Dr. Adam Spector from our Rockville and Wheaton offices was interviewed by Dr. David Doman, M.D. the Host of Housecall on April 16th, 2019. Check out the video to learn about plantar fasciitis, orthotics, running, diabetic foot care, ingrown toenails, fungal nails, and how to stay mobile.
Now that the weather is warmer, are you ready to lace up and hit the open roads?
The air is finally getting warmer, the sun is shining brighter and longer, and the urge to throw on the running shoes that have been sitting in the back of the closet begin to call your name. The feeling of hitting an open road with the wind at your back and pavement under foot has probably crossed your mind a few times during the dark and blustery days. For some of you a treadmill has been your home on the nights that it was too brutally cold to step outside for a run, for others, it was the couch as your rest season came into full swing. My years tend to vary; this was a first that my runs primarily came and went on a treadmill. I find that treadmills just don’t give me the love of running that I find on a hilly back road. Challenging myself to run faster, farther, harder was much more difficult and sometimes lead to injury instead of enjoyment.
The biomechanics of running are fascinating to most foot and ankle specialists, but rarely do I have my running friends ask me the details on the how and why unless they are injured. So what do you need to know about biomechanics and running?
The biomechanics of running are fascinating to most foot and ankle specialists, but rarely do I have my running friends ask me the details on the how and why unless they are injured. So what do you need to know about biomechThree key topics in biomechanics include foot strike, heel eversion and base of support. Foot strike is one of the first things analyzed when evaluating your running stride. There are three foot strike patterns; rearfoot, midfoot and forefoot; however no correlation has been made between injury and foot strike pattern as of yet.
Another important variable is heel eversion, which correlates with foot pronation. There has been some talk within the literature that excessive heel eversion may correlate to specific running injuries such as tibial stress fractures, patellofemoral pain and Achilles tendonopathy. Two of the most common foot/ankle related injuries that runners develop are stress fractures of the tibia and metatarsals, both of which can be prevented with proper training, shoe gear and biomechanics. The highly debated topic of orthotics which provide custom rearfoot control play a significant role in preventing these injuries. Narrow versus wide base of support can be linked to certain injuries. Tibial stress fractures, IT band syndrome and overpronation have all been linked with a narrow base of support. Ideally the left and right foot should not overlap in their grown contact locations.
Is it really important to know what shoes to wear or are they all built the same? Yes and no. Having the proper shoe gear, as well as fit, can make or break your running performance. Part of building a running foundation starts with having the right gear. Each year the latest shoe releases are analyzed based off of weight, cushioning, and drop. Weight has been shown to play a role in expenditure of aerobic energy; therefore a lighter shoe may be better for speed, however for most runners comfort is key and therefore a heavier more cushioned shoe is recommended. Cushion improves impact absorption, therefore for long runs reduces the stress on joints and bones. Shoe drop is the difference in height of the heel and toe box area with the bottom of the shoe. Increased heel strike has been reported with a higher shoe drop. Additional variables analyzed typically involve the flexibility, stability and energy return. The presence of retail stores particularly geared toward running or walking shoes plays a key role in finding the correct shoe for you, as well as the proper fit. Most cities have at least one running store which feature the latest in shoe gear, socks, safety gear and clothing. Not sure where to start? Check out: https://www.apma.org/seal and search by product type.
Tips and Tricks to Staying Healthy
Begin each workout or run with some basic, yet dynamic stretching. Your warm up should be at least 5-10 minutes to properly increase blood flow to the muscles and decrease your risk for injury. Stretching will also aid in decreasing the lactic acid build up which in turn reduces stiffness and prevents muscle strain.
Be aware of the surface that you are running. It’s never a bad idea to walk the trail, road, or path prior to running to evaluate the elevation, and evenness of the surface. Softer ground tends to reduce stress and impact throughout the gait cycle. Weather can also be a factor in safety when running as hazards such as snow and ice can leads to falls/injury.
Pay attention to your body, in particular what your feet are telling you. It’s not normal to experience pain or changes in the feet and ankles. If you experience foot pain that lasts more than a few days, see a foot and ankle specialist for evaluation.
Editors, The Runner's World. “The Best Running Shoes You Can Buy Right Now.” Runner's World, 22 Mar. 2019, www.runnersworld.com/gear/a19663621/best-running-shoes/.
Kulick, Mike. “Foot-Friendly Tips to Prevent Common Running Injuries.” Learn Foot-Friendly Tips to Prevent Common Running Injuries, American Academy of Pediatric Sports Medicine, 1 Apr. 2019, www.aapsm.org/foot-friendly.html.
Souza, Richard B. “An Evidence-Based Videotaped Running Biomechanics Analysis.” Physical Medicine and Rehabilitation Clinics of North America, vol. 27, no. 1, Aug. 2016, pp. 217–236., doi:10.1016/j.pmr.2015.08.006.
“Which Running Shoe Is Right for You? | Tips for Healthy Feet | Patients.” APMA, American Pediatric Medical Association, www.apma.org/Patients/HealthyFeetTips.cfm?ItemNumber=9865.
Dr. Maryellen Waltz works in three offices for your convenience: Culpeper, VA, Fishersville, VA, and Orange, VA.
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