Doctors - PAH! page 2

[Shalimar]

Arch supports are lethal to me. They actually cause me to hobble after a few hours wear. Now when I get new shoes I inspect the insoles and rip them out if they look suspicious. But all you hear from doctors about foot problems is, oh, get these $300 custom insoles, you need arch support, get this painful shot, this operation. I often find the info I need on the Internet or by experimenting.

Last time I went to a doc for something it cost me $600 and guess what, no cure. Eventually an Avon lady offered advice and the problem was gone $6 and two weeks later. WTF!

[thaedge]

I am an exercise physiologist. The bottom line is that most achilles injuries are repetitive stress/overuse injuries. Even if you have been running many miles, and adapted to barefoot style shoes there can still be micro-tears which go un-noticed for many months or years. When someone ruptures their achilles it almost always is not a 100% healthy tendon, usually not even 50% healthy. The bottom line is that if you start feeling pain there it is probably too late to cut back a little an hope it heals. You really need to rest it for a good amount of time. And do some support exercises.

I agree that standard running shoes cause more injuries than barefoot, I wear barefoot shoes myself, but that does not mean you are immune to overuse injuries. You can have whatever footwear you want and still get overuse injuries, its just part of life.

If you rub 2 sticks together over and over and over forever they're going to turn to saw-dust, it doesn't matter if you're wearing gloves or not.

Classically for overuse injuries it is suggested to decrease the irritating activity, and increase support. Most docs will tell you get more supportive footwear, because for 90-95 of patients who are not barefoot that is true. For someone who is barefoot and going to a doctor for an overuse injury I think it is the patients responsibility to know that increasing support means doing exercises or cross-training to improve their foots own muscle and ligamentous support. If they don't know that, maybe they should be wearing regular running shoes. They dont' need to know the specific exercises, but those can be discovered.

In other words, you went to the doctor complaining of an overuse injury. The doctor told you, you have an overuse injury, and that you should rest and get some better support. For you this means improving muscular support to the arches and ankle stability. The bottom line is, for these soft tissu injures there isn't must a doctors office can do, there no pill, test , or cure. When I see someone on the schedule complaining of achilles pain, I know they aren't going to be walking out of the visit cured, and it will be months before they are back to normal.



Can you tell that

[Dr. Bork Bork]

I got an Achilles injury early on in using vibrams and it took about 3 months to heal. My chiropractor did a lot of work on it (including the use of lasers and heat), and I credit him with helping me heal. An achilles support sleeve helped a lot too.


slow down, let your body do what it needs to, and keep building up your strength through that area.

[Tribal Rob]

I am an exercise physiologist. The bottom line is that most achilles injuries are repetitive stress/overuse injuries. Even if you have been running many miles, and adapted to barefoot style shoes there can still be micro-tears which go un-noticed for many months or years. When someone ruptures their achilles it almost always is not a 100% healthy tendon, usually not even 50% healthy. The bottom line is that if you start feeling pain there it is probably too late to cut back a little an hope it heals. You really need to rest it for a good amount of time. And do some support exercises.

I agree that standard running shoes cause more injuries than barefoot, I wear barefoot shoes myself, but that does not mean you are immune to overuse injuries. You can have whatever footwear you want and still get overuse injuries, its just part of life.

If you rub 2 sticks together over and over and over forever they're going to turn to saw-dust, it doesn't matter if you're wearing gloves or not.

Classically for overuse injuries it is suggested to decrease the irritating activity, and increase support. Most docs will tell you get more supportive footwear, because for 90-95 of patients who are not barefoot that is true. For someone who is barefoot and going to a doctor for an overuse injury I think it is the patients responsibility to know that increasing support means doing exercises or cross-training to improve their foots own muscle and ligamentous support. If they don't know that, maybe they should be wearing regular running shoes. They dont' need to know the specific exercises, but those can be discovered.

In other words, you went to the doctor complaining of an overuse injury. The doctor told you, you have an overuse injury, and that you should rest and get some better support. For you this means improving muscular support to the arches and ankle stability. The bottom line is, for these soft tissu injures there isn't must a doctors office can do, there no pill, test , or cure. When I see someone on the schedule complaining of achilles pain, I know they aren't going to be walking out of the visit cured, and it will be months before they are back to normal.



Can you tell that

Thanks for you input, even though if comes accross a tad angry I wast expecting a cure from the docs, but here in the UK the GP is always you first point of call. Your take on overuse injury makes sense in terms of micro undtected injurys - this would explain in my mind why I was fine till I went arse over tit down the steps - extra load and stress making an un-noticed problem rear it's head - possibley due to having to over-companstate for damage to tendons on the top of my foot - even though they didn't hurt when running.

[Tribal Rob]

Thanks everyone else for you input - looks like I'm back to walking for a bit (assuming that's OK?) might have to dig the bike out for the self proppeled speed buzz and do bike spints too.

[Velocity J]

I'm a physical therapist and I'm a proponent of minimalist shoes so we're out there. Hopefully you'll end up with someone who can help get this straightened out. It's my own belief that traditional shoes and arch supports might actually contribute to Achilles problems, but there can be a number of factors and it's probably worthwhile talking it over with the physio especially since you mentioned taking that tumble as well. An Achilles rupture is a major injury and like another poster mentioned the tendon usually starts weakening first so I take it seriously whenever I feel any tendon pain, especially since I'm in that age range when it's likely to happen.

This is an article that gives a better overview of Achilles Tendon Injuries.

[Tribal Rob]

Thanks for the link, interesting reading, I'm becoming more convined it's an overuse injury that happeded due to the stress caused by falling down the steps. I am also thinking I might go back to wearing normal shoes every other day (I'm wearing completly flat cheap skate style trainers from asda (part of your glorious wal-mart chain) with very thin soles that cost me the grand sum of £10. These are a fairly recent purchase too. It might give the tendon a bit of rest by keeping it shorter.

The angle flexation exsersies look interesting, but my first thought was, that won't stretch my ankle at all, but I've always had pretty flexable and strong ankles - possible from years of skating as a kid.

I might try lowering myself on one calf - see how it feels, if it feels fine I'll do that as recovery excersise.

Thanks again you guys are great