Surprising info from running guru/sports med pt (Read 793 times)

Since March I've had this persistent lower leg pain that just won't quit. New shoes didn't help. 3 months of PT didn't help. Rest, rest & more rest didn't help. 3 mile weeks didn't help. Ice, heat & stretching didn't help. I had a bone scan, negative for stress fractures (which I've had in the spot where this pain starts, but it doesn't feel the same). I had an MRI, negative for any soft tissue injuries, tears, inflammation, etc. The pain is present from the start til the end of my run. Sports med doc doesn't see anything jumping out at him, seems to think my shoes are fine for my gait & type of foot. It can bother me when I'm on my feet all day or if I'm walking around the grocery store (no, Trent, I'm not wearing ANY heels, haven't for months!). So, back to PT. I started physical therapy (again!) yesterday with a new therapist this time, Terence, the sports med specialist. He's a runner (marathons, ultras, triathlons...you know, just little stuff), and works with lots of runners. He's the guru of guru's in this area, in high demand with all injured runners & wonderful athletes. During my running time & all my visits to different running stores, I've always been told that I have a fairly "neutral" foot. Not much of an arch, but not entirely flat, don't really pronate, no special cushion/stability needs. I've been running in the Asics GT2110's for several years. I've played around with several other shoes, but always return them & come back to my old faithful 2110. All other shoes I've tried made my shins hurt, or gave me charlie horses in my arches or caused some ailment or another. Terence did his full evaluation & decided my #1 problem is shoes. He feels that I'm a severe over-pronator & have absolutely no arch & that a motion control or high stability shoe would be our first step. He says that while the wear on my shoes is on the outside of my foot, I compensate so much for my pronation that I end up running on the outsides of my feet, which in turn puts stress on the inside of my right ankle, which is where the pain is. I have a long standing low back issue (including some moderate to severe degenerative disc disease) which he feels could have caused me to change my gait to alleviate the back pain (remember I took almost all winter off running last year to do some core strengthening due to the back pain?). This, in turn, has caused the ankle/lower leg pain, which causes me to compensate even more, thus providing a vicious cycle which has royally pissed my leg & low back off! When he was yanking, pushing, pulling & pounding on my leg, he could painfully replicate my foot strike & the subsequent ankle pain (tell me again why we go to PT's that inflict pain upon us?!). His recommendation was to take his list of shoes to the running store & buy 2-3 pair and run in them for a couple weeks, find the one that works best, then come back to see him. He had a good point...we can do PT 2-3 times/wk for the next 6 wks, but if we don't fix the problem, treating the symptom will be useless. So, I dutifully did a hop-sing to my favorite running store & picked out 2 new pair of shoes. I'm typing this while wearing my new Brooks Addiction 7 shoes, which are the most God-awful, uncomfortable pair of shoes I've ever had the displeasure of wearing! He said they wouldn't feel comfortable, as my feet/legs are so used to a more neutral shoe. He said running would be a bit uncomfortable in them the first few times as I'll need to retrain my muscles to run normally without overcompensating for the overpronation issue. Personally, I'm thinking that I need to HTFU & deal with the pain because these shoes are awful! They feel to stiff. The arch support feels like it is shoving the arch of my foot up to my knee (ok, slight exageration, but you get the point!). The shoes come up so high in the front that I feel like I'm wearing those ugly white high-top tennis shoes you wore in basketball in 10th grade (ok, for those of us that are over 30 anyways). I feel like I can't flex or extend my ankle because the shoe is in the way. But the experts know what is best, right? This WILL help the problem, right? This shoe will feel better after a couple runs, right? Skeptical, me? Hell yeah! At least my Asics made my feet happy... Well, off to convince myself that 2 miles in these shoes will NOT kill me. HTFU Eryn!!!

Erin - they do look uncomfortable. I believe that the PT is probably on the right track with his assessment. Just my 2 cents worth on the shoes. I have tested many shoes over time and also need motion control / stability. My favorite so far has been the adidas adistar control. It is a very cushy shoe, has excellent stability without feeling (and looking) like a cast or a boot. It is nice and high and snug at the heel and leaves plenty of room in the forefoot. Somehow my running style/gait must have changed. I am now using the Brooks Adrenaline with special insoles. Very comfortable as well. But more a stability vs. a motion control shoe. But, yes - the addiction doesn't look like something I could imagine in running ... Best wishes and luck to you! May the PT on the right track and you find the right shoes

Well, I tried them! I ran a whopping 1.5mi in them. Actually, that was all I could run & stay within my 10% increase limits, which was fine with me. I wouldn't call them a comfortable shoe. They are big & clunky (I'm sure the difference in weight is minimal between what I'm used to, but a couple ounces feels like 10#). The run was quite painful, but the pain wasn't as bad where it usually bothers me. Instead it was in my arches, my calves, my shins, the tops of my feet just below the ankle...basically everywhere but the normal spot. I won't say the normal pain was 100% gone, but I think it might have been better. Terence, my PT, told me they wouldn't be comfortable the first few runs & turns out, he knows what he is talking about! But I'm giving them another shot either today or Monday.

Erin, they're not orthotics per se. It is an off the shelf model. I went to a store here in WA "Shoes and feet". They only carry certain models on walking, dress and running shoes. Their staff are podiatrists etc. The person there told me I need a little extra support on the outer arches of my feet. I have normal but overall rigid arches (= when I sit and pull my toes towards my shin, my arches stay "arched" and don't flatten.) I tend to roll out onto the outer edge of my foot but then pronate in quite early in the stride. He said my pronating starts early on in the mid-foot area. I also bought work shoes there (expensive!) and insoles for them as well as the insoles for my running shoes. The insoles are very comfortable, don't rub or push anywhere. My feet feel supported. I also don't have the blister issue I used to have with the insoles that come in the running shoes.

Eryn - this does sound promising - hope it works out for you. Good luck

How are your legs feeling, today? Did you get another run in?

custom orthodics are amazing!! i run on the outsides of my feet to an extreme... the tread on my shoes are practically untouched, aside the very outter edges which are quite worn... when i was on college i had custom ones made... they were molded to my feet, had custom molded arch supports and an angled platform attached to ball of my food to force me to walk/run more flat. however, they cost 200.00 a foot... it took me a couple days to get use to them. the Dr. and my trainers would not let me run on them for a couple days until i got use to them.. it was a pretty neat process.. they did 3d modeling of my foot, recorded my running style and then designed the orthodics based on the models and analysis they did through the 3d models.. was a slow process watching them take a piece of plastic and mold and shape it to what my foot needed... however, because i still run like a sprinter and i am not running a lot of miles, the brooks and NB shoes are horrible for me.. asics are tolerable but i love my Nike shox... yeah, im just weird like that... now days, i just put some off the shelf inserts in them. the ones i use have carbon fiber backing around the arch support so they are pretty rigid but have quite a bit of cushioning. i am no expert but i have suffered enough injuries to learn some of the basics.. when it comes to changing running style, sometimes a drastic change is bad. you can seriously hurt yourself by trying to overcompensate for something as small as uncomfortable shoes.. i have pulled hip muscles from competing with a hurt hamstring! However, there are times where a drastic change is needed and although the relearning causes new pains, it is whats needed. with out knowing everything they were having you do in PT, i would of gone with an orthodic before new shoes... with the orthodic, you can add the stability and control you need with out causing as much discomfort from the arch supports/shoe. in all my years of running, there is nothing worse than improper arch supports... i don't recommend straying from what you have been told to do but i would definitely let him know how your body feels after running in the shoes. good luck with the PT and keep us updated with how everything works out!!

I hope things work out for you Eryn. My biggest fear in running is having some chronic injury which prevents me from running or from running how I should be capable of running.