Simple steps to foot fitness
What is a podiatrist and how can a podiatrist help a runner?
Podiatry is a field of medicine which focuses primarily on the feet and lower limbs.
Some podiatrists, however, will consider problems further up the body, including the back, when addressing symptoms.
There are many branches of podiatry which most registered podiatrists study while completing their university degree. Some of these branches are: Routine care ( you may be familiar with what a chiropodist does)
MSK, otherwise known as musculoskeletal. It’s a bit of a mouthful so we refer to MSK. Paediatric Forensic Diabetic With all the advice that’s around, sometimes it’s easy to feel a bit overwhelmed. I’d like to share some insights as to what podiatry is and how a podiatrist may be able to help you.
Information is power. You can then use the knowledge you have to act in a way that meets your needs and to do what feels right for you.
Most people will appreciate that if you have a sore foot it can seriously hamper your training. The two branches of podiatry that are of most relevance to runners are routine care and MSK. Since I am an MSK podiatrist, this article will focus mainly on that. However, I will firstly touch on routine care podiatry. Routine care When cutting your nails, make sure they are short and follow the contour of the nail. Don’t cut down the sides but also don’t cut straight across since this can leave sharp corners which can pierce the flesh.
Deal with any signs of infections such as pus or open lesions by soaking your feet in salty water and applying antiseptic with a dry dressing.
Your feet sweat a lot and running shoes are the perfect breeding ground for micro- organisms so don’t let small infections get out of hand.
If you have a corn it will feel like a small stone. Corns and hard skin occur over areas that are subjected to a lot of pressure. This pressure may be due to shoes but it can also be due to poor foot mechanics ( the way you walk).
If you have a corn do not use a corn pad. These contain an acid which can burn the healthy skin as well as the corn itself.
Verrucae, on the other hand, are simply warts that occur on the feet. These are caused by a virus and will therefore not necessarily occur in places that are subject to pressure.
They tend to have little black dots in the centre and can be painful if squeezed.
Sometimes verrucae do not cause any discomfort and may disappear by themselves.
If you think you have one keep an eye on it. If it gets bigger get it treated since they can be very painful and difficult to treat when they are bigger.
If you have a skin or nail problem that’s troubling you or has the potential to get out of hand go and see an HCPC- registered podiatrist.
Try also to figure out why you have a particular problem and deal with the cause to ensure it doesn’t reoccur. MSK podiatry MSK podiatry concerns itself with the mechanics of the lower limbs. A person’s foot has many bones, muscles and other soft tissues which all work in harmony with each other, allowing the foot and ankle to move in different directions during the walking or running cycle.
Little groups of these bones and muscles work together to move in precise directions during walking or running.
Each joint has a particular range of motion. If these particular movements do not occur when expected or if a joint is very stiff and can’t achieve its full range of motion an individual will compensate for this problem. This is done by engaging and over- working other muscles and joints.
These other muscles and joints that are being over- worked may not complain to start with but eventually aches and pains occur.
Many people go to see an MSK podiatrist when they are in pain but other people like to seek advice before problems occur in an attempt to avoid injury.
An assessment usually involves checking the range of motion at different joints and using an electronic scanner to determine how the foot moves and how pressure is distributed.
Sometimes other technology, including videos and treadmills, is used.
If the foot is moving in a direction that it shouldn’t be medical insoles called orthotics may be prescribed.
In some instances footwear or lifestyle changes do the trick and orthotics are not necessarily required.
It’s worth noting that if orthotics are r recommended it can take up to three m months for them to work properly.
While they are starting to do their j job, there are, of course, other things t that can be done to help alleviate p pain.
Many people feel frustrated that t there is no instant quick fix. This is just h how the body works. Why do aches, pains and injuries occur? Many experienced runners can run for years injury- free then suddenly d develop problems.
Often analysis of this person’s lower l limb mechanics will reveal that their f feet naturally have a tendency to move t too much in a particular direction w when they walk.
The fact that this excessive m movement has not created any problems in the past will likely be due to the fact that other muscles and joints have happily compensated.
Aches and pains often occur when something changes.
That something is often a new pair of running ( or other) shoes, a change in training regime, returning to training too soon after injury or sickness or physiological changes that naturally occur in the body due to ageing.
The new shoes or change of routine are the most common culprits.
Often, however, any change may not evoke symptoms immediately. It can take weeks, sometimes a couple of months, for the aches and pains to appear.
Individuals who increase their distance too quickly or who introduce a regime that their body is not used to are particularly prone to injury.
First- time marathon runners often get into difficulty a month or two before the big day. Often by that stage their injuries force them to deviate from their training plan, sometimes having to pull out of the race altogether. The place for orthotics and other treatments It’s important that a runner can make an informed decision when it comes to support and rehabilitation.
As someone who understands the power of orthotics and how they can aid ( or even hamper) an athlete’s progress, I believe it is important to explain how they work.
Basically an orthotic is an insole that has thicker bits stuck on at the front or back or shaped into the insole itself, bits cut out, bumpy bits added or softer bits added in particular places.
They are more expensive than shop- bought insoles, ranging from £ 120-£ 320.
This is not because the finished product is expensive but because the professional prescribing the orthotic has an in- depth knowledge of lower limb mechanics and knows exactly where the additions should be added.
They may not look like much, but the subtle differences in thickness of only a few millimetres can make a huge difference. People who have endured pain for years suddenly find they are symptom- free.
As previously mentioned, it takes a few months for orthotics to work.
While they will change lower limb mechanics if worn regularly, alleviate symptoms and reduce the incidence of injury, they are not a cure.
You cannot cure bad foot mechanics. Just as you would lose tone and fitness if you were to stop running for a few weeks, your bad foot mechanics would return if you were to stop wearing your orthotics for a period of time.
If you wear orthotics that have additions in the wrong place this can cause longer- term detrimental effects that may not be obvious to start with.
It is therefore important to seek advice, not only from an HCPCregistered podiatrist but a podiatrist who specialises in MSK conditions.
When it comes to the material of the orthotic there are various options.
Many orthotics are made out of harder plastics which, although are very efficient and tolerated in walking shoes, tend not to be tolerated as well in sports shoes.
That said, since walking and running gaits ( cycles) are quite different, it may be that one may have orthotics in their work or walking shoes but they are not required in their sports shoes.
My preferred choice of material is EVA, ethyl vinyl acetate. It is softer, compresses with the heat from your foot yet offers the required support for two to five years.
Many top athletes in the UK wear orthotics made from this material in their sports shoes, since they are tolerated well.
When looking at treatment options don’t just rely on one professional.
Many people call the physio in the first instance but MSK podiatry also has its place.
Other people rely solely ( excuse the pun) on their orthotics to do the job but a combined approach, including treatment from other health professionals often helps to achieve the best results.
It’s best to seek advice from a registered professional who works within a multidisciplinary clinic and is open to bouncing ideas off different team members.
For example, since I know that orthotics take a while to work, I call upon my physio colleagues to help rehabilitate patients in the meantime.
My physio colleagues, on the other hand, often seek advice with regard to specific lower limb problems which they have no experience in dealing with.
They also refer patients they have treated for symptomatic relief since they understand that the orthotics I prescribe have longer- term benefits.
No health professional knows everything. A team approach is always best. What can you do to help yourself? See an MSK podiatrist for an in- depth mechanical assessment of your lower limbs. A lot of running shops offer similar assessments.
Whilst they can be beneficial, staff in these shops lack the professional expertise and in- depth knowledge that an MSK podiatrist has.
Find a brand of shoe that works for you and stick with it.
If you’ve been running for a while, have worn the same brand and style of shoe and have avoided injury, my advice would be to stick with that particular shoe.
If you do suddenly encounter an injury it will likely be due to one of the reasons mentioned previously. Go and seek professional help.
Don’t ignore a niggle since it could lead to something worse.
Taking two or three days off of training is surely better that being out of action for two to three weeks.
Don’t try to go from zero to hero overnight. Setting yourself unrealistic goals could hinder your progress longer- term since you’re more likely to injure yourself. Increase the distance gradually and incorporate different physical activities such as weight training and yoga into your weekly routine.
Finally: ask questions and be realistic. Understanding a bit about how your feet work and what you can do will enable you to have happy healthy runs and achieve that PB you’ve been dreaming of.
Happy running.