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We hope your Cooper River Bridge Run training is going well. We would like to talk briefly about a common running injury that we see in our practice which is the Morton's Neuroma. I have personally battled this condition on and off for many years. A neuroma is an inflammation of the digital nerve that runs between the third and fourth digits. Pain typically is sharp or throbbing and feels as if you have something bunched up in your sock. Radiating numbness and tingling can occur between the third and fourth digits. Contributing factors can be reduction of fat pad on the ball of the foot, increased load to the plantar forefoot, higher heel shoes, and tighter toe box shoes. Conservative treatment options would be wider toe box running shoes, oral NSAIDS, offloading metatarsal pads, cross training to decrease load on the plantar foot, cortisone injection, alcohol sclerosing agent injection, and custom foot orthotics.

I would like to give you my personal insight considering that I have struggled with this foot condtion for the past 10 years. My neuroma pain has been managed with conservative treatment. I have custom foot orthotics with offloading metatarsal pad that takes pressure off the inflammed nerve, I have had two previous cortisone injections that have alleviated my pain. Recently I have changed running shoes. I have researched running shoes options and found that the Brooks ghost 11 has been the best running shoe for my neuroma. I feel that Brooks Ghost and Hoka running shoes would be good options if you are suffering from painful neuromas.

As I increase my mileage I do sometimes feel the neuroma so I usually back off my mileage a bit and cross train. I suggest swimming, strength training, and cycyling. Other suggestions would be to run every other day to let the foot rest. Recently I have been running on the beach and I have found that the softer sand decreases ground reactive forces on my forefoot where the Neuroma is located.

I have had patient's not respond to cortisone injections and other conservative options.  If needed  the alcohol sclerosing agent injection is another good option. This type of injection decreases the pain signal of the nerve that is inflammed.

Good luck with your training and if you have any questions please email our practice or respond to the blog.

www.carolinafootspecialists.net

Image result for neuroma foot

 

Foot-Friendly Tips to Prevent Common Running Injuries

Below is  a nice article from the American Academy of Podiatric Sports Medicine with regards to injury prevention tips for road races. Please look out for weekly advice on foot injury prevention for the upcoming Charleston Marathon, Myrtle Beach 1/2/Full Marathon, and the Cooper River Bridge Run 2019. Good luck on your training!!!

Bethesda, MD – Making running part of a workout routine leads to better physical stamina and a more positive state of mind—but a detrimental foot injury can quickly stop runners in their tracks. Keeping feet healthy and pain-free can go a long way toward ensuring that every run is enjoyable, for both experienced runners and those just starting out. Following a few simple steps provided by the American Podiatric Medical Association (APMA), before hitting the trail or treadmill, can keep foot and ankle injuries at bay.

"Some of the most common running-related foot injuries that today’s podiatrists treat are arch pain, tendonitis, and blisters," said APMA president Kathleen Stone, DPM. “However, if runners can take just a few minutes to stretch properly pre-workout, select appropriate footwear, and see a podiatrist immediately when foot pain occurs, many of these ailments can be avoided entirely.”

In order to get the most out of each run without falling victim to injury, APMA recommends the following:

Select a good running shoe: According to Karen Langone, DPM, president of the American Academy of Podiatric Sports Medicine (AAPSM), the most important running tip is proper shoe selection. “A running shoe purchase is dependent upon the type of foot and function of the foot for the individual. Runners should research shoe construction and keep in mind that footwear can vary in size from one manufacturer to the other,” she said.

APMA has recently given several running shoes its Seal of Acceptance for allowing proper foot function, including models made by Puma, Mizuno, Asics, Reebok, Avia, and Ryka. A sports medicine podiatrist can help aid in the footwear selection process if needed.

Select good socks: Runners should always fit shoes with the socks that they plan on wearing during a run. Socks should be made of a poly-cotton blend that pulls moisture from the skin, fit well, and be comfortable when worn with a running shoe.

Stretch out and build momentum: Before a run, begin by warming up and gently stretching for 5-10 minutes, focusing on lower leg muscles. Amateur runners should start with short distances, increasing distance over time to help prevent injury. All runners should begin every workout slowly, as this allows the body to warm up further and decreases the chance of muscle strain. Runners should also focus on keeping both the feet and entire body relaxed, avoid tensing or cramping toes, and run with a gait that feels the most natural. Cease running immediately if any pain is experienced.

Cool down and rest: After reaching the end of a running workout, cool down and stretch for about 10 minutes. Submerging the lower extremities in an ice bath after longer runs can reduce muscle soreness, as can the use of a self-massager designed for post-athletic activities (Health Enterprises Therapeutic Hot & Cold Foot Massager has the APMA’s Seal of Acceptance).

Muscle pain is common after exercise, and minor injuries may be treated with the RICE regimen (rest, ice, compression, elevation). However, if pain does not resolve itself after several days—or returns immediately upon resuming exercise—runners should seek out care from an APMA member podiatrist immediately.

Frequent runners should see a podiatrist on a regular basis to maximize any running program and prevent serious injury. For more on running and foot health, visit APMA’s new Runner’s Resource page at www.apma.org.

We hope everyone had a safe and injury free walk/run during the Cooper River Bridge Run this past weekend! We would like to get back to basics with proper running form so that you remain injury free for the spring and summer months. Here are some nice tips to help avoid injury and keep you on your feet.

Starting with the foot: Where should you contact

Some say to run on the ball of your foot, others say contact the ground with the heel. I take a middle of the road approach. Studies have shown that good long distance runners usually contact with the midfoot. Slower runners contact between the midfoot and the heel, faster runners a bit further forward. Only sprinters or short to middle distance runners should contact the ground with their forefoot or the ball of the foot. While there may be exceptions to the rule, this is a good way for most beginning and intermediate runners to start out. It allows for better shock absorption, less stress on the calf muscle and Achilles tendon, and better rolling forward onto the next stride. Your muscles will then be used in a manner that is similar to how you walk, and this is the pattern of muscle firing and contact pattern which the muscles are accustomed to.

Hips & Head

This part is hard to think about: Where are your hips when your foot hits the ground. Some people have suggested that your foot should be under the center of gravity of your body when it strikes the ground. A line from your head through your hips should end up at your foot. Keep the head fairly straight and look ahead. Turns to the side should be done carefully and usually mostly from the neck up to avoid twisting your body and making you unstable in your forward progression.

Arm Carriage

This is what you use when you haven't obtained a jogging baby stroller. Actually, it is where you allow your arms to swing. First, and most importantly, don't tense up and carry them stiffly with your hands balled up into a fist and your elbows completely bent. Relax. Carry your arms at your side somewhere between your waist and your chest. Make sure they are not too high or too low. One arm swings forward while the other one goes backwards. This occurs opposite to the foot and leg motion. Sprinters on the track move their arms in a straight forward-backward motion. Most longer distance runners use a slight arc as they swing their arms, but the better ones don't waste motion by moving too much from side-to-side. In other words, they don't swing their arms excessively in front of their body.

Knees

The knees do not have to come up very high for long distance runners. Only sprinters or those of us chugging up a hill have to left our legs high.

Stride Length

One of the biggest problems of form in long distance running is overstriding. Make sure that you don't do this, it can lead to a host of problems including Achilles tendonitis, ITB pain, and iliopsoas muscle pain.

Breathing

While some like to tell you how to count your breathing in seconds both in and out, we will just tell you to keep breathing, deep and regular. In most cases your breathing will take care of itself, as you run faster, you'll breathe faster. And yes, most runners are mouth breathers or at least nose and mouth breathers. It would be impossible to take in adequate oxygen just breathing through your nose.

Uphills and Downhills

Slow up a bit on the uphills. In general it is a bad idea to try going faster. Move your arms a bit more to help you imagine that you are cranking your way or pulling yourself up hill. Shorten your stride and chug on up. You can think of the little train that could and repeat "I think I can" on the way up a big hill.

On the downhill, be careful. Go slow. The biggest risk, is to your knees. Your quadriceps do the bulk of the braking and be overworked without you being aware of it. If you are racing, then you may lean forward a bit and fly down the hill in a short race, but certainly be more careful in training. In fact many runners who use hills as part of their training will walk down the hill while recovering to run up the hill once more. This is a good way to rest and recover while avoiding the excessive knee stress that downhill running can cause.

If you have any lingering pain in your feet after the Cooper River Bridge Run please contact us at: www.carolinafootspecialists.net

 

If you suffer from Bunion pain and find it difficult to exercise in your athletic shoes take a look at this article from Runner's world for effective solutions. Surgery is not the only treatment for painful bunions. I have seen many patients run marathons with large bunions without significant pain. Many accomodations are available from wider toe box athletic shoes, bunion splints, bunion gel cushions, ice, Custom sport foot orthotics, and NSAIDS.

http://www.runnersworld.com/injury-treatment/8-effective-solutions-for-bunion-pain

Also take a look at our CFS video on Bunion evaluation and treatment.

http://carolinafootspecialists.net.edit.officite.com/bunionbunion-surgery.html