Moab Half Marathon 2005
(My first Half Marathon & the pain that came afterward)

I can’t believe that it is finally Friday March 11, 2005. I thought (mostly hoped) this day would take a lot longer to arrive then it has. Sitting at work around four in the afternoon and my mind can’t seem to sit still. I drift off into worry land and back about the task that is at hand tomorrow. Jeanine, my beautiful wife knocks on the door at 4:30 and I have her come in the office as I turn off my computer and grab a last few things. Before I know it we are on our way to Moab to run in the Canyonlands Half Marathon. What on earth have I gotten myself into?

The last few months have been met with soreness and frustration. Shin splints seem to be my constant companion and I had to resort to running many weeks in the grass. As I reflected back on my previous runs, I wondered how on earth I would be able to run in this crazy person’s race(?)! I have always hated running my whole life and decided that I should try something different. Well this sure is different enough. What was I thinking? The miles between Orem and Green River seem to fly by and before I can grasp any sort of reality we are checking into our hotel for the night.

Just as I close my eyes to forget about the run of death I will do the next day, the alarm goes off. I open my eyes and the painstaking fear of doubt haunts my mind! Before I can realize where I am, or fully grasp what I am doing, I am sitting in a bus with my wife and some of her friends from her running group. We are making the long trek to the start line where I will do the dance of either shame or victory!! We arrive a half mile before the starting line where there are thousands of other runners. They are all talking, standing in line at the porta potty, huddling around a heater and some even trying to sleep. As I stand in line for the porta potty I take in my surroundings. The fear and doubt turn into excitement. I start to become assured of myself and the training I have done and doubt starts to fade. I see myself crossing the finish line. Hopefully not last but if so be it then a victory will still be celebrated!

“I can’t believe I have had to use the restroom three times this morning!” We have now been standing around for close to 2 hours and an announcement is made to start making our way to the starting line. The half mile walk goes by so quickly and before I know it I am kissing Jeanine goodbye and leaving her at the 7 minute mile pace runners. I merge through the sidelines looking for my pace. I see 8 and then there is a 9 a lot further back, I think I see a 10 but no 11 or 12 or 13? WHAT THE HECK? Is everyone in this race speed demons? What about those of us who don’t have the legs and lungs of a gazelle? I think next year I will make a sign that says “Whoever wants to finish pace” and hold it up!

I finally make my way to the back of the pack. As I am standing there the warm sun has now hit me and my body warms up. I stretch out my calves so the shin splints won’t kill me to bad at the start of the race. Within a few minutes of stretching, a nice man and his wife start talking to me. I confess that this is my first half marathon and race altogether. They could probably tell due to my uncertainty. I made sure though I did not look to “Touristy”. I have the proper running attire, I have placed body glide on the places that my body needs to glide and I have been so hydrated that I could pee every 2 minutes if I wanted. What a nice couple though. They were telling me about the New York Marathon and several in California. Before I realize it the gun goes off. I can see the front of the runners take of running like there were fresh donuts back were we started walking from. It took a good 5 minutes of good solid walking to get to the start line and then the tail enders were off. I made sure that I did not overdue it to start as it is downhill for the first mile.

“Wow I feel great!!” Coming up on mile 2 and I am still feeling very good. The nervousness has gone and the calm peace of just trying to breath has settled in! There it is… the first water break. I try to grab my cup and drink while running only to find myself having to slow down to stop choking.. “Note to self… Walk through the water breaks if you want to finish and not choke to death.” I walked and finished the water and was off again. I keep seeing a lot of people running past me quickly and then see them walking a few minutes down the road. “Slow and steady, slow and steady. Humm, I didn’t tie my right shoe tight enough,” blister is starting but I am not stopping now in fear of not starting again. “Wow, I can not believe that mile 4 is almost here.” I have said hi to 2 people and many have told me good luck. “GOOD LUCK? Do I look that bad?” I soon figured out that this is a common saying to those who choose to stay behind to bring up the tail. Here it is water station and mile 4. Time to take out one of my Volcano Gels! “Ohh these things are so tasty.” My wife says they taste like flavored castor oil. If this is what castor oil tastes like sign me up for two servings! I think they taste delicious and give my taste buds a wakeup. On we go winding down the canyon and then up a hill. Around mile 5 I see a slow but gradual hill. Blister is killing me now. I know that it is the size of Arizona! Where did this hill come from? I did not see it when the bus brought us up here. Funny thing is I didn’t see any uphill when the bus brought us up. I am glad my mind played a trick on me and not let me see this before hand. Ok, just remember, you can do it. As I am halfway up the hill, a cycler comes behind us ringing a bell and shouts “come on runners take this hill!!” “Take this hill?” Yeah more like this hill will take me to my grave! Almost to the top and breathing is getting harder. “Wait a minute, I am almost there.” Ahhh… a little shade next to the side of the rocks, and some nice downhill. Here it is, mile 6 and more water! Thank goodness for water. “Gatorade, Gatorade” I hear people yelling. “WATER where is the water?” Ahh, finally a nice old gent hands me a nice cup of water. “WOW this water is cold. It isn’t warm like the ones before!” I savor every last drop and throw the cup.

Mile 7 isn’t so bad and the hills are more rolling than I had expected. Blister is roaring now and it won’t leave me alone! The map on the website made this course look like a downhill stroll. “Note to self, find out the true course map as the one they have on the website is there to lure people in…” Just before mile 8 a nice man jogs with me for a bit. His first words are “My legs are 2 miles back somewhere”. “Ha” I say. “Mine are 3 miles back, so you passed mine along time ago!”

Mile 8 is finally here and I am starting to get very hot and tired. I take my water and start back up around the bend. I no longer know if my feet and legs are attached. I just keep looking forward and run hoping they will follow my arms. Right now would be a good time to have a nap break! Just as I come upon mile 9 I see the one small hill I do remember seeing. SMALL?? Maybe to those that have been running for some time. All I see is GOLIATH standing there laughing… Wait a minute though, I hear some people just at the bottom of the hill. If I can make it there and get some water I will do just fine. Just as I get to the climb of the hill I realize they are not giving water. They are giving compliments…. Hummmm!! “Good job, you are almost there!” “Almost there? I am only on mile 9! I still have 4 more!!” Still I stay focused and want to tell them thanks but the lips will no longer move. I give them the thumbs up sign and trudge up the hill. Almost to the top I have to take a quick walking breather. Just as I top the hill there is the camera crew taking pictures… “HEY!!!! NO FAIR!!!” I start running so I don’t look like how I feel inside. Muscles are truly sore now. “Note to self, run more hills in training…….”

As I near mile 10 I can see the water station. I now know that this is by far the hardest thing I have ever done in my life. I hear the drums at the bottom of the canyon playing and hear people singing! I can do it. Jeanine said she would run back and run in with me. She said she would be there around mile 10. “Where is she?” I start back up the pace and I catch up to another guy that asks me “What are we doing this for again?” I laugh and continue on.

I can now see the drummers and we cross under the freeway. Blister is now more than I can handle and body is done! Wore out and tired, ready to quit! Just as I am coming up the hill I see the best thing in the whole world. My wife is there and starts to smile. As I get closer to her I see her eyes and she is crying. She saw me and even though I had on my sunglasses I was crying as well. Nothing could have better than to see her there at that moment. She asked “How are you doing Jon?” I answer “I hurt and this is by far the hardest thing I have ever done!” She looks at me and says “I am so proud of you!!” I looked at her with tears streaming down my face I whisper, “I am doing it!!” We had to walk a little and now we are close to town and the heat is getting to me. We make it to water stop at mile 12. I have Jeanine get me 2 cups and I down them. As I pass a nice lady has a hose and asks “Want to get sprayed”. With all the energy I could muster I shake my head yes. She dowses me real good and some life comes back to me. “Just around that bend up there is the finish line” Jeanine says. I believe her but it seems so far away. Blister is now more than I can handle but I will not stop now! We round the corner and this was by far the most relieving site of the day. In big letters I read FINISH!! I can see it now. I don’t know why or how my legs are doing this but they are. Jeanine tells me she can’t run through the finish chute with me but runs off into the crowd. There is only 200 yards left now. Time to sprint. I hear cheers from all the other runners and people telling me I can do it. I am now in a full sprint. I want to slow down and walk but my mind tells me “NO! NO, Jon!! You have worked too hard and you are giving everything you have to finish this right now!!”I hear Jeanine’s voice “come on Jon, way to go! You are doing it!!” and I then hear my feet step on the finish line mat. “Thump Thump” I can now no longer stand and hit the ground right away by bracing myself up with my arms. A finisher’s medal is placed around my neck. I hobble over to the next stop to take off my time chip and grab water. My heart is feeling swelled now. I had done it. Tears start to stream down my cheek as I realize that I have accomplished something I never thought I could or even wanted to do! I did it! I finished!!! I drink 2 bottles of water and start on my 3 rd. I eat 2 bananas and am ready to now relax! This is the best part of the race! I take of my shoes, and Jeanine’s eyes get big. “Jon, holy cow that looks so painful!” I told her that I did not want to complain much so I didn’t say anything. It didn’t matter now. It was a war wound from a war I have just won! What a victory!

Runnging Moab in Vibram Five Fingers

Little did I know what would happen next.. The next two weeks I could barely walk and there was horrible pain in my shins. Both sides! The xrays that were taken were positive that I now had stress fractures!! Great!! Now I could no longer run, get in shape or loose weight. So what to do now? Well I wanted to be able to run! The feelings of finishing the half marathon were a high I wanted to experience over and over again!! So after watching what I eat, loosing 10 lbs over two months of healing, I took to running again.. The first mile I was TICKED!! My pain was back again. What was going on?? I was so upset! I remembered reading in one of my wife’s Runners Worlds about a man (Barefoot Bob) and how he ran barefoot to be pain free. So, I sat down, took my shoes off and started running barefoot.. I had to slow down some and keep on a paved path, but WOW!! No more shin pain! No more pain at all!!! Maybe this barefoot thing had something to it!! I started out slow and picked it up over time.. I had to tape my toes from blisters, but over time, I have dropped over 60 lbs. My second year at moab I ran it in 2:08!! Wow!! I have evolved to running in Vibram Five Fingers now. Checkout my reviews and updates throughout the site!!

One of the most common chronic injuries in runners is planter fasciitis, or an inflammation of the ligament running along the sole of the foot. There is some evidence that the normally unyielding plantar fascia acts as the support for the medial longitudinal arch, and that strain on the proximal fascial attachment during foot strike leads to plantar fasciitis (Robbins and Hanna, 1987). Barefoot running may induce an adaptation that transfers the impact to the yielding musculature, thus sparing the fascia and accounting for the low incidence of plantar fasciitis in barefoot populations (Robbins and Hanna, 1987).

Chronic ailments such as shin splints, ilio-tibial band syndrome and peri-patellar pain are attributed variously to excessive pronation, supination, and shock loading of the limbs (Siff and Verkhoshansky, 1999, p.451). When running barefoot on hard surfaces, the runner compensates for the lack of cushioning underfoot by plantar-flexing the foot at contact, thus giving a softer landing (Frederick, 1986). Barefoot runners also land mid-foot, increasing the work of the foot’s soft tissue support structures, thereby increasing their strength and possibly reducing the risk of injury (Yessis 2000, p.124).

Wearers of expensive running shoes that were promoted as correcting pronation or providing more cushioning experienced a greater prevalence of these running-related injuries than wearers of less expensive shoes (Robbins and Gouw, 1991). In another study, expensive athletic shoes accounted for more than twice as many injuries as cheaper shoes, a fact that prompted Robbins and Waked (1997) to suggest that deceptive advertising of athletic footwear (e.g., “cushioning impact”) may represent a public health hazard. Anthony (1987) reported that running shoes should be considered protective devices (from dangerous or painful objects) rather than corrective devices, as their capacity for shock absorption and control of over-pronation is limited. The modern running shoe and footwear generally reduce sensory feedback, apparently without diminishing injury-inducing impact–a process Robbins and Gouw (1991) described as the “perceptual illusion” of athletic footwear. A resulting false sense of security may contribute to the risk of injury (Robbins and Gouw, 1991). Yessis (2000, p.122) reasoned that once the natural foot structures are weakened by long-term footwear use, people have to rely on the external support of the footwear, but the support does not match that provided by a well functioning foot.

Measurements of the vertical component of ground-reaction force during running provide no support for the notion that running shoes reduce shock. Robbins and Gouw (1990) reported that running shoes did not reduce shock during running at 14 km/h on a treadmill. Bergmann et al. (1995) found that the forces acting on the hip joint were lower for barefoot jogging than for jogging in various kinds of shoe. Clarke et al. (1983) observed no substantial change in impact force when they increased the amount of heel cushioning by 50% in the shoes of well-trained runners. Robbins and Gouw (1990) argued that plantar sensation induces a plantar surface protective response whereby runners alter their behavior to reduce shock. The less-cushioned shoe permitted increases in plantar discomfort to be sensed and moderated, a phenomenon that they termed “shock setting”. Footwear with greater cushioning apparently provokes a sharp reduction in shock-moderating behaviour, thus increasing impact force (Robbins and Hanna, 1987; Robbins et al., 1989; Robbins and Gouw, 1990). However, in these studies the subjects ran on treadmills or force platforms. Further studies are needed to establish how shoes affect impact force and shock-moderating behavior on natural surfaces such as road or grass.

Other features of footwear, such as arch supports and orthotics, may interfere with shock-moderating behavior and probably hinder the shock-absorbing downward deflection of the medial arch on landing (Robbins and Hanna, 1987). These features reportedly reduce pronation and supination or offer the wearer lateral and arch support. They may help some people with foot pathologies, but their benefit is uncertain for runners with healthy feet (Yessis, 2000, p.121).
Runners with diminished or absent sensation in the soles of the feet are particularly vulnerable to damage or infection when barefoot. Peripheral neuropathy is a common complication of diabetes mellitus and may result in the loss of protective sensations in the feet. Barefoot locomotion is therefore not recommended in this population (Hafner and Burg, 1999). Indeed, proper footwear is essential and should be emphasized for individuals with peripheral neuropathy (ACSM/ADA, 1999; ACSM, 2000).
Economy
Wearing shoes increases the energy cost of running. Burkett et al. (1985) found that oxygen consumption during running increased as the amount of mass they added to the foot increased; shoes and orthotics representing 1% of body mass increased oxygen consumption by 3.1%. Flaherty (1994) found that oxygen consumption during running at 12 km/h was 4.7% higher in shoes of mass ~700 g per pair than in bare feet. An increase in oxygen consumption of ~4% is of little importance to the recreational runner, but the competitive athlete would notice a major effect on running speed.
The increase in oxygen consumption with running shoes could have several causes. An obvious possibility is the energy cost of continually accelerating and decelerating the mass of the shoe with each stride. Another possibility is the external work done in compressing and flexing the sole and in rotating the sole against the ground–up to 13% of the work done in walking, according to Webb et al. (1988). Frederick (1986) reported that oxygen consumption increased substantially with thicker shoe inserts during treadmill running. Not surprisingly, materials used for cushioning in shoes absorb energy, and stiff midsoles should produce a 2% saving of energy compared with standard midsoles (Stefanyshyn and Nigg, 2000). Finally, shoes probably compromise the ability of the lower limb to act like a spring. With bare feet, the limb returns ~70% of the energy stored in it, but with running shoes the return is considerably less (Yessis, 2000, p.123).
Adapting to Barefoot Running
Thirty minutes of daily barefoot locomotion is a recommended starting point to allow thickening of the sole of the foot and adaptation of muscles and ligaments (Robbins et al., 1993). Begin by walking barefoot at every reasonable opportunity then progress to jogging, gradually increasing the intensity and duration (Yessis 2000, p.124). After 3-4 weeks, the plantar skin eventually becomes robust and allows longer periods of barefoot running at higher average velocities (Robbins et al., 1993). To facilitate adaptation, perform progressive strengthening exercises for the foot and ankle, including foot inversion, toe flexion, and walking on the balls of the feet. Barefoot locomotion on uneven surfaces will also help stimulate the plantar surface and provide increased sensory feedback (Yessis 2000, p.125).
Conclusions
• Running in shoes appears to increase the risk of ankle sprains, either by decreasing awareness of foot position or by increasing the twisting torque on the ankle during a stumble.
• Running in shoes appears to increase the risk of plantar fasciitis and other chronic injuries of the lower limb by modifying the transfer of shock to muscles and supporting structures.
• Running in bare feet reduces oxygen consumption by a few percent. Competitive running performance should therefore improve by a similar amount, but there has been no published research comparing the effect of barefoot and shod running on simulated or real competitive running performance.
• Research is needed to establish why runners choose not to run barefoot. Concern about puncture wounds, bruising, thermal injury, and overuse injury during the adaptation period are possibilities.
• Running shoes play an important protective role on some courses, in extreme weather conditions, and with certain pathologies of the lower limb.

Benefits of Running and Walking Barefoot

Man has been running for thousands of years, apparently without the injuries experienced by modern sportsmen/women wearing modern shoes. The human foot is designed to run without the aid of a shoe. In the past runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning relative to modern running shoes. As the incidence of running injuries remains significant despite advances in footwear technology, it seems that the best shoes may be no shoes at all.

Running Shoes and Sports Injuries

The modern running shoe was invented during the 1970′s. Prior to that, shoes offered little or no real protection against impact injuries.

Due to the high prevalence of impact related sports injuries amongst runners, research has been undertaken to study the reasons for such injuries and to design the ultimate high tech running shoe. As it turns out, nature got there first. The startling fact is that research has shown high tech running shoes may be contributing to impact related injuries amongst runners.

According to a study conducted by Daniel Lieberman and colleagues at Harvard University it was found that shod runners are more inclined to heel strike as opposed to mid foot or front foot strike when running. Their research also showed that many shod runners, when asked to run barefoot in laboratory conditions on a treadmill or track way, switch to a mid foot or forefoot strike.

Lieberman concludes that, until recently, most humans had much more varied gaits. Sometimes they landed on their heel, but more often they were mid foot or front foot striking. The heel is not designed to absorb impact all of the time. Running in a mid foot or front foot strike style spreads the impact more evenly across the foot. Considering that most runners will strike the ground around 60 times per kilometer, this significantly reduces the likelihood of developing repetitive stress injuries.

The high tech running shoe, on the other hand, gives the runner a false sense of security, allowing him or her to comfortably heel strike most of the time. Unfortunately, even the most advanced shoe cannot prevent the accumulated damage suffered by consistently running in this way.

Easing into Walking and Running Barefoot

People in the modern age are accustomed to wearing shoes, so running or or even walking barefoot is something to be eased into for many – build calf and foot muscles slowly. By practicing each day, barefoot running and walking will eventually come easily, naturally and painlessly.

(Article from Natural News) Please see link

Shin Splints

OUCH!! My sheath was torn badly after my first half. No wonder I was in Pain!

Definition: Inflammation of the muscle attachments and interosseous  membranes to the tibia (shin bone) on the inside of the front of the lower leg. Note: “shin splints” is a very widely used phrase and can refer to several lower leg injuries. The focus of this description is specifically on the inflammation described above.

Symptoms:
Pain or tenderness along the inside of the shin, usually about halfway down the shin. Pain and tenderness may extend to the knee
Pain on palpation of the shin
Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)

Causes:
Inflexible calf muscles and tight
Achilles tendons – place more stress on to the muscle attachments
Overpronation (feet rotate too far inward on impact) excessive running on hard surfaces, such as concrete pavements
Incorrect or worn shoes
Overtraining, or a rapid increase in training load or intensity
Beginner runners are more susceptible to this problem for a variety of reasons, but most commonly due to the fact that the leg muscles have not been stressed in such a way before they started running.

Treatment:

Self-treatment:
Stop running, especially in the case of severe pain, if pain is mild, then reduce training load and intensity, and avoid downhill running and running on cambered surfaces
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the shin area – for 10 minutes every 2 hours, in order to reduce the inflammation
Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the inside of the shin).

Stretching of the gastrocnemius and soleus muscles. Hold for 30 secs. Relax slowly. Repeat to opposite side. Repeat stretch 2 – 3 times per day.
Remember to stretch well before running
Return to running gradually
full recovery is usually between two to four weeks

Medical treatment:
Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks
Orthotist or podiatrist for custom-made orthotics to control overpronation
Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a bone scan, diagnostic ultrasound or X-ray may be necessary to check for a stress fracture.

Alternative exercises:
swimming, pool running, cycling (in low gear) “spinning”
avoid any weight-bearing exercises

Preventative measures:
Stretching of the gastrocnemius and soleus muscles. Hold each stretch for  30 seconds, relax slowly.
Repeat stretches 2 – 3 times per day. Remember to stretch well before running.

Strengthening of foot and calf muscles.
1) Place a weight around the foot, and move your foot up and down from the ankle, with no movement in the rest of the leg. Or use a partner to grasp the foot and provide manual resistance.
2) Band exercises. Anchor one end of an exercise band (e.g; inner tubing of bicycle) to a heavy object, such as the leg of a couch. Loop the other end around the foot. Move the foot up, down, and from side to side against the band’s resistance to exercise different muscle groups.

Correct shoes, specifically motion-control shoes and orthotics to correct  overpronation
Always apply ice after running
Run on soft surfaces
Avoid overstriding, which places more stress onto the shins
Gradual progression of training program
Incorporate rest into training program

Plantar Fasciitis

Plantar Fasciitis

Definition: An inflammation of the plantar fascia, a thick fibrous band of tissue in the bottom of the foot which runs from the heel to the base of the toes. When placed under too much stress, the plantar fascia stretches too far and tears, resulting in inflammation of the fascia and the surrounding tissues. The tears are soon covered with scar tissue, which is less flexible than the fascia and only aggravates the problem.

Symptoms:
Pain at the base of the heel
pain is most severe in the mornings on getting out of bed, and at the beginning of a run. The pain may fade as you walk or change running stride, in an attempt to alleviate the pain.
This provides only temporary relief

Causes:
Stress, tension and pulling on the plantar fascia
Inflexible calf muscles and tight Achilles tendons – place more stress onto the plantar fascia.
Overpronation (feet rotate too far inward on impact)
High arches and rigid feet
Incorrect or worn shoes
Overtraining

Treatment:

Self-treatment:
Stop running, especially in the case of severe pain, if pain is mild, then reduce training load and intensity take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the plantar fascia – for 10 minutes every 2 hours, in order to reduce the inflammation. An effective way of icing is to fill a plastic 500 ml Coke bottle with water, and to freeze it. Apply the ice as instructed by rolling the bottle under the foot
Self-massage, using arnica oil or an anti-inflammatory gel, to the plantar fasciastretching of the gastrocnemius and soleus muscles
Return to running gradually
Full recovery is usually between six to eight weeks

Medical treatment:
Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks
Orthotist or podiatrist for custom-made orthotics to control overpronation, or to reduce stress on the heel area
X-rays – to check for a heel spur.
Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a cortisone injection, or surgery to release the plantar fascia may be indicated.

Alternative exercises:
Swimming, pool running, cycling (in low gear) “spinning”
Avoid any exercise that places strain onto the plantar fascia

Preventative measures:
Stretching of the gastrocnemius and soleus muscles. Hold each stretchfor 30 seconds, relax slowly. Repeat stretches two – three times per day.

Remember to stretch well before running stretching of the plantar fascia. Sit on the floor with one knee bent and theankle flexed towards you. Pull the toes back towards the ankle. Hold for 30 seconds. Relax slowly. Repeat to opposite foot. Repeat 2 – 3 times per day. Remember to stretch well before running strengthening of the muscles of the foot. 1) Pick up marbles or golf balls with your toes. 2) Pull a towel towards you with your toes. Grab some of the towel with your toes and pull, then release, grab, and pull some more to loosen the plantar fascia, place a golf ball under the foot, and roll the foot over the ball. Start with the ball at the base of the big toe, and roll the foot forwards over the ball, then back again. Move the ball to the base of  toe and repeat. Repeat for each toe. Always exert enough pressure so that you feel a little tenderness. correct shoes, specifically motion-control shoes and orthotics to correct overpronation

• always apply ice after running
• gradually progression of training program
• incorporate rest into training program

Definition: Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint.

Symptoms:
Initially, a dull ache 1-2 kilometres into a run, with pain  remaining for the duration of the run. The pain disappears soon after stopping running, later, severe sharp pain which prevents running pain is worse on running downhills, or on cambered surfaces pain may be present when walking up or downstairs.
Local tenderness and inflammation

Causes:
Anything that causes the leg to bend inwards, stretching the ITB against the femur overpronation(feet rotate too far inward on impact)tightness of the ITB muscle lack of stretching of the ITB incorrect or worn shoes excessive hill running (especially downhills) and running on cambered surfaces overtraining

Treatment:

Self-treatment:
Stop running, especially in the case of severe pain if pain is mild, then reduce training load and intensity,  and avoid downhill running and running on cambered surfaces.
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs  (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist.
Apply ice to the knee (for 10minutes every 2 hours) in order to reduce the inflammation
Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the outside of the thigh). Do not massage the side of the knee where you feel the pain, as this will only aggravate the friction syndrome stretching of the ITB. Stand with the right leg crossed in the back of the left leg. Extend the left arm against a wall/pole/chair/other stable object. Lean your weight against the object while pushing your right hip in the  opposite direction. Keep your right foot anchored while allowing your left knee to flex. You should feel the stretch in the ITB muscle in the right hip and along the outside of the right thigh. Hold for 30 sec. Relax slowly.

Repeat to opposite side. Repeat stretch 2 – 3 times per day.
Remember to stretch well before running
Return to running gradually
Full recovery is usually between three to six weeks

Medical treatment:
Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks
Orthotist or podiatrist for custom-made orthotics to control overpronation
Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a cortisone injection into the ITB, or surgery to release the ITB may be indicated.

Alternative exercises:
Swimming, pool running, cycling (in low gear) “spinning”
Avoid any exercise that places strain onto the ITB, specifically, avoid stair-climbing

Preventative measures:
Stretching of the ITB, quadriceps, hamstring, and gluteal muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 – 3 times per day. Remember to stretch well before running.
Strengthening of quadriceps, hamstring and calf muscles.

Correct shoes, specifically motion-control shoes and orthotics to correct  overpronation
Gradual progression of training program
Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road)
Incorporate rest into training program

Runner’s knee – chondromalacia

Definition: A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.

Symptoms: Pain beneath or on the sides of the kneecap crepitus (grinding noise), as the rough cartilage rubs against cartilage when the knee is flexed. Pain is most severe after hill running. Swelling of the knee.

Causes:
overpronation (feet rotate too far inward on impact) - can cause the kneecap to twist sideways fatigued or weak quadriceps muscle. The quadriceps muscle assists in the proper tracking of the kneecap.
Weakness, especially of the inside part of the quadriceps, can prevent the kneecap from tracking smoothly muscle imbalance – between weak quadricepsand tight hamstring and iliotibial band (ITB)
Muscles can also affect proper tracking hill running (especially down hills) and running on cambered surfaces
Incorrect or worn shoes
Overtraining

Treatment:


Self-treatment:
Stop running
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the shin area – for 10 minutes every 2 hours, in order to reduce the inflammation
Avoid weight-bearing activities and keep foot elevated where possible
Self-massage – using arnica oil or anti-inflammatory gel, on the sore spots around the kneestretch 2 – 3 times per day.
Strengthen the quadriceps muscle only when pain-free.
Exercises include:
1) Place pillow under knee, tighten quadriceps, push knee down into pillow and lift foot up. 20 times
2) Repeat exercise as above with foot turned out in order to strengthen the inside of the quadriceps muscle. Repeat 20.
3) Squats. Perform with back against wall. Bend knees slowly to between 45 – 60. Ensure that knee travels over line between bigand second toes. Hold for a count of 5 seconds. Relax slowly. 20 times
4) Step-downs. Stand on step or box. Tighten quadriceps and lower opposite leg slowly to the ground.Ensure that knee travels over line and between big and second toes.Then raise the leg up onto the step,relax. Repeat 20.  Increase the number of repetitions in increments of 5 every two days, all the way up to 60 reps.
Stretching – of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles
Return to running gradually
Full recovery is usually between four to six weeks

Medical treatment:
If injury doesn’t respond to self-treatment in two weeks, see a physiotherapist or orthopaedic surgeon
Orthotist or podiatrist for custom-made orthotics to control overpronation
Orthopaedic surgeon – surgery to scrape away rough edges of cartilage may alleviate some pain.
Cortisone injections are ineffective

Alternative exercises:
Swimming, pool running, cycling (in low gear) “spinning”
Avoid any exercise that places strain onto the knee

Preventative measures:
Stretching of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 – 3 times per day. Remember to stretch well before running, strengthening of quadriceps, hamstring and calf muscles correct shoes, specifically motion-control shoes and orthotics to correct overpronation
Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road) .
Gradual progression of training program
Incorporate rest into training program

Causes:
Tight or fatigued calf muscles, which transfer the burden of running to the Achilles. This can be due to poor stretching, rapidly increasing distance, or over-training excessive hill running or speed work, both of which stress the Achilles more than other types of running.
Inflexible running shoes, which, in some cases, may force the Achilles to twist.
Runners who overpronate (feet rotate too far inward on impact) are most susceptible to Achilles tendinitis

Treatments:

Self-treatment:
Stop running
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the Achilles – for 10 minutes every 2 hours, in order to reduce the inflammation.
Avoid weight-bearing activities and keep foot elevated where possible
Self-massage – using arnica oil or anti-inflammatory gel. Rub in semi-circles in all directions away from the knotted tissue, three times a day once the nodule is gone, stretch the calf muscle gently do not start running until you can do heel raises and jumping exercises without pain return to running gradually full recovery is usually between six to eight weeks.

Medical treatment:
If injury doesn’t respond to self-treatment in two weeks, see a physiotherapist or orthopaedic surgeon, surgery to scrape scar tissue off the tendon is a last resort, but not very effective.

Alternative exercises:
Swimming, pool running, cycling (in low gear) “spinning”
No weight-bearing exercises

Preventative measures:
Stretching of the gastrocnemius (keep knee straight) and soleus (keep knee bent) muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 – 3 times per day. Remember to stretch well before running strengthening of foot and calf muscles (eg, heel raises) correct shoes, specifically motion-control shoes and orthotics to correct overpronation.
Gradual progression of training program.
Avoid excessive hill training
Incorporate rest into training program

Yumm Yummm Give Me Some!!!

I have people question me all the time about arch, hip, knee etc etc and if I am not worried about ruining them by running unshod? Well most people do not believe me when I tell them this is the only and first time in my life I am running pain free (my fastest too.. Just finished my fastest time ever of 5 miles with a 8:12 pace.. RECORD FOR ME when I was doing 12 min miles in 2005!) I loved the following portion from a recent study:

Sixty-eight healthy young adult runners (37 women), who run in typical, currently available running shoes, were selected from the general population. None had any history of musculoskeletal injury and each ran at least 15 miles per week. A running shoe, selected for its neutral classification and design characteristics typical of most running footwear, was provided to all runners. Using a treadmill and a motion analysis system, each subject was observed running barefoot and with shoes. Data were collected at each runner’s comfortable running pace after a warm-up period.

The researchers observed increased joint torques at the hip, knee and ankle with running shoes compared with running barefoot. Disproportionately large increases were observed in the hip internal rotation torque and in the knee flexion and knee varus torques. An average 54% increase in the hip internal rotation torque, a 36% increase in knee flexion torque, and a 38% increase in knee varus torque were measured when running in running shoes compared with barefoot.”

You can read the full article here: http://www.sciencedaily.com/releases/2010/01/100104122310.htm

RUN FUN RUN FREE  ~UnshodRunner

The comparing of foot strikes

RUN FUN RUN FREE ~UnshodRunner