Children and Sports Podiatry

Starting A Running Program

Beginning a running program can be daunting, especially if you’re doing it alone!

Whether you are new to running or coming back from injury, a graduated running program can be used in a safe manner to reduce the risk of injury. Basically, the goal is to limit the change in number and magnitude of training variables at a time. The key to beginning a running program successfully is to progress at your own pace. The below program is only a guide. If you have a history of running you may find the progressions too slow and you may be able to skip some stages. Or if the progressions are too fast for you, listen to your body and slow it down a notch!

If you are new to running, you should aim to be able to:

  • walk at a decent pace for at least 30 minutes before thinking about running.
  • start slow because your legs and lungs are still going to be getting used to running.

The focus for the first 2 months shouldn’t be on distance or how fast you go but simply just getting 30 minutes of movement in at a time on the legs.

Make sure you have the correct footwear! Did you know the glue holding the EVA together can expire and leave us with a “dead shoe”? If you have had your running shoes for over 2 years best to get an assessment with your podiatrist and get some new ones!

Podiatrists can do a dynamic running assessment where we observe how your foot behaves when you are running. We can identify if there are any asymmetries in your hips and leg strength affecting your style. Advice can be given regarding footwear so that you can have a list of ideal shoes that would be correct for your foot type.

Consistency is key!! Try not to extend the gap between running days any more then 2-3 days as by doing so you will essentially be starting over. Below is an evidence-based beginners running program I recommend which takes up to 12 weeks to complete. The idea is that you complete each phase a few times before moving onto the next one.

Tip: During this program you should be running at a pace where you can still talk whilst running. Any faster at this stage will increase our risk of injury.

Note: If you have any health conditions, please check with your doctor before beginning this program or any other fitness programs.

 

Stage 1

Build up to 30 minutes of nonstop walking.

 

Stage 2

Walk for 4 minutes. Run for 1 minute.

Repeat that sequence four more times. End with 4 minutes of walking.

Total workout time: 29 minutes, 5 of which are running.

 

Stage 3

Walk for 4 minutes. Run for 2 minutes.

Repeat that sequence four more times. End with 3 minutes of walking.

Total workout time: 33 minutes, 10 of which are running.

 

Stage 4

Walk for 3 minutes. Run for 3 minutes.

Repeat that sequence four more times. End with 3 minutes of walking.

Total workout time: 33 minutes, 15 of which are running.

 

Stage 5

Walk for 2 minutes 30 seconds. Run for 5 minutes.

Repeat that sequence three more times. End with 3 minutes of walking.

Total workout time: 33 minutes, 20 of which are running.

 

Stage 6

Walk for 3 minutes. Run for 7 minutes.

Repeat that sequence two more times. End with 3 minutes of walking.

Total workout time: 33 minutes, 21 of which are running.

 

Stage 7

Walk for 2 minutes. Run for 8 minutes.

Repeat that sequence two more times. End with 3 minutes of walking.

Total workout time: 33 minutes, 24 of which are running.

 

Stage 8

Walk for 2 minutes. Run for 9 minutes.

Repeat that sequence one more time. Then walk for 2 minutes, run for 8 minutes.

End with 3 minutes of walking.

Total workout time: 35 minutes, 26 of which are running.

 

Stage 9

Walk for 1 minute. Run for 9 minutes.

Repeat that sequence two more times. End with 3 minutes of walking.

Total workout time: 33 minutes, 27 of which are running.

 

Stage 10

Walk for 2 minutes. Run for 13 minutes.

Repeat that sequence one more time. End with 3 minutes of walking.

Total workout time: 33 minutes, 26 of which are running.

 

Stage 11

Walk for 2 minutes. Run for 14 minutes.

Then walk for 1 minute, run for 14 minutes. End with 3 minutes of walking.

Total workout time: 34 minutes, 28 of which are running.

 

Stage 12

Walk for 3 minutes (or until you’re good and ready).

Then run for 30 minutes nonstop. End with 3 minutes of walking.

Total workout time: 36 minutes, 30 of which are running.

 

What Runners should look for in a good training shoe

Now that research reveals there is no motion control in running shoes. I’m going to talk about what to look for in a good running shoe that you are going to do alot of training in. This may be in preparation for a ½ or full marathon or just a shorter 10 kilometer run.  You want to look for a a mid-tier, highly cushioned neutral and durable shoe. Without doubt, the daily trainer is arguably the most important shoe for a runner, as it is the shoe we do most of our mileage in.

 

Stephanie clocking up some kilometres in her training shoes

There are 3 main things we want in a good running shoe for training

Have a plush, comfortable upper

A midsole cushioned enough for distances up to 25 kilometers

An outsole capable of lasting over 600 kilometers.

What to do when the next model comes out?

Most shoe brand companies will do an updated model of a well marketed she every 6 months. As a runner myself, it is often frustrating to find that a new additional model can sometimes change things up too much. This leaves you striking the pavement with a feeling that you are in a  completely different shoe altogether.

You want the changes between the versions of your shoe to be incremental rather than huge changes every year. As a podiatrist who has taken an interest in running shoes for 20 years, I have found the more reliable good running shoe brands that ease the changes in their models from year to year are the  1. Brooks Ghost 2. Asics Nimbus 3. New Balance 860’s. This is effective for runners as it doesn’t take long to ease into the shoe.

Price & Weight

Price is another point which is important now that we know there are less components needed in footwear. The weight of the shoe is also very respectable and you want your training shoe to weigh around  10 ounces.

Cushioning

You want the cushioning layer to extend beyond the heel, all the way to the forefoot, for an easy transition from landing to toe- off. The mid-sole should feel soft but still provide support. You want the shoe to feel responsive. This means the shoe is designed to feel like it responds to the ground, giving you energy back. There is nothing worse than a shoe feeling dead and heavy under your foot.

Stack Height

For a runner who is looking for a shoe to do more than 10 km runs some heel elevation is necessary. A stack height of 12mm would be what I would recommend. If you are planning on doing short interval sessions or a tempo run a lower heel height is preferred.

Outsole

The durability of the out-sole assists the longevity of the shoe and helps to make the shoe a more economical choice. The forefoot out-sole should also be segmented with flex grooves to provide adaptation to the surface and shock absorption.

Shoe Upper

The upper of the running shoe for training these days should be seamless and provide the optimal balance of stretch and structure. Adequate toe box width is important to allowing enough room for the toes to splay during toe off. The heel counter needs to be firm and lined with a soft grippy material that allows for no heel slippage. This is particularly important if you are wearing a custom made orthotic in the shoe.

What good running shoes do podiatrists recommend?

A quality shoe is an important choice for a runner. There is no set answer when it comes to one stand out running shoe that is appropriate for every runner out there. This is because it is important to ascertain what training loads a person is doing and how a runner is biomechanically aligned. As a podiatrist I get great satisfaction in getting a patient into a new running shoe especially after they have had previously poor-quality shoe. They come back in and say that their legs feel less tired on days they are running back to back.

Ask us for a running gait assessment and we can make recommendations for a shoe that will give you exceptional durability and high-performance comfort.

Proper running technique: 5 ways to run more efficiently!

INSPIRE PODIATRY hint on Running Technique: It’s not just about the legs and feet

At Inspire Podiatry we get asked a lot – how can I improve my running technique to avoid getting injured again? Efficient injury free running does not come easy. But most runners don’t start to think about their running technique until they have been running for more than 2 years. The secret to avoid injury is to remember that the body is a unit connected by fascial lines and running is a complex movement. We just don’t want to concentrate on the legs only. So it may be helpful to read our 5 top tips which you can apply on tomorrows run. Good luck running injury free!

1. Your arms

Firstly arm movement during running can help you drive your knees and propel you forward. Your arms should remain at a 90-degree angle at the elbow. It is important to keep your elbows close to your sides and to ensure that your arms are not crossing over your body as this can decrease momentum. Tip: Relax your hands as well and avoid squeezing them as this uses energy.

2. Your Torso

Secondly keep a tall spine and activate your core muscles. If you are hunched over this will decrease oxygen flow through the lungs. A strong core will ensure there is not too much deviation of the torso from its centre of gravity. However, small deviations are necessary to react to ground forces during foot strike to ensure power is generated through the stance leg and into the torso.

3. Your Hips

Thirdly a slight lean forward from the hips (not the shoulders) increases acceleration ability by activating the gluteus maximus to ensure full capacity energy release.

4. Your knees

Fourthly slight knee lift is necessary to avoid shuffling. A shuffling running gait mis-aligns the muscles and tendons in the lower leg and increases traction on these areas. So for efficiency try to focus on lifting your knees in front of your hips.

5. Your feet

Last but not least, it is best to try and run on the balls of your feet as this will prevent over striding. However if you naturally run on your heels instead of trying to change this, talk to your podiatrist about finding a shoe that will provide the right cushioning and support to reduce the risk of injury.

Book now to have your video gait analysis and running technique assessed. Our podiatrists can breakdown the functional movement of your running form. We can look at the pelvic stability and test your core strength to ascertain if this is contributing to any injuries you make have in the lower body.

HEEL PAIN IN KIDS

Is your child experiencing heel pain after training?

Training season is on! Many active kids are busy training and playing Football, AFL and Netball to keep them healthy and fit. Kids that get heel pain are typically active and sporty. Heel pain, can be known as Sever’s Disease. The growth plate on the back of the heel gets sore when your child runs and jumps a lot during sport. The heel cord that attaches to the growth plate pulls and causes tension and inflammation on the back of the heel.

Kids often enjoy their sport so much, that they fail to tell parents that there heels hurt after they have been training. I think this is because they fear that they might get told that they have to rest. If you notice your child limping or running awkwardly, ask them if they are in pain.

Many active soccer players get heel pain between the ages of 9-13 years

So what can I do if my child has heel pain?

Seeking professional advice from a podiatrist who specializes in children is advised. At Inspire Podiatry we are the experts in managing kids’ heel pain. Initial treatment can include, checking the foot posture and mechanics of how the foot moves when your child runs. We check how aggregated the heel is by hopping on the spot. The foot is assessed to see if there is any inflammation in the surrounding tissues.  The growth plate and the Achillie’s Tendon is examined. It’s important to check and treat any inflammation in the area. We have the latest state of the art equipment such as electro-therapy which will help to heal the tissue on a cellular level. This is a painless treatment.

Kids can get heel pain because they are growing and can often get tight muscles in the leg and thigh. We take the time to check lower limb flexibility. Your child may be given exercises to do at home to improve their flexibility. Pain can be reduced by doing these prescribed exercises.

What treatments are there for my child with heel pain?

Sometimes children just need some sports specific shoe advice. Others may need a cushioned support like an orthotic innersole or insert. This treatment has the ability to reduce the load on the growth plate. At Inspire Podiatry we have 3D laser scanning technology to make this happen. This is the latest state of the art equipment used to scan the foot in the corrected alignment so a truly customized orthotic device can be made for the right fit. These are worn in your child’s shoe. This treatment can change muscle firing patterns during running and realign the foot.

Your child doesn’t have to stop their training if they get the right treatment for their heel pain. I believe in treating the pain first before having to reduce activity. It’s important to keep our kids active and happy so they can enjoy doing what they love. Sever’s pain does not last forever, it will cease by the time your child is around 15 years of age, when the growth plate forms part of the adult heel bone.

IS THE SHOE THE RIGHT FIT?

IS YOUR SHOE A GOOD FIT

A Podiatrist can check if your shoe is the correct fit and type that you need. I have given footwear advice and assessed well over 30 000 patients in my career.  That is a lot of pairs of shoes that have been assessed.

In the footwear world today there is so much choice. I feel it is a challenge for patients to get a shoe that is the correct fit. Given the average Australian spends 7 hours on their feet at day, its important to get a shoe that fits your foot correctly. This ensures comfort, and protects your feet from further deformity.  Podiatrists focus exclusively on footwear and are known experts in the industry.

Fit Tips:

Shoe fit tips from Inspire Podiatry

 

Heel & Ankle

The heel needs to sit comfortably into the back of the heel counter, with the correct depth, height and shape around the ankle bones to avoid irritations.

Width

Ensure that the foot sits into the widest part of the shoe, with no forefoot over hang or excess space.

Volume & Lacing

Making sure the volume of the shoe matches the fitting requirements, and relevant lacing techniques to improve the comfort and fit of the shoe can be used.

Depth

Check that the fit within the toe box matches the forefoot shape.

Length

The shoe length is determined by the forefoot shape and longest toe. The length is checked when the patient is standing up and their toes are down.

Flexibility

Forefoot flexibility in the midsole allowing the foot to flex in a natural position.

 

 

 

Heel Pain & Heel Spurs from Albany Creek Podiatrist

Symptoms?

Do you wake up and limp on your feet and struggle to walk after rest?  The chances are you may be suffering from plantar heel pain or heel spurs or what podiatrists call plantar fasciitis. It’s heel pain on the bottom of the heel that throbs. The heel pain can sometimes sear and cause sharp pains in your heel.

How Common is Heel Pain?

Heel pain is something we see on a daily basis at Inspire Podiatry at Albany Creek.   Heel pain can affect up to 6% of the population. It is a repetitive injury so it can account for 8% of all running injuries (Taunton, 2002). Because if you are carrying a few extra kilograms or standing on your feet a lot at work you can be more prone to developing heel pain.

Imaging?

I rarely send a patient for images unless there are other underlying conditions suspected. An X-ray may show a heel spur but this does not treat your foot pain. Believe it or not the presence or absence of a heel spur is not helpful in the diagnosis of plantar heel pain as, 19% of people without plantar fasciitis have heel spurs (DiMarcangelo MT, 1997).

Treatment for Heel Pain with Shoe Inserts

Most importantly, treatment for heel pain is best achieved when it is detected early. If you have a low arch height, this can directly increase the amount of strain that is placed on the plantar fascia. The plantar fascial ligament is a long fibrous band of connective tissue that originates from the bottom of the heel and runs along the arch of the foot towards the big toe.  This is why shoe inserts or shoe orthotics can directly support the arch because they reduce the strain placed on the plantar fascia. Strapping techniques for heel pain can reduce the strain by 48%.  At Inspire Podiatry we often use foot taping on patients at their initial consultation to give them immediate relief with their walking and to restore a normal walking pattern without the limp.

Treatment for Heel Pain with Strength Training

The latest evidence in the research is to treat heel pain like similar to an angry tendon.  We can show you in your treatment session how to perform high-load strength training to improve your heel pain.

Treatment for Heel Pain with Mobilisation & Dry Needling

Our feet are designed to absorb half the weight of the body on initial heel strike on our heels. Limping and abnormal walking because of pain, can cause an increased stiffness in our ankle. This is why it is really important that we restore the range of movement in the ankle and foot joints to reduce the stiffness, so our feet can absorb shock. Some people can stretch and stretch and still be stiff. At Inspire Podiatry we use mobilisation techniques which are gentle movements that manipulate the joints to improve their congruency (contact points). This inturn assists to release the fascial tissue to improve the range of movement in the feet. We can also use dry needling techniques (a form of acupuncture) to reduce the tight knotting in the calf muscles which can improve ankle range of movement and indirectly reduce the strain on the plantar fascia.

Is Cortisone Good for Heel Pain?

At our Albany Creek podiatry clinic I often see patients who have had heel pain for months. Research has shown the use of non-steroidal anti-inflammatory drugs or ice are not very helpful. This is because there isn’t a lot of inflammation in the tissue. Degenerative changes in the fascia are noted rather than inflammatory. Sometimes patients ask “should I have a cortisone injection in my heel”? Cortisone should not be the first line of treatment offered for heel pain. Research has found cortisone does not improve the long term outcomes (Crawford.F 2003). An injection of cortisone may cause plantar fascial rupture (Aceredo JI, 1998). Cortisone can assist to reduce pain but pain often reoccurs after 4 weeks (McMillan, 2012).  I like to treat the underlying cause of the problem which is often the foot mechanics and alignment of their arch height.