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You are going to injure yourself if you run. Sorry for the bad news, but it will happen sooner or later. That isn’t to say running is bad for you or bad for your feet necessarily, but as in any sport, injuries occur. The most common injuries we see in runners are plantar fasciitis (heel pain), shin splints, Achilles tendinitis, peroneal tendinitis, posterior tibial tendinitis, stress fractures and metatarsalgia (pain in the ball of the foot). In today’s blog, I will go over how to prevent some of these common injuries.
-Shoe Gear: The first thing any runner should look at is their shoe gear. Shoes should be picked by your foot type, type of running (long distance, sprint, track, trail) and gait. Shoes should not be picked because you like the color or the brand is “cool”. Most runners can be comfortable in a neutral shoe to a slight over-pronator. These shoes will be semi-stiff through the midsole and flex at the big toe joint. If you have flatter feet or “over-pronate” (roll your foot inward) while running, a stiffer over-pronator shoe may be beneficial.
In all running shoes, the big toe joint should be flexible and the midsole should be somewhat stiff. A shoe does not need to bend in the midfoot for proper running motion, and shoes that do so can lead to arch pain and fatigue. Shoes should also have padding at the heel and forefoot to prevent over stress. Inadequate padding can lead to heel pain and metatarsalgia.
Shoes should also be changed every 200-300 miles. Shoes have foam rubber cells that get compressed over time. When these cells lose their ability to absorb shock, it can lead to heel pain, stress fracture, metatarsalgia and shin splints. We recommend New Balance, Saucony, ASICS, Mizuno, Brooks, Altra and Hoka shoes. Avoid “barefoot” style running shoes. If we were meant to run barefoot, we wouldn’t have invented shoes!
-Running Style: There are 3 different running categories most runners fall into; heel strike, midfoot strike, or forefoot strike. Each of these gait patterns has their own set of injury risk. If you have been told in the past that “running on your heels” or “running on the ball of your feet” will keep you injury free, it is not true. Patients with a heel first strike are more prone to knee pain, heel pain, peroneal tendinitis and posterior tibial tendinitis. Patients who strike the ground at their midfoot or forefoot are at higher risk for stress fractures, Achilles tendinitis, metatarsalgia and arch pain. If you are prone to a certain type of injury, changing your running style may help to prevent recurring problems.
-Orthotics: Inserts for the shoe are not needed for every runner, but they can benefit runners who have developed injuries in the past or are prone to injury from their foot type or gait. Custom orthotics can relieve arch pain and fatigue, heel pain, forefoot pain and lessen the impact on the foot joints. Your Podiatrist can help to write a proper prescription to help to balance the foot and align the lower extremity joints. This can make your stride more efficient and decrease fatigue.
-Stretching: A good warm up, stretching and myofascial release (foam rollers, etc) are essential to maintain good foot and ankle health. Stretching should be done before and after a run for maximal benefit.
It is important to consider your body long term when running. The human body was not meant to run multiple miles in a week, and repetitive injuries occur when we push our bodies past their breaking point. I like to remind my patients that the “Marathon” distance was named after an ancient Greek runner delivered a message to the King telling the outcome of the battle of Marathon. He died from running that far after delivering his message. That being said, we can safely run those distances if we put in the proper training and preventative care. I have run to marathons and survived both.
Chris Suykerbuyk, DPM, FACFAS
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