Sever's disease will be pain free for the first 5 or 10 minutes of sport and pain will gradually increase towards the end of the game. Achilles injuries will be painful as soon as you sprint or jump with power.
Sever's disease pain will resolve in a few hours of sport. Within a day or two of not running, Sever's disease will be completely pain free. Achilles injuries won’t resolve fast with a short rest. A quick test you can do (if you haven’t played sport for over 24 hours), is to try doing 30 single leg hops. Sever's disease won’t hurt when you do 30 single leg hops. Achilles’ tendon injuries will hurt when testing for power (even after ceasing sport for a few days).
Click here for our more detailed information on Sever's Disease.
Achilles tendons need to be rehabilitated back to normal as swiftly as possible. This involves three angles of treatment:
1. Reduce an appropriate amount of stress though the injury with footwear set-up, heel lifts and adjusting sporting load.
2. Release tight muscles with physio, massage or rolling.
3. Strengthen the injury. This is performed while wearing shoes and heel wedges (not off the edge of the step). Working towards higher energy jumping exercises is critical.
Click here our more detailed information of Insertional Achilles Tendon strains.
If you have a kid with pain at the back of the heel, they haven’t played sport for 24 hours, they are still complaining of pain and they get pain with a hop test, then the probably have an Achilles injury that needs treating ASAP!
We have after hours and late evening appointments available. Book Online Here
]]>With any large changes in exercise routine, the chance of injury increases. The human body is pretty amazing, in that, bones and tendons will increase in strength as exercise loads increase. We also now know that bones and tendons will decrease in strength with reduced exercise loads, for longer than three weeks.
I had no idea what this testing involved or what it even meant, but I liked the sound of something that would help improve my running results. As many of you know, I had a rather non-eventful running season this year, winding up in two moon boots because of six stress fractures in my feet.
To explain, in addition to training for the Gold Coast Marathon in 2019, I decided to undertake a Transformation Challenge at my local gym with some friends. Much to my Podiatrist husband’s dislike (sorry Pete), I was over-training and, without my Sports Dietitian’s knowledge (sorry Kirrily). I was not fuelling my body correctly. I was impatient and time poor…and clearly not very good at listening to the experts!
Without a sufficient calorie intake for the energy that I was expending, in addition to insufficient rest between my training runs, my bones couldn’t repair from the stress of my long runs. A niggle in my foot progressed to being unable to weight bear, and within two weeks, I was in two moon boots, with both feet having confirmed stress fractures. I won the challenge at the gym (losing 8kg in 8 weeks), but at the cost of my bone health, and not being able to run the marathon.
It would be neglectful of me not to mention that I was so excited about running the marathon in 2019, after a DNF in 2018, when I collapsed at the 39km mark due to hyperthermia and acute renal failure!
So yes, it was very apparent to me that something needed to change with my training, and this Metabolic Efficiency Testing seemed like just the right thing to help me change some bad habits.
So what exactly does Metabolic Efficiency Testing involve?
On the day of my testing, I was required to fast for eight hours prior. As my testing was done in the late morning (to allow my busy husband to attend!), I skipped breakfast, and was well and truly fasted by midday!
Once I arrived at the clinic, I was fitted with a heart rate strap on my chest and a mask that fitted snuggly over my nose and mouth. I was then connected to the small machine that does all the analysing. It’s a really quick and simple process.
Once fitted, I lay on the bed for approximately ten minutes while the machine collected data about my breathing, as well as oxygen and carbon dioxide levels. This was used to calculate my Basal (Resting) Metabolic Rate, or in simple terms, my resting energy expenditure, or how many calories I use in a day, while I am exclusively sedentary.
After my short rest, it was time to undertake the exercise challenge. While I chose to do my exercise test running on the treadmill, there was also the choice to do the exercise test walking on a treadmill, or cycling on a stationary bike.
The exercise test was tailored to my running needs by Adam the Physio. At that point in time, my training basically consisted of five runs of 5-10km per week at a pace of about 12km/hour. With this information in mind, Adam started my testing at 8km/hr on the treadmill, increasing 1km/hr every three minutes or so, until it reached 12km/hr. At the 20 minute mark, running at 12km/hr, the incline was steadily increased every minute until I chose to end the test. After 22 short minutes on the treadmill, the incline got the better of me, and my body was screaming for food and a coffee, so I tapped out!
At the completion of the exercise test, the mask and heart rate monitor were removed, and that was the end. It’s a simple, non-invasive test, provided you’re not uncomfortable having to wear the mask, especially while exercising.
Less than a week later, Adam made another appointment to discuss the results of my testing. This was the day I looked forward to, but also dreaded…what were the results going to show? So, here’s some interesting information that my testing showed.
My resting energy expenditure is 1612 calories/day. This figure really put into perspective the fact that I was very under-nourished while I was undertaking the Transformation Challenge. I was consuming approximately 1400 calories per day, in addition to training for the marathon. Is it any wonder that I ended up with multiple stress fractures? No. The scientific name for being under-fuelled is Relative Energy Deficiency Syndrome or RED-S. Bone health, metabolic and endocrine (hormone) health are all compromised while the body is in this under-fuelled state.
As well as my resting energy expenditure, I was also given ranges of calories/day that would be required for varying levels of activity, from being sedentary to extremely active. I know that counting calories isn’t everybody’s cup of tea, and I don’t habitually count calories, but for me, I found these ball-park figures very helpful and informative.
Overall, my resting metabolism was considered to be sub-optimal. The ability of my cells to burn fuel and produce energy was less than ideal. Lower performance in this area is associated with fatigue and issues with weight management, which can become problematic over time.
The results of the exercise test were equally as interesting. Firstly, here's a little about how your metabolism works: When you breathe, oxygen is carried to your muscles where carbohydrate and fats are used as fuel to create energy to keep the muscles working. Your body’s preferred fuel source is fats. It relies on oxygen (aerobic) and produces more energy. Alternatively, carbohydrates don’t rely on oxygen and provide quick bursts of energy. However, your body only has a small storage of carbohydrates, so this is why we need to fuel adequately and frequently with carbohydrate during endurance exercise.
My fuel burning profile showed that at a lower rate, my body uses my readily-available fat stores for energy. In this “steady state”, my engine was working at optimal efficiency, and I felt strong when running. However, once my heart rate increased, (even by a meagre 30 beats/min, which was very minimal exertion while exercising), my body started to access the carbohydrates in my bloodstream. Carbohydrates became my body’s main fuel source once my heart rate reached 120+ BPM. My body continued to rely on this fuel source, right up until my maximal exertion (and my fat burning profile reduced down to zero).
Good endurance athletes, have a higher fat burning capacity. This means that their body is able to use this fuel source for longer before dipping into their carbohydrate stores. This is something I hope to achieve by re-training my fuel burning system.
So how do I do re-train my fuel burning system?
Given I now know the heart rate at which my body switches fuel sources, I am going to modify my training so that I am exercising in a target rate zone, in an attempt to get my body to preferentially use fats as a fuel source, for as long as possible (while still ingesting adequate carbohydrates to keep my stores topped up in my endurance training sessions). For me, this means significantly slowing down my running pace. I now know my optimum fat utilisation occurs at a heart rate of 119-128 BPM, which is at 8km/hr. As my body adapts to using fats as its primary fuel source, I’ll see an improvement in this speed and heart rate, which will ultimately improve my performance.
In order to keep my fitness levels high (because my V02 max was measured to be in the top 90-94% for my age), my training runs will be punctuated with some interval sessions and “regular” threshold training as I’ve learnt precisely my VT1 and VT2. (VT1 and VT2 are otherwise known as Ventilatory Thresholds or markers of intensity observed in breathing when lactate starts to accumulate).
An interesting point that Adam made about the interval training was to ensure that the rest periods between intervals was as much as four to eight times the period of exertion. Also, ideally, any increase in heart rate during an interval is less of a focus, as the goal for interval training is maximal muscle exertion to create the greatest mitochondria adaption. One way to do this, is to increase the incline instead of the speed on the treadmill.
My goal is to retrain my fuel burning system for the next few months so that when I increase my training in preparation for my next marathon, I am adequately fuelled, hydrated and prepared!
So, with my new training strategy in hand from Adam the Physiotherapist, as well as some sensible advice on a sustainable (higher calorie!) nutrition plan from Kirrily my Sports Dietitian, I’m ready to make some modifications to my training and nutrition!
I look forward to trialing this new training regime for three months, and re-doing my Metabolic Efficiency Testing again to see if I have successfully been able to modify my fuel burning profile to make my body more efficient and more enduring for my long distance running. I’ll keep you posted!
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The dreaded calf strain becomes a more common injury as triathletes age, especially in males. Why is this so and what can we do to manage and ultimately prevent these injuries from derailing our training?
Calf pain and injuries can present in several ways;
• Traumatic sudden onset calf tears, usually a sudden sharp pain felt during faster running which results in not being able to continue a run.
• Non-traumatic gradual onset pain, that slowly worsens throughout a run to the point that it stops a runner from continuing. It is often sore after the run but recovers relatively quickly.
• Delayed onset muscle soreness, no specific pain during a run but soreness for a couple of days post run.
The specific details of the above injuries will vary a bit so in this article I will address general principles common to all calf injuries.
A big contributing cause for calf injury will be some degree of overload of the muscle beyond the limits it is ready to deal with resulting in fatigue and sometimes tissue damage. This overload can come from specific changes in training including the introduction of speed or hill work, or sudden increases in volume, frequency and intensity. The overload can also come from trying to change running technique to more of a mid-forefoot strike pattern. This change shifts stress and strain from the knee and hip to the calf and achilles which if done too rapidly results in injury.
An underlying weakness or lack of muscular endurance in either the Soleus or Gastrocnemius can also be a big contributing factor to injury. As we age, we slowly see a decline in muscular size and strength which if we don’t address can contribute to injury. The calves contribute considerable force during the running cycle, surprisingly the Soleus muscle can contribute up to 8 x bodyweight forces during running compared to the Gastrocnemius which can contribute 3 x bodyweight forces.
From a podiatry point of view there are certain biomechanical factors that can contribute to calf injuries which include reduced range of motion at the ankle joint and or the big toe joint. Stiffness in these joints often leads to an earlier heel lift and or pushing off the outside of the forefoot. These changes to gait cause the calf muscle group to work a bit harder for longer. Excessive uncontrolled pronation or supination of the foot can also play a role and shouldn't be neglected when considering potential causes of calf strain.
This is also where footwear can play apart in working out the injury puzzle. Lower drop and minimalist style running shoes can be great training tools, however if the runner lacks good ankle flexion or big toe flexion then running in these shoes or transitioning to them too quickly can be what tips the runner over into the injury zone.
• Allow the initial symptoms to settle with adequate cross training.
• Address potential training errors, reduce fast and hilly running until strength and endurance is increased.
• Work on improving ankle and big toe flexibility with calf stretches and gentle mobilization.
• Work on smoothing out your running technique to reduce bent knee propulsion and excessive up and down bobbing.
Get strong and stay strong!
Start a strengthening program including bent knee and straight knee calf raises. Build the program slowly over about 6 months. Ideally you should work toward heavy, slow calf raises 2-3 x week and eventually some jumping and skipping once strength has been established.
See a Sports Podiatrist
Have your Biomechanics and running technique checked out by one of the Sports Podiatrists at Shoes Feet Gear. We will be able to check for;
• Calf and foot muscle weakness
• Joint range of motion restrictions
• Issues with your running technique
• Check that your shoe choice is suitable for your biomechanics and running ability
• Check for other biomechanical issues like excessive supination, pronation, midfoot collapse that may be contributing to the injury
Depending on what we find we may recommend a change in footwear and the use of custom made orthotics if we think that this will help reduce the overall load on the calf. We would also look to start you off on a calf strengthening program and may consider small changes to running technique.
Non-traumatic injuries often respond quickly and positively to a reduction in load and some strength work. If however this doesn't do the job the other treatments outlined above will be key to getting you back to peak run form!
If you do happen to experience severe pain, tingling, numbness or swelling it is worth seeing your GP as more serious health issues can masquerade as calf pain.
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No more rubbing, blisters, painful ankles or feet!
Our Sports Podiatrists have a special interest in children and adolescent foot conditions such as flat feet, heel pain, knee pain, growing pains, night pains, intoeing and all other concerns.
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These are very common issues for runners, sports people and the general population. The overall result of these is a lack of bending of the ankle during gait and this has important implications for recurrent injuries as well as affecting run technique and performance. One of our sports podiatrists shows how to accurately self test if you have this issue and what can be done.
The term ankle equinus comes from 'walking like a horse' and refers to a lack of forward bending of the ankle joint. People with an ankle equinus will have an earlier heel lift with gait (the heel comes off the ground early when stepping forward), the front of the foot will load up more and some runners will run more on their toes (like a horse!).
Traditionally, we would use the 'knee to wall test', however free smart phone apps with digital inclinometers allow us to measure angles very accurately and efficiently. The problem with the knee to wall test is that it doesn't allow for different length legs, feet and other variables. The inclinometers directly measure how far the ankle joint can bend forward as this is what is required for efficient gait.
Apple Iphones and Ipads come with a Compass app that actually has a built in inclinometer. Open the Compass app and swipe the screen left to reveal the inclinometer.
Tight gastrocnemius muscles. These muscles are the top part of your calf and are made up of the medial (inside) head and the lateral (outside) head of the gastrocnemius. These continue down and join onto the Achilles tendon and if they are tight, they pull on the Achilles more and stop the ankle joint bending..
Tight soleus muscle. This lower, deeper muscle sits under and below the gastrocnemius muscles. It is a broad, flattened muscle that also attaches onto the Achilles tendon and can restrict ankle bending.
Short Achilles tendon. If the Achilles tendon itself is naturally short, this will pull on the heel more and prevent the ankle joint bending far enough.
Restricted ankle joint. Some people naturally have stiff ankle joints, particularly higher arched feet, that simply won't bend far enough forward for adequate gait. This is a bone/joint issue of the ankle joint that prevents the bending. Previous ankle sprains will also commonly stiffen ankle joints to prevent bending.
There are two main ways that stiff ankles can contribute to injury.
The first is the extra tension on these structures as they are stretched to their limit with gait. This will mean that they are being pulled to their limits which strains, compresses and tears some of these structures.
The second is the increases in work load of these areas. When the ankle can't bend forward enough, there isn't enough forward lean with running. Leaning forward is necessary to push more horizontally rather than vertically. Stiff ankles lead to a more vertical drive and a more 'up and down' bouncy gait rather than a 'long smooth' gait. This extra up and down movement means more work for the lower leg structures as they are working against gravity.
Inadequate forward lean with running results in a more vertical drive, as shown in the above picture. The easiest analogy is to imagine throwing a ball. If the ball is thrown more vertically, there is less horizontal. If the ball is thrown at the perfect angle to get the most horizontal travel for the effort, then this is most efficient. This perfect angle for running seems to be 34 or 35 degrees for the majority of people.
This ideal angle that is required can change depending on the running speed, inclines and type of activity.
The impact of poor ankle flexibility is a 'bouncy gait' which is referred to as a high vertical oscillation where lots of energy is wasted as up and down energy fighting against gravity. This wasted energy is obviously less efficient for runners.
A reduced stride length and shorter flight time will also result as there is less horizontal travel. These shorter strides result in a higher cadence as the legs need to turn over more to get the speed up and ultimately a runners pace is negatively affected.
Release tight structures. Tight muscles and tendons need to be stretched, rolled and released. Stiff ankle joints can sometimes be mobilized to increase their flexibility. Working with an experienced physiotherapist to increase this natural range of ankle movement is of great benefit. This can take some time and some runners will never get enough of the natural movement that they need.
Adding height under the heel instantly reduces the angle required for gait.
Increasing the pitch (also called the drop) of a shoe is the first place to start. There are many shoes which are problematic for this problem that have a lower heel drop such as the Nike Free, race shoes and other minimalist shoes. Some alternative brands of shoes may have thick soles for cushioning, but they still have a very low heel compared to the front of the shoe. The Hoka and Altra brands are examples of this being a low drop shoe and contribute to these pains and problems. The most popular technical running shoe brands such as Asics, Brooks, Mizuno and the running range of Nike shoes have higher heels to help with this type of problem.
Adding heel lifts which are small foam wedges to the inside of the shoe allows the heel height to be customised to the correct height. We will remeasure the amount the ankle can bend forward with the shoes on and heel lifts in place to ensure that we are getting our minimal range of movement of 34 degrees.
In some extreme cases, we will add extra material into the sole of the shoe to allow for extremely stiff ankles, however this is quite rare.
This is one of the many small problems that we see in our Brisbane sports podiatry clinic, so book online here or call to make an appointment with one of these experienced sports podiatrists for a full assessment and accurate treatments to resolve pains and improve performance.
]]>Moving from walking to running involves a sudden jump in the load through your body. This has amazing benefits for health, fitness, weight loss and long term injury prevention. However, this sudden jump in force through your body creates some problems with a greater risk of injury, exhaustion and running just becomes way too hard.
Here are our simple tips to protect your body, make running achievable and become sustainable in the long term:
Good quality shoes that are matched to your foot type are critical when you move from walking to running. Correct footwear helps protect your feet, shins, knees, hips from injury.
High quality training gear made from moisture wicking materials keeps you comfortable, dry and reduces chaffing. Compression is fantastic for comfort and to stop the jiggle. Women also need a high quality sports bra for support, comfort and to avoid rubbing.
If you look the part, you will feel the part and the added bonus is that nothing gets you more motivated than some new running gear!
Click here to view our range and shop online at our Brisbane store
Some people start running too slow. Running for a long time at a very slow pace will result in a poor and inefficient technique that will make you prone to injury.
Running at a sprint will get the heart rate up too fast and will load the body quickly.
Run at a pace that feels smooth and comfortable on your body. Too slow and you will feel like you are plodding or walking. Too fast and you will feel like running is way too much effort. Run at your pace that feels smooth, even if you can only manage this for 20 or 30 metres.
Before you start running, stand up as tall as you can. This will extend your hips, knees and tighten your body. It will also engage your core muscles for stability. When you start to run, you should 'think tall'.
Click here for a link of how we demonstrate being tall
Now that you are standing up tall, the second thing is to now lean forward. Staying tall and leaning forward will allow you to push and drive forwards.
Click here for a link of how we demonstrate forward lean
As you are about to start running and while you are running, simply think 'Tall and Forward".
Running constantly, especially when our fitness hasn't developed yet, is really hard. Intervals make running much easier. Interval training involves running for a period until your heart rate and breathing rate increases and then you stop for a minute or two to allow your body to recover. This is process is repeated a number of times in a row.
Interval training allows runners to run at a quicker pace that will be a lot smoother, more efficient and will have less impact on the body. It is also very beneficial in building strength and speed quickly as well as cardiovascular fitness. Elite runners use a lot of interval training with their training programs.
The distance you run for the interval really varies from person to person. Some people will use markers such as the power poles. Some runners will use a set period of time such as 30 seconds, 1 min or 2 min.
The amount of rest time between intervals is usually 1 or 2 minutes. It should be enough time for your heart rate and breathing rate to settle. You need to make sure that you get your breath back so that you can tackle the next interval properly. You can rest by standing still or walking slowly.
Most people will perform 5 or 6 intervals (run followed by rest that is repeated 5 or 6 times). With improved fitness, the intervals will gradually start to get longer and the speed might increase a little. Eventually, it will be achievable to run comfortably for a continuous amount of time, although this is not as critical as you might think.
The best mentality for managing your running is following the 'two steps forward and one step back' mantra. This applies to daily running where you should never run for more than two days in a row. Make sure you have a recovery day where you take a break or go do a different type of exercise. At a week to week level, you will also need to apply the 'two steps forward and one step back' approach. You can build your running each week, however you will need a recovery week every third or fourth week where you back of the pace, reduce the intensity and shorten the distance so that running is very comfortable for the week.
These recovery days and recovery weeks are critical for muscle repair and to give your body a chance to capitalise and cash in on the hard work that you have put in. If you run every day and try to increase constantly, you will become fatigued, you won't improve as quickly, you will drastically increase the chance of injury as well as set yourself up for failure.
The final piece of advice for runners of all levels is to listen to your body and be kind to it. If you feel flat for a run or for a week, don't be hard on yourself. Don't ignore the bad pains, which are the ones that are more than general soreness of your big muscles, and get them attended to by one of our sports podiatrists. Getting help early will make running more fun and rewarding as well as sustainable in the long term.
Click here if you need to Book Online with our Brisbane Podiatrists or email admin@shoesfeetgear.com.au with any questions.
Good luck!
The year was 2007. We had lots going on. Life was busy (or so I thought). We had a new baby and we had just set up our first business. We were living in Central Queensland and had no family support (at the time). We had a baby that never slept. Ever. Day or night. He came out crying and cried for 10 months straight. I’m not even joking. Just ask the other Mums from my Mother’s group! My husband Pete was also suffering from complete exhaustion - working long hours in the business, getting up to a crying baby at night and also suffering from Glandular Fever and Ross River fever - at the same time! We don’t like to do things by halves. You’ll learn that about us! 😂
I started running in an attempt to get myself outside and do something for me. That was once our baby could be entertained in the pram. Any attempt to put him in the pram in the early months were totally disastrous. He was a nightmare in the pram, but I persevered. I decided I was going to run a half marathon and I had to do the training. A few short months later, I completed my first half marathon in 2008. Tick.
After the birth of my second child in 2009, I decided that I needed a new challenge. However, any plans I had for “me” were put on the back burner, the moment she arrived. Unlike our first child, this baby fed and slept like a dream. Amazing! However, we had our own issues with her. A simple diagnosis of “clicky hips” turned out to be much more and we had different challenges to overcome with her. After a tumultuous couple of years including two hip surgeries, hip spicas and various splints, I decided I now had the time to think about me. Having already completed a half marathon, I decided that I now wanted to do a full marathon. I signed myself up. I had no idea what I was in for, and that was probably a good thing!
I roughly followed a training schedule in preparation for the Melbourne marathon. Let me assure you though, that running extended periods with a double pram in Central Queensland while keeping a toddler and baby entertained was no mean feat. It also kind of defeated the purpose (when I took the kids with me), as running was supposed to be “my” time!? However, sometimes there were no options. If I had to run pushing a pram in the middle of the day, doing loops to collect containers and socks that were lost overboard, and stop to deal with tears and tantrums, then I did it. I was willing to do whatever it took.
When I did escape child free, my training was often fraught with pangs of “Mummy guilt”. I needed to do something for me, but I felt guilty (and selfish!) spending time away from the family to get my training done. Silly but real.
Just to complicate things, Pete decided that he too wanted to do his first marathon. Of course he did. This made training more difficult. We both had to somehow schedule in up to six hours of running on a Sunday with two small kids. It wasn’t fun. Or easy. I trained where and when I could and set myself a goal of finishing the marathon in less than five hours.
I was very relaxed heading into the Melbourne marathon (not once thinking about all of the “what ifs” that my worry wart brain can sometimes throw at me). No pressure. I just wanted to finish. I ran and felt great (well, until I hit some hills in the Botanic Gardens a few short KMs from the finish line where I cramped up and had to start walking). I sprinted around the MCG track to the finish line, feeling my calves getting tighter and tighter with each step until BANG, the calves went and I seized up literally ON the finish line. I checked my watch. 4hrs 12min. Not too shabby. I cried. Mostly because I was so happy (well under my scheduled five hours - yay!), but also because there was another uphill section I had to traverse with two cramped-up calves to get my finishers medal! How mean!
I remember thinking to myself that I never wanted to do another marathon in my life, and would happily tick “complete a marathon” off my bucket list! Great. Now fast forward eight years to 2018...
As we know, the brain is pretty good at downplaying painful experiences...like childbirth and running 42.2km for example. It’s called the “Halo” effect, and the reason that, eight years later, I found myself lining up for another marathon. Yes, I’m mad.
Also of mention, is that in those eight years, aside from NOT getting any younger, we’d doubled our offspring and our businesses (yep, so that’s now four kids and two businesses, and me, errr...on the slippery side of 35...). Life with kids also got ridiculously more hectic (...and here I was thinking that life with babies and toddlers was hard 🙄)!!
After the birth of my fourth child, running was harder and less enjoyable than I remembered. I now had less time on my hands and my Mummy guilt had increased to epic proportions, as I tried to be everything to everyone, with my needs always coming last.
I started training for the marathon, just so I could follow a program to give me some direction with my running. Things were going well. I started enjoying my running and keeping up with my training. However, a few weeks from the event, I was in at work when the call came and I was put the spot: “It’s Asics. They want to know if you want an entry to the Gold Coast Marathon”. What do I say? I nodded reluctantly. “Umm...yes please”. Then the question “the half or full”? Eek. “The full, I guess”. “Yep, she’s doing the full”. It was out there. The cat was out of the bag.
From that moment on, I unnecessarily put myself under a lot of pressure to perform. To not disappoint. To successfully reach my goal. Truth be told, no one probably even cared, but I felt like they did! I set myself a goal and put it out there. I wanted to keep myself accountable. I wanted to do a sub-four hour marathon. Surely taking 13 mins off my old time isn’t too unreasonable? Or was it?
So the weeks ticked by and things were going well. I started to despise my long runs and even loathe them, feeling disgruntled at the fact that it was eating into our already limited family time. I would start getting moody about midweek and then feel an instant relief as soon as I literally ticked off the long Sunday run on my training schedule. I tried moving my long runs to mid week to avoid missing out on family time and to prevent the mid week blues, but nothing helped. The long runs were hard and they just needed to be done. No excuses. End of story.
I got up early and ran in the dark. I ran after school pickup into the darkness of night (neither of which were ideal), but sometimes my options were limited. I even used to run for two hours on a treadmill at the gym. Yep, that’s taking boring to a whole new level. I did all it took to get it done.
Three weeks before GCM18, I started to feel a dull pain in my right hip. I hadn’t run for two days. It was odd. My last run was an 8km run, with my son, pushing a pram on my right side. Did I tweak something? Surely not, as I’d done plenty of my runs (reluctantly 🙄) pushing a small child in a pram. I didn’t feel anything at the time. What was this?
The pain continued to intensify and Pete took great pleasure (or so it seemed) in rolling his eyes and saying “I told you that you needed to be stretching and seeing a Physio with all these big KMs that you’ve been running”. I cried. I wasn’t even going to get to the start line after all of this training!
However, lucky my Pete’s a good bloke, and he massaged my tight ITB, adductors and glutes over the weekend until I was able to get in to see a physio on the Monday. He got me walking again, but I was still tentative to go running...just in case.
I decided to listen to Pete's advice (for once), when he suggested that it would be a good idea for me to try running on an Alter-G (anti-gravity) running machine to test out how my sore adductors and hip flexors felt when I started running.
He arranged for me to use the facilities at XPhysiotherapy at Toowong and even came with me (mostly because he knows I’m a sook and wouldn’t try anything new if left to my own devices 😂)! I ran on about 60% (which meant that I was running with 60% impact through my joints). I could feel a slight tightness, but it was ok. I could adjust the gravity (the percentage body weight load I wanted to put through my body) as I went, depending on how I felt. It was awesome. I ran for 45 minutes before Pete almost died of boredom and our poor youngest child decided she’d had enough. Mission accomplished. I could run. Sort of. Aside from another run closer to the event, this was the only running I did in the last three weeks. I was well and truly tapered!
About this time, I started getting paranoid about getting sick...and guess what? I got sick. 🙄 Not flu-sick, just a massive head cold which kept me awake all night coughing. Enough to make me feel flat enough to not want to exercise. I annoyed myself with how much I coughed. I can only imagine how annoying it was for everyone around me. The cough lingered for a good couple of weeks and I was still coughing right up until the night before the event. Not the best preparation I was hoping for, coming into GCM18. Sickness and injury. My two worst fears were realised.
We headed down to the GC in preparation for my marathon (and for Pete to work at the Expo). By this stage, my hip was feeling fine but I was still a bit under the weather. Nothing major, but still not 100% well.
On the morning of the event, I was eerily calm. I didn’t manage to catch a wink of sleep though. Does anyone ever sleep before these events? I woke up, got dressed, had some breakfast, packed my Camelbak and was away. A tram arrived within a few minutes, I grabbed a seat and made small talk with the people next to me on the journey. I arrived at the venue, checked my bag in, went to the start line and waited. No problems. No fuss. I read a few text messages, started my Garmin, checked my music worked and waited patiently for the start. Before long, I was off! I’d made it! I was running. Happy days!
I started with the 3h50 pace group but the crowd was so thick, I found it frustrating (as I have personal space issues)! I was feeling great. At 8km, I saw Pete and the kids cheering me on. I smiled and high fived them. Things were going well. Before long, I’d unintentionally caught the 3h40 pace group. I checked my watch. I was consistently running 5.05-5.15 min/KM and feeling totally fine. I got to the turnaround point at Burleigh and was still cruising. I got to halfway before two hours. No sweat. I was on track.
At about 26km, I realised I was probably pushing a bit hard. I hadn’t drunk much, but I wasn’t feeling particularly thirsty. I’d gone through three gels and literally only had sips of water to wash that down. On my training runs, I would have emptied my Camelbak by this stage, but mine was still full. For some reason, I just didn't feel thirsty. I felt a bit hot, but otherwise ok. I pushed on, but pulled back on the pace a bit; still tracking on time for a sub four hour marathon.
I remember a number of people telling me that the bit of the marathon from the start line (after you've been to Burleigh and back) when you're heading north is tough. I kept telling myself that. "This is the tough bit. Just dig deep. One foot in front of the other". I felt like I was getting slower and slower. I felt the sub-four hour dream slipping away. I had more and more people over taking me. It was soul destroying. I just needed to get to 36km, the turnaround point. "Why was my Garmin taking so long for the KMs to tick over"? I thought. I was starting to feel a bit mentally defeated, but not finishing didn’t even register on my radar.
I made it to the turnaround point. Thank goodness. "This is it" I thought. "The last 5km". I knew I could do it. I looked at my Garmin again. "Hang on...I must have misread it before...I can do this! Even if I walk...I’ll still make it". I looked again. I tried re-doing the math. My brain was fuzzy. I couldn’t work it out. I was starting to wobble all over the place, but I put that down to tiredness. I told myself that I had to keep running and that I couldn’t walk because I wanted to be able to say that I ran the whole way! Say what? I blame my fuzzy logic on my fuzzy brain.
The next thing I know, I have a stranger guiding me by my left arm. I couldn’t see him, but I could feel him and hear him. I heard a wheelchair being rattled behind me. I could hear people talking but couldn’t make out what they were saying. "What are they doing? Surely that’s not for me"? I told the stranger to "let go of me" as I didn’t want to be disqualified (😂😂). He politely let go, but unbeknownst to me, was right there behind me, following me. Ready to catch me...because a few short metres later, I collapsed on the curb.
I could hear the announcer. I was almost there. I looked up. "Where was I? What had happened"? I had a lolly put in my mouth. “You need to eat this”. I looked up. Ambulance offices swarming, the stranger next to me, still supporting me. Holding me. Then a huge wave of nausea hit me.
The ambulance officers drew up some anti-emetics. Too late. I was vomiting. Vomiting and vomiting. So much vomit. I came to a bit. I was joking with the stranger (who I now know was called Luke), and convinced the ambos that I was fine to go on. I joked about no one pausing my Garmin. Apparently we’d already had that discussion. Oops. I had no recollection of that. I then asked for a selfie. How embarrassing, I’d never do that. I didn't even take one on the start line because I was too self conscious. Now I didn't care. I got one anyway. With complete strangers in it, no less.
I thought I’d be fine. I convinced the paramedics that I was fine. They cancelled the ambulance that was on the way. I needed to get to that finish line. I needed to collect my medal and my t-shirt and my checked in luggage. This wasn’t how it was supposed to end. I was all good. Wasn't I?
I went to sit up. Bad idea. They weren't joking about my low blood pressure. Down I went. Things started to deteriorate. They were asking my name. I couldn’t remember. They asked for the pin code on my phone. I couldn’t remember. What was my husband’s name? I couldn’t remember. I was looking at the buildings thinking “where on earth am I”? What was wrong with me? My brain wasn’t working. It was seriously scary.
I had this horrible feeling that something wasn’t right with my body. I started screaming for help. Screaming at the top of my voice in some kind of delirium brought on by my hyperthermia. “I’m going to die. You need to help me. Something is really wrong. I don’t know what it is. Heeeeeeeelp meeee”. Then I passed out again. I was briefly lucid again. I apologised. “I’m so sorry. I have no idea what that was”. I was told I had a panic attack. Did I suffer from anxiety? A little. Had I had an anxiety attack before? No. I knew this wasn’t anxiety. Something was wrong.
By this stage, I had a number of paramedics hovering over me. A short time before, in a moment of lucidity, I’d managed to call Pete and tell him what had happened. He was tracking me doing the marathon on "Find My iPhone" and had seen my dot stop, but just presumed I’d cramped up and had stopped to stretch. Little did he know what was unfolding.
When Pete arrived, I’d been hooked up to fluids and the ambulance transport had been called. My blood pressure was low. My heart was racing. I was severely dehydrated. They also realised that my temperature was almost 40 degrees and I was suffering from the effects of hyperthermia. I needed to be cooled down stat.
I can’t remember much of the bit from being taken from the course to the ambulance. I tried keeping my eyes open but all I could see was black. I could hear people’s voices (but they were incoherent), and the rattling of the trolley, but I couldn’t see anything. "What was wrong with me"? My limbs were contracting involuntarily. “Just stop it” I was telling myself. I couldn’t. I was screaming at the top of my lungs (apologies to all of those people who saw me being wheeled along the course to the ambulance and were traumatised by my screaming)! Again, I tried convincing myself that this was ridiculous and that I needed to calm down. I just couldn’t. The delirium and paranoia was punctuated by brief moments of lucidity. My brain wasn’t working properly. I couldn’t see anything. I was scared. Really scared. It was a truly traumatic experience.
Once inside the ambulance, the paramedics were able to cool me down. I arrived at The Gold Coast University Hospital some time later. The paramedic said that I was starting to look much better. I was feeling much less delirious, but my brain was still fuzzy. I just felt indescribably "yuck". I was still vomiting too. More anti-emetics, but alas, more vomiting.
Just as an aside - big props to the paramedics who did an amazing job (and dealt with my delirium and vomit - sorry). Thanks Jeremy and the other two paramedics (who I didn’t get selfies with...sorry...I was a little more ill by this stage), for taking such good care of me. You guys are amazing, selfless beings. Thank you!
Now in the hospital, I started to come-to again. I was asked my name again. I remembered Rachel but couldn’t remember Charles. I was asked where I lived. I couldn’t remember. The suburb? I was pulling blanks. I wanted to cry. I started crying, but there were no tears. I was too dehydrated. I was asked what year it was. I couldn’t even remember that! 2017 or 2018? I couldn’t be sure. "What was wrong with my brain"?!
I looked down on myself on the trolley. My legs looked swollen and felt like jelly. I asked "what's wrong with my legs"? in a slurred voice. The paramedic reassured me that nothing was wrong with them. I wasn't convinced. I lifted my hand and it was white. Paper white. I hardly looked alive. "Was it even mine"? Clearly my blood flow had more important places to be!
I tried to pick up my phone to try to work out what was happening or where I lived. The buttons looked wrong. The screen looked wrong. "Who has changed all the icons? Why did they all look different"? This was all really weird. I was given more anti-emetic medication, yes more, but it too was useless. The nausea and vomiting continued.
Some time later (who knows how long it was!), Pete and the kids arrived at the hospital. I started to feel a bit more normal. I remembered where I was. I remembered my name. I was still confused about the year but at least I could now remember my kids' names!
The vomiting continued. The kids were horrified. “Yuck...are you contagious Mum”! 😂 They were relieved to hear that I wasn’t. Their faces were a mixture of relief and concern. They were also disappointed for me. “Are you ok Mum”? “I’m ok”, I reassured them.
I was finally discharged from hospital late in the afternoon. I let everyone know what had happened with a post on FB. I know many of my friends and family were waiting all day for my victorious post, medal in hand saying “I did it”. What a disappointment to post a photo of me from my hospital bed saying that I didn’t actually even finish.
I was fitter this time around. I was running on track. I never give up. Why did my body fail me? I’m not really sure, but we have some ideas about things I did differently this time that might have contributed. I’m still ruminating on all the "what ifs" and processing the disappointment. I'll get there.
My recovery has been slower than I would have liked. We headed away for the week so I could do nothing. Literally nothing. I’m not very good at sitting still, so being away from home fixed that! I was a bit stiff for two days, but miraculously no ITB/adductor issues. The one thing I’d worried about wasn’t even a problem! I had a few battle scars, despite the liberal application of Body Glide (as instructed!) before the race. Nothing a few bandaids couldn’t fix.
I’ve physically felt under the weather but that’s probably to be expected given what I’ve been through. I also haven’t been able to shake this Winter lurgie that has been troubling me for weeks. I’m still driving myself mad with my coughing. 🙄
Aside from the measurable physical ailments, the last week has been a roller coaster, mentally. I oscillate from moments of “you did your best”, “lucky you’re still alive” to moments of “that was a bit stupid”, “why didn’t you drink more”, “why didn’t you just walk a bit” or “why did you put so much pressure on yourself”?
Right now, I’m thinking it would have been a whole lot smarter and less disappointing to have just listened to my body, slowed down and at least finished the marathon. Isn't hindsight a wonderful thing? But, I’m an all or nothing kinda girl, and this was just a (much needed!) lesson in finding moderation and learning that you don’t always get what you want, even when you have all your ducks in a row.
I’ve learnt that putting pressure on myself isn’t helpful. I’ve learnt that I need to listen to my body. I’ve learnt that I definitely need to stay hydrated on a marathon! I’ve learnt that it's ok to stop and take a breather or even walk for a little bit of the marathon. I've learnt that the bigger picture is more important than the little details.
You know what though? I’m glad I went through this. I’m glad my kids were here to see the highs and the lows too. Even though I came home without the medal that I desperately wanted and worked so hard for, I’ve had the chance to show them what disappointment looks and feels like; and the fact that we can learn and grow from these experiences, even as adults.
Best of all, I’m still a winner to them. The kids knew how desperately I wanted to complete that marathon in less than four hours. My two youngest even made me paper medals to compensate. I'm also the proud owner of a fourth ribbon that my six year old donated to me (that she won at her athletics carnival last week). Her card reads: "To Mum, you did so well in your race. I want you to feel better. I love you forever. Great stuff"! Well, if that's not enough motivation to get up, dust myself off and try again, then I don't know what is!
I’m not sure where to from here. Do I feel like I have some unfinished business? Yep. Do I want to run another marathon. Not at this stage. However, being the perfectionist I am, I will most likely have another shot. Sometime. Maybe. I’ll just wait for that Halo effect to kick in and let you know later! Probably after I’ve done it. 😉
If anyone recognises Luke from my photo, please tell him to get in touch with us!! I owe him at least a new wrap for his daughter (after I vomited all over one of hers 😩😩).
Seriously though, this guy and his wife are possibly the most selfless, kind-hearted people ever. They were just out walking on the weekend of the marathon and Luke happened to notice me wobbling all over the road. Despite my protests (sorry Luke!), he perservered. He caught me. He held me up. He wiped my face. He held my head when I vomited. He held my arm when I was going delirious. He looked me in the eyes and said “you are not going to die, you’re ok”. Anyone would do this for a loved one...but for someone to do this for a complete stranger? What a guy! Thank you from the bottom of my heart Luke!
His wife helped recognise and find Pete and the kids. She looked out for the kids and kept them away as I’d requested. She even looked after them in the playground while Pete was with me. The whole time she had a baby on her hip (who was amazing and so, so patient). Yep, and she was a complete stranger too. I am just so grateful to Luke and his wife, two complete strangers who were there for me on this day. It certainly restored my faith in humanity. Thank you both so, so much. 💗
We first met Nick back in 2012 as he and a bunch of mates decided to sign up for the Oxfam 100 to raise money for a very worthy cause. It’s fair to say that the closest to an endurance event that these young guys had got was a 48 hour binge when the online game called The Legend of Zelda got released...
These four guys, with the fitting team name ‘The Imperial Walkers’, completed 100km of rough terrain and mountains in 36 hours. That is a really long time on the course and takes a lot of determination and resilience to finish what they started and not to give up.
This event sparked something for Nick and we have watched him sign up with personal training and embark on his own journey of fitness training.
We were so proud of Nick when he signed up and completed his training as an accredited personal trainer, followed by training as a remedial massage therapist. Nick is now making a career out of helping people with their health and fitness goals.
It seems obvious that Nick was inspired by how fitness changed his everyday life and wanted to help other people on their own fitness journey.
Well done Nick, and good luck tomorrow. I’m sure The Imperial Walkers will smash 36 hours!
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Bookings for the Alter G can be made here with costs for casual sessions and packages.
Injuries can stop patients in their tracks, right when they are leading up to an important event or when the new 'get fit' program is powering along. This can be emotionally traumatic for patients as they have invested a lot of physical and emotional energy to get to this point, only to be forced to stop. We now have an alternative to making patients stop their training.
As practitioners, the last thing we want to do is to stop patients training - its not good for their motivation, the rest of their body and we now know that its not good for the injuries we are trying to treat.
The key to managing many injuries is to manage the load through the injured structure. Too much load (or force) through the injured and weak structure means that further tearing and injury occurs, setting the patient back a step. However, too little load and the injured structure isn't stimulated to strengthen and heal.
The difficulty with managing patients return to running programs is that there is a really big difference between the load and energy going through the body with walking compared to running.
Running on a treadmill with zero gravity sounds far fetched, however this patented NASA technology is now easily accessible to the general public. These amazing treadmills allow the gravity to be adjusted from zero to 100 percent of the patients body weight. This allows the patient to run with a minimal amount of load through the injured structure, however the same movements and running patterns are being used as normal.
This has a multitude of benefits from maintaining flexibility, preserving the motor patterns (technique), retaining the routine and psychology of running as well as accurately bridging the gap between the walking and running load.
Most injuries that we see in our Brisbane Sports Podiatry clinic can benefit from this technology and tendon and bone injuries in particular. Here is a list of injuries that would benefit greatly from using a Zero Gravity Treadmill as part of the return to run rehabilitation:
- Tibial stress reactions/shin splints
- Insertional Achilles tendonitis,
- Medial tibial stress syndrome (shin splints - medial)
- Knee cap pain (patello femoral pain syndrome)
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Almost all cases are 'cumulative injuries' where an accumulation of stretching under the arch leads to tearing of the plantar fascia itself or where it joins into the bone. I have written some more in depth information on diagnosing, explaining and treating plantar fasciitis on our webpage that you can find by clicking here.
To allow healing, the strain through the injured and weak plantar fascia needs to be reduced. An important part of treating plantar fasciitis is to reduce the strain on the plantar fascia by using these tips.
Stiff shanked shoes that have the correct support matched to your foot will reduce the bending and load through the plantar fascia. If you can't make it to our shop/clinic to get the perfect advice, try the Brooks Adrenaline/Asics GT2000/Mizuno Horizon/Nike Structure for feet that roll in.
Make sure you have supportive shoes on your feet even when you aren't training as the accumulation of the load and strain all adds up to tearing the plantar fascia. For when you refuse to wear joggers, these Archies Thongs are great for around home or alternatively the Birkenstock/Orthaheel Thongs.
Rigid strapping tape (not flexible Kinesio or Rocktape) applied the correct way can really reduce the strain. I have a video on our webpage of how to strap the bottom of the foot to really reduce the strain using specific techniques that can be found here
Strapping the foot every day will really reduce the strain overall, however some patients only strap for their training sessions.
Orthotics are 3d inserts made exactly for your foot that have specific angles and design elements to change how your foot is working. An orthotic designed to reduce the strain through the plantar fascia is ideal.
The orthotic needs to be super comfortable so that you totally forget about it within a few days. If it isn't comfortable, it can actually aggravate this problem. More info on how we make our soft 3D laser scanned orthotics here.
Tight calves, soleus and achilles tendons add extra strain and tension through the plantar fascia. Loosening these with a physiotherapist or by massage, foam rolling, stretching or trigger points is beneficial.
Before you throw in the towel and quit altogether, there are some simple adjustments that can be made to the way you train. Try and replace longer runs with shorter tempo runs and avoid hill sprints where you are up on the forefoot. Injured plantar fascias seem to handle the intervals better.
If you do need to get a really long walk or run done, you can split it in half and still get the total mileage done that day or over the weekend. It is a far better alternative to cancelling altogether and the training benefits will be almost the same.
Injured plantar fascias don't have much blood flow to them, so they take a lot longer to heal back to full strength compared to muscles or even tendons. Reducing the load with the above tips to allow this gradual healing is important. Once healing and re-strengthening has commenced, the load can be gradually increased back to normal.
If you need more advice with treating this common, but difficult foot problem, book in to see one of our Brisbane Sports Podiatrists by clicking here
]]>As parents, we are constantly trying to get kids to move their bodies and get away from screen time. We know that physical activity is good for all aspects of development and most kids want to get out there amongst it on the sports fields, but the moment that they get a pain, parents and even practitioners are quick to blame too much structured sport for the appearance of these problems.
There is no doubt that some groups of kids are participating more than ever in structured sports, especially school aged adolescents who haven't specialized in their chosen sport yet. It is common for these kids to be training and competing in Soccer, Cross Country and Tennis all at the same time. It is rare for these kids to get a day off. It is difficult to determine whether their overall activity load is actually higher than the good ol' days when kids went hard every afternoon with non-structured activities as there still seems to be a lot left for screen time! Either way, adolescents are said to be training more and more like professional athletes.
If kids are training more like professional athletes, we should be managing these adolescents more like professional athletes. The training principles and structures in place for competitive sports are better than ever as the better coaches understand more and more about training loads and managing athletes. The kids want to be the best they can, parents on the sideline want their kids to perform to the best of their abilities and the coaches are aiming for optimum performances. To achieve this, everyone is committed to pushing the boundaries. These are the same motivations that elite athletes have, the only difference is that adolescents are doing the training but aren't managing their bodies like the elite athletes. Here are some principles to help prevent and manage adolescent sports complaints.
It is critical to identify if a complaint is a normal discomfort from training or if is the start of something more sinister. Good pains are the normal muscle or tendon soreness that presents in the days after a particularly solid training or game. This micro tears in the tissue stimulate the muscles and tendons to repair stronger and are important for development. These good pains are normally mild and present in the big muscles or tendons.
The bad pains are any pain that occurs more than once, is building in intensity, has a sudden onset or is localised to a smaller structure (such as the shin, foot, ankle, knee, etc). These small structures can develop big pains and stop athletes in their tracks. All problems are more treated quickly, easily and more cheaply if they are dealt with earlier. More information on diagnosing and treating common lower limb pains by clicking here.
Sleep is a very simple factor, but often overlooked for adolescents. During sleep Human Growth Hormone is released and is critical for recovery so that athletes can turn around faster and do it all again the next day. Without adequate sleep, the structures of the body don't repair as quickly and won't get the full benefit of the training. The same goes for nutrition with recovery and improvement being impeded if the the building blocks your body requires aren't delivered at the right times and in the right proportions.
It is suggested that teens require 8-10 hours of sleep. Taking on appropriate hydration and nutrition in preparation for training and after training will help performance, recovery and development. Sports Nutritionists like these guys can help - Apple to Zucchini.
With back to back trainings, games, fitness, strength and other sessions, it is critical to prepare and maintain adolescents bodies. Coaches are great at implementing active warms-ups, warm-downs and stretching routines. A big consideration for adolescents is their growth spurts where the long bones extend quickly and the muscles lag a few months before they catch up. This results in tight muscle units and higher chance of injury.
Stretching helps, however a large percentage of adolescent complaints that we see are from inflamed growth plates (Sever's disease at the back of the heel at around 12 yrs, Osgood Schlatters below the knee at 14 and Sindling Larsen of the hip at 16). These growth plates become inflamed by the tendons pulling on them, so stretching can aggravate these conditions at times. Foam rollers to speed up the elongation process seems to work better than stretching.
Stretching straight after sport and holding for 3 sets of 90 seconds seems to be the latest advice with stretching and regular sessions on the foam roller are excellent. Focus on the calves for the 10-13 yr olds, quads for the 13-15 year olds and the hip flexors for the 15-18 year olds.
If these young bodies are being pushed to their limits with their training load, then any inefficiencies with the lower limb are the first places to present with cumulative injuries (overuse injuries where the accumulation of load through a part of the body becomes too high and it breaks down). Fine tuning their lower limb function with run technique, specific footwear design or custom orthotics ensures that the work load through the lower limb is balanced so that certain structures aren't working harder than they need to be. This forms the basis of treating many cumulative injuries and it is smart to get these things in place before injury and to improve function and performance.
This is exactly what we do for elite athletes and more info can be found by clicking on the links in the above paragraph.
There can be challenges with adolescents coming into a sport season under cooked. It is easy to spend 6 months of the year in swim season or have a light summer with a bit of cricket, only to roll into term 2 with Cross Country, Soccer, Netball and Rugby firing up simultaneously. Without the running and impact load through their bodies, the tendon, muscle and ligament strengths are reduced as well as lower bone densities. The sudden increase in load makes all athletes more prone to injury.
Start some impact and run based activities at least 6 weeks earlier. Adolescents performing at higher levels or in multiple run based sports may need to build into the pre-season (a pre-pre-season does sound crazy) or maintain some level of run based activity year round. Maintaining stronger bodies will result in more resilient bodies.
Sometimes young athletes have everything in place with their bodies fine tuned and maintained perfectly, yet they still struggle to get through the training workload. The only option is to drop back the training load, however there are smarter ways to do this than simply skipping sessions or dropping sports. As sports podiatrists, we will work with elite athletes and their coaches to manage their load to help them through injury and return to full training.
Adolescents might have a number of coaches and multiple training programs overlaid. Writing down the full training load on a weekly planner and working with your sports practitioner or senior coach to manage these sessions will adjust the loads into appropriate blocks. A kid who is part of a comprehensive cross country training program probably won't get too much benefit from the fitness component of a soccer or rugby session. Sometimes, managing the different elements of each training session can reduce recurrent injuries and at times improve performance. Connecting with a coach experienced with managing young athletes such as these running specific coaches (High Cadence) can help.
We keep in mind that kids want to participate in every training, they want to be a part of the team and they don't want to appear slack, so every effort is made to allow them to participate.
Kids, parents, coaches and clinicians want kids participating in as much sport as possible.
Adolescents need to manage and maintain their bodies more like professional athletes if they want to train and compete more like professional athletes.
Stretching and in particular foam rollers as well as physical therapies are important for maintenance.
Identify and deal with bad pains early.
8-10 hours of sleep, adequate hydration, a balanced diet and nutrition plans pre and post exercise for recovery and performance.
Fine tuning with shoe set-up, run technique and strength programs is important to reduce cumulative injuries and improve performance.
Build the impact and running load earlier. A pre-pre-season isn't so silly.
Work with a senior coach or sports practitioner to manage the training components across the whole week and the overlaid sports.
If you need help with adolescent sports issues, Shoes Feet Gear - Brisbane Podiatry has experienced sports podiatrists who can help. Call (07) 3367 8667 or book online here
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The shoes felt great and I was happily bouncing (ok, plodding) along until about 2km in to my run, when I noticed some tingling in my little toes on the right foot. I’m sure most sensible people would stop and turn around and go home, but alas, not me. I frequently (intentionally) put myself in the hurt locker, so this day was no different. 😂
Within another couple of kilometres, it felt like the front half of my right foot was numb. Unpleasant but not impossible to run with, I persevered to get through my 10km. Done. The shoes were banished to the back of the cupboard and I decided they just weren’t for me.
Fearing another eye roll and sarcastic comment from the podiatrist husband, I was tossing up whether to mention it to him or not. (He still reminds me of how ridiculous but lucky I was to get through 42.2km in a brand new pair of shoes that I’d taken out of the box on the morning of the Melbourne marathon 😂). I thought I’d casually drop my symptoms into a conversation...as if asking for a friend, and see what he had to say. I was most relieved to hear that my symptoms didn’t spell the end of my running career. Yay!
However...I did feel a little bit silly when I realised it was all because I’d just laced my shoes up too tightly. Who would have thought, something as simple as lacing your shoes could cause so much grief?! It turns out, that with a little relaxing of the laces and tying them a little less heavy-handedly meant that the shoes were actually perfectly fine, and so was my foot! (Click here for a video on how to change your lacing for a Morton's neuroma).
What had happened was, the tight lacing had minimised the area in the toe box of my shoe, causing inflammation of the nerve that runs between the little toes. Basically my toes were too cramped. In fairness, the shoes didn’t feel particularly tight, but the slight increase in firmness was enough to stir up this little nerve, causing tingling and numbness. Oh.
I was lucky, and my numbness and tingling was short-lived and easily fixed with some minor lacing modifications. Some people however, have ongoing issues with nerve pain in their feet. One such example is the common Morton’s neuroma, which can be easily diagnosed and treated. (Click here for more information on Morton's neuroma and how we can treat this issue). There are also plenty of other reasons for nerve pain in the foot, and our podiatrists can help diagnose and treat these too.
So, the moral of my story is, make sure your shoes aren’t too tight! Some times, even just a few mms less space in the toe box (even just from thicker socks!) can make all the difference.
Also, just to keep things interesting, shoe brands like to keep us on our toes (pardon the pun!), and slightly modify the material used or design of a shoe between models. Even a small “tweak” by the shoe companies can mean that you might now need a slightly larger or wider shoe, than previously. So, if you’ve ever wondered why you’ve always been a size 7 in B width and now all of a sudden need to wear a size 7.5 or change to a D width, don’t worry, it’s not you, it’s them! It’s not like going up a dress size, so relax! It’s best to ignore what’s on the box and just go with what feels right for you.
I'm not the podiatrist (they have a lot more tricks up their sleeve to help even the most difficult of cases), so best to make an appointment to see the experts if you need help with your sore feet. Make an appointment online by clicking here.
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Brief History
The trend for minimalist shoes is very cyclical and rears its head every decade or so and has usually been associated with a talented athlete winning a significant event with bare feet or a minimalist shoe.
1960 - An unknown Ethiopian stands at the start line bare feet and goes on to win the Olympic Marathon in a world record time.
1985 - Zola Budd Pieterse of South Africa and Great Britain won the world cross country championships twice with bare feet.
These events gave minimalist footwear and barefoot running great exposure in the following years.
The latest minimalist trend ramped up in 2010 with most shoe companies developing new designs of minimalist footwear; however this trend has cooled over the last year.
The Good
For decades runners have used lighter and firmer shoes to help them run faster. Less weight means less energy used when running and the firmer the material under foot, the less energy lost on impact.
Some runners are ‘feel runners’ and really enjoy the feedback from the road with these firmer shoes. It helps them feel fast, responsive and in control when they run.
Extra load is placed through the body with the firmer materials, lower heel and less support and the body will gradually adapt to increase overall strength.
The Bad
The body will be able to strengthen to a point, but if the load becomes too great then human tissue will become injured through overuse. Human tissue cannot keep strengthening indefinitely, it will reach it’s limit eventually. The most significant things that add to the overall load through the body include the runner’s anatomy, training load, running surfaces and running technique. These factors all need to be carefully managed.
The majority of runners seem to be ‘float runners’ and enjoy the feeling of cushioning under their feet. Firm shoes will not feel right for these runners.
Bare feet or thin soles provide little protection for puncture injuries from rocks and sharp objects.
Should I Give Them a Crack?
If you like the feeling of a firmer shoe and you don’t have any significant overuse injuries then you could try what it feels like to run in a minimalist style shoe.
Do It Slowly!
The most important advice is to transition very gradually to a minimalist shoe. It takes a minimum of 3 months for your body to physiologically increase strength with the extra load through your body.
Start with a slightly more minimalist shoe first and gradually transition to firmer and lower models over many months.
The other option is to introduce the minimalist shoes or barefoot running to soft grass on a very short run session and gradually increase the distances and firmness of the surfaces over many months.
Don’t simply trade in your full support shoes for a minimalist running shoe and train normally as this is very high risk for injury.
Find Your Happy Place
Most people will gradually move towards a slightly firmer and lighter style shoe, but everyone finds their ‘happy place’ which may be wearing quite soft and supportive shoes all the way to running marathons with bare feet on bitumen.
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1. Shoe selection can make the world of difference:
Getting the right shoe underfoot can make training all the more enjoyable and help assist injury minimisation. Some people will rotate multiple pairs of shoes depending on the type of training and racing they are undertaking. Others will be happy to stick with one pair all season round. It all comes down to what's best suited to your training/racing needs and bio-mechanical function. That's why we recommend getting your shoes properly fitted and having a basic assessment to help guide you in the right direction and take out any confusion. If you've had your shoes for a while or are unsure of if they need replacing, drop in and we can give you some guidance!
2. Bonds shirts aren't made for running, nor is sunburn cool:
As much as your favourite well worn t-shirt may feel comfortable, the chances are it won't be your friend while out running. Chafe sucks, period. Basic cotton shirts have a tendency to hold moisture which is normally the key ingredient for things to go wrong, couple that with a bit of friction and you'll want to be buying shares in Band-Aid's! When looking for shirts, singlets and shorts, we recommend ensuring that they have some form of moisture wicking technology. This will help draw moisture away from the skin and minimise the risk of chafe, having the correct fit will assist in prevention.
Summer in Brisbane can be harsh so making sure you dress appropriately is a must. A cap or visor is always a great idea and unlike big lunch in Grade 1, no one will pick on you for being sun safe! For longer or later runs, also get stuck into the sunscreen, it's something often bypassed but can make a big difference and help to prevent sunstroke/resembling a Truss tomato.
3. Pay attention to what your body is saying:
There is a fine line between pushing yourself in training and going a bridge too far. It all comes down to the concept of good pain vs bad pain. There is a level of discomfort you should expect to feel while training, this may present as fatigue or a decrease in speed and you should still be able to finish your session. Any pain that is sharp, unusual or brings about rapid and marked discomfort falls under the "bad pain" banner. If this arises, call a halt to training immediately and get on top of it ASAP. The longer you try to persist through an injury, the more likely you are to increase the severity. Also pay attention to little niggles, increased fatigue and lingering illness, all of these are risk factors for injury. So if you're feeling a bit more run down than usual, take a rest day, the missed km's may be the difference between running tomorrow or being stuck in bed watching Dr. Phil.
4. Fuel; not the terrible radio rock band, but why hydration is important.When most of us head out for a run the last thing on our mind is nutrition and fluids, often we end up having to play water fountain roulette. While we're all aware of the importance of taking on board sufficient hydration during summer runs, it's implementing a strategy or plan that's the hardest part. Our bodies burn through fluids and electrolytes significantly faster than we realise, as the mercury rises this occurs at an accelerated rate. So for shorter runs, be aware of potential stops where water is readily available and try to run in the mornings or late afternoons. For those longer runs, a hydration belt or camelbak is great option as you can choose between water and sports formulas. Gels or any form of food is also something to keep on hand and most will fit in the pocket of your running shorts or a hydration belt. The final recommendation is to always carry cash and ID, it's a simple trick that can make a huge difference, I find $5-$10 dollars is all you need. There have been a few long runs where I've done the zombie crawl to a 7/11 where I'm sure the attendant hoped I wasn't going to vomit. So be wise and take a few necessary precautions for your summer runs and it could save you in the long run.
5. Don't lose the enjoyment of running.
As simple as this sounds, it's often the one aspect of running we lose sight of when getting back to training . Commonly it happens after 4-6 weeks of consistent training. Motivation to train decreases, long runs become more and more laborious, and you feel both physically and mentally fatigued. If you are stuck in this boat, take a rest day, run somewhere different, buy some new training gear or just leave the watch and planned set at home and just run for the sake of it. Any way you can break up your regular routine is an excellent way to refresh your attitude. I personally find running with a squad or friends once a week or fortnight a great way to break up any monotony in my training and keep a positive mental attitude towards my goals.
Hopefully these tips will give you some food for thought and help get you back out on the road or trail!
]]>Pete Jacobs will give his personal advice for you to have a faster run leg off the bike as well as dealing with running injuries and improving run technique.
Pete Jacobs has had a string of successes in the 8 years he has been a professional triathlete. An 8th place at the Hawaii Ironman World Championships in 2009 showed Pete’s promise of being World Champion one day. At Hawaii in 2010 his 9th place (after a 4 minute penalty stop for taking too long to pass on the bike) was thanks to running the 3rd ever fastest marathon at the Hawaiian Ironman, and the fastest of the day, a 2:41:05. Then, in 2011 Pete proved to everyone and himself he is one of the best triathletes in the world by being runner up at the World Championships, and once again had the fastest run split with a 2:42:29.
Regarded as one of the worlds premier Ironman swimmers and runners, Pete knows his ability on the bike is there to use, and showed this when he won Ironman Australia 2011 in Port Macquarie after an 11 minute lead off the bike.
Pete’s ability and talent has not gone unnoticed by the heavyweights of the sport and he has been named an ambassador for the John Maclean Foundation, an Australian based charity that supports young Australians who need assistance and was founded by Olympian, English Channel swimmer and Hawaii Ironman Hall of Famer John Maclean. Pete’s profile and development within the sport helps to drive and maintain the close relationship that John and JMF has with Ironman.
In 2012 Pete’s dream came true and his hard work paid off. He won the Ironman World Championship in Hawaii. His maturity and experience showed through with one of the most controlled performances seen on the big Island for a long time. Pete had the 3rd fastest splits for the swim, bike, and run, leaving him a winning advantage of 5minutes.
Pete is young enough and talented enough to be winning Ironman races for the next ten years. His career is still in the early developmental stages, and he can become the most successful Ironman triathlete ever. Pete will never stop learning and looking for a more efficient and smarter way to train and race, so you can be sure his foretold rise to the top of the world will not be short-lived.
A dedicated group of locals have been hosting a triathlon event called the Samoa Warrior Race (www.samoawarrior.com) each year. Numbers have been increasing each year with swelling support from the local communities. The international contingent has been growing with more Australian and New Zealand competitors combining travel and local hospitality with this exotic triathlon event.
Book now for August 2015! www.samoawarrior.com
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With increased training for half ironman events and marathons, runners expect to experience some sort of pain during and after training. Some pains are good pains that are normal with training and others are bad pains that should never be ignored. Picking the difference is the key to preventing serious injury.
The five most common pains that our Shoes Feet Gear podiatrists see that should never be ignored are:
Deep pain under the heel, first step out of bed pain and arch pain are consistent with the large ligament called the plantar fascia tearing under the arch or tearing away from it's attachment to the heel bone.
Pain at the back of the heel or above this is commonly caused by the fibers of the Achilles tendon tearing or the attachment of the Achilles tendon tearing away from the heel bone.
Pain along the inside edge of the shinbone or down the front of the shinbone are caused by the muscles of the lower leg working too hard to control the foot. The small attachments of these muscles into the bone cause the lining of the shinbone to become inflamed.
The knee collapsing inwards causes the kneecap to get pulled to the side of its groove and track incorrectly. This causes inflammation and pain under or around the edges of the kneecap. Feet that roll in or poor hip stability (from weak gluets or poor run technique) causes the knee to collapse inwards
The tight illiotibial band rubs on the outside of the knee and causes pain and inflammation on the outside of the knee. The ITB compensates for poor hip stability (weak gluets or poor run technique) and also tries to reduce excessive internal knee rotation (feet that roll in too much).
These lower limb pains should never be ignored as they commonly develop into serious and difficult injuries. These problems only get worse with increased training intensity and volume. The sooner they are treated by a Podiatrist and other health providers, then the faster the recovery and smaller the impact on training.
Here are my top 3 tips to give yourself the best chance of achieving your next goal.
The first priority is to get any known lower limb injuries, complaints or niggles assessed and sorted quickly. Old problems or the subtle signs of new problems will always be an issue when increasing your training program. These issues shouldn’t deter you; just make sure that they are being managed in the best possible ways.
Make sure that your foot gear is set up to suit your individual anatomy, mechanics, run technique and they should also suit the type of training and racing you will be doing. Get the right shoes for training and race, invest in some premium socks and make sure any issues with existing or old orthotics are sorted. Check how many miles each of these things have done and replace them before your training starts ramping up. Replace shoes every 700 to 1000km (six to nine months for lighter training) and orthotics should be checked annually.
Prepare your feet. There has been some very recent evidence that suggests that the small muscles of your feet play a more important role in maintaining foot function with exercise than what we initially thought. We also know that as the large muscles of the legs become more fatigued (and they will in a half!) the smaller muscle groups have to work harder to compensate and risk injury.
Strengthening the foot muscles with picking up a towel with your toes and building the lower leg muscles with calf raises can be good to target these muscle groups. However, most lower limb strengthening programs are more effective if they involve multiple joints and muscle groups in more real life and dynamic situations.
Some better (and more fun!) ways to build strength could include introducing some trail running mid week, throwing in some sort of cross training (dynamic sports such as touch, netball, etc) or introducing a more flexible and unstable straining shoe similar to the Nike free concept. The idea of the uneven surfaces, dynamic movement and unstable shoes are to make these intrinsic muscles of the foot, the ankle stabilisers and other lower limb muscles work harder.
Like any new training program, start gradually! Start on gentle trails for short mid-week runs, keep the intensity of the sport low and only wear the flexible shoes for light sessions. Give yourself recovery periods and build gradually like any strength program.
If you have any lower limb concerns or would like any further advice, contact Shoes Feet Gear]]>Register here:
http://qld.tri-alliance.com.au/six-week-run-technique-course/
Whether you are running for the first time or are a seasoned athlete, every runner questions the way they run and wonders how they can improve their running style to go further and faster for less effort or to help avoid that niggly injury that just won’t go away.
Check out this sample video of what we look for with running:
Numbers are limited so if you are interested in please register below.
http://qld.tri-alliance.com.au/six-week-run-technique-course/
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Good luck to the Australian under 20 rugby team who are heading off to the World Cup in 2 weeks.
Shoes Feet Gear Brisbane podiatrist Dan Holmes fitted out the team yesterday.
]]>We would like to celebrate the 2013 season and welcome them into the 2014 season.
Check out Albert Anae presenting Peter Charles our Podiatrist with his #2 Game Jersey (Above).
Our Biomechanist Jaryd Grantham fitting up the boys.
Pete's 6 year old Will was having a ball hanging out.
]]>For questions, enquiries or appointments with our full-time biomechanist email jaryd@shoesfeetgear.com.au
]]>The Straddie Salute is coming and we have put together some great run and race tips to help you get the most out of this awesome weekend away.
*new* 7. Plan Ahead - If you have to travel, don't leave it to the last minute
If you're travelling a significant distance to race make sure you've booked accommodation, flights, friends to car pool with etc. There is nothing worse than leaving it all to the last minute and having to fork out a small fortune!
*new* 8. Bring Along Friends And Family - A little support goes a long way
If possibly, bring along your partner, parents brother, sister or best friend. There is nothing like hearing a a familiar voice when you're in a tough patch or getting a high five heading down the finishing chute.
*new* 9. Hydration - Just because it's cool, doesn't mean you can't dehydrate
Like sleep, you need to start hydrating correctly in the days leading up your race. You want to make sure you're drinking 2 litres a day, the easiest way to do this is live with a water bottle next to you for at least the 3-4 days leading into the race. Also try to avoid alcohol, soft drink and chocolate during those few days, all of these products will assist in dehydrating your body.
10. Treat Yourself - There's nothing wrong with looking sharp on race day
Don't be afraid to spend a little cash on a new singlet or shorts for a big race. It can often be a great source of motivation seeing your new race kit laid out the night before the big day.
11. Don't forget your weaknesses - Stretching isn't an evil word
Everyone is guilty of skipping sessions, not stretching or finishing a set early on occasion. Just remember that these are the things that will come back to bite you on race day. So make sure you add in time for that long run you've been avoiding or get a stretching routine going each night while you watch the news. You'll reap the benefits on race day!
12. Play with your nutrition - Trying new things on race day can be a recipe for disaster
Everyone has different nutritional needs on race day, some like Endura and gel while others will swear by bananas and Mars bars. What's important is finding what works best for you and long training runs are the best time for a little trial and error. I can testify that port-a-loo stops mid race are never fun. So don't be afraid to try different products, that way come race day you'll have honed in on your own nutritional plan.
13. Buddy Up - Running with a partner or friend is a great way to maintain motivation
Getting your partner or friends is one of the best ways to stick to a training program, plus a little friendly competition and bragging rights doesn't go astray. You will be surprised how much of a difference a training partner makes, especially on the days where you may feel tired and flat. It also makes getting out of bed at 5 am in winter not so bad.
14. Shoe Rotation - Like that favourite t-shirt with all the holes in it, shoes have a life span too
Many runners make the mistake of wearing their shoes for well beyond their intended life span. Quality running shoes have a 700-1000 km expected life before they should be replaced. If you keep a training diary, monitor your mileage so you have an idea as to when you'll need to replace your shoes. Uncommon soreness is often a signal that your shoes may have had their day and it's time to get a new pair. If possible, have two pairs which you can alternate between, this will help the longevity of your shoes.
15. Train Specifically To Your Event - The more you're used to race distance, the easier it'll become race day
It's important that you allow your body to become accustomed with the distance that you're running. There's nothing worse than getting a rude shock on race day! Another benefit is that it'll help you pull up better post race.
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The Straddie Salute is coming and we have put together some great run and race tips to help you get the most out of this awesome weekend away.
*new* 10. Treat Yourself - There's nothing wrong with looking sharp on race day
Don't be afraid to spend a little cash on a new singlet or shorts for a big race. It can often be a great source of motivation seeing your new race kit laid out the night before the big day.
*new* 11. Don't forget your weaknesses - Stretching isn't an evil word
Everyone is guilty of skipping sessions, not stretching or finishing a set early on occasion. Just remember that these are the things that will come back to bite you on race day. So make sure you add in time for that long run you've been avoiding or get a stretching routine going each night while you watch the news. You'll reap the benefits on race day!
*new* 12. Play with your nutrition - Trying new things on race day can be a recipe for disaster
Everyone has different nutritional needs on race day, some like Endura and gel while others will swear by bananas and Mars bars. What's important is finding what works best for you and long training runs are the best time for a little trial and error. I can testify that port-a-loo stops mid race are never fun. So don't be afraid to try different products, that way come race day you'll have honed in on your own nutritional plan.
13. Buddy Up - Running with a partner or friend is a great way to maintain motivation
Getting your partner or friends is one of the best ways to stick to a training program, plus a little friendly competition and bragging rights doesn't go astray. You will be surprised how much of a difference a training partner makes, especially on the days where you may feel tired and flat. It also makes getting out of bed at 5 am in winter not so bad.
14. Shoe Rotation - Like that favourite t-shirt with all the holes in it, shoes have a life span too
Many runners make the mistake of wearing their shoes for well beyond their intended life span. Quality running shoes have a 700-1000 km expected life before they should be replaced. If you keep a training diary, monitor your mileage so you have an idea as to when you'll need to replace your shoes. Uncommon soreness is often a signal that your shoes may have had their day and it's time to get a new pair. If possible, have two pairs which you can alternate between, this will help the longevity of your shoes.
15. Train Specifically To Your Event - The more you're used to race distance, the easier it'll become race day
It's important that you allow your body to become accustomed with the distance that you're running. There's nothing worse than getting a rude shock on race day! Another benefit is that it'll help you pull up better post race.
The Straddie Salute is coming and we have put together some great run and race tips to help you get the most out of this awesome weekend away.
Getting your partner or friends is one of the best ways to stick to a training program, plus a little friendly competition and bragging rights doesn't go astray. You will be surprised how much of a difference a training partner makes, especially on the days where you may feel tired and flat. It also makes getting out of bed at 5 am in winter not so bad.
Many runners make the mistake of wearing their shoes for well beyond their intended life span. Quality running shoes have a 700-1000 km expected life before they should be replaced. If you keep a training diary, monitor your mileage so you have an idea as to when you'll need to replace your shoes.
Uncommon soreness is often a signal that your shoes may have had their day and it's time to get a new pair. If possible, have two pairs which you can alternate between, this will help the longevity of your shoes.
It's important that you allow your body to become accustomed with the distance that you're running. There's nothing worse than getting a rude shock on race day! Another benefit is that it'll help you pull up better post race.
I have been having some chronic pain on the arches of my feet (maybe fascia muscle). I have tried massaging it with a tennis ball with no improvement, stretching - Is there anything I can do? It is hard to walk in the morning until my feet have warmed up.
This sounds consistent with plantar fasciitis (also called ‘heel spurs’), which is our most commonly treated foot injury. The strong ligaments (plantar fascia) that run under the arch and into the heel bone become strained and injured. With treatment, the pain should improve immediately, however the plantar fascia can take up to 3 to 12 months to fully strengthen. Treatments need to be tailored to each individuals needs depending on the severity of injury, activity levels and anatomy.
Self-treatments include massage under the arch and the calf muscles, stretching the calf muscles and regular icing to reduce pain and inflammation. If the pain isn’t resolving quickly, the strain through the plantar fascia will need to be reduced by selecting footwear that is stable and matched to your lower limb mechanics. Particular strapping techniques and the use of specifically designed orthotics also reduce strain through the plantar fascia.
Involving a physio and other therapists for help with massaging, needling, strengthening of the supporting muscles and other therapies are also helpful. If the pain is not reducing, your training program can be adjusted to minimise high stress activities.
There are a range of more invasive treatments that for very stubborn cases that can involve using anti-inflammatories, US guided cortisone injections, air casts and sometimes surgical release. The sooner this problem is addressed the easier, cheaper and more likely a full recovery is.
As natural strength of the plantar fascia improves, training can be increased, support reduced and a gradual return to normal activities can be made. Most cases require the identification of risk factors that contributed to the injury and a plan put in place to reduce the chance of it recurring.
If this sounds like you:
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