“Parting is such sweet sorrow”

breakup

We all remember those early days in a relationship. Long walks together with close intimate contact. It felt right paired up with this attractive ‘model’ most guys dreamed of having. To onlookers it probably looked like the perfect match but below the surface there were problems beginning to emerge. What started as some minor nagging had developed to a more lingering pain. In hindsight we may have been moving too fast. Some days we probably spent too much time together. I tried painting over the cracks and ignoring it but it was just becoming all too irritable. No relationship could or should have to endure this. So it was time to face facts and do the right thing. We’re going our separate ways. I need a new pair of running shoes.

It’s not you, it’s me

Shakespeare’s description of Romeo and Juliet’s parting, although sorrowful, is still somewhat “sweet” knowing they will see each other again soon. In recent weeks I have been forced into an untimely emergency purchase of new running shoes and my parting with the old pair could also be described as both sorrowful and sweet. Sorrowful because I spent €140 on the bloody things but sweet because with only weeks to go until the Dublin City Marathon I am now pain free again during runs. I had changed mid summer to a shoe many reviewers and runners alike ranked highly and gave glowing reviews of and like all consumers I was drawn in. Not that I was having any issues with my usual brand, they had just clocked up too many miles. Any new shoe takes a while to accommodate to and the recommendations would be to adapt slowly. So I did what every professional does – and paid absolutely NO heed to my own advice (a plumbers tap is always dripping). The first week totalled 70 km incorporating a 30 km weekend run along with some shorter snappier work during the week. Six weeks in I began to notice pain along the outer border of my baby toe – an overuse tendinopathy due to the increased demand of the different strike pattern I was developing. I persisted, obviously. It got worse, naturally enough. But with a training plan to stay on top of and time running out there was little choice. So it was back to the drawing board, a topic discussed in a previous blog: The which running shoe debate?

“You probably need orthotics”, a fellow runner told me.  He may be right, but since my teenage, pre-physio years I’ve always been skeptical about orthotics. Mainly because everyone, regardless of their injury, seemed to be wearing them back then. From back pain, hamstring strains, knee pain and ankle sprains the industry seemed to be cashing in big time pointing the finger towards foot mechanics as the culprit of all musculoskeletal issues. This never sat well with me and lead me to undergo post graduate training in the area of orthotic prescription. This just furthered my skepticism. As a result I try to avoid it as standard practice, for the most part, and evidence would support this. A systematic review by Collins et al. (2007) concluded that ‘there is some evidence to support the use of foot orthoses in preventing lower limb injuries but little evidence to support their use in treating overuse conditions. And anyway so what if your foot is over pronated? During the gait cycle of walking and running the foot actually needs to pronate. Newman et al. (2013) reported no higher incidence of shin splints in the over pronated foot type versus the more neutral foot. Incidentally they also reported those that previously used orthotics at significant increased risk for the development of shin splints.

So what of cushioned versus the more minimalist shoe? Runners with a cushioned shoe tend to land on the big cushioned bit, i.e. the heel, and hence are heel strikers. Ever tried landing with force on the heel of a shoe with no cushioning? Don’t. And this is the transition I’ve been making over 5-6 years; trying lighter, more neutral shoes with less cushioning in an attempt to master a mid foot strike, something I was doing pretty well with until I was lured into following the current trend in running fashion. Becoming accustomed to running with a forefoot strike in shoes with less cushioning promotes landing with lower loading rates. This has big implications for reducing risk of injury. Was there anything wrong with the runners that failed me? Much like my bum is not suited to skinny jeans, and my head not suited to being shaved (Trust me I’ve tried both), my feet were just not suited to this particular shoe.

I am not sold on any one particular brand. I am asked all the time which shoe is best. But the answer remains the same – whichever feels most comfortable…FOR YOU! From stability to minimalist footwear find a shoe that suits your foot and gradually progress from there.

For more information on any of the issues addressed throughout this article please contact Rob via email at mccabephysiotherapy@gmail.com, Twitter @mccabephysio, Facebook at McCabe Physiotherapy or visit http://www.mccabephysiotherapy.com

Rob McCabe MISCP

Chartered Physiotherapist

MSc (pre reg) Physio, BSc Sport Science and Health, MSc Sports Physiotherapy, PG Dip Orthopaedic Medicine

Orchard House, Moorefield Rd, Newbridge, Co. Kildare

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