Browsing Tag

foot pain

Health, running, Shin Pain

Shin Pain and Stress fractures – Heal strong and fast

July 16, 2015 • By

marathonTreating your shin pain and foot pain from stress fracture the right way, as soon as possible, means you heal faster and stronger. In this series on stress fractures, I will tell you what a stress fracture is, what causes them and most importantly what rehab exercises and self-treatment you can do to get it right.

Following on from the first post in the series which detailed what stress fractures and stress reactions are and why endurance athletes are so prone to shin pain and foot pain and what to do initially, this post gives you the rehab to help it heal faster, by covering phase 2 and 3 of stress fracture rehab.

Phase 2 – Strength, conditioning and rehab

When to start: Phase 2 of rehab from stress reactions starts when general activities of daily living (walking, hanging out washing etc) can be done without symptoms – Pain is an indication of overload to the bone in many cases, so we need to listen to our bodies.

The main three aspects that need to be covered in home rehab of stress fractures are:

  1. Exercise to maintain cardiovascular fitness and prevent muscle loss
  2. Rehab exercises to address cause behind the injury

So let’s address those:

1. Maintain fitness

It is important to note that in most cases you don’t have to completely rest – there is always something you can do, and very important not to lose fitness. So with that in mind, and the fact that exercise actually boosts healing, here are some things that you could do:

  • Pool training – this can start light, treading water in the deep pool and swimming, progressing to jogging in chest-deep water.
  • Stationary bicycle or exercycle – this is a great way to keep up the fitness without causing pain
  • When poor walking etc is pain-free, begin going for short walks and build this up. Eventually you should be able to walk without pain for 30 minutes at the end of this phase

Tip: Remember, you cannot return to loading the bone until the bone is pain-free to tap on and touch

2. Rehab exercises

These should aim to:

  • Increase muscular endurance
  • Improve core and pelvic stability
  • Work on balance training
  • Address flexibility issues
  • Re-train running pattern

Here are some great options to work on:

Heel raises to build calf endurance

Calf raise, calf exercise, heel raiseLevel 1: Start these on two legs, aiming for 3 sets of 10 reps

Level 2: When comfortable and pain-free, progress to single leg heel raises

Level 3: Goal: 30 heel raises in a row

 

 

 

One leg squats to retrain pelvic and lower limb stability

Single leg Squat, hip stability and strength

Aim for 3 sets of 10 reps.

These need to be done with good technique so it can help to do them in front of a mirror

 

 

 

 

Wobble board balance re-training

Bosu ball, wobble board ankle and calf re-training rehab quick

 

Re-training your balance and coordination of the muscles is very improtant, and easily done with either a wobble board or a Bosu ball.

Aim for at least one minute on each leg.

If you can’t get a wobble board, try rolling up a towel firmly and standing on this

 

 

Stretching:

Calves

calf stretch , soleus, gastroc - self treatment for shin splints

Hang one heel at a time off a step and hold for 30 seconds

 

 

 

 

Hamstrings

doorway stretch

 

MTSS shin splints self treatmentStretch out your hamstrings up a doorway of wall as shown here and hold for at least 30 seconds each side

Alternatively you could use a foam roller to loosen up your hamstrings and calves!

 

 

Tip: Continue to ice after exercise and exercise should always be pain-free – a return of shin pain or foot pain can’t be taken lightly.

Phase 3: Safe progression back to full activity

Before starting this phase, you need to be able to do all the previous exercises and painfree and ideally be cleared by your physio or doctor.

When returning to running, a good guideline is to increase activity by no more than 15% to 20% per week. You should also be able to walk for 30 minutes comfortably and you can build this up the same way.

A good starting point, is to run 500m followed by a day of rest or a short walk. If this is pain-free, then you can jog 3 x weekly, ensuring that there are rest days

The distance above is just a guideline but basically start with a short distance and if this is pain-free, slowly increase this, never increasing by more than 15% per week. This is because bones take time to adapt, heal and get stronger – you need to give them this time and only increase in small amounts so as not to overload them.(1)

Numb feet when running lace up properlyTip: when returning to running, it is important to have the right technique – pay a visit to your local sports physio or appropriate professional to have this looked at and also to get some advice on footwear for you as this is very individual (but maybe stay away from minimalist or “barefoot” footwear and aim for motion controlled footwear initially (2)).


Foot pain, Health, Lower limb

Arch Pain? Easy Self-Treatment

July 22, 2014 • By

sore-feet - myofascial releaseIn today’s world of concrete pavements, cushioned shoes and sedentary lifestyles – Our feet get stiff, imbalanced, achy and neglected. This often leads to arch pain and plantar fasciitis (or fasciopathy) but luckily these is a way to help loosen off your arch!

It is time to take 2 minutes to wake up your feet and get them loose and mobile again with one simple exercise.

Our feet lay the base for our entire body to work off and they really are an amazing piece of machinery, they:

  • Absorb impact
  • Propel us forward with spring-like mechanisms (see more here)
  • Have cat-like reflexes
  • Balance out and lay the foundations for our whole upright body

 

The amazing human footplantar fascia - myofascial release : This BBC documentary on the human foot gives a great insight into all the structures that combine to give the foot the ability to take all of our weight, day in day out. At 18-19 minutes you can see the plantar fascia that runs along the bottom of your feet clearly and how it gets tensioned as you walk, acting like a spring – this is the spring that you are going oil up with this treatment today!

The feet really do have a lot to do, and have a lot of weight and forces going through them every single day. This combined with us tending to keep them cramped up in fabric coffins for the better part of the day, or even worse in flat shoes and flip-flops – leaves them needing a little R & R.

 

So how can you say “thank you feet” and give them some relaxation and mobility?

Myofascial release foot pain, plantar fasciitisTake a ball, any ball will do (I prefer to use a lacrosse ball as they are grippy and firm) but the firmer, the better. Place it under you foot, apply some pressure and slowly roll it around the bottom of your foot.

Maintain a comfortable pressure, while rolling it into all the tight spots in the sole of your foot – namely the inner arch and outer arches of your feet between your heel and the ball of your feet.

Do this for two minutes on each foot and feel the difference. You do this while standing or sitting (under the desk at work even), so really there is no excuses 🙂

This is a great little exercise to really loosen up the Fascia (connective tissue), massage the muscles and mobilize the bones, and as a bonus, it increases your flexibility.

Myofascial release foot, plantar fascia

 

As a quick test to see if your tight feet are affecting your flexibility – before you start the myofascial release, slide both hands down your legs and see how far down you can get (toe touch), and remember how far down you get. Roll out both feet for two minutes each and then re-test – Most of you will be pleasantly surprised that you get significantly lower down

 

And YES if you have Plantar Fasciitis or Heel spurs – This will really help you.

So, if you have any foot arch pain, heel pain, calf pain or just generally want to look after your hard working feet – Take a few minutes out of your day and get this done and you will be much better off for it.

 

Thanks for reading, you will most likely also enjoy our value packed Ebook and these past blog posts:

Please share, like or comment if you want more

 

 


Calf Pain, Foot pain, Health, Shin Pain

Flip-flops and moon boots

April 26, 2014 • By

jandals profWhenever I see a patient with a lower limb injury come into the practice wearing flip-flops I cringe inside. Really, these simple bits of plastic are causing a lot of pain and injury and are not something you should wear all day.

Flip-flops absolute lack of arch or heel support puts you at risk of unnecessary pain and injury. We are (I am generalizing here) so careful to wear the best footwear when exercising, keeping up to date with the latest running shoes, orthotics, braces etc but when it comes to relaxing and what we wear outside of work and sport – we aren’t so smart. A study found that in a large shopping center, 43% of all women were wearing flip-flops(1) – That is a huge amount of foot, calf, shin, knee and back pain! Yes this may keep Physio’s and podiatrists in business but it keeps a lot of the population out-of-pocket – And often there is a very simple thing you can do to ease your pain and injuries….

Throw your thongs away!!

Really flip-flops aren’t that bad if you just wear them to the beach, around the changing room or shower etc – It’s when you start wearing them out shopping, to lunch, all day, everyday that they can cause real problems. What problems can flip-flops cause you may ask? and why? Flip-flops can lead to:

  • Plantar fasciitis
  • Stress fractures – Hence the moon boots
  • Shin splints
  • Calf pain and strains
  • Foot pain e.g. Mortons neuroma, metatarsalgia
  • Low back pain
  • and more

And Why?

Flip-flops change the way we walk

They wouldn’t be so bad if our feet weren’t so weak and de-conditioned. Yes we evolved to roam the open plains and jungles barefoot but now that we live in this concrete world – we need a little more protection for our feet. Also because we so often wear cushioned supportive shoes the rest of the time, our feet are not able to handle the complete lack of control and support when wearing flip-flops – Like sleeping on a nice comfy bed one night and then on concrete the next – You will get sore right?

And because they change the way we walk, we use our muscles in a different way, while increasing the shock going through and feet and legs due to lack of shock absorption. Wear them for a long time and the repetitive strain leads to overuse injuries. For example:

  • Every time you step, you need to squeeze and scrunch your toes to hold the flip-flops in place! Meaning your feet and calf have to work very, very hard = tight, tight calves.
  • Due to the total lack of arch support the arch can repeatedly over-pronate, increasing the stretch on your plantar fascia. Repeat this over hundreds of steps and you get micro-tears, inflammation and pain. You can read more about this here.

Good things in moderation

So, you don’t need to go and throw your flip-flops out but PLEASE limit the amount you wear them as they can be a huge cause of pain and injuries. This is also such an easy thing to change that can drastically improve your function and decrease injury risk, so why not do it huh?

jandalsAddendum: As a proud Kiwi I feel I should give a quick history on the proud origin of flip-flops.. or should I say Jandals! The flip-flops was originally invented in Auckland, New Zealand in 1950. The idea came from the original Japanese sandals which allied soldiers saw while doing occupation duty in Japan during WWII. The original name Jandal (Japanese sandal) was trademarked so that lead to other countries having t come up with other names such as:

  • jandals 1Flip-flops
  • Sandals
  • Slippers
  • Thongs, etc

So wear this great invention in moderation and save yourself a lot of trouble. Please Share, like and comment away!


foot pain, Health, running

Heel pain running? Check your shoes and hips…

February 25, 2014 • By

Plantar fasciitis treatment and exercisesHeel pain running is one of the most common running injuries and can really put the brakes on living an active life. Today we will sort out some hidden causes behind heel pain!

Heel pain running is most often caused by Plantar Fasciitis and this is what I will be writing about today. The pain will be on the base on your heel – if it is on the back of your heel where your Achilles tendon attaches to the bone, that is another matter and I see to this in a future post.

Plantar Fasciitis is the 3rd most common running injury behind “shin splints” and Achilles tendinopathy(Lopes et al, 2012), yet is something than can be improved quickly if the right things are done to help it. Earlier in the week I wrote a post explaining Plantar Fasciitis and how re rehabilitate it at home. Have a quick read of that as it gives you a good base knowledge for what we will talk about next and also shows you the exercises you should be doing if you have heel pain.

 

Why check your running (or walking) shoes?

Windlass mechanism, heel pain - self treatment and exercisesThis is very important, especially with the new craze at the moment being lightweight, flexible footwear. Giving the foot move movement is fantastic if you have great foot mobility, flexible, strong calves and fascia. But if you don’t have that then these can really increase your chances of getting heel pain OR worsen it. This is because when you are running, as the heel comes up off the ground, your big toe is pushed up, putting the fascia on the bottom of your foot on stretch. This is a natural spring-like mechanism called the windlass mechanism, which when you have heel pain, can really tug, pull and stretch at your heel – Causing you more pain and inflammation.

So what is the best footwear to wear if you have heel pain?

It doesn’t matter if you have Plantar fasciitis, achilles pain or shin splints, this applies to them all. You should wear running shoes with a supportive arch (some padding under the arch), heel support (not zero-drop shoes) and with reaonably inflexible sole. Over all it is very important to get your shoe matched for you as every persons foot is different and moves in a different way, there is no perfect or “normal” way for a foot to move.

If you are trying to venture into minimalist running shoes or even barefoot running, it is very important to do this progressively as your muscles work very differently in different foot wear or lack there of.

A recent study by Shih, Y et al 2013 showed what affects load and stress on the muscles and tendons most is your running technique and not shoes. So it is important to get you technique right (form before footwear) before heading into minimalist shoes or making any big change. The study also showed that forefoot running (which a lot of people start doing when they go into minimal or no shoes) increased the work of your calf muscles – leading to increased risk of shin pain, achilles pain and heel pain.

Hips:

Often with lower limb injuries there is glute weakness that is contributing to this. Having string hips that can control your foot and knee, absorb force and power you forward is so important and if you are not already regularly strengthening your hips, you should add this to your routine.

First of all it is good to test you hips to see if you do have a problem: Have a go at this quick balance and stability test to see how you stack up.

And HERE is the glut strengthening for you that I prepared earlier – This can really decrease your injury risk and improve not just your running but everyday function.

End note: Minimalist and flexible shoes are not a bad thing if you go about it the right way but for heel, calf or shin pain they should not be your first choice.

 

Please like, share and let me know how you get on 🙂


foot pain, Health, running

How to run Properly – Ironing out your running

June 5, 2013 • By

There are a few easy things that everyone can apply to their running to decrease injury, pain and simply make running easier and faster! I have worked on a lot of my patients running technique lately and having great results with less injuries and faster times.

So here is your easy guide on to how to run properly and improve your run!

1: Cadence: This is basically the number of steps that you take per minute and for best efficiency this should be 90 steps per minute on each foot (180 total per minute). To achieve this, first of all you need to measure what your current cadence is. You can do this by counting the amount of steps your right foot takes in one minute. Most likely it will be around 80.

Try then increasing your rate (if needed) and time again in another 5 minutes. The trick is to think like you are running on an icy or slippery surface and your heels are coming up behind you. This could well feel awkward to do at first and can take weeks to get used to, but once you get use to it, running will feel much easier.

2: Don’t stride out: When striding out the foot lands on the heel and with the leg relatively straight out. This creates a braking force up through the leg and acts to slow you down, meaning YOU have to work harder. So if you want to increase the speed, increase the cadence and make sure your foot is landing below your knee – this means you will be landing more on your magnificently designed shock absorbing mid foot and not your heels.

Take a look at this picture below: their front leg is in the perfect position – foot below the knee, meaning their momentum is going to be maintained, meaning you can go and go and go!

3: Think smooth, light and easy: If you look at the best medium to long distance runners you will see they have very little upward head movement (less bobbing up and down). This means less wasted energy! So to do this we need to lean our body weight forward more and imagine projecting yourself forward and slightly up. Practice standing 1 meter in front of a wall and leaning forward through bending at your ankles until you are about to fall forward and then come back again in order to get a feeling of shifting your body weight forward.

Remember – Perseverance is key with this! You will feel like you can just keep running and running when this becomes second nature – and then you tell others how to run properly – I still find it amazing that no one gets taught how to run!

Keep an eye out – If you like this post then make sure to subscribe as I will be posting on barefoot running information and must do exercises for runners in the future.

Barefoot running argument and how to do it properly!