Your "First" Race

Spring weather is almost upon us! Some of us have continued to run throughout the winter. Others, you know who, have stayed indoors. Along with the warmer weather and no snow banks comes more road work. It’s time to get outside and increase your weekly mileage.

Watch out for stressful conditions such as heel pain. Sometimes it is referred to as heel spur syndrome or plantar fascitis. Many other conditions also can cause heel pain but we’ll have to wait for another article. However, if simple therapies like stretching and over the counter (OTC) inserts fail to improve your pain, then you should consider a professional evaluation. Of course, reviewing your training schedule and your current running shoes will also shed light on possible causes of your foot problem.

Heel pain and plantar fascitis although not synonymous coexist quite regularly. Post static dyskinesia or pain after rest, most commonly occurs after arising out of bed. Your pain may last for only a few minutes or a few steps. But should it linger for several days maybe a few weeks it will be harder to cure if you delay treatment. So don’t delay, if its spring, muddy and your heel hurts:

• get new shoes
• stretch in bed before arising
• avoid going barefoot for 2-3 weeks
• try otc meds like ibuprofen (read labels)
• use ice or heat what ever works for you

Now it’s over three to four weeks and your heel pain is still present your skipping days or avoiding hills! You’ve spent over $95 on shoes and otc inserts now what. Can you spell Podiatrist?

Podiatry is keenly positioned to use specialized training in biomechanics, surgery and sport shoe anatomy to get you back on the road. Using computer based gait analysis, sometimes video and weight bearing (standing) x rays you’ll have your joint position, angles, shoe gear and lab work reviewed to pinpoint the cause of your painful condition. You may have a strapping applied to your foot, be giving a prescription and/or use a night splint to provide prolonged stretch of your heel cord and plantar fascia. Follow up appointments will be necessary to ensure an accurate diagnosis and rule out those “other” possibilities.

A shot of cortisone could be quite helpful to reduce the inflammation and in about 25% of the heel pain conditions surgery is required to elongate the fascia to reduce the tension. Assuming the OTC inserts and/or custom orthotics failed to alleviate the pain.

Specialized therapies include:

• Iontophoresis -electrical current and steroids
• Phonoporesis -sound waves and steroids
• Pemf pulsed electro magnetic field (actipatch)

My newest favorite to avoid a shot!

• Final take home message
• Replace your shoes, stretch regularly, avoid prolonged barefoot when sore.
• Seek professional care early enough to avoid difficulties. Happy Trails!

Dr Perry trained at Harvard Medical School/Cambridge Hospital and worked in the ski industry for years before becoming a podiatrist. He specializes in the biomechanics of the lower extremities. He lives in North Yarmouth Maine with his wife and four children, whom he actively coaches in sports. For more information go to www.atlanticfootankle.com