Top 5 Running Injuries

Dr. Peter Wishnie of Family Foot & Ankle Specialists in Piscataway and Hillsborough, NJ discusses the top 5 running injuries amongst runners at the annual Hillsborough Hop 5K. Unfortunately, plantar fasciitis (heel pain) made the list.

TightRope Procedure

Stop bunion pain today! New advancements in bunion surgery...
Dr. Vargas Performs New Tightrope Procedure for Bunions!!
Revolutionary procedure for bunions using a device called a tightrope. There is no doubt that this procedure represents a huge advancement in bunion surgery.

Traditionally, the bunion procedures I perform involve a bone cut to reposition the bone which is held together with a pin or a screw. Following the surgery, patients walk around in a cast boot for 4-6 weeks to allow for bone healing. With the new tightrope procedure patients experience a faster recovery, less pain and fewer complications. Patients are out of the cast boot and into regular shoes as soon as 3 weeks postoperatively.

While the tightrope procedure is not indicated in every type of bunion deformity, it can be performed in the vast majority. It represents a revolutionary change in bunion surgery and will allow more people to undergo bunion correction due to a faster recovery, less pain and fewer complications. This means fewer days missed at work or less down time with the kids – 2 of the main reasons many people avoid bunion correction.

Dancing With the Stars: Another Foot Injury?

What doe this have to do with running? A lot, if the training before a race or before a dance performance is not done properly.

Donny Osmond is the latest in a series of injuries from the reality show "Dancing with the Stars." He was dancing this week with a broken toe. A fractured toe can be quite painful, depending on the location, angle, and severity of the break in the bone(s). I speak from personal experience on this injury. I fractured one of my toes while I was a surgical resident and had no choice but to work, walk on it, wear closed toe shoes, and stand on it for prolonged periods of time. However, I did not continue to run or dance or engage in other sports for the weeks that was required for it to heal.

But...there seems to be a trend on this show with injuries and the stars continuing to dance and perform while injured. We saw this in the past few weeks with Tom DeLay who continued to dance on stress fractures in both feet until it got to the point where he had to quit the show...eventually. Other previous foot & ankle injuries included Misty-May Treanor with a ruptured Achilles tendon, Lance Bass with a toe fracture, and Kristi Yamaguchi with an ankle injury.

This is similar to what us physicians see with "weekend athletes" or runners to try to do too much, too soon. Proper sports training is just that--training. If an athlete is a beginner, such as these celebrities, with respect to a particular sport, then a gradual and incremental training process in necessary to prevent injury. If this does not occur, injury is more than likely to happen. So it is not surprising to me and many of my colleagues that these stars are getting injured at such a high rate. Perhaps the medical professionals associated with the show could point this out to the show executives and try to do something about it...or perhaps we will continue to see another series of injuries in upcoming episodes.

What do you think? Feel free to comment below on this possibly controversial subject. In my professional, medical opinion, it is quite obvious what will occur if changes are not made in the show's training schedule.

Are Your Legs Different Lengths?

From early in the development process, the body's two halves develop independently. As they develop, usually they will be very similar and almost identical. But since they are independent, each individual has eyes that are different sizes, nostrils that are different sizes and ears that are different sizes. This difference can also be seen in different size feet and legs. In many individuals this may be without problems, but in a runner this matters.

Which foot is larger?
- When fitting shoes, ensure that you know which foot is larger and fit that foot especially. A shoe that is too small (even for one foot) will predispose a runner to more injuries from loss of toenails, to ingrown toenails, to blisters and even stress fractures. Check your feet and fit both feet to the shoes, especially the larger foot.

Which leg is longer?
- If the leg length difference is only minor, you will often not notice any difference and can continue to run without difficulty.
- If one leg is longer, it is important to understand this and modify your training as necessary. Do you need a heel lift to even the legs and reduce the pronation force on the shorter leg? Do you need to switch sides of the road you run on so the longer leg is on the down side of the road? Is the pain you currently have when running due to the leg length difference.

Although these differences are normal, injury and pain can be the result of not recognizing even the smallest foot or leg length differences.

For additional information on leg length differences, visit Dr Gibson's blog at www.UtahRunDoc.Blogspot.com or his website at www.UtahFootDoc.com.

How do I begin to train for my first marathon?

This is a question that comes often in our office, so here are a few things to keep in mind:

Running a marathon requires both physical and mental strength, focus, commitment, and time. If you do take this step and make the commitment, you will find that completing a marathon could be one of the most satisfying experiences of your life.

Getting Started:
*Training to run a marathon will test your physical limits and stretch the boundaries of your endurance. Before you hit the pavement and before you purchase equipment, you must first formulate a plan and educate yourself on all aspects of marathon training. It is similar to planning a trip. Once you find out where you want to go you have to figure out how to get there. Give yourself at least 6 months of training to get there.
*Set a date. Find out when the next marathon in your area will be by checking a marathon calendar or a marathon guide.
*Start running regularly. It will be extremely helpful to have your body used to running when you start a 16-week training program.
*If you haven't exercised in some time, allow yourself more time to train and try an 8-week conditioning program. Listen to your body. Your body might adjust quickly, or it might take a little longer to be ready for the marathon training program.

Invest in the proper running equipment:
*Running shoes are the most important purchase you will make on your quest to successfully train and participate in a marathon. You will be putting more miles on them per week than all of your other shoes combined. The right shoes will alleviate stress in your legs and back. Before you visit a running shoe store, check with your podiatrist to see what it is that YOU need in a running shoe. Is it stability, cushion, motion control, or would you be best off with a light weight trainer? Your podiatrist can help you with this by evaluating your foot type and your gait pattern.
*Having the right running clothes isn't as important as having the right shoes. However, you must know what type of clothes to avoid and what clothes can aid you while you train.

Preventing Injury:
*Once you begin your training program, injury prevention will be of utmost importance! Stretching, warm-ups, proper training, and nutrition will all come into play during your training in order to prevent running injuries.
*If you do experience pain in your feet or ankles while running, it is very important to visit your podiatrist right away to diagnose the problem and get proper treatment. Don't make the mistake that many people do when they think "it will go away eventually."

Walking for Cancer: How to Save Your Feet!

Throughout the summer and into the fall, many hit the city streets to walk for breast cancer, arthritis, and many other devastating medical conditions. If you have ever participated in a Breast Cancer walk, you know the emotional drive behind finishing the race for yourself, and loved ones. Nothing stands in the way of a herd of women and men in pink. Well, maybe foot pain. Many of these walks are 20+ miles a day and for most of us, we don’t normally put that kind of millage on our feet. Even if you are an avid runner, walking applies different kinds of forces on your feet compared to running so don’t be surprised if you have some aching feet. Is there anything to prevent the blisters, aches, and pains during and after the walk? Here are some helpful hints to prepare you for your walks against cancer!
Train, train, and more training!
You may think that walking doesn’t take too much training, but it does! Just as marathon runners prepare for the big race, walkers should train for their big walk. Some walks are 50+ miles long. When was the last time you put that kind of mileage on your body? The best way to prevent injury is to build up your body’s endurance and appropriate muscle support. Walk daily and slowly increase the distance daily and weekly.

Don’t Forget Your Shoes!
Most walkers wear the wrong size shoes which can cause blisters, loss of toenails, and aches and pains. Proper fit is one of the most important factors in finding the correct shoes for your walking adventure. Make sure you try both shoes on and walk around in them before you buy them. While standing (not sitting) you should have about a fingers width between your big toe and the end of the shoe. Make sure the shoe is wide enough. You should be able to freely wiggle your toes inside the shoe. Buy your shoes several months before the walk and train in them. Never wear brand new shoes on a long distance walk.

Grease Up!
Most walkers get painful blister! Luckily, there are ways to prevent these fluid filled monsters! Vaseline or products such as Body glide decrease the friction of your skin with your shoe and sock. Applying such products to “high risk” areas of your feet will decrease the chances of a blister. Apply the product regularly along your walk or when you feel a blister coming on. If you have a blister, seek help at a medical tent. They can pop the blister and provide padding to relieve the pain.

Don’t Ignore the Pain!
There is so much emotion and drive in these walks that people stop listening to what their body is telling them. If you are experiencing pain, there are medical professional at every pit stop to help you. Something as silly as a blister can be cared for and you won’t have to stop walking, but some pains may be serious. Drinking lots of fluids and paying attention to how often you urinate is very important. Dehydration is the most common complication on these walks! If you want to finish the walk it is best to address your aches and pains on the way so you don’t end up with a more serious problem!

Enjoy Yourself
No matter what you are walking for or who you are walking for, remember to embrace the experience. You are making a statement for you community and the ill across the nation. The walks are long and hard, but stay positive and focused on the real meaning and purpose of this community gathering. WALK ON!!!

Don't Let Shin Splints Get You Down!

As the northern cities clear the last snowfall, spring is on everyone’s mind. Warm weather and outdoor activities are around the corner. Though we are all eager to play catch or hit the running trails, we need to make sure we do not get injured in the process. Outdoor sports often mean uneven terrain. This can lead to a disaster if you do not take time to warm up and train for the demands of outdoor sports.

One of the most common complaints of spring athletes is shin splints. We have all had them and they are just strait up uncomfortable! Your leg muscles are over working and you may develop small tears or inflammation in the muscles or tendons. The injury is minor and can be relieved by rest and icing but the injury can be very painful and will interrupt your training schedule. Through the pain is caused by inflammation of the muscles and tendons in your lower leg, it may actually be the result of a foot problem!

Poor shock absorption can lead to increased stress on the muscles of your lower leg. Imagine when you are jumping and running how much force is being applied to your leg. We wear shoes to help absorb this shock and decrease the stress on our feet and legs. After time, your shoes will eventually lose its shock absorption quality. So if you are planning on wearing your 2 year old sneakers to the track today, you may need to stop at the local shoe store first.
Certain foot types are also poor shock absorbers. Our feet and legs are naturally constructed to absorb the stresses of walking, running and jumping, but not everyone’s foot is created equal. A high arched foot is a poor shock absorber and shoes with additional support should be worn if you have this foot type. You can also get the needed support by wearing custom made orthotics from your local podiatric physician.

Flat feet can also lead to painful shin splints. Flat feet are often caused by excessive pronation. This means that your foot and ankle roll inward at a greater degree than normal. Since your foot and leg function as a unit, when your foot over-pronates your leg will twist. This twisting puts stress on your leg muscles that will lead to inflammation and shin splits when exercising.
Don’t let these common foot problems and painful shin splints keep you off the field or track this season. Podiatric physicians are highly trained to accommodate your footgear and to provide custom support devices or orthotics to help manage your foot type. If you commonly have shin splints, your podiatric physician may also recommend physical therapy to strengthen your leg muscles and to prevent further injury. If you are currently suffering from shin splints remember to rest and ice your leg to allow your muscles and tendons to repair and recoup from the injury.

Are Your Feet Overstressed?

A stress fracture is a tiny crack in the bone caused by overuse. Most stress fractures occur on your metatarsal bones in your foot but they can occur in any part of the body. Stress fractures develop over a long period of time and are often initially unnoticed. Your bones naturally break down bone and rebuild bone on a continual basis. If too much force in repeatedly applied to the bone, then the breaking down of bone will exceeds the rebuilding of bone. The bone is insufficiently repairing itself. This is called bone fatigue. Over time the bone becomes weaker and eventually cracks. The fracture is very small and is often unapparent on x-rays.

Physical activity is always encouraged, but working out too hard too fast puts your body at risk for injury. When starting to work out or changing your workout routine, make sure you give your body time to adjust to the new stresses. It takes time for your muscles and bones gain the strength necessary to absorb the impact of running, jumping, and jarring. When your muscles fatigue, they no longer distribute the forces along the entire bone and the bone has to carry an increase of load. This will lead to fractures. Sometimes even changing the surface you run on can lead to injuries. If you are used to running on the grass or a softer surface, changing to cement or concrete surfaces will force your body to absorb more of the impact. You may not notice the bone fatigue initially but over time, you may develop a small crack in the bone or stress fracture.
Stress fracture pain is usually experienced with increased activity. Therefore, one may notice the pain to get worse the more they work out. The pain also occurs earlier in the workout as the fracture progresses. Initially the pain will subside with rest, but as the fracture increases in size the pain will become more constant. The pain may also be elicited by palpating the area over the fracture. Sometime a doctor may use a tuning fork to elicit the pain. The fork causes vibrations in your bone, and if a fracture is present it will cause pain. If no fracture is present, the tuning fork will not cause pain. Your podiatric physician will also take x-rays to rule out any other complications. The stress fracture will often be unapparent on a x-ray because the crack is so small. Therefore, the physician may need to order an MRI or bone scan to further assess the injury.

The best treatment for a stress fracture is rest. Chen Lu, a professional figure skater, missed the Olympics due to a stress fracture, Scott Neidemayer missed his Hockey All Star Game, and Yao Ming had to sit out a large portion of the season to nurse his stress fracture. Whether you are a professional athlete or have sport hobbies, you need to rest if you have a stress fracture. The only way to fully recover and prevent the injury is to slow down and allow your body to heal. Changing your workout to less impact sports and slowly increasing your body’s demands is highly recommended. Athletic shoes lose their shock absorptive properties and should be replaced at least every 6 months. NSAIDS can be taken to reduce the pain but should not be taken for long periods of time. If you are experience any foot pain that is continually getting worse, you should see a podiatric physician to assess the injury.