Running without pain


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Running without pain

  1. 1. How to avoid foot pain with running Running does not cause foot pain Running improperly does The key to running form, and running injury free, is to have a stable base with which to run. The base is NOT the foot! The base is the pelvis. To highlight this point, think of what is acceptable when you have an injured foot. People who can’t run due to injury are most often able to ride a bicycle or use an elliptical. Why? Because there is less pressure and load on the foot? Partly. The main reason is that a bicycle seat stabilizes the pelvis, or at least, the body is able to leverage against the seat to create stability and keep consistent motion of the legs. The elliptical also reduces stress on the pelvis by creating lift of the “swing phase” leg without the need for lifting the leg. Thus the body never has to utilize the hip flexors to do their job, creating leg lift, and improper form is enabled. Neil Feldman, DPM Central Massachusetts Podiatry 299 Lincoln Street – Suite 202 Worcester, Massachusetts 01605 508-757-4003
  2. 2. Body Position  Align ear, shoulder, hip and ankle  Think long  The key is to keep the pelvis neutral and stabilize with abdominal muscles. The tendency is to bend forward at the waist, lurch head forward or slump shoulders forward.  Run with Relaxed legs and feet.  Resist the urge to “push off.”  Be sure the toes stay relaxed and down. If the toes come up, the heel goes down.  Every foot fall should be In Line with the Body and land underneath the body. Neil Feldman, DPM Central Massachusetts Podiatry 299 Lincoln Street – Suite 202 Worcester, Massachusetts 01605 508-757-4003
  3. 3. Tendencies With fatigue, the pelvis loses stability and the upper body leans forward. The hip angle is reduced as a result and thus the hip range of motion is reduced. The foot will land in front of the body (think relative positions - if the upper body is leaned forward, then the foot should be landing in line with the body, and thus behind the pelvis), and the toes will have to lift to allow the foot to clear the ground as the hip won’t be able to lift high enough. The leg muscles in the shin lift the toes and can fatigue leading to shin splints. The heel will hit the ground first and can lead to plantar fasciitis and achilles tendonitis, among other ailments. The toes will grip the ground to stabilize the foot, leading to bunions, hammertoes, metatarsal pain, stress fractures and/or neuroma’s. Those are just the problems that develop in the foot! Neil Feldman, DPM Central Massachusetts Podiatry 299 Lincoln Street – Suite 202 Worcester, Massachusetts 01605 508-757-4003
  4. 4. Speed Speed comes from maintaining or increasing cadence with increased body lean. Our tendency is to overstride and push more. This creates major inefficiencies and increases energy expenditure leading to rapid fatigue and breakdown in form. Shoes Shoes must allow the foot to function and be shaped as it’s intended to be. If the big toe wants to go toward the inside; it must not be forced to the outside. Fit must be comfortable and not constrictive. Proper fit is also heavily dependent on proper mechanics. Don’t let shoes be enablers of bad form! Focus on width at the areas of need (forefoot and toes) as well as last shape (curved, semi-curved or straight). Understand posting, stability and the weight of the shoe. Orthotics Support of the arch is a misnomer. All feet pronate (leg rotating inward and arch flattens, destabilizing the foot) and all feet supinate (leg rotates outward, arch raises and foot stabilizes). Some do it more than others, and some are at extremes. Essentially, a flat foot is an over-pronated foot whereas a high arched foot is an over-supinated foot. Not to belabor the point, but over-supinated and under-pronated are the same thing, and thus this foot type will be more rigid, and less adaptable. Pronation is the necessary function of unlocking the foot to allow it to adapt to the ground and ground reactive forces. Usually, due to poor mechanics or proximal instability (think pelvis), the body is unable to reverse the pronation (i.e. supinate) and the foot remains unstable throughout the stance phase of gait (foot on ground). This is NOT necessarily a foot problem!!!! It has as much to do with the body moving over the foot as it does with the foot itself. The key is the heel. If the heel is turned outward relative to the lower leg (valgus), then the foot is unlocked or pronated. At an extreme (over-pronation), the body will always be “fighting” for stability atop the unstable foot. This will force many of the larger muscle groups above the feet to overwork and fatigue. I like to use the analogy of walking barefoot on a soft, sandy beach. It takes much more effort as the ground provides no stability. Overpronators are essentially always on this proverbial soft, sandy beach. A good orthotic will stabilize the heel and prevent the foot from unlocking past that which is normal. This will create a consistent point of reference for the body to then work on gaining stability and hopefully regaining proper movement and form. Neil Feldman, DPM Central Massachusetts Podiatry 299 Lincoln Street – Suite 202 Worcester, Massachusetts 01605 508-757-4003