Runner’s Knee – Tips for prevention

Runner’s knee, or patellofemoral pain syndrome, is one of the most common overuse injuries.   This malady isn’t reserved only for runners but rather can result from many sports including skiers, soccer players, or any other sport that put high demands on your knee.  It occurs when patella, better known as your knee cap, causes irritation of the femur, or the large bone underlying the muscles of your thigh and hamstrings. Normally the ligaments and muscles of your leg hold everything in proper alignment allowing the two bones to glide past one another. There are several factors that can contribute to ‘throw a wrench’ in this efficient function. 

Overuse can cause muscles to weaken and put you at risk for injury. Without proper periods of rest and nutrition, our bodies cannot build or repair the muscles fibers that are affected during our runs.   24 hours between runs, with a good night’s rest and a decent diet are often enough to prevent overuse, but each of us are different and need to make adjustments accordingly.  Additionally, our muscle groups almost always pull against or counteract another group.  When we fail to work both groups appropriately, one group may gain an advantage over the other. Unfortunately, imbalance or weakness in any of the components that act on your knee can lead to this pain condition.

Prevention can be as simple as running smart.  Allow for sufficient rest and slowly increase the distances you run. In addition to eliminating the overuse component by doing this, you can be proactive in keeping your muscles strong and preventing imbalance.  Implementing strengthening exercises for your lower limbs is just as important as stretching when it comes to preventing runner’s knee. We recommend exercises to strengthen your ‘quadriceps’ and ‘hamstrings’ as they act on your knee.    Keeping these two muscles groups stretched and strong will do a lot to keep imbalance from occurring.  Problems can always occur despite your best efforts.  When a few days rest don’t improve the pain, make a visit to see your Austin podiatrist.  There are a variety of bracing or shoe inserts that can be used to keep you in proper alignment and allow your painful knee to resolve.

Form and Function – Foot structure and running style

A recent article out of Pennsylvania State University kinesiology research shows that sprinters and non-sprinters have measurable differences in their foot structure and the muscles affecting them.  With a relatively small sample size, 16 runners, they compared MRI images to find shorter Achilles tendons and longer ‘big toe’ bones on average in sprinters than in non- sprinter runners.  The men examined in the study were all active athletes of several years duration.  The rational of a more efficient lever arm because of these findings is interesting for kinesiologists, but somewhat misleading from our point of view.

Shortening of the Achilles tendon may contribute to greater speed in competitive sprinters, but it can have detrimental effects in the long term.  The metatarsals are the long bones behind your toes that take up a good portion of your foot. They do create a lever action where they meet the toes during normal heel to toe walking or running.  When instead, as in sprinting or wearing high heels, they take the full force of your body weight on one leg problems can occur. It is true that the tendons and muscles transfer the force through your foot and up your leg as the barefoot philosophy relates. Unfortunately, without carefully building up the muscles or bone tolerance, fractures can and often do occur. Spending too much time on your toes either in heels or while running can lead to stress fractures or actual breaks in your metatarsals

This isn’t to say that sprinting or barefoot running doesn’t have a place in your running regime.  Implementing these things as a part of your running routine can help to diversify and build on your abilities. We strongly encourage you to implement a variety of stretching techniques to keep any of your leg muscles from become tight or contracted.  It is a good idea to see your Austin podiatrist to address any concerns or problems with your running regime.  Be sure to slowly introduce changes to your running regime and limit the amount of time you spend on the balls of your feet. 

New Runners - Running in Austin is a Year Round Event

While other parts of the country a buried under inches or feet of snow or dealing with sub zero temperatures this time of year, we Austinites can enjoy being outside year round.  Yes, the temperatures can dip into the teens on that rare occasion, but running outside is almost always an option. If improving your health is part of your resolutions for this year, running is one of the simplest ways to do it.

In addition to shedding fat, adding muscle, and improving cardiovascular health, this activity will help increase the strength and density of your bones.  Many people, especially women, will lose bone density with age.  Running is a great way to build that density up and keep your bones strong which will make them more resistant to breaks.  There are many activities that one can do to stay healthy, but, as we pointed in this month’s newsletter, few others require less equipment.  Strap a good pair of running shoes on your feet and you have a wealth of many different trails and paths to run on in the area. No gym membership required!  Do pay attention to the type of surface you are running on.  While it may be easiest to run on the sidewalks in your neighborhood, concrete can be very demanding on the joints of your legs and feet.  Instead, consider a dirt trail or designate running track as a new runner.  Running on a softer surface will give your body opportunity to adjust to the new demands placed on it.

Before you join the large community of Austin runners, make a visit to your family physician.   A regular check up is a good way to catch any possible problems before the increased demands can cause damage.  Likewise, make an appointment with your Austin podiatrist to investigate any minor aches or pains.  That mild ache in your heel or nagging stiffness in your toe can become very painful, very quickly if not cared for before you begin running.  Too often foot pain and limit or prevent you from participating in various activities.  Unfortunately, many of these pains can be eliminated with proper treatment by a podiatrist.  A proper evaluation of your feet can also help you to select the proper running shoes for your foot type.    Take the time to properly prepare yourself now and you can enjoy your runs for years to come!

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Dwayne Wade – Heel Pain & Ankle Sprains

Miami Heat’s Dwayne Wade returned to action on Tuesday after missing 3 games and many practices over the last week.   He had been ‘taking it easy’ during that time in order to recover from heel pain.  The team had reported he was recovering from a ‘bruised foot’ that occurred against the Charlotte Bobcats. When the injury didn’t resolve after a week, Wade speculated that the injury may be his plantar fascia.  Whether he was fully recovered or not Wade seemed to have any problems in the game against the Golden State Warriors.  Unfortunately, the team hasn’t secured a win since his return and Wade’s injuries have mounted.  He strained his calf against the LA Clippers on Wednesday and sprained his ankle Friday against the Denver Nuggets.

Wade was concerned that he may have broken something as he’d ‘never sprained it like that before’.   With any ankle injury, it is important to rule out fractures with x-rays.   NBA players are liked to get to an x-ray quicker than you or I, but it is important to RICE (rest, ice, compression, elevation) any kind of ankle injury as excessive swelling can often make the problem worse.  Your body uses swelling to supply healing nutrients to the site and protect it.  The ankle joint often cannot easily accommodate large amounts of swelling and can complicate the injury.  For ankle injuries like this, an early treatment would be an injection to the ankle with a local anesthetic to relieve pain as well as a corticosteroid to help reduce swelling.   Doctor’s will most likely recommend early physical therapy as ankle sprains can become chronic if not treated aggressively.

While the ankle injury appears to have occurred on its own, we have to wonder if the heel pain played any part in problems over the last few games.  Heel pain can have many causes and all are not as straight forward as we have tried to point out before.  A thorough evaluation by a podiatric physician will identify the cause of your pain and the best course to correct it.  We hope Mr. Wade heals quickly and is able to get back on the court.

New running shoes for the new year – Know your foot type

Most of us have probably found a brand of shoe that works better for us than another. Since each shoe company uses a different design for the sole this is not surprising, but even within a brand there can be much variability in the support and structure of different styles.  Shoes designed for cross training or hiking need to provide more side to side stability, where those designed for running are focused on energy transferred from heel to toe.  Within the styles of running shoe, we can further look at the amount and type of support to address the motion of your foot.  Pronation, or the motion of pressure from outside heel to the inside ball, can be exaggerated in some individuals.  Because an excessive amount of motion in this manner can cause problems, Austin Foot and Ankle Specialists recommends these shoes based on your foot.  A thorough examination of your feet in our clinic can provide you all the information you need to select the proper footgear.

Foot pain can often be caused simply by the structure of your foot.  The normal foot exhibits an arch on the inside when standing normally.  A foot with a very high arch is cavus, and a foot with no arch, or flat foot, is planus.  Most individuals fall somewhere between these two extremes, but knowing which extreme your trend towards can help you from incurring the aches and pains that can come from putting then in the wrong shoes.   Often the right type of padding or support in the right places will be enough to keep you running, but many options are available to correct painful foot structure through your Austin podiatrist.

In addition to our website, there are a variety of sources out there to help runners with shoe selection.  The American Association of Podiatric Sports Medicine has an extensive list of shoes based on the support they offer as well as other advice for the runner.  The APMA has a webpage devoted entirely to the runner. You can also find a link here to guide your shoe selection based on arch height.

Heel pain due to weight gain

Image via Wikipedia

At a time of the year when spending time with family, doing for others and eating big meals, there are few of us who are surprised when we put on a few pounds.  Even though Mother Nature treats us a little better than other parts of the country it is definitely not as pleasant for walking and running outside as rest of the year.   It is an unfortunate fact, but those few extra pounds may be the source of heel pain.  On the same note, a survey by the American Podiatric Medical Association indicates that foot pain, of which heel pain is a large component, cause many Americans to gain weight due to lack of activity.

This can often become a compounding problem. The more weight you gain, the more heel pain your may have and more heel pain you have the less likely you are to exercise those pounds away.  While there are a variety of exercises, such as swimming and biking, that are not limited by heel pain, we must admit that for most of us these options are not as easy as walking or running.  Strapping on a good pair of running shoes and taking a lap or two through your neighborhood is about as easy as it gets.  Remembering to do proper stretching of your feet, especially the plantar fascia, as well as your legs can help to keep the loose. Heel pain can often be the result of tight ligaments and muscles.  Foot pain can quickly limit this and should not be ignored.

This can be a very demanding time of the year.  The last thing you need is heel pain limiting your activity.  An evaluation by Austin Foot and Ankle Specialists can identify the source of your heel pain and get you back to your activities pain free.  There are many different causes of heel pain beyond weight gain and tight tendons so a thorough evaluation is necessary to avoid more serious problems.   A variety of treatments are available through your Austin podiatrist.  Don’t delay in having your heels feeling good for the holidays!

Runner’s World Body Breakdowns – Heel pain big part of the list

This past months’ print issue of Runner’s World had an article on common injuries to besiege runners.  If you are not a subscriber, an online version of this article can be found here.  Unsurprising to us is that at least three of these injuries can show up as heel pain.  Whether it is a stress fracture, Achilles tendonitis, or the all too common plantar fasciitis, this article highlights some of the steps you can take to deal with them if they occur. Because it can be difficult to distinguish the bone damage that occurs from a stress fracture from tendon damage, we must recommend you recruit the help of a foot specialist.

Often ‘taking it easy’ or giving yourself a few days of rest can help many mild inflammations, aka ‘itis’.  Beyond this you need to address why the problem occurred in order to prevent it from happening again. In the case of stress fractures which may often require X-ray or CT imaging to verify, you may requires more than a few days of  resting and immobilization to allow for the bone to properly heal.   Resting an injury sound like an easy solution, but even if you slow down or stop your running routine for a few days you still have to continue your daily life.   Honestly, who amongst can afford to stay off our feet for any extended period of time?  Special boots can be used to transfer the pressure and strain on your foot bones and tendons higher up your leg, these specialized boots can effectively rest the injury while keeping you mobile and various modalities can be implemented to help you heal.

If your symptoms worsen or do not get better, it is important that you visit your Austin podiatrist.  A thorough review of your activities, home treatments, symptoms, and foot mechanics can help your doctor to identify and implement ways to correct the problem.  Proper foot wear, warm ups, stretching, and building up to greater distances can all go a long way in preventing heel pain and other running related injuries.  When good prevention fails, it is time to seek out podiatric care…..

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