Spring is in the air and the Cooper River Bridge run is three weeks away. If you are training for the bridge run and are experiencing discomfort on the ball of your feet you may have a Neuroma. The combination of wearing narrow, pointed-toed shoes at work and the pounding of that your feet endure from running on hard surfaces can cause a neuroma, a painful nerve disorder of the feet. It can be a stressful combination for your feet.
Active women who enjoy running, especially those with flat feet, are prone to develop neuromas. A nerve located between the toes becomes enlarged and inflamed and produces tingling, burning pain.
Neuromas enlarge as the condition progresses, causing pain and numbness to a consistent area at the base of the toes. Patients often complain it feels as if something is stuck inside the ball of the foot. The symptoms may go away temporarily by massaging the foot, wearing wider shoes with low heels, and tapering your running and other activities that aggravate the condition.
Symptoms become more intense as the nerve enlarges and the temporary damage becomes permanent, so it's best to seek treatment if discomfort persists for more than a few days.
Neuromas can develop in different areas of the foot. The most common occurrence is called Morton's neuroma, which develops at the base of the third and fourth toes. Thickening and swelling of the nerve usually is caused by compression and irritation from wearing very narrow shoes or high heels that crunch the toes in the front of the shoe. A neuroma can be detectable with an ultrasound examination , but the diagnosis is typically based on symptoms and a physical examination to palpate the nerve or a maneuver that elicits an audible click.
Treatment options for Morton's neuroma depend on how far the condition has progressed. At early stages, padding (Metatatarsal pad) lessens pressure on the nerve, icing reduces swelling, over-the-counter anti-inflammatory medications and cortisone injections decrease pain and inflammation, and over the counter or custom orthotic devices provide support to reduce compression. If you are training for the bridge run it may help to run on softer surfaces such as grass or dirt trails until the condition improves.
In severe cases, surgery might be the best option to provide relief.

One month until the Cooper River Bridge Run. Have you been gradually increasing your mileage? Are overuse aches and pains settling into your feet, knees or hips? If so it is possible that your running posture and biomechanics are setting you up for failure and breakdown. Focusing on form and technique can help you stay injury free.
In 2004, Danny Dreyer wrote Chi Running: A Revolutionary Approach to Effortless, Injury-Free Running. He outlines a running form and posture to prevent injury and provide energy efficiency. Based on the physics of body mechanics and some of the teachings of Tai Chi he recommends the following:

1) Run Tall- Stand straight without slumping your shoulders or bending at the waist.
2) Lean Forward- A slight forward lean from the ankles while keeping your spine straight.
3) Land on the Mid-Foot- Land with a mid-foot strike when you run while allowing your feet to land underneath or slightly behind you.
4) Run from Your Core- Keep your pelvis level by engaging your lower abdominal muscles throughout the run.
5) RELAX- Keep all your muscles as relaxed as possible and let your forward lean propel you.

It is possible to change your running technique, but it takes time to break inefficient habits. I have personally switched to the Chi Running techniques for the past 6 months and I have eliminated many of the nagging injuries I have been dealing with for years. Give it a try. Who knows you may find yourself running farther, faster and with less injuries than ever before. See you on the Bridge!

Carolina Foot Specialists on TV: Dr. Saffer appeared on Lowcountry Live Channel 4 news on Monday morning February 8th. The topic was "Heal that Heel Pain". If you have heel pain and are training for the upcoming brige run than look on our home page website and find the You Tube icon for the segment:

Carolina Foot specialists website/You tube icon

Look out for previous TV segments with Dr. Brown in the upcoming weeks on our You Tube icon.

Bridge run website

It's that time of year again. The Cooper River Bridge Run is only 2 months away. Many of you are thinking about starting a training program in preparation of the big run at the end of March.
Due to the large number of overuse foot injuries we see in the office following the Bridge Run, we have decided to write a Foot Injury Prevention Series to hopefully decrease the amount of heel pain, joint pain and ball of foot pain to our locals and out of town runners and walkers.
Two important factors can aid in proper training and prevention of overuse foot injuries. The first is a new pair of running shoes. As a shoe is worn over time it gradually loses its stability and cushioning, which would normally help decrease strain to the foot. Visit any of our knowledgeable running stores in Charleston to be fitted properly.
The second factor is a plan to gradually increase your mileage each week. If you are just getting off the couch and have not been very active then try a walk/jog program for the first week or two. I generally start my patients out with 3 minutes of walking and 2 minutes of jogging for a total of 15 or 20 minutes. If there are no increased aches and pains the following day then we will progress to 2 minutes of walking and 3 minutes of jogging and continue this pattern until you are able to jog for 20 minutes straight. Try to avoid consecutive training days if possible. I prefer for my patients to run 2 sessions at the same rate and distance before progressing to the next stage. A gradual increase over the next several weeks of short and long runs should have you ready for the Bridge Run.
If at any point in your training you begin to have constant aches and pains try returning to a time and distance of a previous run where no foot pain was present and try to progress at a slightly slower rate. If pain continues try taking several days off with rest and ice or see a foot specialist.
Good luck with your training. See you on the bridge!

Jimmy Clausen injury link ESPN.

The quarterback for the Notre Dame football team, Jimmy Clausen, recently underwent surgery to repair torn ligaments under his big toe joint. Twisting and flexing the joint caused a "pop" that was felt in a game early in the season. He continued to play with the injury which never fully healed.

"Turf toe" is a condition in which the big toe bends upwards to an abnormal degree, causing pain at the bottom of the big toe, damage to the ligaments that connect the foot to the big toe, and damage to the joint capsule. Usually, the front of the foot is flat on the ground and slightly flexed upwards, with the heel raised off the ground. With the heel in this position, an outside force, which is usually another player, forces the joint of the first toe upwards even more.

Initial treatment includes rest, ice and elevation. A stiff soled shoe can help decrease movement of the big toe joint while walking. Crutches and/or a walking boot may be necessary in a severe injury. If discomfort continues a custom orthotic device can be made to decrease strain to the bottom of the joint.

Jimmy Clausen underwent surgery only after an MRI revealed that he had completely torn ligaments under the big toe joint. This severe of an injury rarely occurs and most athletes can return to the field within several weeks of a "Turf Toe" injury.