pronation hypothesis - does distance matter?? (Read 1535 times)

I've been plagued with peroneal tendonitis for almost two months now. I've been to regular docs worn the boot, went to my local running store to be fitted / get advice on how to beat this stuff. The good news is that it is getting better, but not good enough. i've had it in both feet - so I went to a podiatrist today and he told me something interesting that I did not know. "Pronation is the result of a tight Achilles tendon" Every time I go to get new shoes, I tell them that something isn't right - they throw me on the treadmill, do the video tape thing, and say that they fixed my pronation and my stability shoes with the super-inserts are absolute must for me. the doc says the opposite. When I go to get shoes, I'm completely cold. I'm like anyone else, it takes 3-4 miles to warm-up and 5-6 before running feels good. Since tendons lengthen when they are warm... ...after 5 miles or so, my level of pronation would be less than at 0 miles, and my shoes would be over-stable. Peroneal tendonitis is a common sign of overstability in the shoes. My everyday speed and tempo runs don't bother me - its the long runs that keep my feet hurting. Gestaldt? or is this stupid...

Grateful Runner: You, running store guy and podiatrist... Out of those 3, as far as I'm concerned, YOU are the only one who makes sense! This day and age, you get TONS of information right and left. You go to the running store, some kids working there part-time, he would be an "expert". You go to podiatrist and they'll most likely tell you that you'd need an orthotics. Who makes those orthotics? Most likely, they do--so who makes money off that practice? Be sensible and think about it for a minute. Use logic, as you did. Now I'm no "professional" but with my layman's thinking, Achilles tendon is completely different plain from Peroneal tendon (runs more like laterally). I don't see how tight Achilles can affect your Peroneal tendon (it might)... Now pronation... Don't even get me start with this one! Pronation is a natural movement (to a degree) as long as our legs come out from the outside of the center plane (stickes out from the edge of our hip bone). As long as your legs come down from the outside plane to more or less the middle line, you WILL get certan torque and create some degree of rolling motion. Some do more than others and, if excess, it becomes "OVER-prination". Now, you get one of those thick, high-heeled training flats; in other words, the higher off you are from the ground; the less stable you'll become, hense you're more likely to roll even further! So what would they do? They put whole bunch of thick rigid plastic material for your foot to stop rolling. This would invariably creates un-natural OUTWARD roll-over and what would this create? ITB syndrome and Peroneal tendonitis! Think about it; you're putting a lot of un-natural pressure on the outside of your legs, running all the way from the tip of your hip bone, outside (lateral side) of our knee, and outside (lateral) of your ankle. What do you have there? IT band and Peroneal tendon. I would say you go get as low profile shoes you feel comfortable wearing when running as you can find. I personally like ASICS HyperSpeed or Mizuno racing flats or some NB racing flats if you have somewhat straighER feet. adidas has great racing flats (adiZero) and so does Nike (Katana Racer). Try them on at the store, hop on the treadmill and run in them and see how they feel. If they FEEL right, who cares what the store kids would say to you. What's more with this type of shoes is, with low profile shoes (low heel), you would be stretching your Ashilles tendon so your "problem" should also be fixed. Some stores offer filming your form on treadmill. If they claim you OVER-pronate, ask them to show you the video. Be observing about it; check out to see how OVER-pronating you are. If you can't really tell that you're rolling over that much, ignore what they say--they don't know what they're talking about; they're just using some fancy words most magazines love to repeat.

Interesting...I never had peroneal tendonitis until after my last marathon...now I am really struggling with it. (mine is the peroneal long tendon - I think there is more than one). In my case I thinkthe injury happened when I was warm and fatigued. I am about to look for new shoes anyway....I may look for something less stable now. I've been running in the same 2 (brands&make) of shoes now for quite awhile...in fact through 2 pregnancies and weight fluctuations ...all of which could play heck with my pronation. ...actually now that I think about it the Asics I usually wear were what fit me best 55 lbs ago. Plus I think I was within 6 months of pg, which means my piriformis was probably still weak which can lead to pronation. I was already planning on going in and NOT bringing my old shoes this time and asking them to pretend I was a brand new eval. I have been told I pronate when I walk but not when I run. Definitely something for me to think about. I need forefoot cushioning as I have mild metatarsalgia but it seems much better at this weight...another 5-10 lbs and I may not need to worry about it. Have you thought about trying to go in for the videotaping warm?

Nope, I'm with ya'. My own PT issues only started resolving when I moved into a less stable shoe. I was told I needed "moderate stability," yet I had far more issues in those higher stability shoes than I do in a lightweight, low-stability trainer. I won't be going back to the mod-stability shoes if I can avoid it. k

That sounds like me too. I was always told by the running store guys that I over-pronate a little and they went with stability shoes. They feel right at first for the short and easy runs, but for long runs of 10 miles or more, my knees would start to hurt like hell. Well, after a couple pair of shoes like that, I decided to try a flat shoe. They warn me that I should not run with those. Well, a couple of HM and a marathon later, I can say that I will never go back to stability shoe. Never had a problem with my knees or my feet since then. Like Nobby says, in the end, only YOU know how you feel and what seems right or wrong.

All good points. My story several years ago was I had shin splints for 2 years. Extreme pain. Finally, took off 1 month. They got better. Did a lot of dorsiflexion, icing etc. but they were always an issue. Went to podiatrist and said, "I need orthotics". He said, maybe not. You do have semi tight calf muscles and over pronate a bit. He wrapped my foot up and said, go teach your high impact exercise class. He said you will know if you need orthotics. I immediately felt better. Unbelievable. I got orthotics made up and he encouraged a lot of calf/achilles stretching as he said your foot will function much better. Within 4 weeks I was pain free and have been for last 17 years. Not saying this is for everyone, but my podiatrist didn't give them to me unless I needed them. He wrapped me up and the rest is history. To this day, when I don't wear my orthotics, my back hurts, my feet hurt within an hour. I need them.

Tchuck: I'm interested...how did you "wrap" your feet? With what? Wrapping helped for you to do high impact exercise? And in the end you got your orthotics anyway? I'm not necessarily always against orthotics (though I would prefer if you can get away with them); I'm just trying to get a clearer picture. I feel, in general, shin splint, or general shin pain, is caused by a lot of "slapping" of the foot. If you have very thich bulky shoes with thick heel, you tend to "slap" your foot down; if you wear shoes like than and run downhill, you slap evern more. That creates shock-waves up your shin. Over-pronation can cause it, yes. Tight Achilles, in other words, running extreme tip-toe, can cause it also. High impact exercise is not quite a thing to recommend for someone with a shin pain... Was the orthotics soft or rigid? I'm a very much Curious George... ;o)

Tchuck: I'm interested...how did you "wrap" your feet? With what? Wrapping helped for you to do high impact exercise? And in the end you got your orthotics anyway? I'm not necessarily always against orthotics (though I would prefer if you can get away with them); I'm just trying to get a clearer picture. I feel, in general, shin splint, or general shin pain, is caused by a lot of "slapping" of the foot. If you have very thich bulky shoes with thick heel, you tend to "slap" your foot down; if you wear shoes like than and run downhill, you slap evern more. That creates shock-waves up your shin. Over-pronation can cause it, yes. Tight Achilles, in other words, running extreme tip-toe, can cause it also. High impact exercise is not quite a thing to recommend for someone with a shin pain... Was the orthotics soft or rigid? I'm a very much Curious George... ;o)

Nobby, A bit late here but podiatrist put a semi rigid pad in the arch and wrapped my foot to hold it in place. Its purpose was to reduce pronation I believe. Not sure exactly but the results were immediate.

If you've had tendonitis for that long you may want to ask your Doc about a graduated dose of steroids. I had it in my hip for more than a month and steroids had it completely cleared up within a week. Steroids interrupt the inflammation process and gives the tendon a chance to heal. Ask about the Medrol Dose Pack. Tom

Cured My PT in 1 week. I am now back to running. This is not a dangerous Steroid that everyone hears about, it is a mild dose, and a graduated dose. Magic....

Wow - I forgot about this thread... I switched from Saucony Hurricanes to Asics 2130's (which is a notch lower in stability). Instantly a good move. I'm thinking about going a little lower to the 1130 sometime soon. Something else I changed...I had a retired pair of shoes that I would wear to work (i'm a teacher and am on me feet a lot, and can get away with wearing running shoes with a tie.) This is a little weird but it did help. I put two layers of felt into the heel of all of my shoes - a heel lift. It took just enough pressure off the tendon to let it heal. This was about 6 weeks ago, and I have had no problems with PT since. I put on the Grid Omnis to mow the grass, and they felt terrible. I haven't worked into the high mileage yet, but I'm definitely over PT. Too much stability is just as bad as too little. There, I said it. Good week to everyone!