Robert Rosenstein, DPM
Michael Coppers, DPM
CONDITIONS AND TREATMENTS
JOGGING AND RUNNING
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
Jogging gained enormous popularity in the 1970s as a great form of cardiovascular fitness. Since then running has become one of the most popular form of physical fitness in America. Whether you run on an indoor track or outdoors, you can enjoy this activity year-round and fit it comfortably into your daily routine.
During jogging or running, the 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels that make up the foot all work together. That's why you need to condition your body, build up to a routine, and stretch your muscles, tendons, and ligaments before and after each run. Debilitating muscle strain or more serious injury can result when runners or joggers don't build up their routines and allow their bodies to strengthen over time.
The most common foot problems associated with jogging or running are blisters, corns, calluses, Athlete's Foot, shin splints, Achilles tendonitis, and plantar fasciitis. You can prevent many simple foot problems by using proper foot hygiene. Keep your feet powdered and dry. Wear clean socks every time you run. Make sure your shoes fit properly. Most importantly, let your body be your guide so that you don't overstrain your legs, ankles, and feet. If you develop recurring and/or increasing aches and pains from jogging or running, please contact our office and we'll help you pinpoint the problem and prevent more serious injury or long-term damage to your feet.
Jogging/Running Shoes
Because of the force placed on your legs, ankles, and feet, jogging/running shoes need to provide cushioning for shock absorption. Like walking shoes, you need to select a pair designed for the shape of your foot and your natural foot structure or inclination.
There are three basic foot types:
- Pronators are people with relatively flat feet, caused by low arches, which generally leads to overpronation, or a gait in which the ankle rolls inward excessively. People with this foot type need motion control shoes that offer support for mid-foot. Motion-control shoes are more rigid and built on a straight last. These are generally board-lasted shoes, which have a piece of cardboard running the length of the shoe for greater stability. Look for sturdy uppers for added stability and avoid shoes with a lot of cushioning or highly curved toes. Also look for a reinforced heel counter to maintain foot support and stability.
- Supinators are people with high arches, which can lead to underpronation that places too much weight on the outsides of the feet. People with this foot type need stability shoes designed for extra shock absorption and often having a curved or semi-curved last. A slip-lasted shoe is also recommended, because the sewn seam runs the length of the shoe giving it greater flexibility. Also look for shoes that are reinforced around the ankle and heel to stabilize the foot and extra cushioning under the ball of the foot.
- People with normal feet can wear any type of running shoe, although a curved last is generally preferred.
When you run, your foot rolls quickly from the heel to the toe, with your foot bending at the ball on each step. That's why it is important for running shoes to have enough flexibility in just the right places. However, to help with shock absorption, you need a little more rigidity to support the middle of the foot. Make sure the heel is low, but slightly wider than a walking shoe to help absorb the initial shock when your heel strikes the ground.
Here are some other important tips for buying a good pair of running shoes:
- Shop at the end of the day when your feet are slightly swollen to get a good fit.
- Try on shoes with the socks you will wear when walking. If you use an orthotic, bring that to the store when you try on shoes as well.
- Have your feet measured standing up and fit your shoes to the larger of your two feet.
- Be sure there is enough room in the toe box for your toes to wiggle and about a half inch between your toes and the end of the shoe.
- Take time when shopping to try on different brands and walk around the store in each pair. Be sure to walk on a hard surface, not just on carpeting. Let your foot be the guide to the fit, not the shoe size or style.
- Look for lightweight, breathable materials for greater comfort.
- Run your hand all over and inside the shoes to feel for any seams or catches that might irritate your foot.
- Choose shoes that lace for better foot stability and control.
- Make sure your heel fits snugly and does not tend toward slipping out of the shoe.
- Consider buying two pairs and rotating your wear to give each pair time to breath between runs and extend the life of each pair.
- Replace running or jogging shoes twice year or about every 400 miles.



