Running Advice from the APMA
Nowhere is the miracle of the foot more clear than watching the human body in motion. The combination of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels all work together to establish the graceful synergy involved in running. The balance, support, and propulsion of a jogger's body all depend on the foot. But before entering a fitness regimen that includes jogging, don't forget to make certain your body's connection with the ground is in proper working order.
Running in the Dark
Well yesterday I was running in the dark on my street. As I was merging into my friend's front lawn, he has this little bump on the perimeter of his lawn, you can't even really consider it a curb since it is barely seen and black. Anyways, I did not see it running onto the grass and landed on my ankle incorrectly after somewhat tripping over this bump.
I went to sleep with what was a mild ankle pain at the time. I could normally walk, but with some discomfort. Now as I just woke up, there is no swelling in the ankle, maybe some minor inflammation. BUT, I can barely walk, I mean it really hurts to put pressure on that foot.
This is my first injury of this type, should I seek professional care or just do the standard home treatment (Ice it, and rest)
I would get it checked out by a doctor, even if it is just a sprain it's better to get it looked at by a professional. If it's just a sprain take Advil to bring down the swelling in the joint (there's swelling even if you can't see it) and ice it for periods of 10 minutes on and then 10 minutes off.
DOCTOR'S RESPONSE: Any kind of tripping, twisting, or sprains normally doesn't require a visit to the doctor. However, any time you are "barely able to walk" after an injury should ring alarm bells that something is possibly amiss. There could be a variety of injuries. I recommend that you make an appointment with your local podiatrist, a physician with specialized training for problems in the foot and ankle.
IT Band Syndrome
If you are a runner, chances are good that you've suffered from an injury at some point in your running career. It may have been hip, knee, lower back, or foot pain that brought you to a stop. In any case, the experience was likely unpleasant. Some of the most common running-related injuries are also the most preventable. One of the most common running-related injuries is iliotibial band syndrome (IT Band Syndrome).
The iliotibial band is a sheet of tissue that runs from the hip to the knee. At the hip, it connects to a muscle called the tensor fascia latae. This muscle works in abducting the thigh (pulling it away from the midline of your body) and rotating the thigh medially while walking or running. At the knee, the IT band attaches to the tibia, or shin bone, at a point known as Gerdy's Tubercle. This point is located on the tibia just below the knee, on the outside of the leg.
Pain from iliotibial band syndrome can be quite debilitating, and will certainly bring your running to a temporary halt. The pain is generally diffuse, and is located at one of the attachments of the band of tissue. Most people complain of pain at the knee, specifically at Gerdy's Tubercle, but the pain may also be referred to the hip.
If you have a tight iliotibial band, there may be some relief from stretching out the tissue:
- Stretch #1: From a standing position, cross the injured leg behind the uninjured leg. Next, lean towards the uninjured side, with your hands on your hips for balance.
- Stretch #2: While sitting on the ground, extend your uninjured leg straight out in front of your body. Next, cross the injured leg over the uninjured leg, and pull the injured leg as close to your chest as possible.
Try each of these stretches, holding the position for 30 seconds each. These should be done every day, especially after running. If the pain persists, you may want to go to a doctor to rule out any other causes of hip or knee pain.
If you're just beginning to run, don't let IT band syndrome discourage you. It's something that is easily fixed, and can often be attributed to a pair of poorly fitting shoes.
Remember that pain is not normal. It is the body's way of warning itself that something is wrong. If pain persists, it may something more serious and should be evaluated by your doctor.
See Your Podiatrist
It is a good idea for a beginning jogger to visit a podiatric physician before starting an exercise program. Your podiatrist will examine your feet and identify potential problems, discuss conditioning, prescribe an orthotic device that fits into a running shoe (if needed), and recommend the best style of footwear for your feet.
Frequent joggers ought to see a podiatrist regularly to check for any potential stress on the lower extremities. During a 10-mile run, the feet make 15,000 strikes, at a force of three to four times the body's weight.
If you are more than 40 years old, see a family doctor before starting any exercise regimen. The doctor will perform an electrocardiogram, check for any breathing problems, high cholesterol levels, and high blood pressure before giving the go-ahead for a vigorous exercise program.
Anyone, regardless of age, should check with a doctor if a cardiac condition, weight problem, or other medical complication already exists.
The Importance of Stretching
Before beginning an exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.
Stretching exercises should take 5-10 minutes, and ought to be conducted in a stretch/hold/relax pattern without any bouncing or pulling. It is important to stretch the propulsion muscles in the back of the leg and thigh (posterior) and not forget the anterior muscles.
Some effective stretching exercises include:
- The wall push-up. Face a wall from three feet away, with feet flat on the floor, and knees locked. Lean into the wall, keeping feet on the floor and hold for 10 seconds as the calf muscle stretches, then relax. Do not bounce. Repeat five times.
- The hamstring stretch. Put your foot, with knee straight, locked, on a chair or table. Keep the other leg straight with knee locked. Lower your head toward the knee until the muscles are tight. Hold to a count of 10 then relax. Repeat five times, then switch to the other leg.
- Lower back stretch. In a standing position, keep both legs straight, feet spread slightly. Bend over at the waist and attempt to touch the palms of your hands to the floor. Hold the stretch for 10 seconds and repeat 10 times.
Shoe choice should be determined by weight, foot structure, and running regimen. Keep in mind that all shoes have a different shape, and sizes and widths are not uniform from shoe to shoe.
Consider whether an orthotic device will be placed in your shoe and whether your running style is flat-footed or on the balls of the feet. Shoes should provide cushioning for shock absorption and ought to be able to fully bend at the ball of the foot area. Visit the shoe store in the afternoon, when the feet are slightly swollen, and wear thick running socks when trying shoes on.
Systematic exercises must progress slowly from easy to rigorous to prevent debilitating muscle strain or more serious injury. The best and safest way to start a running program is with a four-day-per-week conditioning program for 12-16 weeks.
Begin with two sets of two-minute jogs interspersed with five minutes of fast walking. If muscles are stiff, walk only; have an "easy day" if you're in pain. As the weeks progress, gradually increase the number of minutes jogged per set to 20 minutes. Spend at least five workouts at each new level attained.
By the 16th week, you should be able to run two sets of 20 minutes each, with a five-minute walk before, between, and after. Make adjustments for heat and altitude, and don't be frustrated if you think your pace is too slow. Remember, a disciplined regimen will decrease your chances of injury.
Proper foot hygiene can also prevent injuries. Keeping feet powdered and dry is important, especially to the jogger suffering from blisters. Blisters can be prevented by application of petroleum jelly or creams to the places where they tend to occur.
Aches and Pains of Running
Even with the best preparation, aches and pains are an inevitable result of a new jogging regimen. If the pain subsides with slow easy exercise, you may continue, but if it gets worse, stop the activity and rest. If it persists, see your podiatrist.
The most common pain associated with jogging is known as runner's knee, a catch-all for jogging-related knee pain. One of the most common causes of runner's knee is excessive pronation, or rolling in and down, of the foot. Orthoses (arch supports -- shoe inserts) prescribed by your podiatrist are the best way to alleviate the problem. Occasionally, rubber pads in the arch of the shoe will help.
Shin splints, which are painful and appear at the front and inside of the leg, are caused by running on hard surfaces, over striding, muscle imbalance, or overuse. Treatment includes changing running technique or insertion of an orthotic device in the shoe.
- Start easy and build up your distances slowly
- Don't forget to stretch regularly
- Use sport specific shoes
Fit your shoes with the socks that you plan to wear during your running.