Heel Pain Can Be a Calcaneal Stress Fracture!

Not all heel pain is plantar fasciitis, you may have a calcaneal stress fracture!

 

 

Got Heel Pain? Give me a call!

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.

National Running Day

Today, June 1st, is National Running Day. Here in New Jersey, it is a beautiful day to run. I ran my six miles. Why do I run? I run for me. Running clears my head and makes me feel good. After a good run I am more motivated and creative and definitely in a better mood.

Besides the mental benefits, running keeps my heart strong, gets rid of excess fat and can make you a lean, mean, fighting machine. Today is a wonderful day to get a group of people together to run. Running with others will make the run easier and is also an excellent way to increase the bond of friendship with the people you like.

If you are not a runner and would like to start, remember to go slow initially. Maybe start with a fast pace walk and then run a little. Always warm up your muscles and stretch and make sure you stretch afterward your run. There are excellent books on running. I recommend a book titled, “If Your Running Feet Could Talk,” by Dr. Marybeth Crane. Go to: http://www.faant.com/reports/.cfm and get a copy.
Now, how about you? Why do you run? Let me know. Happy running.

Buried Alive and STILL on his Feet!

Five hours, 40 minutes, and 51 seconds is how long it takes to run a marathon after training underground. Edison Pena was one of the 33 men who survived trapped underground in a mine for 69 days. He was known as “the runner,” because he filled the days underground by running through the mine tunnels and signing Elvis. Not even a dark hole of abyss stopped him from keeping his running spirit. What have you done lately?

It is all too easy to start making excuses to not hit the pavement, go to the gym, or attend your weekly yoga class. Are any of our excuses any good? The Chilean miner had only work boots, mining clothes, a bummed knee and dark tunnels and he found a way. What’s the secret to keeping up with the running spirit?
2 hours, 8 minutes and 14 seconds is how long it takes to win the New York Marathon. Gebre Gebremariam won the marathon while a former marathon champion Haile Gebrselassie announced retirement leaving the race after only 16 miles with an injury. Running professionals, these men make a living by concurring world records and finishing in times unfathomable by the hobby runner. Does it have to be your source of income to stay dedicated?

The first couple weeks of training are strenuous, mortifying, painful and agonizing, yet so many make it through with one goal in mind: finishing the 26 mile, 385 yard race. Nearly 45,000 runners had that common goal in New York City this year. Whether your goal is a marathon or a mile on the treadmill, it takes self motivation and determination to get to the end of your race. No one will do it for you and only you can get yourself there.

The Chilean miner stated he did this to motivate others. Hopefully he motivated you. The only way we can keep ourselves healthy and decrease the growing rates of obesity and diabetes is to become more heath conscious and active. There is a solid link between obesity and diabetes, heart disease and a number of other illnesses. Going to the gym or hitting the pavement is more than a hobby, it is a life saving activity. Every day I see patients who let go of their running hobbies because they got too busy. Not only did they lose an enjoyable hobby, but they also lost their health and are now trying 10 times harder to reverse the consequences of an inactive lifestyle. Let Pena, Gebremariam and Gebrselassie’s running accomplishments be your motivation to get up, get out, and run!

Common Running Pains & Injuries

Aches and Pains of Running

Even with the best preparation, aches and pains are an inevitable result of a new jogging regimen. If the pain subsides with slow easy exercise, you may continue, but if it gets worse, stop the activity and rest. If it persists, see your podiatrist.

The most common pain associated with jogging is known as runner’s knee, a catch-all for jogging-related knee pain. One of the most common causes of runner’s knee is excessive pronation, or rolling in and down, of the foot. This syndrome is now often called the patello-femoral pain syndrome.

Orthoses (arch supports — shoe inserts) prescribed by your podiatrist are the best way to alleviate the problem. Occasionally, rubber pads in the arch of the shoe will help.

Shin splints, which painfully appear at the front and inside of the leg, are caused by running on hard surfaces, overstriding, muscle imbalance, or overuse. Treatment includes changing running technique or insertion of an orthotic device in the shoe.

Common Running Injuries

Plantar fasciitis (arch pain) — Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot. When the plantar fascia, a supportive, fibrous band of tissue running from the heel to the ball of the foot, becomes injured, pain on the bottom of the foot results. Forefoot and rearfoot instability, with excessive pronation, may result in plantar fasciitis. Overtraining may contribute. Shoes with good midfoot stability may help prevent plantar fasciitis. If pain persists visit your sports podiatrist.

Heel spurs — Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by a proper warm-up that includes stretching the band of tissue on the bottom of the foot. The soft tissue injury is usually the cause of the pain and not the spur itself.

Sesamoiditis — Sometimes referred to as the ball bearings of the foot, the sesamoids are a set of accessory bones found beneath the large first metatarsal bone. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can be useful in treating sesamoiditis.

Shin splints — Aside from ankle sprains, shin splints are perhaps the most common injury to the lower body, as the muscles attached to the shin bone bring the foot up and down. The pain is usually an inflammation of the shin muscle and tendon due to stress factors. Treat shin pain with cold compresses immediately after the workout to reduce inflammation. Proper stretching before the workout should prevent the onset of shin splints. Strengthening of muscles also helps reduce shin splints.

Achilles tendon and calf pain — The frequent rising on the toes of an aerobics routine often creates pain and tightness in the large muscles in the back of the legs, which can create pain and tightness in the calf and inflammation of the achilles tendon. Again, stretching the calf muscles gently and gradually before and after the workout will ordinarily help alleviate the pain and stiffness.

Stress fractures — Stress fractures often occur from overtraining. Make sure you gradually increase your running distance and intensity and have an adequate dietary intake of calcium.

Before beginning an exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.

The foot is an engineering marvel consisting of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels all working together to establish the graceful synergy involved in running. Running requires balance, support and propulsion which all depend on the foot. Therefore, it is important to make sure your feet and shoes are in good working order before undertaking a serious running regimen.

A good start for someone just starting a training regimen is to examine your feet for anything that may seem irregular to you, such as lumps and bumps, skin irritations or discoloration. A podiatrist can perform a thorough evaluation and recommend any treatment if necessary along with shoe buying recommendations. Of course if you have any underlying medical conditions or have not been seen by a doctor in less than a year, a thorough check up is recommended before starting any training program.

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."

Don't forget your stretches before you run!!!

As podiatrists, we treat all types of foot and ankle injuries, but we also want to PREVENT foot and ankle injuries...so we encourage our patients (and friends and family) to always remember to do their stretching before running and exercising.

We practice what we preach!!! Although we all have different styles of exercising and running, we all do our stretches first. Feel free to ask us questions about your stretches and techniques. We're here to help you!

Here are some simple stretches that you can try:

HEEL CORD STRETCHES #1 (Gastrocnemius Wall Stretch)

1. Lean against a wall with one knee locked and the other bent. You will feel a pull in your calf muscles.

2. Hold the stretch for 15 seconds & alternate the locking and bent knees.

3. Relax for 15 seconds & do 10 REPS.

4. Repeat this exercise 2-3 times a day.

HEEL CORD STRETCHES #2 (Soleus Wall Stretch)

1. Position is silimar to Gastrocnemius stretch but with both legs bent and the buttocks dropped. Make sure you are facing straight and not turned out.

2. Gently lean into the wall and keep your heels on the floor while bending both knees, putting a little more weight on the back leg.

3. Continue until you feel stretching in your lower calf.

4. Hold the stretch for 30 seconds.

5. Repeat 2-3 times on each side.

HEEL CORD STRETCHES #3 (Gastrocnemius Stair Stretch)

1. Stand with the ball of the foot on the edge of a stair and heels off of the step.

2. Rise as high as possible on the toes and then lower yourself slowly as far as you can without rolling the foot inward or outward until you feel a stretch in the calf.

3. Hold this position for 1-2 seconds.

4. Repeat 10-20 times.

PLANTAR FASCIAL STRETCHES

1. Raise toes toward you while bending your ankle as high as you can.

2. Hold this position for 15 seconds.

3. Alternate doing this with the opposite foot 10 times.

4. Perform this exercise 2- 3 times a day.

HAMSTRING STRETCHES

1. Lie with your back flat to the floor with your eyes focused upward.

2. Grasp the back of the thigh with both hands and, with the leg bent, pull the thigh until it is perpendicular to the floor.

3. Slowly straighten the knee.

4. Repeat the exercise with the other leg.

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.

Run Smart And Avoid Shin Splints

Commonly runners are sidelined or limited by the presentation of leg pain during and often after runs. The pain is usually located at the sides of the "shin" bone and can be debilitating, even limiting the ability to walk. Over the years, this has been a problem that I sometimes have encountered in my running. Since I love running (and don't like not running), I have researched over the years some ways to limit the presentation of shin splints while training for a race, or in my case a marathon. I will discuss some ways that we can "run smart" and limit the injuries that have been commonly classified as shin splints.

Although I will not discuss the full causes of shin splints, or what a shin splint is here, additional information can be found at another blog: Utah Running Doctor. For this blog, however, here is the findings I have:

1. Use Correct Shoes --> Running shoes should be used for running, not cross trainers or walking shoes. A quality running shoe will assist in the running motion by limiting over pronation (excessive flattening of the foot) or over supination (increased arch height - rolling out). In choosing a shoe, price is not the most important, but cheap priced shoes are usually cheap shoes. Get a quality shoe, designed for the exercise you are doing (running shoe for running or walking, basketball shoe for basketball, etc.).

2. Train Smart --> As you run or train, Run Smart!

If you are running on a track, understand that always running the same direction on the track will work muscles differently than switching directions. One of the possible causes for shin splints is working muscles at different rates, therefore switching directions regularly will work all muscle of the legs equally and reduce the chances for shin splints.

If you are running on a road, most roads in most locations throughout the country are canted (or tilted to improve water runoff). Therefore, running against traffic always will cause supination of the left foot and pronation of the right foot. With supination, you will work the lateral (outside) muscles of the leg more than the medial (inside) muscles of the leg. Pronation does the opposite. By switching sides periodically, you will again work all muscles equally and prevent the presentation of shin splint symptoms.

Lastly, in running smart, the speed of training should be carefully controlled. Start slow and progress slowly to the amount of running you desire. Give the leg muscles time to get strengthened before forcing them into harder regimen. The speed of progress will require understanding of how much running you have done and where you should start. Cross training (elliptical or bike) can also help even the muscle strength as you progress.

In all these aspects of running smart, it should be understood that shin splints are caused by overusing a muscle group and creating an injury. By adjusting the training to reduce this overuse, you will have a more enjoyable run.

3) Evaluation for possible "gait" abnormalities.

“Gait” abnormalities are best described as running or walking abnormalities. Do you have a leg length problem? Do you over pronate or over supinate? Do you have imbalance issues, back problems, knee problems, or other reasons to overwork a muscle group that may cause your shin spints?

By being evaluated for your running, your “gait” abnormalities can be evaluated and often adjusted to help you return to running without the pain. Once you start to run and love it, everything should be done to keep you running.