Springtime Running Tips

Springtime is here and running season is back!  If you're looking to get back into running shape, shed a few winter pounds, or even run your first marathon, here are a few tips to get you started.

Check your gear. How old are your running shoes?  Did you get them last summer?  Maybe the year before?  Have you been beating them up on the treadmill all winter long?  Chances are, you'll need a new pair to start running with.

Look at the EVA padding along the shoe. The EVA, or ethylene-vinyl acetate, is that layer of foam between the upper and the rubber sole of the shoe. Are there vertical creases in the EVA that don't go away?  This is one of the signs that the shoe's padding is wearing thin, and isn't doing its job anymore. Also take a look at the bottom of the shoe. The sole of the shoe should have a nice tread on it, and the wear pattern should go down the middle of the shoe. If the sole is very worn down, particularly if it unevenly worn down, a new pair may be necessary.

Start slow. Even if you've been running on the treadmill all winter, running outside can take some adjusting. Pavement is much harder than treadmill running, and can be much less forgiving on your muscles and joints. Overuse injuries like stress fractures and tendinitis are extremely common in the beginning of the training season.

If you haven't been running at all, starting slow is especially important. Going from the couch to running several miles can be very hard on the body. Warm up with stretching and a brisk walk before getting into a quicker pace.

Stay hydrated. Running outside in the heat can cause you to sweat even more than usual. Drink a glass of water about 20 minutes before going for a run, and be sure to bring some extra water with you for longer runs. Gatorade and other sports drinks can help replenish electrolytes, which are also lost during heavy sweating.

Watch the sun exposure. While it may feel great spending time in the sun, too much exposure can increase the risk of skin damage and development of skin cancer. Be sure to wear sunscreen, sunglasses, and a sun hat to limit your exposure. If you are fair-skinned and burn easily, you may consider wearing a lightweight long-sleeved t-shirt when running outside.

Enjoy yourself. Spending time outside running can boost your mood and energy level, and can make you feel great. It is a great way to get exercise, and a great way to enjoy the weather.

Central Florida Foot and Ankle Center, LLC. 
101 6TH St. NW. 
Winter Haven, Fl. 33881 
863-299-4551 
www.FLFootandAnkle.com

Dustin McGowan with Plantar Fasciitis

Dustin McGowan, pitcher for the Toronto Blue Jays, has recently been diagnosed with plantar fasciitis in his right foot.  This injury comes as part of a streak of injuries to McGowan, most notably Tommy John surgery on his throwing shoulder as well as suffering from several other shoulder and labrum injuries.  The right-hander was just given a two-year, $3 million contract extension to stay with the Jays. 

The plantar fasciitis injury, luckily, is being reported as not serious.  Blue Jays fans and teammates hope that McGowan can recover quickly, and perhaps in time for the season opener.  Dustin McGowan is currently listed as day-to-day. 

Plantar fasciitis is a condition of the foot that most commonly presents as heel pain.  It is common to feel the pain with the first few steps of the day, or after a period of rest.  The pain can be excruciating for some, while others may be able to deal with it.  The pain may ease a bit after the first few steps following rest are taken, but will typically develop as the day progresses.  This is especially true for people who spend a lot of time on their feet.

Plantar fasciitis is caused by excessive strain on the plantar fascia, which is a structure located on the bottom of the foot.  This excessive pressure may come from things such as foot mechanics, foot structure, increased activity, or excessive weight.  The condition may begin as an acute inflammatory reaction to this excessive strain, but generally presents as a chronic condition.  

Most cases of plantar fasciitis will resolve with rest, ice, anti-inflammatory medications, and orthotic devices.  The orthotics may be over-the-counter type devices or custom molded to a person’s foot.  Other methods of treatment may include injection of cortisone into the area, ultrasound therapy, or other advanced modalities. 

Occasionally, a case of plantar fasciitis may be bad enough to warrant surgical correction.  These cases are generally instances where conservative therapy has failed after several months or even years.  Surgical intervention involves cutting a small portion of the plantar fascia to relieve some of the tension on the structure.  The plantar fascia serves to keep much of the integrity of the structure of the foot, so caution should be taken by the foot and ankle surgeon not to compromise this integrity. 

As for Dustin McGowan, hopefully his case of plantar fasciitis will resolve soon.  Keep an eye on his progress to see how this injury will affect his starting date this season. 

Central Florida Foot and Ankle Center, LLC. 
101 6TH St. NW. 
Winter Haven, Fl. 33881 
863-299-4551 
www.FLFootandAnkle.com

Fractures of the Calcaneus

With springtime upon us, warmer weather is coming, and spring-cleaning is right around the corner.  As people dust off the ladders and start climbing to fix the shutters and clean out the gutters, emergency rooms start seeing fractures of the calcaneus in waves. 

Fractures of the calcaneus, or heel bone, are the most commonly seen foot fractures, comprising about 75% of all foot fractures.  This makes up between 1-2% of all fractures of the body.  The most common mechanism of injury in a calcaneal fracture is a fall or jump from a height, as well as motor vehicle accidents. 

Fractures of the calcaneus can be devastating.  Because the skin and soft tissue surrounding the bone is so thin, the fractures can often present as open, and are prone to infection.  The crushing nature of the fracture has been likened to an egg exploding. 

The subtalar joint, which sits between the talus and the calcaneus, is commonly affected by most calcaneal fracture patterns. When the fracture line goes through the joint surface on the calcaneus, post-traumatic arthritis can develop.  The subtalar joint plays a key role in connecting the foot to the ankle, and injuries to this joint can have a huge impact on daily activities.  Thus, one of the critical things for the foot and ankle surgeon to evaluate is the integrity of this joint following injury. 

When a person presents to the emergency department with a suspected calcaneal fracture, the first thing that is done after the patient is evaluated and stabilized is to take x-rays of the foot.  Often the x-rays will not show the physician the entire picture, so a CT scan is usually necessary.  The CT scan can give much better images of the bones and joints involved. 

The decision to operate on a fractured calcaneus depends on a number of variables, both intrinsic to the injury pattern as well as factors determined by the patient’s overall health.  Patients that have diabetes, poor vascular flow to the legs, increased age, or other injuries that are more urgent than the foot may not be god candidates for surgery.  These patients, in certain circumstances, may be better off with limited intervention or conservative therapy, which may or may not be followed by further intervention in the future.

Looking at the injury pattern can also determine if surgical intervention is necessary.  Fractures that are displaced, meaning that the fragments are separated from each other and don’t line up anatomically, may need surgery to bring the pieces back together.  However, when the calcaneus is broken into too many pieces, or highly comminuted, surgery may not increase the likelihood of a positive outcome.  The condition of the skin can also influence the decision.  If the skin is very swollen, or if there is a lot of blood in the skin, surgery may be postponed until the swelling has a chance to subside.

Surgery for calcaneal fractures has been an area of great interest in orthopedic and podiatric surgery for a very long time, and continues to be an area that is discussed at length.  A number of different surgical techniques exist, and every case is different.  The research has led to greater outcomes following surgery, but a calcaneal fracture can still turn into a truly life-altering event.  

Central Florida Foot and Ankle Center, LLC. 
101 6TH St. NW. 
Winter Haven, Fl. 33881 
863-299-4551 
www.FLFootandAnkle.com