A Discussion on Diabetes, Training, and Health......
Tuesday, March 19, 2013
Free-Tip Tuesday Volume XXXVI: Plantar Faciitis/-osis and Achilles Tendonitis/-osis
I’ve grouped these two painful conditions together because the both
occur across the same joint – the ankle – and therefore the causes and
treatments of each are very similar.
To begin, let’s first
define a few terms. The suffix –ITIS simply refers to inflammation of
the affected tissue. –OTIS on the other hand, refers to a situation
where said inflammation has been allowed to propagate long enough that
the condition has now become degenerative in nature. Yes, that is as
bad as it sounds.
You may be surprised to know then that
tendonITIS is actually a pretty rare condition; in reality what most
people are suffering from is tendonOSIS. The bad news is that while
tendonITIS is fairly easily treated and resolved, full resolution once
things have progressed to tendonOSIS is also rare.
Therefore, the idea is to not get to this point in the first place!
Lastly, this post is not meant to serve as an attack on runners or long
distance running, but more simply just a function of runners being the
population most commonly seen suffering from these afflictions in our
practice and therefore whom we thought would benefit the most from the
That being said, most people would be
well served to appreciate the difference between ‘running to get fit’,
and ‘getting fit to run’. But at the end of the day if running provides
you with joy, provides an outlet for stress, and encourages you to be
more active – these are all positive things!
If you choose running as your preferred activity, we just ask that you do so intelligently.
Without further adieu, our top tips for avoiding foot frustration:
1. DON’T OVERDO IT!
The foot of the matter – bad pun intended – in all of these conditions
is OVERUSE. Especially overuse stacked on top of dysfunction. Due to the
‘No Pain, No Gain’ mentality, using soreness as a marker of a ‘good
workout’, and other similarly misguided attitudes towards health &
exercise, many people simply do too much. Whether it’s too much volume,
frequency, or intensity – eventually you are asking for problems.
So how much is too much?!
- Soreness is severe enough to effect movement - Soreness lasts more than one (1) day - Observed decrease in performance
If any of these things are present, your volume/mileage needs severely adjusted. Period.
Pushing through pain isn’t ‘tough’, it’s foolish.
2. ADDRESS DYSFUNCTION
Whether it’s the FMS or one of the many other assessment protocols
available, have your movement QUALITY measured. Who cares how many or
how much of something you can do if you repeatedly do it incorrectly and
with compensations?! There is a reason the FMS is used by every major
professional sports league.
Is your body any less valuable to you as a multi-million dollar athlete’s is to them?
Common dysfunctions can include:
- Lack of ankle mobility and/or stability - Lack of hip mobility and /or stability - Weak glutes and hamstrings - Tight hip flexors
Any or all of these dysfunctions severely distort running mechanics.
The result is a stride which more resembles ‘hopping’ across the ground
as opposed to correctly ‘pulling’ it behind you.
movement screened and your gait analyzed, not only will you reduce your
risk of injury – you’ll see your times go down too!
3. Examine Your Running Surface
While we are fans of the barefoot and minimalist running movement and
the substantial improvements in gait that are often observed, one must
also realize that 100’s of years ago everyone also DID NOT RUN ON
CONCRETE! It’s only logical that the harder the surface is that you are
impacting the more stress it will place on your body. Just like over
doing it in terms of mileage, frequency, or intensity; constantly
running on hard surfaces is just another example of tissue loading
exceeding tissue tolerance.
Split time between running on hard
surfaces, as well as more gentle options like crushed limestone, grass,
and track work. The key is to do this early in your career while you
have the choice, not after your body removes that option for you!
4. Spending Too Much Time In Shoes
The over-reliance on shoes, orthotics, etc. removes all stimuli for the
many small muscles, tendons, and similar structures of the foot and
ankle to do anything. In essence, they are asleep. Running mechanics
will once again be negatively affected, and these structures will remain
weak and possess little to no tolerance for tissue loading.
Spend more time barefoot, but again, be intelligent about it and build
up more and more time in a progressive fashion. Strength train barefoot
and establish YOUR OWN arch and support by strengthening all of those
aforementioned structures of the foot and ankle.
Again, once things progress to the –OSIS stage, full resolution is
unlikely. Combine this with the realization that many rehabilitation
protocols produce lukewarm results due to solely focusing on the
immediately affected tissues (i.e. strengthen the calves, stretch,
etc.), and it makes much more sense to use these tips that are more
global in nature in order to be proactive as opposed to reactive!
If you are too late to the party and already trashed yourself, no
worries, check the following link to see a few of the modalities we
instruct our clients to use in order to begin providing relief:
Those of you familiar with diabetes will no doubt recognize the name of this blog as an obvious play on words and reference to something millions of diabetics do everyday; it may also describe our general opinion of dealing with diabetes from time to time.....
This blog was created as a place to document my own experiences and journey with diabetes; and to provoke thoughtful and intelligent discussion in an effort to help reverse this growing epidemic. Thanks for visiting!
Russ is currently the Pittsburgh area’s ONLY triple Certified Strength & Conditioning Specialist (CSCS), Hardstyle Kettlebell Certified (HKC), and Progressive Calisthenics (PCC) instructor who specializes in calisthenics, kettlebells, and diabetic populations.