Foot Pain

Running With Injury – Is It Time For A Rest?

Running With Injury – Is It Time For A Rest?

If you’re a runner, chances are you’ve asked yourself this question. Up to 80% of runners will sustain a running-related injury at some point. If we include running with a cold or flu, then the number jumps to 100%. The question is, do you rest, modify your training or continue on as if nothing’s wrong!

running-rest-day-myths

running-rest-day-myths

Whilst we’re all different and each of our circumstances unique, here’s what I suggest you think about as you contemplate whether to strap the shoes on or stay in bed:

  1. Is it acute? If you suffered an injury significant enough to cut a training session short, you should take 48-72 hours off, give it a chance to settle and throw some ice on it. If it’s still troubling you after this rest period, get it seen to.
  2. Is the injury bad enough to affect your running style? If you can’t run with your normal gait, continuing to train will lead to a worsening of the injury or a secondary injury somewhere else. We see this all the time. Take some time off, cross-train, and/or see a professional.
  3. Is this a recurrence of an old injury? Keep an eye on these ones. It may just be that your brain (and your genes) have some ‘memory’ of the old injury, but always better to get on to managing these injuries quickly. If you do, you can usually stop them from progressing.
  4. Is the injury getting worse? In most cases, if you record a worsening of an injury over the previous week of training, it’s not going in the direction you want! Take some time off and consider getting someone in the know to have a look at it.
  5. Is your ‘cold’ more than just a ‘cold’? If your symptoms are typical for an upper respiratory tract infection (sore throat, sniffles and other things above the neck) then you’re probably ok. Research suggests that training in this situation wont make you worse or slow your recovery. However, if you have symptoms of a fever or cough (i.e. anything below the neck) then you need to rest, or there’s a good chance you’ll regret it!

I hope these tips help, but regardless of your answers, as you start to feel better and make your way back into training, back off a little and build your training up slowly. Taking some time off and then jumping straight back in is one (if not the most-likely) reason for problems to occur.

Most injuries are simple to manage with a common-sense approach. Be wary of reading too much on the net, as there’s an awful lot out there and a lot of it is…not prudent advice! If you’re unsure whether you need to see someone, set up a Skype appointment with one of the expert Sydney Physio Solutions Physiotherapists. They’ll ask you a series of questions and help you wade through the plethora of information available to advise you how best to tackle it.

Thongs / Flip Flops – Pain Triggers

 

flip-flops

Thongs / Flip-Flops / Jandals (?!)… Are they killing your feet?

It might be the depths of winter (brrr..) but some clients here are still in recovery from the Summer-killer: Thongs!

What’s so wrong about them?

  • Arch – Thongs generally provide no arch support whatsoever. Over time this can lead your fascia to work harder, potentially creating micro-tears as the fascia gets stretched and over-worked/un-supported. This can lead to a dropped arch called “pronation”, which is hard work to build back up, or needs supportive shoes/Orthotics to correct it and support your foot again
  • Gait Biomechanics – normal gait sees us strike the ground with our heel, roll through form the outside boarder of the midfoot, and back towards the big toe, pushing off from all of your 5 toes. Practise this – how good (and normal!) does it feel? …Now try clenching your toes upwards and do the same thing… Hard?! Yes, that’s what your feet are doing every step in Thongs, toe-clenching to grip the shoes on your feet, making the foot more rigid, altering the way your foot and fascia move, and the whole way up the kinetic chain
  • Heel Pain – heard of plantar fasciitis?  (Read our blog here) You probably know at least one person in your office with it!? Not just from running.. The flimsy 1cm of rubber under your heel doesn’t do much to support and cushion your heel every time it strikes the ground, sometimes causing bruising of your Calcanea Tuberosity, potentially leading to plantar fasciitis, and the development of Heel Spurs in some people. Studies have found that people who wear Thongs all the time alter their gait to have less Heel-Strike, leading to tightening in the calf, and altered Biomechanics..

…All in all, they don’t sound too great?! In reality, your feet aren’t going to drop off if you wear them down to the beach or going to a BBQ, but if you’re going to be walking much more than 10-15 minutes, then consider changing your footwear. Before spring/summer shopping happens and you pick your favourite new colour of Havianas, consider our top tips for footwear choices:

Top Tips:

  • pick a Thong with an arch support
  • aim to go for a sandal that holds in your heel, and AROUND your toes, not sitting between them
  • consider one with a slightly thicker sole, and one that predominantly flexes (bends) just under the ball of your feet, as our wonderful feet are designed to!

Top Tips for Ankle Exercises After Injury

Top Tips for Ankle Exercises After Injury Using Small Pilates Equipment

  • Retraining balance (proprioception) after an ankle injury is vital to prevent repeat injury. The picture below demonstrates how to do this using a Pilates wobble cushion. You could also use a bosu dome up or down.

 

Ankle ex on bosu

  • Calf raises are a great rehabilitation exercise after ankle injury. Using the ball or band with them helps to retrain your ankle in its neutral position whilst also retraining your inside (medial) and outside (lateral) ankle stabilisers isometrically at the same time.

ankle ex with ball

ankle Ex with theraband

 

ankle4

  • Ankle inverters and everters are the two groups of muscles on either side of your ankle that control our rolling in and rolling out action. Therefore these muscle groups are commonly injured during an ankle sprain and are also paramount in preventing ankle injury. They need to be strong through their full range to help us recover from a small roll and bring us back to neutral. They exercises below demonstrate how you can strengthen these muscles through range using a Pilates Theraband.

ankle6ankle5

 

 

 

 

 

 

 

 

 

Heel Spurs

Heel Spurs – A side effect of Plantar Fasciitis?

Do you have pain in the arch of your foot when you first put your foot down to walk in the morning?

You may well be suffering from a condition called plantar fasciitis (‘plantar fasciopathy’). The plantar fascia is designed to provide shock absorption for the arch of the foot and if overused, can become painful and interfere with daily and recreational activities.

A ‘heel spur’ is a bony growth that forms on the heel as a result from prolonged or excessive pulling of the plantar fascia from its attachment on the bone. Activities such as prolonged walking, running and dancing are the common causes.

Fasciitis

A heel spur may or may not be present with plantar fasciopathy, therefore, an X-ray is not needed when determining a diagnosis. In addition, a heel spur may even worsen on X-ray once symptoms have completely resolved.

The take home message… If you have been told you have a heel spur, or a heel spur is present on an X-ray, don’t stress, it may not mean anything! It’s best to go and get your condition properly assessed from a physio.

The Worst and Best Shoes

images - heels

We’ve all heard of the phrase ‘beauty is pain’, but could you shoes be destroying your feet?? The answer is Yes! Here are my 5 top shocking shoes……

  • The higher they are – the further you fall! Or roll….. Ankle sprains and nasty fractures often result from a lateral roll of the ankle when wearing heels. The heel height alone puts extra stress on the ball of the foot (see pic above) and shortens the achilles tendon. In fact, some women who have been wearing heels for a long period of time find it hard to get their heel to the ground when not wearing heels! Thats some serious foot fauxpas! The solution? Go low….. the lower the heel the more natural the foot position.
  • Beware the stiletto heel! Pinpoint heels a have a smaller the base of support and result in a greater chance of you wobbling around like a baby giraffe on stilts! What this means is that there is much more of a chance of tripping, rolling or slipping! The solution? Opt for a more chunky heel which will better distribute your weight.
  • The next type of dangerous shoe is the pointy toe heel! Not only do you have to deal with the effect of the heel – the triangle shape of it forces your forefoot into an unnatural position and can result in the development of unsightly bunions! (see pic above). The solution? Pick a heel with enough space for your forefoot – or at the very least one which goes triangle shaped after your toe line!
  • On the flip side of the stiletto you also need to watch out for the completely flat shoe. Those are the ones with zero arch support. This covers the ballet flats and the thongs (or flip flops for the British). The lack of support here makes your foot quite vulnerable to developing plantar fasciitis – a painful condition involving inflammation and sometimes tearing of the connective tissue underneath your arch. So if you opt for these type shoes – make sure you add some support (ie in the form of an orthotic or a thong with some built in arch support).
  • The final shoe I’ll ruin for you is the hard soled wedge! Although these offer a much nicer support base – the rigidity of the wedge can restrict normal movement of the foot. Try to choose a wedge with a little flexibility to counter this.

So when all is said and done…. most of the shoes that look amazing on the catwalk are not so amazing for your feet. As I said earlier… beauty is pain so choose your shoes wisely! Wearing these not very sensible but ever so sexy shoes will not do too much damage if worn in the short term. In saying that you need to be aware of long term use and day to day poor footwear choices! Your feet will thank you for it……

shoe fall

Morton’s Neuroma

Pain in the foot?  Feel like there is a ball squashed up between your toes when there isn’t?  Tingling and/or numbness in the toes?  All these signs and symptoms may be linked to pressure building on the nerves of your feet, officially called a “Morton’s Neuroma”.  This is usually a build up of stress around the plantar nerve where it travels between the 3rd and 4th toe, and the tissue surrounding the nerve thickens and compresses the nerve -ouch!

Common culprits for this stress may be shoes that are too tight across the width (therefore squashing the mid foot area) and or too high (which put more load through the toes). People with changes to the foot posture (e.g bunions/flat feet; hyper mobile feet) may be more predisposed to Morton’s neuroma.

So how do I manage this pain?

Sometimes the obvious answer is the best one…by simply offloading the stress and pressure to the toes you can change your pain – if possible, try wearing footwear that doesn’t force all the toes heavily together.  Failing that, certain types of orthotics (foot supports) can be trialled to support the arch and spread the toes – this can offload the building pressure.  Ultimately if these changes don’t improve your pain, a cortisone injection may be advised by your doctor.