Any podiatrists passing?

Triathlon Forum
1

Have just made a big change from seven years of motion control run shoes to neutral ones. This was on the basis of video analysis with a top shop. The guy had me run in my old Structure Triax’s, pointed out how my ITBs and calves were working over time as the shoe was combating a pronation I don’t have.

I love the new shoes (NB 1023). The first thing I noticed is that I could actually feel the ground beneath my feet. The second thing was that it felt like running always used to when I was young. Didn’t up my volume but was flying already with a useful 10 mile race result.

Only problem is that three weeks in I was out on a run and I experienced discomfort deep in one calf quite low down. It wasn’t my achilles. I had to stop after 20 minutes. It didn’t tear or pull (I have know that sensation well enough in my calf!). Saw my regular therapist a few days later. She detected no muscle damage, nor loss of strength or flexibility. On that basis and my observation that the sole of that foot was experiencing some discomfort when biking plus the toes were cramping near the end of a swim, she thought that the posterior tibialis was irritated by the new position in found itself in the stance phase. She advised run little and often to get acclimitised.

A week on and I run every other day but can’t get beyond 20 minutes. Question is, how long to you persist in the acclimitisation phase? I am convinced the change of shoe is the right one and want to stick with it but not at the expense of being able to run at all.

Any advice out there?

Thanks in advance

Mark

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Hey Makr! I’m not a podiatrist, but I just made the same change about 3 months ago, while training for a marathon. I agree with everything you said. The shoes are much lighter and my foot feels more natural. I had some weird knee pains adn cramping (very mild) for about 3 weeks, but then things worked themselves out. None of the pain caused me to stop running, though.

An interesting note-I just started going to physical therapy for a lingering IT band issue and the first question the therapist asked was what type of shoes I was wearing. I told him I had just switched from Brooks Beast to Brooks Adrenaline. He said that was a good move and I should probably go with something with even less motion control. The IT band issues may have started from the motion control shoe not allowing my foot to function the way it was meant to.

Sorry I can’t answer your question, just wanted to let you know that I think your on the right track. Hope you get it figured out!

3

Hey Kitty! I am right with you there. My ITBs are already loosening off since the new shoes. They had been like piano wire despite constant foam rolling and stretching. The moral is that you can ease it off as much as you like but that’s all for nought if the moment you get back in your motion control shoes they are going to be put under pressure.

Thanks for your encouraging words

Mark

4

Hey Flash,

I own a running store that does video analysis of runners, and have helped a lot of runners convert to a forefoot strike in neutral shoes. Almost all, including myself, have had some pain in their calves along the way. The reason is quite simple: running in a more natural way is a joyful experience, and we overdo it. In my case, I made it through a season of training for half-IMs feeling great, but when I increased my running and cycling and started weights all at the same time, I did a job on my calf and foot. Lesson: don’t do that. :slight_smile:

Most likely is that you have a muscle spasm in your posterior tib or soleus. That happens when you overwork a muscle and/or don’t give yourself enough time to recover. The treatment is massage, which helps the muscle fibers relax and breaks up the scar tissue if there is any, and allows the muscle to go back to its normal length and strength. Good massage therapists cost a lot, so most people use a foam roller or the quad roller from TP Massage to work on their muscles themselves. In my case, I took 6 weeks off running, and am now running 2-3 miles 5x a week, combined with using the roller twice a day. I’m still not 100% back, but I’m much better. I’m still not biking, but with the storm today I’m going to substitute a ride on the trainer for my run and see how it goes.

I’m curious which shop you went to; there aren’t many with a good video system, let alone a staff that knows how to use it.

Lee Silverman
JackRabbit Sports
Park Slope, Brooklyn

5

I have been treating my calf condition with “The Stick” This is the first time I’ve heard of foam rollers and quad roller. Do these tools produce similar results. What are the pro/con of each system. What is a good source to learn more about rollers and etc. Thnx

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Prune & All,

I’m not a big fan of “The Stick”, and in fact don’t carry it in the store. I do carry the products from TP Massage, as well as foam rollers. (Check out www.thestick.com and www.tpmassageball.com for more info about each.)

The reason I don’t like the stick is that I don’t think it allows you to apply enough pressure to get very deep into the muscle, where the spasms really are. With the stick, you lean on your thigh with your body weight, or you get it under your calf and pull. First of all, the stick is designed to be flexible, so instead of applying pressure deep into your muscle it just wraps around your leg. Second, you don’t have enough strength in your upper body apply enough force, no matter how strong you are.

In contrast, foam roller and TP Massage toys are designed for you to use your bodyweight. When I’m rolling my calves, for example, sit on my butt with my ankle on the roller, cross my good leg over to add extra pressure, and then lift my butt of the ground with my hands and push my body forward. In that mode, I’m putting a little more than half my bodyweight on my calf. The Quad roller doesn’t bend, and in fact it’s curved inward to apply additional pressure into the muscle, so it really goes deep (and hurts like hell!). For my quads, I lay on my stomach with the roller under my thigh and lift my body off the ground. I put about 3/4 of my bodyweight on my leg, and just balance with my hands. Again, I can really get into the muscle and work out the spasms, and again, it hurts like hell.

If you’re going to buy one TP Massage product, buy the quad roller; you can use it on calves, hamstrings, quads, and ITB. You can’t use it on your glutes or your TFL, but the TP Massage ball is VERY good for those areas. (A baseball is a workable alternative, but I find that a baseball is too hard and doesn’t have enough “give” to it.)

Lee Silverman
JackRabbit Sports
Park Slope, Brooklyn

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I am based in London (England). The store is called Pro Feet (www.profeet.co.uk)

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Lee, They make a “travel version” that I bought and works quiet well. It is shorter than the std. size stick so it doesn’t flex as much, allowing one to put more pressure into muscles.

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Mark -

Cheers, I am a podiatrist. Advice you have seen so far is reasonable, esp. from Mr. Silverman.

Why were you in the “Motion Control” Nike Triax shoes to begin with? Were you treating a “foot” condition? They were likely “working” since you wore them for 7 years, so why the switch? On the basis of the video analysis? I’m not a hug fan of modern motion control shoes, but they are “right” for some people. Neutral, cushy shoes almost ALWAYS “feel” better though (the 1023 is a great shoe BTW).

Many shoe companies are moving slightly away from the very strict motion control shoes and are callling them “structured cusioning” (to quote ASICS). They will sell more shoes this way. Women’s specific shoes (such as Easy Spirit) are famous for this tactic at malls. You may want to aplit the difference and try something like a Gel Kayano for a while, then move into a more neutral shoe in due time if that is your wish. Sounds like you just overworked your lower leg/subtalar joint (i.e. posterior tibial muscle which is the main invertor of the foot and helps “support” the arch - now allowed to flatten more and move more naturally) by drastically changing shoe types.

Best wishes -

10

Thanks alot.

I was poorly advised by a podiatrist over here who get nearly everything wrong you could get wrong - pronation that was not pronation, a leg length imbalance that wasn’t there. I was in his orthoses for 4 years and am still working my way out of the after effects. Still time to move on and I am optimistic about the future.

Mark

11

…on the subject of leg imbalance. what’s the proper way to measure leg length? i’ve heard folks talk about the slightest of differences in leg length, and it seems to me it would be really easy to get a “false” imbalance if not measured correctly. are there specific points to be measured from and to?

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Glad to see some actual podiatrists on this thread! Keeps wannabes like me honest.

There’s two kinds of leg length discrepancy. The less common version is due to differences in the lengths of your bones or the way your joints are built. The only way to really determine if you have that kind of discrepancy is with an X-ray, where a technician or radiologist will actually measure the bone lengths and will evaluate your hip socket (and probably your knees and ankles as well) to see if they’re constructed the same way on both sides.

By far the more common cause of a length discrepancy is called a functional leg length discrepancy. It means what it sounds like: there’s nothing different about your bone structure, but your muscles, tendons, and ligaments are acting to shorten one of your legs relative to the other. For example, if one of the long muscles in your quad is supposed to be 400 mm long when relaxed, but you overwork it and it gets perpetually tight, it may shorten to 395 mm long. That 5 mm difference puts a compressive force on your knee, which ultimately can cause that leg to act shorter than the other. It won’t shorten your leg by 5 mm, but even a 1-2 mm difference can cause problems for some runners.

Measuring a functional leg length difference is tricky. Chiropractors, physical therapists, practicioners of the Alexander technique and good massage therapists will have you stand up and look at the alignment of your pelvis to see if you’re tilted to one side or another (if they’re dilligent they may measure the distance from the pelvic bones to the floor). But you can have a functional leg length discrepancy that only occurs when you’re in motion, and to measure that takes some VERY expensive and elaborate high speed video equipment. In our shop, I can tell you if you’re pushing off harder with one leg or the other (many people do) by watching the video, but I don’t have the tools to tell you why.

Hope that helps, and I hope those more knowledgable than me will chime in.

Lee Silverman
JackRabbit Sports
Park Slope, Brooklyn