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I am a student athlete and have recently started working out
at a local gym. My training includes spin class and pilates. At this time I'm
wearing my running shoes (which were purchased at Princeton Running! I love
them!). What type of shoe should I wear? Do I need to purchase cross trainers
and cycling shoes?
Thanks
ANSWER: Are you an athlete that participates in any lateral movement sport? If so,
then you'll need specific shoes designed to handle the lateral stresses
(basketball, tennis). Running shoes should be fine for cross training activities
like spinning and Pilates (I'm assuming you mean mat Pilates, since Pilates
machines are generally done barefoot). When I cross train (spin, Elliptical
trainer), I use lightweight trainer running shoes. These give me nice cushion
and just enough support without feeling bulky. If you are a heavier athlete,
then stick with more supportive, stable (and possibly motion control) running
shoes.
Hi,
I'm writing because after several weeks of foot pain, I went
to an orthopedist to have my injury evaluated. The diagnosis
was pain created by bunions. (Actually, the doctor called it
something like metatarsal impaction injury, which
incidentally, does not produce any hits on Google.) He
explained that I have a bunion that will require surgery
within the next few years, and that running is putting
excess pressure on the bunion and creating pain. His
recommendation was to have metatarsal bars placed on my
running shoes, as well as other shoes of mine. Unlike an
orthodic, this device goes on the outside of the shoe. It's
a piece of rubber that is glued to the bottom of the shoe.
It is supposed to redistribute your weight as you walk or
run, thereby minimizing the stress on the bunion and the
resultant pain.
When I contacted the shoe store/"shoe hospital" that makes
these, they said they wouldn't recommend this for running. I
contacted the doctor about this, and he then suggested a
metatarsal pad for inside my shoe.
I'm feeling that I would be better off seeing a doctor or
podiatrist who specializes in sports medicine. I don't want
to stop running, nor do I want to make my condition worse.
Any recommendations on sports medicine physicians? Also,
have you heard of my problem before? Any suggestions you
have would be appreciated.
ANSWER: Let me
ask you a bunch of questions first. I have the same problem
(I was told I'd need surgery about 10 years ago!!). You may
be able to work through this with the proper adjustments.
- what kind of shoes are you running in now?
- any recent changes in your running (speed, distance)?
- was this a sudden onset of pain or gradual?
- how old are you and how long have you been running?
These need to be answered first if you want specific
answers. Generally speaking,
metatarsal bars were first designed for anyone that needed
assist with push off (stiff, arthritic toes, i.e.). They are
definitely not designed for running. You need to get a
really good physical exam of your feet. No one can give you
advice until this is done. Not to sound biased, but a
physical therapist that is board certified in sports or
orthopedics is the way to go. You can actually get an
evaluation without a physician referral (only an eval; not
treatment except in NJ). You can go on the APTA website (apta.org)
and look for the clinical specialist listings in your area.
OCS is an orthopedic specialist and SCS is a sports
specialist.
Again, generally speaking, you are looking for a really
cushioned shoe, especially in the forefoot, that will give
you an assisted push off. Some shoes taper at the forefoot
(not the width, but the height of the toe off the ground);
these add an element of assist to your toe off.
A metatarsal pad won't do it for you if the problem truly is
a bunion. You may need either a slight forefoot posting
(this will slightly "lift" your bunion off the ground and
relieve pressure at push off; or you may need an orthotic
with a more springy-type material in the forefoot to assist
with push off)
I need to know more about your feet to tell you the way to
go.
BUNION FOLLOW UP
1) I'm wearing (expensive) New Balance 1220s
2) I've been increasing my mileage and speed very slowly. I
was staying at roughly the same mileage for 2-3 weeks before
adding on, and I wasn't really adding on so much (2 3/4
miles to 3 or 3 1/4, for example). I was up to about 5
miles. My pace wasn't changing radically.
3) There is an exception to what I just told you. What
happened was I was out of town and had plotted out a 5 mile
run. I was just up to about 4 ¾ miles at the time.
Unfortunately, the last leg of my run had an awful head
wind, so I attempted to find an alternative route. To make a
long story short, I failed (there wasn't an outlet on the
street I thought would help me out), and all I did was add 1
3/4 miles onto my run and then I had to go back and face the
headwind. The wind was so bad that at one point I turned
around so that my back was to the wind and I sort of jogged
backwards for about 20 yards. When I got back to my
relatives' house, I had run 6 3/4 miles. When I stopped
running, I noticed that my foot was sore around the bunion.
4) Now for the cincher: I'm 44 (!!) and I just resumed
running in October after taking off for about 1 1/2 years.
Honestly, I really hadn't done a lot of running since
college days. However, I was already in good shape and used
to exercising (aerobic and strength training) at the gym a
lot. So, I started at around 2 1/4 miles and worked my way
up to about 4 3/4-5 miles.
Any additional info you can provide would be appreciated. Do
you think an OCS or SCS is better? Do you know of anyone in
particular whom you recommend? I live in Westfield. Also,
are there any particular makes of running shoes that you
recommend (with the characteristics you described). I think
that I tend to run on my toes some. In fact, sometimes the
tip of one of my other toes is a little sore--like from a
callus or something--but I can assure you that it's not b/c
my shoes are too small; they're definitely large enough. I
know that I need to get the pressure off the bunion area.
It's sore to pressure, even just a bit. Shoes that taper off
a bit concern me, since I've always read and been told that
people with bunions should look for shoes with wide toe
boxes.
One final point: I'm hoping to do my first triathlon this
spring (a sprint triathlon), so I don't really want to stop
running for long. I did take off about 3 weeks (thinking it
was maybe a tendon injury or stress fracture), and I'm just
easing my way back. I did do one 3 mile run this week and
one last week (both on treadmills, not the roads), and I
hope to run (indoors) again tomorrow or Sat.
ANSWER: NB 1220's
are good - a nice cushioned trainer. You may want to
consider changing the insole to a better cushioned one (spenco,
poron, ie). If your foot is reasonably structurally sound
(this requires an eval), changes can me made to an over the
counter insole. I have found OCS and SCS to be quite similar
(I'm an OCS and I see lots of athletes) when looking for a
physical therapist. There are many in your area. My only
concern is the time allotted for each patient in different
clinical situations. Ask how long an evaluation is
(hopefully it is an hour - all spent with you!)
Your mishap (running backwards) is no big deal. Backwards
running requires a lot of extra toe extension inder the big
toe, which probably irritated the bunion. Your training
sounds reasonable and well thought out. Why not just cross
train until your foot is dealt with and evaluated? Bike,
swim (aqua running is great, too)!
Go to the Westfield store and ask to see Gary. I already
discussed your problem with him and he has some good shoe
ideas for you, and possibly can make some insole changes as
well. Be sure to bring in your 1220's so he can look at
them.
When I said a tapered forefoot, remember, I said the
distance from the toe to the ground, not the width. This
does not compromise space. Yes, you want a nice large toe
box.
Forefoot Post
How do I
get a forefoot post? I've tried many over the counter
orthotics as well as at least 4 done by professionals. Don't
really know what to look for...many of them advertise
correcting flat fleet and other stuff that I don't think I
need and has led to more ITB pain. What kind and brand would
you recommend - just a cushioning spenco one? What is PPT? I
can certainly do the toe and foot exercises daily - thanks!
ANSWER: Go onto
www.apta.org for listings of certified specialists (OCS or
SCS physical therapists). You can't get posting on your own.
You need to be properly evaluated (try and find a PT who
specializes in feet) to see how much and where the posting
should be. I can't even begin to guess, since I would need
to see your feet. PPT is a really awesome cushioning
material (it can be used as a top cover or alone in your
shoes. I actually posted a piece of this for myself and it's
great). I'm guessing people are telling you that you have
flat feet, but like I said your rear foot may be OK, and the
problem could be in the forefoot (which can look like a flat
foot on weight- bearing, but paints quite a different
picture in a non weight-bearing position). So, if people are
giving you too much arch, this could easily be aggravating
to an ITB problem. Get yourself evaluated.
Leg Length Discrepancy?
Hello-
I have been a consistent runner for two years now, and
something has drastically gotten in the way of my running.
Recently after a nice long run, I began to feel a radiating
pain from my gluteus all the way down to my outer knee and
sometimes even further down my leg. At first I thought it
was ITB, which I have suffered from before, yet the pain has
been much stronger and worse. I believe that I have a bit of
a leg length discrepancy after reading about it on runner's
world, and I was wondering if there was a particular kind of
orthotic or insert I could wear that would allow my legs to
be even. The longer right leg is the one that if suffering
from the pain, and I have not exercised since I discovered
the problem and it has simply just been getting worse, even
just walking to and from classes. Please Help!
ANSWER: Whoa!!
My gut reaction is that you may have developed a functional
leg length discrepancy and not have a true structural one.
True ones are pretty rare. The only way to truly measure a
structural one is by x-ray. A comprehensive physical
exam/evaluation is definitely in order. You do not start
playing with lifts or orthotics to correct what may be a
skeletal misalignment (from the running stresses) or a
muscular imbalance (quite common). Judging from your history
I'd say you may have developed some spinal or pelvic/sacrum
dysfunction which can lead to (or have been created by) a
muscle imbalance (these can develop when the muscles start
to work "out of synch"). If you are really bugged by this
"short leg" notion you can simply see an orthopedist and
have x-rays taken to make sure; but I always lean toward a
good physical evaluation (if you've read any of my recent
answers, I always seem to advise seeing a good physical
therapist - one that is not just licensed but board
certified in orthopedics or sports. They have either OCS or
SCS after their name. Go to APTA.org and find one in your
area). It doesn't sound like a difficult situation to
correct. Rest alone will not be enough; once you start up
again, the pain most surely will return. There are some good
PT's in the Brunswick area.
Runner's Knee
I
recently started running seriously after a few years of off
and on running - with the hopes of getting ready to run a
half marathon or maybe even a full marathon. Training was
going well for the first 5 weeks - with my weekly running in
week 5 at 21 miles.... Although I felt great cardio-wise, I
started having pain in my knees, which I believe is the
dreaded runners knee. What is my best course of action to
get back into training?... Any strength building exercises
you can recommend. I hate the thought of having to stop
running for any period of time...but even a short run
results in soreness around my knee-cap... It gradually
subsides after I ice it down and take some Advil...any help
you can provide to get me back on track would be greatly
appreciated! (p.s. I did stop by the store recently and pick
up a new pair of sneaks hoping that would help)....
ANSWER: Yep, sure
sounds like the dreaded runners knee. pretty commonly
affects women, mainly because of biomechanical differences
we have from men. Are you a pronator? I'm sure someone took
a brief look at the store. How's your shoe wear (patterns)?
Do you have a "knock kneed" type style of running? do you
"toe in"? These all make you more at risk for this problem.
Generally, you can do some exercises to help. First you need
to check your flexibility, especially in your hips (Is your
piriformis tight? Cross one leg over the other and pull up
to chest. Any tightness in the butt of the crossed leg?),
hamstring? (straight leg raise with the other leg straight -
use a rope to pull leg up. tight? how far? 90 degrees?),
calf?, hip flexors/quads? (kneel on one knee with the other
foot up on the ground in front of you and lean forward
keeping your back straight. Any tightness in front of the
kneeling leg?), any IT band tightness (This one is tough to
tell - it's easier to dig deep and palpate along the length
of the outside of your thigh to the knee. Any tender spots?
Work these out with, no kidding, a rolling pin, or purchase
"the stick" (Check the running store for this device). Work
on flexibility is important to reduce any patellar pressure
in the front. Strengthening is next. It is important to
watch (A mirror is helpful) to make sure your kneecap moves
in a nice straight line and not out to the side when you
contract your quad. this may be difficult at first and if
you can't control this it may be wise to pay a visit to a PT
who can show you how to tape this for the beginning stages
of strengthening until you can control this. Do you belong
to a gym? If so, it makes it easier to work on this using a
leg press machine (start in mid range at first - do not ever
lock your knee straight!! Work up to 90 degrees of knee bend
at first - make sure your feet are high up on the plate so
your kneecap doesn't go over/beyond the toes. You should be
able to see your toes throughout the exercise). Also good to
work on hip strengthening exercise - butt lifts with your
legs up on a physioball; sidestep with your knees tied
together with an exercise band for the abductors also good;
stand and bend over keeping your back straight to about 90
degrees and tighten your butt muscles really tight and
straighten back up using only these muscles; wall squats to
90 degrees are a few you can start with. Lunges (front and
side) also good, but a bit more advanced. Someone needs to
check your form for this. Get the idea?? There are a lot of
good functional type strengthening books out there
(exercises where your feet are planted on the ground and
involving the core/trunk). check out those published by
Human Kinetics (they have a website). Remember, this is
without my seeing you. you may want to make this more
specific to your needs by seeing a PT maybe once or twice.
You may want to cross train a few weeks while working on
this - whatever doesn't hurt (elliptical may not hurt;
cycling; water jog)
Buckling Knees
I am 27
years old and have been running seriously since high school.
I generally run about 20 to 30 miles a week. Over the past
few years I have begun to integrate other types of
activities including bike riding and weights. Recently (over
the past 6 months) I have also started doing yoga maybe once
a week. Although I have had some problems with me knees in
the past, it seems that since I have started with the yoga
my right knee has been giving me trouble. Although it does
not hurt when I run, when I am walking it will pop and then
give out. This does not happen consistently, but does happen
at least twice a day. Basically, it feels weak. I am afraid
that I hyper extended it in the yoga class. It could by
totally unrelated but I have since stopped doing the yoga.
Both knees hurt when I do a quad press at the gym and they
also bother me when I slowly go into a squat. Is there any
kind of exercise that I can do to strengthen them?
ANSWER: Knees
giving way, or "buckling" is never a good sign. Especially
if it occurs at the frequency you say. There are several
possible causes, usually involving some sort of joint
internal disruption like a chronic ACL tear (major
supporting ligament - usually torn in hyper extended
situations), or a cartilage (meniscal tear that may be
broken loose in the joint and occasionally floating into a
"bad" position. You have several options here. See a good
orthopedic MD and get it properly analyzed (MRI), or you can
try some midrange strengthening exercises. Don't neglect
trunk stabilization exercises (this allows all the joints to
be more properly aligned); hip strengthening is
important(hip extension with knee bent - over a large ball
is good; hip extension with knee straight - several good
Pilates sources will show these; as well as hip abduction -
where leg goes out to the side away from body). Knee
strengthening should stay midrange to avoid excessive
ligament stresses -like midrange leg presses (don't go
beyond 90 to 100 degrees knee flexion and keep your toes in
sight), hamstring strengthening - seated or prone curls;
also sit on a stool with wheels and facing forward dig heels
into floor and forward walk while seated. If you do have an
ACL tear, hamstring strengthening will be very important as
these can be secondary stabilizers for an absent ACL. Also
work calf strength - heel raises off the edge of a stair -
as part of your calf muscle crosses the knee joint from
behind along with the hamstrings. Single leg balance with
knee held partially bent(on a mini tramp or unstable surface
as you get better) gets more advanced, but is necessary for
overall joint position awareness, and may help lessen your
unstable feeling. This is just the tip of the iceberg, as
there are many ways to approach these exercises, but be sure
never to have your knee locked straight or completely bent
while strengthening.
Good luck!
BUCKLING KNEES FOLLOWUP
Thank you so much for your reply. I will follow your
advice. I have one more question - is it ok for me to
continue running in the meantime?
ANSWER: Does your
knee buckle or lock while running (no lateral or cutting
moves)? If so, I would definitely see an orthopedic MD and
get it checked out. If you have a generalized knee pain, I'd
work on the exercises and cross train(elliptical, pool run,
bike or spin) for a few weeks first (nothing joint strenuous
like yoga!!). If you have patellar pain, see the response I
gave to the last girl with this problem on the website. If
you have specific pain in an area not mentioned, let me
know.
I am an avid soccer player and have played as competitive as
semi-pro in Germany. After moving back from Germany, I
realized that I don't have the same amount of time to
dedicate towards soccer and I wanted to start working on
distance running so I started trying to log a few miles each
day at a slow pace. Cardio wise I feel ok but my lower back
starts to ache after about a mile and I have to stop and
walk for about 50 yards before I can start again. I have
been going to physical therapy for a few weeks and it
doesn't seem to be helping. Can this be due to an improper
running shoe? All the running I have done in the past has
been in the form of training for soccer and hasn't had much
to do with distance. I am 28 and really am determined to
become at least an "average" runner. Any advice would be
greatly appreciated!
ANSWER: I need to know a few more details. Has the PT
given you any ideas on what he/she feels is the source of
the pain? Have they watched you run (treadmill)? Shoes can
definitely be a problem area. Did they check your foot type?
You may require more stability in your shoes. You could also
have postural or low back "stability" issues that need to be
addressed. Let me know what has gone on thus far in therapy.
IMPROPER RUNNING SHOES FOLLOW UP
The PT that I have been seeing seems to think it may be
a combination of work posture (I sit all day at work) and
weak hip muscles and hamstrings as I sometimes have
hamstring tightness. They haven't watched me run but the
other day at the track a girl training for a marathon did
say my form wasn't right and I might want to look into
better running shoes, I currently run in Adidas Motion
control shoes and was running in Nike Shox. How important is
it to have shoes that fit your feet and how do you tell if
you need motion
control, cushion...etc?
Thanks for your help!
ANSWER: I'm inclined to believe the weakness issues
do exist; but I find that many runners have a hip flexor
weakness as well as a gluteal (buttock) weakness that tends
to force the hamstrings to be overused (especially with your
soccer history) and get tight.
Wow, what can I say. this really needs to be analyzed.
Also, check your shoe wear. Are you wearing the (1) outside
of your heels and forefoot? Or (2) the outside heel and
under big toe? Or (3) totally the inside of the sole? If
(1), then you could have a forefoot and rearfoot varus which
may require some orthotic and posting, or a shoe with lots
of cushion. If (2) it could be just a forefoot varus, but
still needs cushion in the forefoot, or (3) stability or
motion control shoe. Not many people need a true motion
control, but more a stability shoe (which offers more
cushion). Someone really needs to watch you run from behind.
Ask the PT about this(hopefully they understand running
mechanics and are sports oriented). Many runners are "hard"
heel landers. Be careful on your foot strike. Think "soft"
and more of a quick heel to midfoot type landing. Keep your
weight just ever so slightly forward while landing, not back
over your heels. Pull in your stomach muscles/navel to
maintain a nice erect posture, and keep your arms relaxed
and skimming just above your hips.
Again, ask the PT for some good trunk stabilization
exercises.
Feel free to keep in contact.
Flat Feet and Knee Pain
I am a 25 year old Physical Education Teacher. As a track
runner and
volleyball player in high school, I began to experience feet
pain, mainly
from low arches. Throughout my volleyball collegiate career,
I experienced
knee tenderness (I'm guess from the impact of jumping). My
workout consist
of jogging 1-2 miles daily, elliptical training, and
aerobics. Last year
while teaching, I was experiencing knee pain and tightness
in the knee area.
As I continued to workout and as this school year began, the
knee pain
worsened. So I went to the Georgetown Running Company and
purchased a pair
of Adidas Response Trail. I only wore those shoes during my
workouts and
wore regular sneakers from the local foot locker to work.
Still experienced
pain. So one day I decided to wear the addidas to work to
see if I felt any
difference. I DID! So, I still would like to see a doctor
that specializes
in feet to recommend a special device for flat arches and
knee tightness and
pain. Do you have any recommendations on a type of shoe and
doctors who
will help fix my problems?
ANSWER: If you noted an immediate change in pain just
from a shoe change then you're
on the right track. Why the trail shoes, though? They're
basically
cushioned shoes with some stability with serious off road
vehicle typetread! If you like the response trail, why not try the
respone or response
cushion?
Other cushion with some stability-type shoes are adidas
supernova (or
supernova cushion), asics nimbus, asics 2080/2090, NB 765 or
more cushion in
the 1023.
You may be able to get away with a simple over the counter
orthotic designed
to give you a neutral type of arch support, or you may need
a custom fit
from a podiatrist (pick one that specializes in foot
evaluation and orthotic
fabrication); or get a good thorough lower body exam from a
physical
therapist specializing in sports or orthopedics (SCS, OCS -
see APTA.org).
Get to the root of the problem by having your lower body
joints evaluated at
rest and in motion.
Good luck!
Knee
Injury
I love running and now I just injured my knee and
I'm in physical therapy. I've been in it for about 3 months
and my knee isn't getting better but I still run. Do you
think I should still train because I have a track meet in
about 2 weeks or not go?
ANSWER: If you've been in PT for 3 months and are
getting nowhere, you need to see
the MD again (for possible MRI and further evaluation).
Has your running gait been evaluated?
Have your feet really been looked at?
Has your low back and hip also been checked? All of the
above should have
been addressed by the PT.
If not, then find a PT in your area with a board
certification in either
sports or orthopedics (they should have SCS or OCS after
their name. You
can find a listing at APTA.org for your area)
If it doesn't hurt to run, then why not? If it hurts to run
you arent't
doing anything to help the injury process. Don't mask the
problem with
medication.
Winter Shoe
Hi there. I currently run with the Nike Air
Structures, and I need a winter shoe. Something that is
water, snow, and ice/rain deterrent. What would you
recommend? I run about 35 miles per week, and I really do
not like the treadmill.
ANSWER: You're asking a lot out of one shoe! You
should probably consider a reasonably stable (since you're
using the structures - which are highly stable) trail shoe.
Some suggestions:
Asics 1090 trail shoe
Asics trabuco trail shoe
Brooks adrenaline ASR (trail)
Adidas Wanaka trail
These also offer decent stability, nice deep outsole "lugs",
and I believe all are water repellent or water proof. For
extra traction on snow and ice you can get Yaktrax - these
are lightweight devices that slip over your shoes and have
metal rings that fall into place under the sole. Great extra
traction!
Back to Top
Flat
Foot
I am a track sprinter with flat feet. I have
never been able to wear the usual track spikes due to severe
pain in my feet. I wear a running shoe that gives me added
support. I'm looking for a track shoe that will give my flat
feet the support that a running shoe does. Help!
ANSWER: You may have to consider a XC spike rather than a
solely track spike. XC spikes offer more cushion and
stability for the long haul that a track spike doesn't have.
You'll be sacrificing a few extra ounces as well, but I
think it's a good tradeoff - your difference in performance
will be notable(unless you're a miler and above). I myself
have found the asics 15-50 to be a good shoe. I took out the
liner in the shoe and put in a lightweight, thin over the
counter insert with just enough arch support, but you may
find the shoe itself offers enough support. If your feet are
considerably "flat" you can have a thin lightweight insert
fashioned by a podiatrist to wear in one of the XC spikes.
Be sure to bring the shoes with you so the fit is just
right. Another XC spike to consider is the Adidas Neptune XC.
Similar to the Asics I mentioned above. Go over to the
Running Co. store nearest you and they can troubleshoot with
you.
BACK PROBLEM
I am a 47 year old male that has been a constant runner my
entire adult life. Typically I run 2 miles during the week
and 9 miles on the weekend.About 6 weeks ago I noticed it
hurt to cross my right leg and I had a bit of stiffness on
my hamstring. It didn’t bother me when I ran so I just tried
to stretch it more. Over the next 6 weeks it became more and
more stiff and it started to cause slight pain and stiffness
where it now radiates up to my buttock. It still doesn’t
hurt when I run, in fact it feels better.
Any ideas of what it is and what I should do?
ANSWER: It sounds more like a possible low back
injury. Were you doing anything involving a lot of bending
and twisting of the spine (moving heavy items; or even
sitting for a long car/ plane trip) or any change in your
routine? Running involves mostly extension of the spine
(which our discs like - since we spend most of our days in
bent/ flexed positions), which you say feels good!
I would suggest you go to a physical therapist that is an
OCS (orthopedic specialist - find one in your area at
apta.org), or certified in the McKenzie method (cert.MDT or
dip.MDT). The McKenzie method is a specific way of
evaluating and treating YOUR spine (it's not generic).
They could also determine the possibility of a sacroiliac or
pelvic dysfunction (either a muscle imbalance or joint
malalignment). It really doesn't sound like a hamstring
injury (unless you were doing some sprinting that your body
wasn't used to!)
Stress Fracture
I have a stress fracture of the second metatarsul (this is
the fourth week)….is an elleptical trainer a non-impact
exerciser I can use? Thank you.
ANSWER: You may actually put more stress on the
metatarsal with this exercise, since your bodyweight tends
to be on the front of the foot. I would stay on the safe
side and do some stationary biking (low resistance with
quick spinning for the least pressure); or better yet,if you
have access to a pool, invest in an aqua jogger and run in
the water (feet not touching the bottom - water up to chest
level so you can use your arms also). I would wait 6 to 8
weeks (again, play it safe- I have seen too many recurrences
because patients are told 4 weeks is enough for healing!!).
Gradually resume your running by reintroducing it into your
cross training slowly!!
Shin Splints
I am 26 years old and am trying to get back into my running
habit again
that I had while in High school. I used to run cross country
and I am
trying to train myself again to run long distance, however,
I have been
getting horrible shin splints, plus I have flat feet which
adds to the
pain. I have been trying to run about 3 miles a day for the
past 2 weeks,
but now I can barely make it around the second mile, because
the pain is so
bad. I am getting very frustrated. I used to get shin
splints in high
school but that was 8 years ago, is there anything "new" on
the market that
I can use or do?
Thanks for any advice you can offer!!
ANSWER: I find most runners with shin splints tend to
have an upright/ slightly backward lean to their running
style; usually due to hip/buttock weaknesses. This places
quite a bit of force through the heel up through the shin
and anterior knee ("runners knee"). Ideally, you should
heel strike with your center of gravity over the mid to
forefoot (your heel still lands, but the force is more on
the front of the foot). You may want to look into the "Pose" method
of running (you'll find lots of info on the internet); and
you'll definitely want to be wearing a stability shoe (the
degree of stability depends on what you need). If you're
close to a Running Co.store, go have your gait analyzed.
They should be able to tell you what you need. You might
also consider a visit to a physical therapist to see about
any muscle imbalances (or any inflexibilities) as well.
Chronic Calf Pain?
Whenever I in bark on a running program, I immediately get
severe calf tightness, ranging from the mid calf down into
the achilles tendon. If I push it, it doesn't take long
(maybe a week), before I stop in the middle of a run/walk
because it gets so tight I feel it's going to tear.
I feel like I'm doing proper stretching and starting my
program out slowly (run 1 minutes, walk 2 minutes, etc).
But, nothing seems to work.
What approaches can I take to get rid of this problem?
ANSWER: There are a few things you can consider
1. You can get an ultrasound/ doppler (see your MD for info)
to check your circulation. This has come up in several of my
patients (teens!!)
2. You may benefit from using heel cushions; or get a more
cushioned shoe (get yourself checked while running on a
treadmill to see about foot position and lower leg
alignment). A bit of a higher heel in your running shoe can
also relieve calf pressure.
usually an achilles/calf problem gets looser, not tighter as
you warm up during a run. Definitely consider having your
circulation checked, or speak with your MD about it.
Knee
Pain
I have undergone several ACL/MCL/PCL reconstructions and
related arthroscopies dating back to 1991. I am 32 years-old
and suffer from moderate/severe arthritis and asscoiated
knee pain on a daily basis. Any suggestions on how to
proceed to limit the knee pain? Can you recommend athletic
shoes most suitable to a person with my knee problems? A
suggested brand name and style would be much appreciated.
ANSWER: Normally, for my arthritic patients, I
recommend very high end cushioned shoes. However, in your
case, I need to know about your foot alignment as best as
you can tell. Do you have reasonably sound arches, or are
you low (flat footed) or high (very rigid, cavus foot). If
you need support for a low arched foot you may need to
sacrifice a little cushion for stability (and also if you
are very overweight) ie: Asics Kayano or 2100; Nike
structure; saucony hurricane; New Balance 1221; Brooks
Adrenaline. If you are relatively structurally sound, you
can go with all cushion: New Balance 1023; Asics Nimbus;
Brooks Epiphany (my fave); Saucony Triumph or Shadow; Nike
Air Max; Adidas Supernova cushion.
If most of your arthritis is limited to the medial
compartment of your knee (which most times it is), ask your
MD about a brace called the "unloader" - a streamlined 3
point pressure brace designed to do just that along the
medial side of the knee. I've seen it work wonders after
several months use.
good luck!
Cross
Trainer
I'm writing with the hope that you might have some specific
shoe recommendations. I wanted to get a cross-trainer rather
than a running shoe, since most of my activities are
everything but running, including walking and gym classes
such as step aerobics and weight training classes In the
past I had used Asics running shoes which had been good to
me (I have slight pronation), but to lower my chances of
ankle injury, I bought the Asics Gel 220TR cross trainer (a
half size up from my normal shoe size). Since I have been
wearing them, I develop numb toes while wearing them for an
extended period of time during a workout (doesn't seem to
happen if I'm just wearing them around the house). It has
happened both in spinning class and step aerobic classes. I
have tried loosening the laces as much as I can w/o the heel
of my shoe slipping off (my foot is relatively narrow,
especially my heel) but that doesn't seem to work.
I'm thinking I need to change shoes, if you have any
suggestions on which ones to look given the above activities
(I have a separate tennis shoe) at that would be great.
Thanks for your help.
ANSWER: If you are doing enough lateral activities
that warrant a Xtrainer, then stick with it. You need to
find the biggest toe box you can BUT do not mistake this
advice for buying a bigger size shoe!! A bigger shoe will
allow too much "pistoning" of your foot (sliding forward/
back) inside the shoe. Consider a new balance trainer for
this (or a Saucony). If you find you don't really need the
lateral ankle support, I'd go with a running shoe with a lot
of forefoot cushion (if your pronation is not excessive) -
try NB 1060 (awesome shoe); possibly the asics nimbus Vll;
saucony shadow 9.
A point to consider is your form during these activities - I
have found when I do the activities you describe I have to
remember to keep even pressure/ weight bearing throughout
the foot. If you keep ALL your weight on your toes, no
matter the shoe, they will indeed go numb. Try to maintain a
more midfoot to forefoot foot strike/ position.
Supination
Hi! I am having a hard time finding a good shoe for me. I
log approximately 5-9 miles per day - sometimes on a
treadmill and sometimes on the street. I have medium size
arches but the tread wear on my shoes is on the outer part
of the toe section (almost no heel wear) which makes me
think I must be running on my toes? I have been told that my
running form is very good, and the turnout in my feet barely
noticeable. I do have bad knees and lower back so am looking
for good shock absorption. Any help and guidance would be
greatly appreciated!
ANSWER: You could be a rare supinator (which is
generally a compensation for a valgus/pronation somewhere in
the fore or rear foot but that doesn't really matter). I run
exactly the same way - you are probably striking somewhere
mid foot and rolling off the toe, which isn't necessarily a
bad thing! Hopefully your back and knee problems aren't a
direct result of the running. Definitely stick with a
neutral cushioned shoe - I really like the Brooks Epiphany;
but some others to try: Adidas supernova cushion (somewhat
of a more stiff feel); Saucony shadow 9; NB 1023/1055 or
also really nice are the cheaper 754's - great cushion and
lightweight; Asics cumulus or nimbus. Good luck!!
Hamstring Pull
I have a question regarding a hamstring pull on the upper
part of my leg, where tendons attach to the hip bone.
I have been feeling this pain for over 2 months, have seen a
doctor who said physical therapy...stretching & strength
training would help. I did 3 times a week with little
benefit. Doctor gave me a cortisone shot in upper leg /
butt.
I'm now going on my second week after the shot, and still
feel pain when in exercise or jogger slowly....
What can I do ?! It's been over 10 weeks! Any suggestions
would be welcome!
ANSWER: I can relate to your problem. I've had
serious hamstring pulls (3 in the last 10 years) when my
track training got intense. Sounds like you're pushing too
quickly, depending how badly you're injured.
I only cross trained for about 2 months after my injury with
whatever activity did not hurt at all: small arc deep water
running (legs only stretching out in a painless range), the
elliptical trainer minimal resistance, spin classes, then I
worked up to jump roping - jumping in all directions for a
good 20- 30 minutes (you have to be able to do this without
stopping!).
While I was doing this I slowly started to stretch the area
using what is called nueral gliding techniques. I find many
hamstring injuries are really stemming from the low back/
sacroiliac joint. Rather than stretch the injured area
first, you might start lying flat and place your foot on a
wall (straight leg) then slowly point your toes toward you (dorsiflex
the ankle) then relax. do this in a slow pumping pattern
20-30 times. As this gets easier you can place the leg
higher and higher on the wall, and then slowly introduce
more and more low back flexion by placing pillows under your
shoulders. Get the picture? You are mobilizing the sciatic
nerve which runs right through that hamstring. You can find
a good physical therapist (go onto apta.org and look up
orthopedic certified specialists in your area) that can make
this specific for your problem area.
Once I start working into a bigger and bigger stretch, then
I gradually work in eccentric hamstring strengthening ONLY
ie: on a hamstring curl machine I will raise the weight with
both legs, and lower it with the problem leg. Start with
extremely light weights and do many reps. After weeks of
this, I will bring concentric training and then switch back
to light weight and kind of toss the weight up with the bad
leg and "catch" it at different bent knee angles for a good
plyometric introduction.
ONLY after I can do these things comfortably - to give you
an idea, it took 4 months in total of all this type of
training (no running), but I got in great shape when I did
return to running. My first few times out running were
tough, so I actually spent a week or two on the track just
jogging lightly forward, back and side to side. No hills
yet!!
Sorry I'm going on and on, but bottom line is you have to
take the time and work this out properly, especially since
your bad spot is close to the ischial tuberosity (where the
muscle inserts into the butt). I have found ultrasound to be
completely useless. Massage can help but ONLY as an adjunct
to the program I outlined.
Like I said, go onto apta.org and find a certified
specialist in either sports or orthopedics. They can guide
you specifically.
Hope this helps!!
FOLLOW UP
Thank you for your very informative reply...sounds like
there is no quick fix.
I thought I would try to rehab the injury by very slowly
begin running (read jogging....no, better yet, fast
walking!) For real, I jogged for maybe 15 mins every other
day and still no improvement....My follow-up question is why
is even very slow jogging not good for this injury? While
jogging it feels almost less stressful then when I do
hamstring curls (low weight) or step-up exercises the p/t
was having me do.. Oh, and why did the cortisone shot do
absolutely nothing ...strange!
ANSWER: Even slow jog puts a great deal of eccentric
pull on the bone near the muscle insertion (the area of your
injury takes a notoriously long time to heal - it's more
tendinous therefore less elastic, less blood supple rather
than mid belly pulls), and don't forget the compression of
the bodyweight - it adds a vibratory irritation to this
area.
I'm not sure i agree with the step up exercises nor the HS
curls (if they were concentric - even with low weight). It's
much "easier" on the muscle if it is a lengthening
contraction - muscles can generate more tension more easily
with this contraction.
I find cortisone shots are really just band aids, if that -
like I said, I would clear your low back/ SI joint area to
make sure all is OK here. The area is inflamed for a reason
- a shot won't change anything.
this is also an area that is difficult to remove stress from
- walk, sit stairs are all pulling on the area.
New to Track
My daughter has just joined a spring track team, this is her
first
time running at such lengths. She's beginning to have pain
in her shin.
Is there something we can do at home to remedy the pain?
ANSWER: Is your daughter new to running? Is she young
(pre- high school age?)
It can be due to many things - most commonly if the kids are
out there on
the track trying to run fast from the get go and not
building up to it they
will develop lower leg pain. When running fast, the front
shin muscles have
to work harder to get the toes to clear the ground. When
running more
slowly, this is not as necessary. Make sure she's in a good
cushioned shoe (like a Nike air max; or new
balance 717; or asics cumulus - these are all good "starter"
shoes), and
that she is easing into this program. She can do standing
toe raises and standing heel raises to strengthen this
area; stretching the area by having someone pull down on her
toes while she
is long leg sitting; and plenty of ice (NO HEAT). Make sure
they do a good
warm-up of easy running and stretching prior to any fast
running.
Hope this helps!!
Walking vs. Running Shoes
Someone at your store just told me on the phone that you do
not handle walking shoes, but that you have running shoes
that can be used for walking. Everything I have read on the
web tells me that a walking shoe and a running shoe are
built completely differently. Can you resolve this for me?
Do you carry walking shoes? Do you have a therapist on-site
who can properly fit me for a walking shoe?
ANSWER: I don't work at the running stores, so I can
give you a very unbiased opinion.
I do many lectures for walking clubs, and I've done research
also comparing run vs. walk shoes.
the walking shoe people will tell you that a walking shoe
has a better "toe break" (where the shoe bends under your
metatarsal heads) and a better taper under the toes to make
your toe off more efficient; they also claim that they have
a slightly lower heel to also better transition to a nice
smooth toe off.
I say baloney. specific types of running shoes also have
these features with the added bonus of much better
cushioning; better heel counter stability (if you need it or
if you wear orthotics); and a much better and longer lasting
sole. it can be all this and lightweight, too!
If you have achilles problems, you do not want this lower
heel found in most walk shoes!! Not to worry, there will be
a run shoe that has a higher heel for you.
Go in to any of the stores with this information, and the
sales folk will be able to find the shoe for you!! there are
many many running shoes that have the walk shoe features you
want - let these people help you!!
Does running lead to knee problems?
I am a runner, but nothing too serious. No marathons and no
long distance. I run for fitness, but I have been told by
several people that it’s bad for your knees and can cause
problems later in life. Is this true, and should I forget
about running and take up some other form of exercise?
ANSWER: There have been more than a few exhaustive
long term studies done on runners regarding MRI and Xray
changes on the weight bearing joints (hip, knee, ankle/foot)
and so far there has been NO evidence to suggest joint
damage. That said, it's important to look at the individual.
If you have no prior history of joint pain or previous
surgeries/ injuries AND you are wearing the proper shoes for
your body type and running "form" (go to a local Running Co.
store and get properly fit) then proceed using your head.
Never increase your mileage quickly; also try and get in
some "softer" running (on a trail/ grass). And it's always
great to cross train (biking, Elliptical trainer, swim or
aquajog just to name a few) and mix in some light weight
training to maintain overall strength and muscular balance.
DS Trainers
I have had a problem for approx 3 months with tingling toes
leading to numbness, on both feet, starting usually within
the first mile of a 6 mile run & remaining numb until I
stop.
I thought it was poor tread on my trainers, but when I
purchased an expensive pair of Asics DS trainers, the
problem is still there, if not worse, preventing me from
doing half marathons etc, which is a real annoyance.
The trainers are relatively comfortable, having adequate
room for expansion, although I fear that there is slightly
too much room in the toe end, as the shoes are approx 1/2 a
size larger than what I usually wear. Also, the
padding/cushioning appears to be thinner than what I am used
to in the toe end of the shoe, as these shoes are designed
to give a quick "toe-off" during running.
Any Ideas? Your comments would be appreciated.
ANSWER: DS Trainers are really considered lightweight
trainers - not that much cushion going on in the forefoot. I
find that shoes that are slightly turned up at the end
(designed for quick toe off) tend to also "splay" the
forefoot. This can theoretically expose the digital nerves
that run between your toes (the ones responsible for the
dreaded neuroma). Now add on to that is the fact that your
shoe sounds like it's too big - this will cause a certain
degree of "pistoning" forward and back within the confines
of the shoe.
I'm assuming that you have a relatively neutral foot if
you're wearing these shoes. You need to think about a shoe
that has more cushion throughout the shoe (especially in the
forefoot) with just a little more rigidity in the sole; and
it goes without saying that the toebox should be high enough
- that doesn't mean a larger (in size) shoe!! Look into the
Asics Nimbus, or maybe the Saucony Triumph (just to name a
few - a reputable running store like the Running Co. can
give you many more options).
Orthotics
I run with orthotics to help with some ITB and hip issues. I
think
they helped but it also could be that I train smarter now
but find
them comfortable and wouldn't want to risk running without
them.
This year I've been running on Brooks Adrenaline which I
have been
happy with and prior to that Asics Kayano's. Are these an
appropriate shoe for orthotics? I think the Brooks are for
mild
pronators but if my orthotics are suppose to correct my
over-
pronation and give me stability should I be running on a
true neutral
shoe?
ANSWER: Neutral shoes are all about cushion. an
orthotic (I assume it's a rigid one) needs to have some
degree of external support to function well; so this can
cause very early breakdown in a truly neutral cushion shoe.
I find that you can most likely use a shoe with a lesser
degree of stability such as the adrenaline that you're using
(as well as the kayano). If you look at the way shoes are
classified now (look at Runner's World shoe reviews), you'll
see that shoe categories are really broken down now such as
moderate stability vs. mild stability. Any shoe with a
torsion- type control system (several Adidas models have
this) can also cause torsion and subsequent cracking in a
rigid orthotic, so these should be avoided as well.
Small/Narrow Toe Box Causing Blisters
I have recently been fitted with new running shoes Asics.
they feel fine, but even before my new shoes my 2nd toe on
both feet get very sore and blisters on top. now I am
increasing my distance and they are hurting worse again just
the 2nd toe. what is wrong and what can I do. My shoes fit
great. the last pair were a little big so I decided to spend
the money and have my running shoes custom fitted at a
running shop.
ANSWER: Blisters are a sign of pressure. This can be
from: a small/ narrow toe box; a shoe that's possibly to
big/ long and your foot is pistoning (sliding forward and
backward) while you run; the presence of a hammertoe on the
2d toe possibly related to a bunion on the big toe; possibly
a shoe that is TOO stable and you're not pushing off your
big toe but your 2d toe; socks that are too thick or not
designed for the stresses of running or made of COTTON
(BAD!). Check the upper material of the shoe- is it the
newer "stretchy" type material ? This really helps keep
pressure off the tops of the forefoot also. Check your
lacing as well - are you having to pull the laces too tight?
Then the forefoot may be TOO big! Maybe consider changing to
the stretchy laces favored by triathletes.
Motion Control Sneaker or Orthotics
I have a teenage daughter with very flat feet who is getting
significant metatarsal head blisters from running during
field hockey practice. Do you know a good motion control
sneaker and cleat that she can use? Or should I get
orthotics?
ANSWER: I've treated a few soccer players before with
similar problems. I have been unsuccessful in finding a
soccer cleat with a decent amount of motion control - you
may need to get an orthotic (I'd try an over the counter
type first - like Power Step - these are relatively thin
enough to fit in this type of shoe). Make sure you bring the
cleats with you to make sure they fit - if your daughter
already has blister issues, you can't take up a whole lot of
space in the shoe with an insert. If these aren't
controlling enough you may need to get a custom fit orthotic
- at least these can be made with special space saving
considerations.
If she needs to get a running shoe for her "training" days
(general running ; not soccer- related drills or play) you
should go to a reputable running store (like the Running
Co.!) and see first if she needs just a stability shoe or a
real motion control shoe. Motion control shoes tend to be
heavier - sometimes you can get away with a stability shoe
with an over the counter orthotic. Some ideas: Asics Kayano
or 2110; Brooks Beast or Adrenaline; Nike Structure; Saucony
Grid Stabil are just a few. Every company makes a good
stable shoe - it really boils down to comfort and control of
her problem. A stability/ motion control running shoe isn't
designed for lateral type running or cutting motions like a
soccer cleat - you're apt to sprain your ankle!
Sesamoiditis?
I have Sesamoiditis - what shoe do you recommend for running?
ANSWER:I'm guessing it's under your big toe - this is the most common area for this problem (sesamoid bones are found under here among many other places). Generally they can get irritated by direct friction (if there isn't enough forefoot cushion; if you're a real forefoot striker; if you have an excessive pronation at toe off; if you have a stiff big toe that doesn't bend enough at toe off are among a few of the causes). So, you need to assess what's causing this problem from the areas I noted above. This will decide what type of shoe you need - if you're a fairly neutral runner you need a decent amount of cushion in your forefoot; if you have an excessive pronation problem, you'll need some degree of stability (hopefully without sacrificing cushion) to get this under control (or you can try an over the counter orthotic). Have someone at the Running Co. watch you both walk and then run to see what you'll need.
Hammer-Toes?
Help, I have a high arch and do not pronate. I do have some hammer toes. I
bought Asics nimbus VIII which felt great at first, however by mile 3-4 the
bottom of my toes began to hurt. They felt almost numb.
I need a shoe that will feel comfortable with longer distances..What do you
suggest?
ANSWER:
Either:
1. The forefoot isn't wide or deep enough which will cause pressure under the toe.
2. The shoe is TOO large/ long and your foot is acting like a piston and pushing forward against the shoe.
3. The hammer toes tend to expose the underside metatarsal heads (and associated nerves that can inflame and cause a neuroma).
Do you change the insert that comes with the shoe to a more cushioned one? That can help.
Are you a severe underpronator? Can you feel if you're pushing off the big toe or is it more the 2d or 3d metatarsal? If it's the latter, then this will also cause pressure under the met heads.
Most underpronators tend to land more on the forefoot at "heelstrike" as well; which can also cause a pressure problem. It might be a good idea to have your gait analyzed by an orthopedic or sports certified (OCS or SCS) physical therapist (you can go to apta.org and find one in your area).
I have a similar problem (I'm a supinator), and I find the Nimbus pretty accomodating EXCEPT that I change the insole for even more cushion - I use a PPT one (found it online), but a Spenco or a Sorbothane one can work well, also.
Just a bit off track here, but after doing many foot analyses on supinating runners I find a forefoot post is necessary to basically "bring the ground up to the foot" to spread more of the pressure at push/ toe off (this can actually be added to a regular over the counter insole).
Some shoe suggestions (but I suggest going to a Running Co. store and asking for some advice on neutral cushion shoes) - the Brooks Radius (it has a series of "pods" on the sole that can guide your foot through a nice transition without sacrificing cushion), Brooks Glycerine, Saucony Trigon Ride, Adidas Supernova Cushion, Nike Vomero.
Make sure you go think about all the things I mentioned first, though!
good luck
Pain While Spinning?
I have recently took up spinning classes and frequenty have to sit in the saddle and peddle because the bottom of my feet hurt. The pain only comes when I am out of the saddle and lets up when I get in the saddle for a few minutes. I have flat feet and am overweight. Do you have any suggestions?
ANSWER:
Don't try and use any cycling shoes for these classes - make sure you have a stability running shoe with a decent amount of cushion in the forefoot, as well as a high enough toe box for space!
When you stand up to pedal, there is significant forefoot pressure that comes with this. Your body shouldn't be too far forward when you do this; make sure your bodyweight lands more through your midfoot and don't have your toe pointed down towards the floor. Try and keep the pressure spread through the mid and forefoot, not just the forefoot.
You may need to back off just a bit and sit and spin while the others are up out of the saddle. Focus more on your form as I described for now, and work up to increasing the time up on your feet (hey, you'll still get a great calorie burn with the quicker sit and spin if weight loss is your goal)!!!
Tight ITB
I have been diagnosed with a very tight ITB and bursitis in the hip. The Dr. has given me a cortisone shot and I have started on a program of stretches and exercises to strengthen the knee. What type of shoes should I be wearing as I progress to walking as an exercise?
ANSWER:
Hopefully you're stretching your piriformis, calves and hip flexors; and strengthening the hip abductors, external rotators and your entire core (abdominals, pelvic floor, low back stabilizers...) as well.
Most people with your problem tend to have a bit of a "pronation" problem. Is this you? You should be able to tell by shoe wear patterns - have someone at your local Running Co. store check out how you stand (barefoot) and walk also. If this is the case I'd recommend a shoe with some degree of stability (unless you are a serious overpronator, in which case you would need a bit more motion control). Every shoe company makes running shoes that are good - see which one feels the best on your feet!!
Excercise while waiting for knee surgery
While waiting for arthroscopy for a medial meniscus tear, what activities
are safe to do that will not extend the tear? It does not hurt when I run
or go to spinning class, and only bothers me in full flexion at yoga. I do
not have access to a pool for swimming.
ANSWER: Sounds like it's most likely a posterior horn tear, since full fexion is the most bothersome. Straight midrange purely flexion/ extension activities are generally ok - this theoretically would fit under running, but you'd have to be careful not to torque the knee on uneven ground, turn your ankle on a rock, etc. I'd go with the spin class since it's in the most "controlled" environment - but I'd avoid too much of the quick in/ out of the saddle motions. elliptical training is also OK, although moving the legs backwards may bother the knee; I'd maintain a forward motion throughout. Don't forget to maintain your flexibility (hamstrings, hip flexors, piriformis, calves)!!
Using Nike Shox for Step Aerobics
I just bought a pair of Nike Shox NZSI # 314561 running shoes. Would it be safe to wear these while participating in Step Aerobics?
ANSWER: Shox are not known for their stability; and they're not designed for lateral activities. Step classes tend to involve quick turns and lateral (side to side) motions; your ankle could roll right over in these shoes. You may need to consider getting more of a cross trainer that has a high amount of forefoot cushion and not as high of a heel like you'd see in the Shox.
Hip and Knee Pain
I am 25 years old and I began running in high school. I was in physical therapy for a short time for hip and knee pain. I never fully understood what the actual problem was, and was simply told that one of my legs is slightly longer than the other. I have continued running throughout the years, though not nearly as intense (a mile or two at a time). This winter I have taken up snowboarding as a new hobby, and have fallen a couple times on my knees with no obvious injury. However, lately my knees feel achy and tired, and following a day of snowboarding it is painful to bend/straighten them and they buckle at times. There have been a few occasions where the back of my knee-towards the outside is so painful that it causes me to limp. My concern is that I have torn a ligament. Is that possible if it is painful all the time? If not, what do you recommend?
ANSWER: Sounds like it's time to see an orthopedic MD. Knee buckling symptoms can signify internal derangement - most likely a meniscal (cartilage) tear. You may have started the injury way back when you were running, but the quick turns and more lateral type motions involved with snowboarding probably put you "over the edge" with your problem. Get it checked out; possibly an MRI.
Pressure on Front of Foot
I am 25 years old and I began running in high school. I was in physical therapy for a short time for hip and knee pain. I never fully understood what the actual problem was, and was simply told that one of my legs is slightly longer than the other. I have continued running throughout the years, though not nearly as intense (a mile or two at a time). This winter I have taken up snowboarding as a new hobby, and have fallen a couple times on my knees with no obvious injury. However, lately my knees feel achy and tired, and following a day of snowboarding it is painful to bend/straighten them and they buckle at times. There have been a few occasions where the back of my knee-towards the outside is so painful that it causes me to limp. My concern is that I have torn a ligament. Is that possible if it is painful all the time? If not, what do you recommend?
ANSWER: Ok, you don't say which models you're running in. The Asics VII is generally wider in the heel and toe box, where the newer VIII has a narrower profile, especially in the heel. This can put higher amounts of pressure on the front, inside or outside of the foot/ankle (especially on the tendon that runs down the front of the ankle into the foot). You can try changing your lace-up technique. In the last eyelet near the ankle, you can create "loops" by placing the lace through the 2d to last hole and bring it up and over into the last hole on the same side (thus the "loop").Do this on both sides, then take the end of the lace from one side and bring it through the opposite side loop and tie. This creates somewhat of a "space" between your knot and the shoe.
there really is quite a fit and feel difference between the vii and the updated viii as asics did change a few of the features (I also wear the vii; and I tried the viii and noticed this fit difference immediately).
The Width & Depth of a Shoe
I love the cushioning of Asics but to find something that has a med arch and a nice width...(I take mens 4E)...is impossible. Do u know of what ASICS is wide and deep enough to have my feet actually not feel squished in the sneaker? Im thinking a running type shoe...even know I am a walker. This way the heel is abit elevated and that would help my heel pain that I have since I have been wearing the wrong type of sneakers.
ANSWER: You'll find that within the huge variety of running shoes out there, you'll be able to find one that will specifically address your needs. Most heel pain can develop from an achilles irritation (like you mentioned - the heel of a walking shoe tends to have a low profile) or a lack of reasonable arch support (straining the plantar fascia - which can lead to a heel spur). If this sounds like you, you may need a stability-type shoe rather than simply a cushioned shoe. Don't get me wrong, you can find a stability shoe with a good amount of cushion. Ideas: my sources at the Running Company tell me that the Asics 2120 (a good mix of cushion with moderate stability) would be a nice choice (and they come in 4E). If you're close to one of their stores, they'll be able to take a better look at your foot and make other suggestions.
good luck!
Shin Splints?
I hope you can provide some insights for me. I ran the 8k Philadelphia run on Nov 19th. Two weeks prior I ran my best effort 6 mile run for
endurance and conditioning. A couple of days after the 6 mi run I
experienced slight pain in my shin area. After the 8 k race which I ran
in 48:02 (good for me as I am 58 yrs old) I began to experience
increasing pain. I ran a couple of 2.5 miles sporadically during the
following weeks and now have not run for at least two weeks just work
out on an elliptical trainer. I first feel the pain is walking
downstairs. Sometimes I do not feel it at all, but it seems to be
getting worse. Nothing noticeable on the leg itself. I have tried ice
treatment and heat ointments, but have to admit I am getting
discouraged. I have had 3 stress fractures in my feet at various times.
Just wondering if you have any ideas what may be the problem and how to best to address it. The weather has been so great and I am desperate to
run but leary.
I appreciate any comments. I actually plan to come to the store in
January for new shoes by the 'experts'.
ANSWER: That's tough for me to say without actually looking at you.
What were you wearing when you ran the hard 6 miler? Is/was the shin pain along the front or either side? Does the pain radiate? Have you had a recent (or ever) a bone density test (given your age)?
FOLLOW UP
First, I did go to the nj running store on Friday and purchased Asics based on recommendation and cushioning. The young lady said by my walking and observation of the Brooks shoes, that I run straight/midline. I used Brooks for both runs but have to admit the shoes are probably 2 years old. I did run 2 miles this weekend to test the shoes out and the leg. I have some pain initially and it is not too bad when I run, however it is the up and downstairs mostly when I feel the pain and some sting occasionally on the lateral inside aspect of the leg. I did ice the leg after that run. I did have some major burning in my feet during the night after that first run with the new shoes, but I had experienced that also the first time with the Brooks as well. Is that a usual phenomenon with new shoes?
I do appreciate your comments. Just wondering to take it slow or rest some more. Prior to two weeks ago, I had not run for a month, but the pain resurfaced pretty quick. Any guidance is duly appreciated.
ANSWER: Yikes! Using 2 year old shoes! That's asking for trouble...
If the pain eases while running I'd suspect a shin splint type injury (muscular - most likely the muscle that runs along the inside of the shin - posterior tibialis). This muscle acts as a real foot stabilizer - it helps to "slow down" or control the amount of pronation happening during weightbearing on that side. It can somewhat "loosen" up as you warm up into your run - but get stiff and painful when you stop and rest. Walking down stairs is an activity that occurs more on the ball of the foot - another action that uses this muscle (again to stabilize the foot).
Stress fractures typically just feel worse when you run (unless you're in the early stages - what MD's call a "stress reaction"). Generally 8 weeks of rest is recommended for a stress fracture.
That being said, the injury should be addressed by an MD and hopefully a referral to a physical therapist. A thorough evaluation by both should uncover any alignment issues, or weaknesses in ANY part of the leg (the hip is a likely culprit for runner weaknesses). Before you return to running have this taken care of, as you will just continue this injury/rest/injury vicious cycle.
Cramping - Top of Foot
When I participate in a rigorous strength training / weight loss program, the tops of my feet hurt, and they cramp during the darndest times! Sometimes just walking. I would have to "pull over". Do you have any advice for a comprehensive stretch program? I do have some anatomy and biomechanic knowlegde, but is it very basic. The frustration and confusion is being unable to apply my knowledge thus far to help me to acheive my own fitness goals. I have been in the fitness industry for a year, and my lack of answers and practical use of information for myself drastically hinders my success as a professional because I am afraid of injury and injuring others. It's not "clicking" yet with the flexibility. Many terms of externally / internally rotated this-and-that but not much on corrective flexibility programs. Please help. I would love to have sanity, more money, and a fit body! :-)
ANSWER:This may not be simply a flexibility issue. The tops, not bottoms , of your feet cramp? very unusual. Do you have rigid, high arched feet? If so, you may need to look into a more cushioned shoe (preferably a good cushioned running shoe- ie: asics cumulus or nimbus; NB 1061; saucony trigon ride to name a few - get over to a Running Co. store for a specific fit) - be careful how you lace up the shoe - you may be cutting off circulation. At the 2d to last eyelet nearest your ankle, create a loop by bringing the lace up through this 2d eyelet and over into the first on the same side. Do this on the other side also, then take the ends and bring them through the loopholes on the opposite side and pull. This will decrease pressure on the top of the foot.
stretching is always a good idea - calf/ arch (use a prostretch); and also the front of the shin - a ballet teacher showed me a good one - standing: cross right foot over left with the top of the foot facing down and pressed against the floor; then bend your left knee and "push" it into the right calf to get a stretch in the front right shin.
Remember to stretch hip area - especially the hip flexors, ITB and piriformis (use a foam roller prior to work out any tender points) - tightness here can affect leg circulation.
Work on strengthening the foot also - 1 leg balance- type activities first on the floor then on a foam roll or pad for an unstable surface - do it barefoot to really use the foot intrinsics.
If all else fails, you can get a Doppler from a vascular MD to get a good look at your circulation.
remember to hydrate and get your electrolytes in!!
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