With winter just around the corner,  It's time to start preparing for your winter runs! At Foot and Ankle Specialists of Utah we get asked questions about running in the colder temperatures all the time. Let's review  some running tips for cold weather.

Starting with your socks. Even in the cold tempertures, your feet will still sweat. It is so important to have moisture wicking socks. Avoid wearing cotton. While cotton is a wonderful natural fabric, cotton lacks the ability to wick moisture away from your feet. Remember, wet feet equal cold feet so thermoregulation is key. One pair of socks is plenty for winter runs. There is no need to wear several layers of socks. If you prefer a thicker sock in the colder months, just make sure the socks wick moisture.

Shoes are so important. Especially living in snowy icy areas. Consider wearing a trail shoe over your usual running shoes. Trail shoes have deeper lugs on the bottom of the shoe and can help with traction. No shoe is totally slip proof so be careful when running on snow. Many trail shoes are waterproof or water-resistant. This option may be helpful in keeping feet dry and allowing more warmth to your feet. If you are running and notice you cannot feel your toes or have pain from the cold stop running at once and get indoors as this could be warning signs of frostbite.

When lacing your shoes, do not lace them too tight. Compressing your feet into shoes can cause decreased circulation and pain. Always ensure you are properly fitted with your winter shoes with the socks you intend to use for running. The shoes may need to be increased in length as well as width to allow for a proper fit. 

For many people, the colder months allow for cross training activities. Cross training is a great way to keep your cardiovascular health and also allow your legs and feet to take a break from the repetition of running. When you cross train, you reduce your risk of running injuries. Check out your local health club or YMCA for alternative cross training activities!

Even though the temps are down, hydration is still important. Carry hydration with you and drink accordingly. Being cold and dehydrated is a dangerous mix!

Remember to warm up slowly when running in the cold. A brisk five to ten minute walk prior to running will help with circulation and allow the body to prepare for the run. 

Get ready for colder temperatures! 

The foot is a very complex structure which when functioning optimally supports and balances the weight of the entire body. Walking alone puts up to 1.5 times one's body weight on the foot. Running has been seen to put 3 times your body weight through every inch of your foot.

Foot pain is not normal and should not be ignored. It can lead to serious problems that can affect the functioning of other parts of the body, including the hips, knees, and back. Foot-related problems are often treated very successfully with orthotic shoe inserts.

Orthotics are prescribed to:

1) Reduce pain
2) Provide support
3) Prevent or slow down the development of a foot deformity
4) Provide better positioning of the foot, knee and hips
5) Improve the overall biomechanical function of the body

Orthotics allows the muscles, tendons and bones of the feet and lower legs to function at their highest potential. When correctly fabricated, orthotics can decrease pain, not only in the foot, but in other parts of the body such as the knee, hip and lower back. By eliminating the need for one's muscles to compensate for imbalances, orthotics can reduce fatigue and promote efficient muscle function to enhance performance. They can also increase stability in an unstable joint and prevent an early foot deformity from developing additional problems.

What you should know about orthotics:

The use of orthotics adds a new dimension in the treatment and prevention of overuse injuries of not only the lower extremity but also of the hip and back. However, there is still confusion as to what orthotics are, what they can and cannot do, along with who really needs them.

What is a functional orthotic?

An orthotic is a device that fits into running shoes to accomplish two things:

(1) To ensure that the foot moves correctly through the various phases of running which includes heel contact, whole foot contact and toe off, the orthotic functions like a rudder to help the foot function efficiently biomechanically.

(2) To support the foot, the orthotic assists the foot and enables it to communicate and align with the rest of the body. The body is then balanced above the foot in midstride as well as when the foot is on the ground.

A true foot orthotic is a custom-made device prescribed by a podiatrist. 

BIOMECHANICAL BASICS

To fully appreciate why some runners need orthotics and others do not, an insight into basic biomechanics will go a long way towards explaining the need for orthotics.

Our feet go through a very complex series of movements to help propel us forward. One of the most important functions of the foot is to help the body absorb shock when it hits the ground. Every time we strike the ground in running, our lower extremities experience a force between one and a half and three times our body weight.

Pronation

The foot normally strikes the ground on the outside (lateral) part of the heel. As soon as this occurs, the heel should roll in. This motion, called pronation, which absorbs shock, gives the appearance that the arch is flattening out. This mechanism of pronation reduces forces to the ankle, knee, hip and back and helps prevent impact related injuries such as stress fractures.

Once this 'pronation phase' is complete, the foot begins to roll-out or supinate slightly, creating a more stable foot position and allowing the lower extremity to achieve maximum efficiency when pushing off.

Pronation then, is a normal, necessary biomechanical motion in foot function. However, if the foot pronates too much or for too long it will remain unstable, making the lower extremity less supportive of body weight. This can result in a multitude of overuse injuries from heel or arch pain, stress fractures, knee, hip and back pain and injuries.

Pronation, therefore, is a problem only when it becomes excessive. Excessive pronation can result from several causes. Hereditary congenital bone structure refers to our foot type, which to a great extent, is genetically predetermined. The position of the joints can cause the foot to assume a pronated position.

Excessive pronation can also result from biomechanical abnormalities. If a certain part of the foot or leg is unable to go through the motion necessary in normal walking and running, another nearby joint may be required to make up or compensate for this lack of motion. For example, one of the most common biomechanical problems causing the foot to over pronate is a tight calf muscle also known as an equinus. The foot needs to bend (dorsiflex) upwards five to ten degrees at the ankle for normal lower extremity motion to occur.

If this motion is unavailable, the foot will overpronate to make up for the limitation. By stretching the calf muscle properly, these forces acting on the foot can be reduced and can help to prevent lower extremity injuries.

Finally, improper shoe gear is another cause of overpronation. Running shoes that have a curved last or shape will tend to increase the amount of pronation that occurs in the foot. Many shoes are categorized as 'motion control shoes', usually made from a straight last, have more supportive materials on the inner (medial) side of the shoe to limit the amount of inward roll (pronation). They are not included to stop pronation but to let this motion occur in normal limits.

Many runners almost literally run their shoes into the ground and discard them only when they have the shoes reduced to little more than a pulp. Shoes are meant to only last 6 months or 500 miles; whichever comes first. Remember that if the shoe is worn-out or broken down it cannot function in the way it was designed.

Supination

Is the opposite motion of pronation. It occurs normally right after heel strike to help the foot become a 'rigid lever' to propel toe-off. 

A foot that underpronates is not able to absorb ground shock very well and can be prone to stress fractures. A foot that underpronates needs a shoe capable of absorbing shock well. Motion control is usually not very important in this type of foot; however, in some cases foot orthotics can help in supporting and redistributing pressure in the foot when a neutral cushioned shoe is just not enough.

How do you know if you need orthotics?

Most serious runners who have biomechanical imperfections end up with orthotics out of necessity. The runner who runs fewer than 20 miles per week will not likely need orthotics unless they have a serious biomechanical weakness, but for the serious runner any biomechanical weakness will be magnified, with the result being injury.

When a runner gets a series of nagging injuries one after the other, they are probably caused by a biomechanical flaw and can be corrected by orthotics. Runners who suffer from chronic knee pain, arch pain, plantar fasciitis, heel spurs, hip and lower back pain and certain types of muscular fatigue very often benefit from orthotics.
 

ESWT
Extracorporeal Shock Wave Therapy is a noninvasive treatment that uses sound waves to increase blood flow and metabolic activity, accelerating the body's own natural healing process. Extracorporeal means outside the body and this is exactly where the therapy is applied. The ESWT treatment is most commonly used for plantar fasciitis, which is also known as heel pain.

About the Treatment
Shockwaves are applied via hand piece and held against the skin. In the initial phase of the treatment it may cause some pain, however, this indicates correct targeting of the problem area. The treatment sessions are 7 minutes, and you will receive up to 5,000 sound pulses. Many patients receive pain relief in just 8-10 days after the first treatment. This ESWT treatment can eliminate heel pain in as few as 6 treatments, although depending on your condition, you may require 6 or more treatments, usually depending on how long the condition has persisted.

After the Treatment
You may feel some soreness, which may intensify on the night of the treatment. You may simply take acetaminophen (Tylenol) to help the pain, but make sure not to take an anti-inflammatory pain reliever, it's the inflammation of the tendon that triggers healing. There may also be some minor bruising in the treatment area. You should rest and avoid aggravating activities, such as impact heavy workouts, for 2-3 days after the treatment.

If your struggling with heel pain please feel free to Contact Us, or schedule an appointment to see if shockwave therapy is right for you.

 Make sure and request a free copy of "Heel Pain Very Common, Yet often Untreated" at www.utahfootspecialists.com  or simply call #1-888-808-4944 to request a copy.  If you or someone you know struggle with heel pain, let us help you get rid of it!

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"We wrote this book because too many people suffer from heel pain unnecessarilly."Ryan K. Anderson, DPM, Bryan L. Seagle, DPM