The poll results are in! The February 2009 issue of Runner's World Magazine reports on the most painful afflictions and injuies that plague runners.
...and the winner is....SHIN SPLINTS!
Thats right, that aching pain in the front of the leg came out as the most painful running ailment based on 2,263 respondents of the Runner's World poll.
The other top finishers from the complete results were:
Shin Splints 36%
Side Stitches 20%
Chafing 13%
Blisters 12%
We will discuss each of these running injures...and how you can beat them, instead of them beating you over the next few days.
Dr. Christopher Segler is an award winning foot surgeon and Ironman Finisher who treats elite athletes. His podiatry sports medicine practice is at the Doc on the Run Podiatry Sports Medicine House Calls in San Francisco. To learn more about increasing your speed and avoiding running injuries like tendonitis, shin splints and stress fractures, you can register for a FREE membership and copy of his monthly newsletter “Finisher’s Circle” by visiting http://www.AnkleCenter.com .
Showing posts with label prevention. Show all posts
Showing posts with label prevention. Show all posts
Tuesday, January 6, 2009
Tuesday, December 16, 2008
Young Woman Dies in White Rock Marathon
On December 15, 2008 during the Dallas White rock Marathon, a 29-year-old woman collapsed and was pronounced dead, the race director said.
According to the Dallas morning news, Marcus Grunewald, director of the 39-year-old Dallas White Rock Marathon, said that the young newlywed woman’s death was the first in the event since 1986. In that race a 47-year-old man collapsed after suffering a heart attack and died during the marathon.
Witnesses to the event said the woman appeared to be running fine until mile 21, just a few miles from the finish, when she suddenly stumbled. She was helped to a nearby curb and then lost consciousness. "Her body was cold," one witness said. "She was already gone."
The race director told the Dallas Morning News that due to the marathon's 66-degree weather, higher than the race's average, medical aid and water were readily available along the race route. Although heart attack is suspected, the exact cause of death had not been determined. An autopsy was pending.
This tragic event illustrates the importance of checking with your primary care doctor before training for any endurance event. Undiagnosed heart disease or other underlying medical conditions can lead to disaster.
Even if you have been training for months without any episodes or warnings of trouble, distress of running faster during an organized marathon can lead to enough over-load to cause a heart attack.
After running for many miles particularly at your maximum capacity, dehydration can lead to electrolyte changes that can contribute to a heart attack. It is critical to make sure they don’t have any underlying heart disease before considering when these events.
Dr. Christopher Segler is an Ironman Finisher and award winning foot and ankle surgeon specializing in elite athletes. His podiatry practice is at Don On the Run Podiatry House Calls in San Francisco, Marin and the East Bay. To learn more about Achilles tendonitis, runner’s heel pain, stress fractures, bunions and other common causes of foot pain, you can register for a FREE membership and copy of his monthly newsletter “Finisher’s Circle” by visiting http://www.AnkleCenter.com .
According to the Dallas morning news, Marcus Grunewald, director of the 39-year-old Dallas White Rock Marathon, said that the young newlywed woman’s death was the first in the event since 1986. In that race a 47-year-old man collapsed after suffering a heart attack and died during the marathon.
Witnesses to the event said the woman appeared to be running fine until mile 21, just a few miles from the finish, when she suddenly stumbled. She was helped to a nearby curb and then lost consciousness. "Her body was cold," one witness said. "She was already gone."
The race director told the Dallas Morning News that due to the marathon's 66-degree weather, higher than the race's average, medical aid and water were readily available along the race route. Although heart attack is suspected, the exact cause of death had not been determined. An autopsy was pending.
This tragic event illustrates the importance of checking with your primary care doctor before training for any endurance event. Undiagnosed heart disease or other underlying medical conditions can lead to disaster.
Even if you have been training for months without any episodes or warnings of trouble, distress of running faster during an organized marathon can lead to enough over-load to cause a heart attack.
After running for many miles particularly at your maximum capacity, dehydration can lead to electrolyte changes that can contribute to a heart attack. It is critical to make sure they don’t have any underlying heart disease before considering when these events.
Dr. Christopher Segler is an Ironman Finisher and award winning foot and ankle surgeon specializing in elite athletes. His podiatry practice is at Don On the Run Podiatry House Calls in San Francisco, Marin and the East Bay. To learn more about Achilles tendonitis, runner’s heel pain, stress fractures, bunions and other common causes of foot pain, you can register for a FREE membership and copy of his monthly newsletter “Finisher’s Circle” by visiting http://www.AnkleCenter.com .
Sunday, December 7, 2008
Os Trigonum Syndrome: A Rare Form of Posterior Ankle Pain
The day that Jessica came into the office she was worried. Not only was she worried, her mother was worried as well. Jessica is a 26-year-old healthy runner with a penchant for training and a high tolerance for pain.
She was in the middle of training for an upcoming marathon. Her mother had noticed her limping about and recommended that she go see somebody. She came in because she was worried about her Achilles’ tendon. She had heard that could be very serious.
I asked her about her training routine. She said that she typically ran 8 miles at a time on a very hilly course area. She felt that this was a good training strategy given that the upcoming marathon would contain a lot of hills. She wanted to make sure that she would be ready. But running up and down all of those hills was aggravating her condition.
She could remember exactly when her pain started. It’d been getting progressively worse. She pointed at the back of her ankle, but it wasn’t right at her Achilles’ tendon where she had the most pain. It was actually deeper in the back of the ankle.
I poked and prodded and couldn’t find any pain or tenderness anywhere around her Achilles’ tendon. However, if I squeeze the back of the ankle, away from the Achilles’ tendon, she had a great deal of pain and tenderness. Next, I put my thumb underneath her big toe. I had her try to push down with her big toe as hard as she could. And when she did, she had the same kind of pain in the back of the ankle.
We took some x-rays and noticed that she had a portion of bone that was not completely fused to the back of her talus bone. This is a condition known as os trigonum syndrome or posterior ankle impingement syndrome.
We got an MRI that reassured us that she had no issues with her Achilles’ tendon or the tendons to go to the big toe area. The flexor hallucis longus (FHL) tendon which pulls the big toe down against the ground when a runner pushes off can sometimes become torn or irritated and have the same type of presentation. But her FHL was fine.
However, not everything was fine. There was a great deal of swelling with in the talus bone (the bone that connects the foot to the ankle), as well as an accessory bone at the back of the talus called the os trigonum. These two pieces of bone in her ankle were connected with some soft tissue attachments which were very irritated.
Os trigonum syndrome is not a common injury. However one study showed that runners who to do a significant amount of downhill running have an 18% chance of acquiring posterior ankle impingement syndrome. And when it does occur, it can be debilitating.
Runners who develop this problem might have no pain at all when walking on level ground. It starts to become painful when they walk on uneven ground. It becomes much worse when they run on hills. This is because the foot needs to point further down (plantarflexion) and the soft tissues can become irritated or even get caught and pinched between the talus and the calcaneus (the heel bone). This causes a great deal of inflammation and pain.
Not only will there be pain, but many will also have swelling and stiffness in the back of the ankle that may extend all the way to the Achilles’ tendon. That is why many patients who think they have Achilles tendinitis might actually have this problem instead.
Although this is not the most common running injury we see, it is important to get it treated. Chronic inflammation can lead to pain that interferes with activities ranging from normal walking to running. Anytime you suspect an Achilles tendon injury, it is important to be evaluated.
Even though Jessica did not have an Achilles’ tendon injury she did have an injury which could be treated effectively. In most cases, immobilization and physical therapy can calm it down. In rare cases, surgery is needed to take out the accessory bone and inflamed tissue. In any event, with this type of problem it is never a good idea to stick your head in the sand and foolishly hope you’ll cross the finish line in record time.
Dr. Christopher Segler is an Ironman Triathlon Finisher and award winning foot doctor specializing in elite athletes. His podiatry sports medicine house calls practice is based in San Francisco. You can reach him directly at 415-308-0833. You can register for a FREE membership and will receive the monthly newsletter “Finisher’s Circle,” which provides expert advice on increasing your running efficiency and preventing injuries and foot pain by visiting http://www.AnkleCenter.com .
She was in the middle of training for an upcoming marathon. Her mother had noticed her limping about and recommended that she go see somebody. She came in because she was worried about her Achilles’ tendon. She had heard that could be very serious.
I asked her about her training routine. She said that she typically ran 8 miles at a time on a very hilly course area. She felt that this was a good training strategy given that the upcoming marathon would contain a lot of hills. She wanted to make sure that she would be ready. But running up and down all of those hills was aggravating her condition.
She could remember exactly when her pain started. It’d been getting progressively worse. She pointed at the back of her ankle, but it wasn’t right at her Achilles’ tendon where she had the most pain. It was actually deeper in the back of the ankle.
I poked and prodded and couldn’t find any pain or tenderness anywhere around her Achilles’ tendon. However, if I squeeze the back of the ankle, away from the Achilles’ tendon, she had a great deal of pain and tenderness. Next, I put my thumb underneath her big toe. I had her try to push down with her big toe as hard as she could. And when she did, she had the same kind of pain in the back of the ankle.
We took some x-rays and noticed that she had a portion of bone that was not completely fused to the back of her talus bone. This is a condition known as os trigonum syndrome or posterior ankle impingement syndrome.
We got an MRI that reassured us that she had no issues with her Achilles’ tendon or the tendons to go to the big toe area. The flexor hallucis longus (FHL) tendon which pulls the big toe down against the ground when a runner pushes off can sometimes become torn or irritated and have the same type of presentation. But her FHL was fine.
However, not everything was fine. There was a great deal of swelling with in the talus bone (the bone that connects the foot to the ankle), as well as an accessory bone at the back of the talus called the os trigonum. These two pieces of bone in her ankle were connected with some soft tissue attachments which were very irritated.
Os trigonum syndrome is not a common injury. However one study showed that runners who to do a significant amount of downhill running have an 18% chance of acquiring posterior ankle impingement syndrome. And when it does occur, it can be debilitating.
Runners who develop this problem might have no pain at all when walking on level ground. It starts to become painful when they walk on uneven ground. It becomes much worse when they run on hills. This is because the foot needs to point further down (plantarflexion) and the soft tissues can become irritated or even get caught and pinched between the talus and the calcaneus (the heel bone). This causes a great deal of inflammation and pain.
Not only will there be pain, but many will also have swelling and stiffness in the back of the ankle that may extend all the way to the Achilles’ tendon. That is why many patients who think they have Achilles tendinitis might actually have this problem instead.
Although this is not the most common running injury we see, it is important to get it treated. Chronic inflammation can lead to pain that interferes with activities ranging from normal walking to running. Anytime you suspect an Achilles tendon injury, it is important to be evaluated.
Even though Jessica did not have an Achilles’ tendon injury she did have an injury which could be treated effectively. In most cases, immobilization and physical therapy can calm it down. In rare cases, surgery is needed to take out the accessory bone and inflamed tissue. In any event, with this type of problem it is never a good idea to stick your head in the sand and foolishly hope you’ll cross the finish line in record time.
Dr. Christopher Segler is an Ironman Triathlon Finisher and award winning foot doctor specializing in elite athletes. His podiatry sports medicine house calls practice is based in San Francisco. You can reach him directly at 415-308-0833. You can register for a FREE membership and will receive the monthly newsletter “Finisher’s Circle,” which provides expert advice on increasing your running efficiency and preventing injuries and foot pain by visiting http://www.AnkleCenter.com .
Saturday, October 25, 2008
Do I Really Need "Running Socks"?
Runners need their feet to run. To enjoy running, their feet must function properly and efficiently. To run fast, a runner’s feet cannot be a distraction. For all of this to work, the feet must be pampered and cared for. That is the whole point of this series; to prevent injury through caring for the runner’s main tool for transferring energy into speed…the feet.
Shoes are critical, but socks can be crucial as well. The longer the run, the bigger the goal, the longer the race, the more important the socks become. Proper socks can achieve several things. Socks can prevent injury. Socks can reduce fungal infections that runners are prone to develop. Socks can increase blood flow to the muscles and enhance performance. Socks can even help you to recover faster. Socks increase comfort and allow you to feel better at the end of your run.
One of the obvious ways socks can prevent injury is through blister prevention. There are a couple of ways this happens. Cotton fibers are excellent at retaining moisture. In fact, cotton can retain 14 times the amount of water as some synthetic fibers. This is not a good trait for a running sock. The excess moisture can weaken the outer layers of the skin and make you more likely to develop blisters. In addition, the fungus that causes athletes foot and thick yellow fungal toenails just loves a warm, dark, moist environment…like your sweaty socks. By contrast, socks that are made of synthetic fibers can wick moisture away from your skin and allow it to evaporate, decreasing the chances of these problems.
Aside from reducing the moisture that makes the skin susceptible to blisters, they can actually decrease the mechanical irritation that causes blisters. There are also many double-layered socks that allow the friction to occur between the two layers instead of between the sock and your skin. In essence the idea is to let the sock take the beating instead of your skin.
Not only can socks help remove the moisture that can predispose you to athlete’s foot or other fungal infections, there are now socks that have actually been shown to decrease the amount of fungus that can grow. These socks have copper fibers incorporated into the material. In lab tests, the copper creates a “hostile environment” for fungus and bacteria and decreases their growth.
Socks can help you run faster and farther with less effort. You may have noticed more and more marathon runners and Ironman triathletes wearing knee-high compression sportsocks. Mariska Kramer-Postma, female Champion at 2008 Ironman Louisville, was one of the many elite athletes at that event sporting these compression socks. They work by exerting an almost consistent compression pressure onto the entire lower leg thereby increasing blood flow by approximately 40%.
The main feature of the compression sportsocks that produce such a considerable increase in blood flow is the consistent pressure. This distinguishes them from traditional compression socks (which are supposed to improve the venous return of blood back to the heart). Is there any science behind the socks? Yes. A study comparing the effect of compressive running socks with standard running socks found that sport specific compression socks increased run time by 6% and the VO2Max by 3%. A follow-up study found that 47% of marathon runners perceived their long runs to require less effort. In addition, 60% found relief of common aches while running distances.
Socks can even help you to recover faster. When you run you work your muscles intensely enough to get tissue damage. It is of course that very tissue damage that leads to increases in muscle fiber strength and development. A by-product of this damage is swelling. The swelling can be dramatically reduced by wearing compression stockings. Less swelling equals faster recovery.
So what does all this mean to the average marathon runner? Most importantly, wear running specific socks made of synthetic wicking materials such as Coolmax ®, Ultramax®, or any of the other many proprietary brands available. Don’t wear cotton. If you are prone to athlete’s foot infections try the Copper SoleTM antimicrobial technology found in Aetrex socks. If you feel the need for speed, compression socks just might be for you. According to published studies you could shave 12 minutes off a 4-hour marathon. Or you could run with less exertion and recover faster.
All of these highly technical pieces of equipment are worth trying. Of course, you will find high-tech running socks, as well as new shoes, at your local specialty running shoe store right here in San Francisco. Always see an expert if you are looking to try some new socks or other running gear. (Along those lines, feel free to email me at drsegler@anklecenter.com for a list of recommended running shoes.)
If you discuss your needs with your local experts, they will guide you smoothly down the path to the finish chute. Just remember… Never, ever experiment on race day. Test out your new socks on a short run to see how your feet feel with the new set-up. When the big day arrives, you’ll knock their socks off!
Dr. Christopher Segler is a marathon runner Ironman triathlete and award winning foots specialist in San Francisco. He specializes in the treatment of busy athletes by offering convenient house calls, direct access to a true expert and extended patient visits to help prevent injury and recurring sources of pain that interfere with training. You can learn more about the best trteatment of sports medicine injuries at www.AnkleCenter.com
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