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Plaxico Burress Conquers Foot Pain With Orthotics

Posted by: Dr. Marybeth Crane Posted Date: 09/01/2008

New York Giant Ready For the Season in His New Orthotics!

Plaxico Burress makes his living running routes and catching balls for the Super Bowl champions New York Giants with a nagging ankle injury, flat feet and a new pair of orthotics. Burress is breaking in his orthotics in practice and expects to be ready for the season opener this week. In May, Burress was advised to use orthotics to help improve the function of his feet. He said it took time to get fitted, and he did not start using them until recently. He admits that he is sore after running but is getting much better. Functional orthotics are improving his gait so he will not be as prone to injury as he has been in the past.

55 million Americans experience one or more foot problems every year! Many fail to seek medical advice early and develop more complicated foot conditions that can be severe and difficult to treat. One of the most common foot problems is heel pain. It is estimated that 15% of the adult population complains of heel pain, which includes one million runners who experience heel pain (plantar fasciitis) every year. The American College of Foot and Ankle Surgeons has stated that heel pain has reached epidemic proportions in weekend athletes. This common condition is typically ignored, especially by athletes. People tend to seek treatment only after the problem becomes severe and disabling or when they just can’t run. When foot health concerns are ignored, simple conditions can develop into more serious problems affecting the ankles, knees, hips or the back. A simple functional orthotic is the answer for many people experiencing this kind of foot pain.

 

Orthotics are devices which fit into the shoe to aid the foot and allow it to function more optimally. "Functional orthotics" are usually relatively rigid in shoe braces that are designed to control motion and correct the function of the foot. Individuals with flatfeet, tendonitis, plantar fasciitis, knee, hip and back problems  and certain foot deformities, may benefit from functional orthotics.

 

Will orthotics help my foot problems? The goal of the functional orthotic is to control the abnormal motion in the foot, improve foot function, decrease the pain in the foot, ankle, knee, hip or back and to add support. The orthotic should make standing, walking, or running more comfortable. The orthotic must be rigid to help control the motion in the foot and add support. If the orthotic is soft, the weight of the body would collapse the device and it would no longer function.

 

Functional orthotics are a successful treatment for many problems affecting the lower extremity. In a recent article in the Journal of the American Podiatric Medical Association, 75% of patients surveyed had good to excellent results from functional orthotics. This includes 17% who felt the orthotics "cured" their pain. Less than 10% had no relief. The most commonly treated condition in the study was a painful heel. Over 20% of patients surveyed were treated for a painful heel and 20% were treated for a painful arch. Fourteen percent of the individuals were using orthotics for flatfeet. Other conditions treated with orthotics were knee, hip and back pain, foot arthritis, bunions and high arches. Tendonitis was not specifically evaluated.


Individuals with plantar fasciitis (heel and arch pain) who also have flatfeet usually respond best to orthotics. People with high arches may require orthotics as well, but they do not respond as well. Orthotics can help slow the progression of bunions and hammertoes, but they will not prevent this process. Orthotics may help with some pain at a bunion, but they will not "cure" the bunion. When the motion in the foot is contributing to the problem, orthotics are generally recommended.

 

Podiatrists are the most common prescribers of orthotics, but pedorthotists, orthotists, physical therapists and sometimes chiropractors will also provide orthotics. Remember that the device is only as good as the doctor taking the mold and writing the prescription. Make sure that your practitioner is trained in foot biomechanics and experienced in orthotic therapy.

 

Orthotics are a staple in the treatment of the majority of foot pain. When utilized for the correct indications, orthotics are highly successful in controlling foot pain and can add pep to your step! Orthotics have helped Plaxico Burress conquer his chronic injuries and they may help you!

Run Happy! And Thank God Football Season is almost here!!!!

 

Oh My Aching Legs! Shin Splints Slowing Your Run?

Posted by: Dr. Marybeth Crane Posted Date: 07/12/2008

Shin Splints

 

“My shins are killing me after running,” is a common complaint of new runners or runners increasing their mileage or intensity. My daughter Caitlin complained of shin splints after only two weeks of running summer track! It has been estimated that "shin splints" account for approximately 15% of all running injuries and may account for up to 60% of leg pain in runners. Many terms have been used to describe exercise-induced leg pain, including shin splints, medial stress syndrome, tibial stress syndrome, recurrent exercise-induced ischemia, and chronic exertional compartment syndrome. "Shin splints" has been commonly used as an all-encompassing term for many disorders causing lower-leg pain so that’s how I’ll refer to it during this discussion.

 

So what is a “shin splint”? Shin splints are pain in the lower leg usually caused by a variety of overuse or chronic stress related fatigue syndromes. The root cause of most shin splints is chronic biomechanical imbalances of the lower leg and feet. What does that mean? Bad feet, muscle imbalance, bad shoes, or improper training. In Caitlin’s case, she was running too much, too soon, too fast like many new runners and needed better stretching and arch supports.

 

What can a “shin splint” represent? The underlying pathology of a shin splint can be a fatigue injury of almost ever tissue seen in the lower leg. This can include:

  1. stress fractures
  2. periostitis (irritation of the covering of the bone also known as medial stress syndrome)
  3. Muscle fatigue or fascial herniation (compartment syndrome)
  4. Tendonitis
  5. Peroneal nerve entrapment
  6. popliteal artery entrapment or intermittent claudication (decrease blood flow)
  7. spinal radiculopathy (spinal nerve compression causing referred pain).

Wow! That’s a lot of things that can cause shin splints!

 

While every shin splint injury has its own specific biomechanical causes, most are rooted in tight calf muscles and relative weakness in the front leg muscles. What's going on is that your tight calves are pulling up on your heel, which in turn pulls the front of your foot down. This puts strain on the muscles in the front of your leg, which unfortunately are not strong enough to resist the pulling. This causes a big pain in the leg! This is very, very common in runners, since running tends to exercise the calf muscles more than those in the front. But fear not, a little rest and a lot of stretching and strengthening will fix you up and possibly make you a better runner, too. 

 

How do we treat them? Early on in the syndrome, shin splints are treated with ice, relative rest (slow down and get off the hills and uneven surfaces), anti-inflammatory like ibuprofen, stretching, and arch supports. Take a good look at your shoes. These often need to be replaced or upgraded to a better pair for your foot type. (More discussion on that topic in a future article).

 

After we address your shoes and overpronation or underpronation (your foot rolling in or out excessively when you run), then we move on to the muscle imbalances in your lower leg. Your calf muscles are too strong and tight, while your front leg muscles (anterior compartment) are too weak. This is easy to remedy but won’t happen overnight. Stretching your calf muscles with a simple wall stretch for your Achilles tendon many times a day( how many?) will help. Strengthening the front of your leg can be done by actually putting a small weight (or an athletic sock full of sand) on your foot and lifting it towards your shin. Hold that for a count of ten then relax. Repeat twenty five times. You will be amazed how tired those muscles are!

 

If your pain persists after two weeks of these simple solutions or is at any time pinpoint or severe in nature, call my office or your sports medicine physician. Stress fractures can creep up on the overzealous new runner and can take 8 to 10 weeks of no running to heal!

Shin splints are common in today's active population. It is important to keep in mind that shin splints, like most running injuries, are basically an overuse injury. Listen to your body and back off when you begin to feel pain.

 

These are just a few tips to get you on the road to recovery! Run Happy!

 

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