Experience From - Various , Ed Furtaw , Suzi , Leonard Jansen , Dana Roueche ,
Subject: Foot Pain
What do you do with fore foot pain without loosening your laces to the point that your foot moves in your shoe and possibly causes more problems?
The way I prevent this from happening is I leave the forefoot of the shoe loose and tie the top tighter to get control in the shoe. One thing that I know others do is when you get the proper looseness in the forefoot, tie a knot in the laces a couple of rows up from the bottom, so that it will stay that way.
Another way to tie one part of the shoe loose and the other snug is to use two short laces. Lace the toe box loosely and tie that lace. Then lace the upper snugly and tie it. As an added advantage, if you break one lace, you still have the other and can easily improvise accordingly.
Subject: Hapads in Lieu of Orthotics
In my recent post about the AT100, I mentioned that Nick Williams had introduced me to Hapads. Hapads are felt pads that are inserted into the shoes, under the insoles, for foot support. Nick wears them in lieu of orthotics to prevent heel spur pain. I too have heel spurs, and have worn custom-made rigid plastic orthotics for about 14 years. Now I am attempting to make a transition to Hapads in lieu of orthotics.
After I aggravated one of my heel spurs back in August at the Colorado High Passes Run, Nick first told me by e-mail about Hapads. I took his letter to my podiatrist, who said he had heard of Hapads, and would order me some. Then at the AT100, Nick graciously gave me a pair that he had bought directly from the Hapad manufacturer. Upon returning from AT100, I went back to the podiatrist to get the Hapads which he had received. We immediately noted that the ones the podiatrist got were very different from the ones Nick gave me. The podiatrist told me that Hapad makes many different types, and he isn't sure which type will work best for me.
The ones Nick gave me are called "Longitudinal Metatarsal Arch Pads". They are about 3+1/2 inches long and 2 in. wide. The ones the podiatrist gave me are called "Comforthotic (registered trademark) contoured insoles". They are about the size of an orthotic - about 7 in. long and 3 in. wide. I am now wearing the larger ones. I have not worn my orthotics since AT100 - 16 days now. This is the longest I have gone without wearing orthotics in over 14 years. So far, NO HEEL PAIN !! And they are definitely more comfortable than wearing orthotics.
The manufacturer is Hapad, Inc., P.O. Box 6, 5301 Enterprise Blvd., Bethel Park, PA 15102, phone 1-800-544-2723. I have called them and requested a product catalog, which they will send. They seem happy to sell their products directly to individuals.
Obviously, I can't yet be sure that this will be an acceptable long-term solution for the prevention of hell (oops, that was an inadvertent but interesting misspelling) I mean heel spur pain. I will keep this list informed on their effectiveness.
This could raise an interesting dilemma for me. For the past ten years or so I have kept my running mileage below about 30 miles per week average, actually about 21-24 mpw annual average for the past few years. I have found that consistently running more than that would eventually cause aching heels. But now, what if the Hapads are more effective at controlling my heel spurs, such that I could comfortably run more than 25 mpw if I wanted to? Should I increase my mileage in hopes of becoming a "better" (or at least, faster) ultrarunner? If I could become 5 or 10 or 20 percent faster by training more, should I? Oh No! I could risk losing my status as a low-mileage ultrarunner! I'm not sure I really want to train more, even if it wouldn't hurt my heels. I like the fact that training doesn't dominate my discretionary time, the way it must for someone who runs tens of hours per week. I like being able to spread my time and energy around to several addictions at once.
So if the Hapads really work, it could present me with a tough decision to make.
Subject: Anterior Tibio Tarsal Tendinitis
The question has come up recently about an over use injury in ultras that causes a swelling on the front of the ankle. I believe the area in question relates to an injury Dr. Bob Lind first told me was Anterior (front) Tibio (along the Tibia, your bigger bone in the lower leg) Tarsal (refers to the bones in your foot, so leading to the foot) Tendinitis (a swelling, or inflammation on the tendon sheath). I have had this injury a number of times and so has Gene. We both found it to be due to over use, and self limiting, in that it goes away when you stop "over using".
The injury can appear as a slight ache along the lower shin, or develop into a swollen red hot area extending from below the knee to the top of the foot. Treatment seems to be the classic RICE Rest, Ice, Compression, and Elevation for two or three days, and then gentle return to normal flexibility and use. In the extreme cases you can feel the grating of crepitus along the tendon, with the feel of sand like grit when you place your hand on the tendon and move your forefoot up and down. (this is one of the great fun things to do post 100, besides eating, and leaving toe nails on your spouses side of the bathroom counter.)
Anyway, Bob Lind told me when he first saw this injury he couldn't find it written any where in the med journals, because nobody over used themselves to this extent I guess. So he wrote it up.
When it occurs, the onset can usually be delayed with anti nflammatory drugs, or better still, finishing the race! But if neither of these options is available, be aware this condition is not fatal. The two problems I have most suffered with it though, are the result of a loss in control of the front portion of the foot. The Tendon involved raises and lowers the forefoot. When it gets over used, swollen, and tired, it stops being effective at these tasks. An occasional stumble when my toe doesn't clear the ground, and worse, the forefoot slaps the ground without the tendon to slow its descent. One year at W.S. I was leaving Last Chance for the steep down hill into the canyon, with a bloody toe and remarked, "We'll soon see what curls my toes besides Gene Thibeault!". I was right, it was the Anterior Tibio Tarsal Tendon amongst others! You can forget your blister and toenail problems when this comes along.
The only long term problem I've had with it is during recovery when I had to work and couldn't keep from dragging both my feet. No joke! Swinging the legs from the hip instead created bilateral trochanteric bursitis, but that's another post.
Subject: Anterior Tibio Tarsa
The question has come up recently about an over use injury in ultras that causes a swelling on the front of the ankle. I believe the area in question relates to an injury Dr. Bob Lind first told me was Anterior (front) Tibio (along the Tibia, your bigger bone in the lower leg) Tarsal (refers to the bones in your foot, so leading to the foot) Tendinitis (a swelling, or inflammation on the tendon sheath). I have had this injury a number of times and so has Gene. We both found it to be due to over use, and self limiting, in that it goes away when you stop "over using".
Here's a few tips from the race walking world on how to deal with this:
This is an extremely common complaint in racewalkers when they first start. However, other than the things mentioned in your post you can also do the following to help:
Subject: Running w/out Insoles
Joel Zucker wrote:
"But I wonder what I might be risking by running without the insoles, and I'd like to hear about the experiences of others who have tried this. Especially if you run trails, and have flat, rigid feet (like me) and/or pronounced Morton's Toe (again like me)."
Joel, the only thing you are compromising is possibly some arch support and cushioning. Since you need less cushioning than Nike tends to provide for trail running, I don't see that as a problem. I didn't know you could have both flat and rigid feet at the same time. Rigid tends to go with high arch, instep. In any case, you need to be careful if you are compromising some arch support. Ask the orthotic wearers about plantar fasciitis.
I am also a big Nike wearer but recently tried a few different models of Adidas hikers. One pair I like, the other is too heavy. The pair I like is the Seeya II Lo. Even though they have an extremely rugged tread, they have a great feel for the trail below your feet. This is for two reasons, your heel sits much lower in the shoe and to the ground than in Nikes and there is less cushioning. You don't need the extra cushioning on the trail and in my mind it is worth getting a better feel for the ground. The tread works better than anything I've worn in the snow and ice. The toe box is as big as it gets with plenty of room for Morton and the rest of his family. I have close to flat feet and the insole provides a lot of arch support that is extremely comfortable. I bought my shoes from a retail store but I know Road Runner Sports carries them in their catalog if you'd like to see what they look like.