resulting depression from the mental trauma of having something so meaningful and enjoyable taken away can lead to an even more prolonged layoff from which you may never fully recover, long after the injury has healed.

The Nike Free Running Shoe

Nike has developed a line of shoes called the Nike Free that has become very popular among long distance runners, track and field athletes, and football and basketball players. Nike Free is unique because it has a special design incorporating new technology that simulates barefoot running mechanics while still wearing shoes. The goals that barefoot running technique strives to reach, and that Nike Free has adapted, is attempting to strengthen the intrinsic muscles of the foot and leg thus preventing long term injuries.

Although Nike Free has become popular among runners there are some important things to take into consideration when deciding to buy these shoes or not.

1) Versions - If you do a little research on the Nike Free you will come to find out that there are actually many different versions of this shoe. The Nike Free can be ordered on a scale of 10.0 to 3.0 with 10.0 being the most supportive shoe and the 3.0 being the least supportive and most similar to barefoot running.

2) Ease into the Shoes - If you have never done any barefoot running, or ran in any minimalist shoes that strive to achieve the same goal as Nike Free shoes, then it is important to ease your way into these shoes. It is recommended to start off running a mile in these shoes and then gradually increasing your distance based on your body’s response to the shoes.

3) They aren't for everyone - Although Nike is continuously trying to find ways to make small changes and adding versions to the Nike Free to allow the largest population of runners to use them, these shoes still aren't for everyone. If you don't run consistently, need extra-cushioned running shoes, or are prone to ankle sprains, I would not recommend these shoes to you. The Nike Free is really built for routine runners with no other major foot problems. Furthermore, barefoot-style running requires significant changes in running mechanics to be successful. If you run in these shoes just as you would in a structured running shoe, you will put yourself at risk for becoming injured.

Nike Free technology has really changed the face of running shoes, opening a whole new vision into what running shoes could do for your feet and body. Although these shoes are becoming increasingly more popular in the running community, these shoes simply aren't for everybody. Be sure to visit with your sports podiatrist who can help recommend the right shoe for you.