The most common overuse injuries in running and how to protect yourself from them: Plantar Fascitis

As you begin ramping up your running in preparation for an upcoming race, triathlon or just general fitness, it is also the season for overuse injuries. One such injury is plantar fasciitis. Plantar fasciitis results from the breakdown of your arch which stretches a tissue called the Long Plantar Ligament. Unfortunately, this ligament is not elastic and therefore does not stretch. Rather, this tissue undergoes micro-tearing. Symptoms can reveal themselves as general arch pain, bottom of the heel pain or a gradual achiness which does not go away. If the first step out of bed in the morning elicits extreme pain, you more than likely have plantar fasciitis. Regardless, it is extremely important that you address these symptoms sooner, rather than later. The general rule: it will take twice as long for these types of injuries to heal as from the time you first experience symptoms until the time you first start your treatment. Rest, ice, gentle stretching and a break from training are your early treatment interventions. If, in your opinion, you have excessive arch breakdown (a.k.a pronation), a treadmill evaluation (biomechanical exam) can be done by The Foot Mechanic™. In many cases, an orthotic can be the answer. An orthotic is a device that replaces the liner in the bottom of your shoe and re-creates your arch, thereby returning your foot back to its “normal” mechanics. When choosing the proper orthotic, it is important to avoid over-the-counter (a.ka. retail) products as they are not custom to your feet.

Dr. Brett Purdom, DPT, ATC, CSCS
The Foot Mechanic™
www.thefootmechanic.com

Deconstructing ‘Five-Finger Running’ From an Injury Standpoint

The latest craze in running is Vibram’s new “Five-Finger” types of shoe ware. Although these products may be appropriate for a very select subset of the running population, the recent explosion of hype regarding this new craze has exposed many runners to a significant risk of injury . The premise of this style of running is that it will make the muscles around the lower leg and foot strengthen, subsequently restoring the runner’s function back to its evolutionary pre-shoe “normal state.” The untested theory behind this new fad can lead to two very serious problems. First, it requires the runner to adopt a new midfoot striking running pattern. Ninety-eight percent of all runners are heel-strikers. Without the proper coaching into how to transform from a heel-striking pattern to a midfoot striking pattern, the runner is left in the dark concerning this crucial modification. In fact, Ross Tucker, PhD “The Runner’s Body“ has found that 83% of all runners who make the switch to Vibrams continue their heel-strike pattern. Dr. Tucker’s research has concluded that since there is no cushioning in the Five-Finger shoe ware, heel pressures are seven times greater than running in a normal running shoe, markedly increasing the chance of injury. Here is the second problem of Vibram’s theory: Muscles and tendons by definition are meant to create motion across joints. Ligaments on the other hand, are meant to connect bones together and are responsible for giving the body structural integrity. In the foot they are responsible for holding your arch in a high position. When a person over pronates, the ligaments fail to do their job. Five-Finger systems would have you attempt to train muscles to do the ligaments job. This creates abnormal stress on the muscle/tendon unit and leads to inflammation, pain and eventual loss of function. This breakdown, in its early stages will present as small areas of inflammation and minor tendinitis. If left untreated, it can proceed into chronic tendinitis (which is much harder to treat), plantar fasciitis, Achilles tendinitis and other problems of the ankle, shin, knee, hip and low back pain. Additionally, all the muscles throughout this “kinetic chain” may be forced into performing stabilizing work which is not their primary function. This too may lead to overuse injuries which are not directly associated with the movement dysfunction down the kinetic chain.