Podiatry Portal » Sports Medicine

Top of Foot Pain in Runners

admin — Sun, 22 Jan 2012 07:19:51 +0000

With the increased popularity of barefoot or minimalist running, there is an increased incidence of and injury that is being label TOFP (Top of Foot Pain) on many forums and blogs. There are a number of causes of pain on the top of the foot such as a ganglions, tendonitis and metatarsal stress fractures. What most of the barefoot or minimalist runners seem to be describing with the term, TOFP is a dorsal midfoot interosseous compression syndrome which occurs when the forefoot dorsiflexion moments on the rearfoot are too high for the tissues to tolerate and there is some compression over the dorsum of the foot between the tarsal bones and bases of the metatarsals. The treatment of top of foot pain is to increase the forefoot plantarflexion moment with strapping, rearfoot striking, heel raises, calf muscle stretching and foot orthotics with the appropriate design feature. If the runner wants to continue barefoot or minimalist running then they need to use the foregoing to get over the injury and then gradually transition back to forefoot striking and away from the foot orthotics to allow the tissues to adapt to the load. In some cases the loads or dorsiflexion moments are so high, the tissues may never adapt.

Medial Tibial Stress Syndrome

admin — Wed, 31 Mar 2010 08:39:47 +0000

What causes medial tibial stress syndrome? There are many theories and ideas as to exactly what medial tibial stress syndrome is. The most recent theory or idea that is gaining some traction is that it is due to increased bending moments in the tibia. This sets up a bone stress reaction that causes the symptoms of medial tibial stress syndrome. There has been some recent discussion on Podiatry Arena about this theory of medial tibial stress syndrome.

Barefoot Running

admin — Mon, 08 Mar 2010 01:50:41 +0000

Barefoot running is a current fad and is getting more publicity recently from the publication of the book, ‘Born to Run’. This book and many barefoot running websites claim many benefits for running barefoot, but there is little or no evidence to support the claims. The barefoot runners do tend to misuse research to support their causes. Podiatrists have been quick to point out the misinformation in the barefoot running community and often find themselves the target for criticism for this. It is hard to find a podiatrist who is opposed to barefoot running. One is even an active proponent of barefoot running! Most podiatrists who seem to get labelled as opponents of barefoot running are not opponents, they just objecting to the misuse of science and research. Several pieces of research have recently found there way into the news media claiming benefits for barefoot running or the harm done by running shoes, when the research did actually show that (see Barefoot Running Debate on Podiatry Arena). The French are also getting into the debate on barefoot running and athletics trainers as well.

Foot orthotic mechanisms of action

admin — Sat, 12 Dec 2009 10:55:34 +0000

A meta-analysis and systematic review in the British Journal of Sports Medicine shows just how little clear research there is on how foot work (Foot Orthoses and Gait: A Systematic Review and Meta-analysis of Literature Pertaining to Potential Mechanisms. Br J Sports Med. 2009 Dec 8)

The authors looked at the evidence for the biomechanical, shock attenuation and neuromotor paradigms. They concluded that:

Based on our review, we conclude with rudimentary guidelines for the prescription of orthosis to individuals with a range of injury histories. We also highlight the need for further research focusing on the role of injury, particularly in neuromotor modification and long term adaptation to orthoses.

While we all now and the evidence shows that foot orthotics do work, much work remains to done to explain how.

Factors assoicated with plantar fasciitis

admin — Sat, 12 Sep 2009 11:38:26 +0000

This retrospective case control study in the Clinical Journal of Sports Medicine on Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners concluded that:

A significantly greater maximum instantaneous load rate was found in the plantar fasciitis group along with an increased ankle dorsiflexion range of motion compared with the control group. The plantar fasciitis group had a lower arch index compared with control subjects, but calcaneal valgus was similar between groups. No differences in rearfoot kinematics were found between groups.

Foot orthotics in achilles tendonitis

admin — Thu, 20 Aug 2009 08:20:08 +0000

The use of foot orthotics for Achilles tendonitis is the subject of an interesting blog post. It is suggested that foot orthotic work in Achilles tendonitis because they change the supination moment. It is suggested that a heel raise does not help Achilles tendonitis by shortening the distance between the origin and insertion of the calf muscles. They cite evidence that supports this. They also mention a study in which foot orthoses designed by a podiatrist fixed those with Achilles tendonitis, but they all pronated more with the use of the foot orthotics. This is kind of paradoxical. More on Achilles tendonitis treatment.

What do podiatrists need to know about Chi Running?

admin — Thu, 20 Aug 2009 03:28:28 +0000

Have you had a runner come into your office and say that they are a Chi runner? Did you look at them sideways? Chi Running was by popularized by an ultramarathon runner, Danny Dreyer who also practices Tai Chi. He claims that Chi running is a more efficient and natural way to run. Supporter of Chi running considers the traditional approach to running as focuses too much on the use of strength and power that pushes the runner along the road as fast as possible. In contrast the focus of Chi running to run in the spirit of Tai Chi and Yoga and be more efficient and more relaxed and to feel ‘at one with the road’. This is supposed to make the running experience much more enjoyable and more of a spiritual experience.

A key principle of the method is the use of a midfoot strike rather than a heel strike and New Balance has developed a shoe specifically for this type of runner. A number of extraordinary claims are made by the Chi running supporter. One study does suggest that there is a reduction in injury in those who practice Chi running. Running experts do disagree over the validity of changing the running style to being a midfoot striker. There is clearly a division of opinion on this and there are a number of You Tube videos promoting the benefits of Chi Running, but nothing is mentioned on about the critic. There is some more reasoned discussion on Chi Running elsewhere.