Feet First

Like most things in life, a strong and balanced foundation is crucial and this also applies to the human body. The solution to some of the body's most nagging ailments could quite simply be resolved by wearing the right type of shoes for your type of body and its mechanics.

Pronation is the term used to describe the normal motion of the foot when it strikes the ground during the gait cycle. Normal weight distribution travels from the lateral side of the heel (subtalar) to the medial (talocalcaneonavicular) side of the ball of the foot.  Knowing if one is an “over pronator" or "supinator” is valuable information in diagnosing other areas of injury, as well as choosing the correct footwear and/or foot supports.

Over pronation occurs when the feet roll inward excessively, creating a flat foot which can lead to a variety of injuries, especially in runners, including:

• Achilles tendinitis
• Anterior compartment syndrome
• Bunions (Hallux valgus)
• Patello-femoral pain syndrome
• Plantar fasciitis
• Shin splints
• Tarsal tunnel syndrome

For a supinator (under pronator), the foot will not roll far enough in a medial direction during the gait cycle, with excessive weight put on the baby toe (metatarsal) towards the lateral side of the foot, and therefore not allow the foot to provide efficient shock absorption. Extreme supination can lead to:

• Ankle sprains
• Plantar fasciitis
• Shin splints 
• Stress fractures of the tibia, calcaneus and metatarsals

In both excessive cases of pronation, the wearing patterns on the soles of the shoes can say a lot about how your feet are striking the ground during gait. Depending on the severity of the correction required, the proper shoe or insole can straighten things out. There are also custom orthotics, specially fitted devices, that can be made for sports and dress shoes.

If the feet are out of line, so will everything else be. So don’t let misalignment create unnecessary wear and tear on the body.

For more information on biomechanics, please visit SIRC.

Walking on pins and needles?

Nerves that get stuck and irritated by swollen muscles or ligaments can be a torment to athletes.  The ultimate goal for any athlete experiencing the pain of a pinched nerve is to alleviate any pain or discomfort you are feeling, all while working within your boundaries and keeping up a comfortable range of motion.  As an athlete it's important to know what to look for so you'll have a better chance of getting the proper treatment.

The symptoms of a pinched nerve are more intense than a mild soreness and athletes experiencing the pain of a pinched nerve will often complain that the area has:

• numbness
• tenderness to the touch
• pins and needles
• burning
• tingling
• an aching pain that won't go away

Common nerve injuries for athletes are Tarsal Tunnel Syndrome, Morton's Neuroma, and Piriformis Syndrome.  Depending on the severity, a pinched nerve can be treated a number of ways, such as supportive braces, anti-inflammatory drugs, injection therapy, massage, chiropractic manipulation, physical therapy and sometimes surgery.

Once diagnosed, a good practice along with the various treatments above, is to keep moving but at a minimal or modified level.  As soon as pain will allow, it is recommended that rehabilitation starts as soon as possible.  Take the time to review your exercise regimen, revise your fitness goals to accommodate your recovery and make sure you give yourself extra time for warm ups.  Focus on building up and stretching out core muscles like the chest, back, legs and abdominals. 

Most people that have nerve injuries will improve in time with rest, heat, limited activity and anti-inflammatory drugs.  The problem can reoccur but can be avoided if you apply the treatment methods mentioned above.  It's important to keep in mind that with all pain that lasts between 7-10 days and doesn't respond to self care measures, it's a good idea to consult a doctor or physiotherapist about possible treatments.

References from the SIRC Collection: 

1. Alshami A, Babri A, Souvlis T, Coppieters M. Strain in the Tibial and Plantar Nerves With Foot and Ankle Movements and the Influence of Adjacent Joint Positions. Journal Of Applied Biomechanics. November 2008;24(4):368-376.
2. Beare S. Pain in the Butt! Piriformis Syndrome. Sportsaider. 2004;20(4):9
3. Filley A. Piriformis syndrome: don't let it become a pain in the backside!. Peak Performance. June 15, 2009;(277):1-4.
4. Hariri S, McAdams T. Nerve Injuries About the Elbow. Clinics In Sports Medicine. October 2010;29(4):655-675.
5. Kinoshita M, Okuda r, Yasuda T, Abe M. Tarsal Tunnel Syndrome in Athletes. American Journal Of Sports Medicine. August 2006;34(8):1307-1312.
6. LeRoux M. FEELING THE PINCH. American Fitness. November 2006;24(6):32-33.