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Runners' Shoes and Injuries

By Chris Chapan

Director's Introduction: For this issue of FitTips for One and All, I am running three articles from Christina Chapan. These all are related to running. I am not a runner myself, but I know enough that the proper footwear and taking care of injuries is vital if you are going to engage in this exercise modality.

Choosing the Perfect Fit:
A Guide for Selecting Running Shoes

Running is a terrific sport that defeats stress, increases energy, improves fitness, and burns calories at a high rate. One thing that you cannot cheat yourself in running gear is the type of shoes that you wear. Running with the wrong shoes accounts for 80% of injuries. Good running shoes provide the first defense against the potential of injury. Here are some tips to keep you on the road and injury free.

First you need to invest good money in a running shoe. That means that you need to be willing to spend $75.00 and up for good running shoes. You are not paying for fancy extra features but equipment that will help keep your feet free from injury. Large department sports stores take off essential equipment in a brand name shoe such as reflector tape, stability backing, and essential cushion fiber and motion control oftentimes to sell a cheaper name brand shoe.

On the first fit for a shoe go to a running specialty store. Make sure that the salesperson is a knowledgeable runner. Consultation with a running podiatrist is great help as well. Another suggestion is to try your shoes later on in the day and buy shoes that are to 1 size bigger since your feet can swell that much due to long and difficult runs.

The shoes must have a comfortable first feel that will enable you to use them immediately. Your heel should fit snugly into the end of your shoe. The part of the shoe that wraps around the top of the foot should fit securely but it should not bother or press too tightly on any area of the foot. Lacing or material should in no way rub or scratch any part of the shoe. This is an indication that this is the wrong kind of shoe for you to wear. Feet at any time in the shoes should not slide in the shoe.

Bringing in your old shoes to show wear, typical socks that you wear and orthotics are helpful in the shoe selection process. This will give you the best fit for your running. Be sure to be fitted with both width and size since makers of various brands have different sizes and features. Even the same brands of shoes can vary in size and fit. Some runners have commented that their feet have grown with running and some women have commented that pregnancy can add a half a size to their foot.

Choose shoes with your larger foot. It is important to take time to shop and try on more than just a few pair of shoes before purchasing them. The minimum you can expect to spend on trying on shoes is at least 30-45 minutes.

Some experts suggest that you rotate shoes or it is also helpful to buy two pairs and replace them when you have run 300-350 miles. For example if you run 30 miles a week remember that you will need to replace them in 10 weeks or 2 and a half months. This is important for those who are running big races in the coming months. A marathon shoe should have more than 60-70 miles logged into them.

Discussing your history and running goals can be very helpful in choosing the right shoe. Some questions include how long have you been running, what is your weekly mileage, where do you do your running, what is your weight, and current foot conditions such as flat feet, overpronation, or supination? Be sure to allow the salesclerk to watch you run to see if the shoes look like a good fit.

Running shoes should be used only for running. Cross-training shoes are fine for short runs but cause injury if you run long distances. Never dry your shoes with a dryer machine and use newspapers to help keep the shape of your shoe and accelerate drying time if they accidentally get wet.

Shoe wearers come in three basic styles. The Normal Foot has an arch that leaves a wet footprint but shows the forefoot and heel that is connected by a broad band. A normal foot lands on the outside of the heel and rolls inward and slightly to absorb shock. Stability shoes are good for this type of runner. A normal foot means you probably are a normal pronator.

The Flat Foot has a low arch and leaves a print that looks like the whole sole of the foot. It indicates an overpronated foot. It is the one that strikes on the outside of the heel and rolls inwards (pronates) excessively. Over time, a flat foot can cause different types of over-use injuries. Many doctors will recommend orthotics for this shoe wearer and motion control or high stability shoes are suggested for this type of runner. Sixty-five percent of all runners fit into this category.

The High-Arched Foot leaves a foot print with either a very narrow band or no band at all between the forefoot and the heel. A curved, highly arched foot is generally supinated or underpronated. Cushioned or neutral shoes with flexibility are great for this type of runner. Running is a sport that can be enjoyed over a long lifetime. Spending time in a running store and the willingness to buy a good shoe that will keep you on the trails for life!

References:

Burfoot, Amby (2004) Complete Book of Running. New York: Rodale.

Choosing the Right Kind of Shoes.

Galloway, Jeff (2002) Galloway's Book on Running. Bolinas, CA: Shelter.

How to choose the right kind of shoe.

How to choose the best running shoes for you.

How to choose running shoes.

How to choose the right shoe.

Some Things to Consider When Buying Running Shoes.

Director's Note: It is best to buy shoes locally so that you can try them on, as discussed in the article. But if you know what shoes you want, then they probably can be purchased less expensively online.

Sprains, Strains, Pains, Shin Splints, OH MY!

As a runner, it is quite common to suffer from shin splints. "Shin splints" is a term used to describe a variety of different lower leg problems ranging from tendonitis, strains, sprains, and stress fractures.

The bones and the muscles of the shins are divided into three distinct departments of the anterior, posterior, and deep posterior. These areas can be the cause of shin pain often characterized as an aching, throbbing, or tenderness of the lower leg about halfway down or all along the shin from the ankle to the knee. Runners who are beginners or other runners who add more than 10% percent to their weekly training often suffer from this disorder. Ignoring the initial pain can lead to medial tibia stress syndrome or a stress fracture. Pain usually starts at the beginning of a run, disappears, and then comes back after a run.

Some of the common causes of shin splints include:

1. Training with a group that is too fast;

2. Doing too much too soon;

3. Tight gastronmenious or tibilas anterior muscles;

4. Injury to the tibia;

5. Running on uneven or hard surfaces;

6. Using the same pair or worn out shoes;

7. Not rotating your running shoes with two or three other pairs;

8. Training too intensely or too excessively during a given week;

9. Poor body mechanics such as muscle strength imbalance and muscle inflexibility;

10. Flat feet or a high arch;

11. Shoes that are too small, and

12. Inexpensive footwear.

It is very important to treat shin splints. Treatment includes:

1. Ice before and after running. Cryotherapy is also effective;

2. A warm towel or heating pad 10-15 minutes before exercising;

3. Icing the injured area for twenty minutes at least three times a day;

4. Reducing your running;

5. Active rest from your running. Try cross-training such a biking or swimming;

6. Strengthening of your gastronenimus and tibialis anterior with weights or body weight exercises;

7. Cross training with no-impact exercises such as swimming and biking;

8. Using anti-flammatory medications such as Tylenol or aspirin. Your doctor may prescribe Naproxen which is an anti-inflammatory as well;

9. Running on soft surfaces and avoiding excessive inclines or uneven streets;

10. Warming up and cooling down before each workout;

11. Avoiding activities that put weight on the affected area;

12. Wearing a support hose after the workout;

13. Using Biofreeze or another pain relieving gel;

14. Consider getting a pair of orthotics. Many insurance companies offer partial or complete coverage.

15. Static and partner stretches of the calves and heel. Be sure you don't feel pain as you stretch.

Tips for avoiding shin splints:

1. Have quality shoes. Visit a racing store and have them carefully measure your feet and evaluate your running;

2. Never increase your mileage more than 10% per week;

3. Run in the winter at least once a week outside to keep your running base up, and

4. Avoid running on sidewalks, concrete, grass, or sand surfaces.

Tips on buying shoes:

1. Replace shoes every 350-500 miles;

2. Check frequently for wear and tear on your shoes;

3. Rotate your shoes with at least three different pairs;

4. Buy your shoes from a running store or a knowledgeable sale staff member who runs, and

5. Stick to one model or type of running shoe that you know and trust.

When dealing with shin splints, remember that it is not a crime to take a day off. It is just your body telling you to slow down and regroup. Remember that smart running is a lifetime sport.

Plantar Faciitis: More than Just a Real Pain!

Plantar faciitis is a very common foot ailment. What starts as a dull ache skyrockets to pain whenever they do any exercise such a walking or running. This condition is more than just a pain in the heel. This pain is often most present when someone first awakens or has sat or stood in one place for an extended period of time.

The plantar fascis is a thick broad band of fibrous tissue than runs on the bottom of the foot. It is attached to the heel bone (calcaenous) and goes out to the toes (metatarsals) of the foot. This tight band of tissue is elastic and acts like a bowstring to maintain arch of the foot. As a person ages, this band becomes less flexible.

Plantar faciitis is a type of overuse injury caused by micro tears to the plantar fascis. It is present with inflammation of the plantar fascia and often feels like sharp knives digging into your heel. What is thought to be pain in the ball of your foot originates in the middle of the bottom of your foot.

It comes from overuse of the foot through sports that involve the pounding of feet, running, jumping, or walking. A sudden change of more than 10% increase of activity, wrong shoes, worn out shoes, an increase in weight, pregnancy, and arthritis can increase plantar faciitis. Middle-aged persons and women are more likely to get this condition. Those who spend their lives on their feet in one place also frequently suffer. Genetic conditions such as flat feet or high arched feet also suffer most frequently. Having an uneven gait and foot-landing pattern also increases the problem.

Even with plantar faciitis, many people have found relief. Many runners, walkers, athletes, and others who suffer from this condition are able to still exercise long distance with self-help and preventive care. Some of these methods include rest. People with plantar faciitis have found that complete rest or at least a decrease in activity have helped them heal this condition. Experts suggest that athletes take complete rest from their particular activity until their feet do not hurt. People with flat feet and high arch have found that with the use of insoles, heel cups, or doctor-prescribed orthotics, they are still able to run marathons, ultra marathons, or hike long distances with great success.

Going to a quality sports store will give you the right shoe and help you in your particular sport or activity. Some people have found that cross training with low impact activities is great way to substitute exercise while you are healing. Biking and swimming are great aerobic non-impact activities. When stationary biking, some trainers and experts suggest you pedal on the ball of your foot instead of going on your toes to decrease friction on the plantar portion of the foot. Swimming in deep water also takes the tension off the bottom of your foot.

Stretching is also a great way to prevent or heal plantar faciitis. A calf stretch and a reverse calf stretch are great exercises to do BEFORE and AFTER exercising. One stretch is where one knee is flexed; toes are pulled back toward ankles and held for a comfortable 8-10 seconds. Stretching should never hurt. Stretches should also be done in the morning before you get out of bed and whenever you sit for an extended period of time. Making the ABCs, words, or shapes with your toes also strengthens the ankle and shin as well as the bottom of the foot. Other remedies include picking up tennis balls, golf balls or picking up a towel with your foot. Take a pair of new athletic shoes that have not been outside and wear them instead of going around barefoot in the house for extra foot support. Don't forget supportive orthotics, heel supports, or arch supports in the shoe as well.

Medical interventions include using ice, topical ointment, and pill or capsule muscle pain reliever. Taking a Styrofoam cup and applying the ice in a massage for 5-10 minutes is a great natural healer. Take a small Styrofoam cup and fill it with water. Stick it vertically in the refrigerator, and in a few hours, slowly tear from the top of the cup to make the ice massage for your foot. Wearing an ice pack to bed with a sock on encourages healing without fear of freezing your foot. An unopened frozen water bottle is great to use to massage the ball and bottom of your foot. Biofreeze is a topical agent that will give the feel and effect of ice without the water. Aspirin, acetaminophen (such Tylenol), naproxen (such as Aleve), ketoprofen (such as Orudis and Actron), or ibuprofen (such as Advil, Motrin, Nuprin) can ease the heel pain, but talk to your doctor before you take any medicine. Take with caution because they mask the problem and don't really deal with the real issue of pain and injury.

Once in a while, you need to consult a professional. A foot doctor can prescribe additional exercises or special footwear that will help with healing. Sometimes they will prescribe a special taping of the foot or heel cradle/splint that can be worn at night. Foot doctors who are athletes in your particular sports will help you overcome the injury and not be unnecessarily sidelined by an injury. Occasionally they will give cortisone shots in the heels or perform outpatient foot surgery. This is done as a last result. Remember that the pain of plantar faciitis sometimes does not come until 12-36 hours after you have completed your sport. Minimum rest is also recommended for that time period as well.

Personal trainers, physical therapists or seasoned athletes in your sport can be another great help. They can watch how you walk, run, or jump and give tips for proper posture and body alignment. They can even give exercises that will help promote good balance. Core training such as crunches, bridges, flies, and hip flexors strengthen both the upper and lower body so all the pressure is not on your foot. Once the foot has heeled, some trainers will also suggest stride training or gentle speed work for a small distance. Cross training using the opposite muscles and strength training build up not only your muscles but your bones as well.

Your feet are an essential part of your body. Take care of them and understand how to make them happy. When you maintain balance in fitness and your personal life you will have an optimum lifestyle.

References:

Burfoot, Amby (2004) Complete Book of Running. New York: Rodale.

Galloway, Jeff (2002) Galloway's Book on Running. Bolinas, CA: Shelter.

Plantar Fasciitis

Plantar Fasciitis.

Plantar Fascitis: A common cause of heel pain.

Plantar Fascitis.

Plantar Fascitis.

Plantar Fascitis.

Plantar Fasciitis and Heel Spurs.

Plantar Fasciitis is a Common Cause of Heel Pain.

Plantar Fasciitis (Heel Spurs).

Treatment of Plantar Fascitis.

What is Plantar Fasciitis?


2007 TeacherWeb, Inc. Used by Permission.

Christina Chapan is an ACE certified personal trainer, ISSA Youth Fitness Trainer, SCW, Sports Nutrition, fitness author, conference speaker and elementary school teacher. She also works in the after school care program at her school. If you are interested in learning more about Christina, please visit her website:

Fit 4 Fun Kids' Fitness
http://worknotes. com/IL/Chicago/Fit4FunKidsFitness/

The above article appeared in the May 2005 issue of the free FitTips for One and All newsletter.

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