NFT: to any runners with arch issues

I saw your thread title, and I knew and felt your pain instantly. I am presently dealing with PTT in my right foot. It started in July, 4 weeks prior to half marathon I was training for.

I have been a steady runner for 5-6 years averaging 30 miles per week. Nothing had changed in my training or my weight/body. Only thing I can attribute it too was age, and that Brooks changed the design of their 2019 Adrenaline GTS (which had been my go to shoe). At that point I had about 75 miles on the new shoe.

An MRI revealed no significant tear, only inflation, so no surgery necessary. The Orthopedist recommended rest, PT and perhaps new shoes.

After 6 months of rest and yoga, which incorporated most of the PT exercises, I switched to Brooks Beast and started training again 6 weeks ago. I started with 2-3 mile runs total mileage was 12 per week, and have built to a long run of 8, and total mileage 22 miles last week.

I was really building confidence, feeling only mild tenderness post run, but nothing alarming..... until just the other day. A stupid misstep while carrying my trash can down the steps of our back deck caused me to miss the last step and I landed, with all my body weight, on my right foot, in an unsupported shoe. I instantly felt I slight tear that I fear may have set me back several weeks again. Gahhh.

This is the most frustrating injury I have ever had and nothing on the internet is encouraging.

I guess the good news is, that I really felt I was on the road to recovery, building strength in the arch and increasing mileage, until this freak accident just this past weekend. Although I hate Brooks Beast, they really seemed to be helping.

My routine includes lots of stretching of the calf ankle, yoga for additional strength and stretching, and compression sleeves in the evening.

I'll keep you posted and I completely feel your pain.

more so in my upper tibia + knee when I was a teenager - that really fucking sucked. The growth rates weren't the same so my knee didn't sit right in my tibia - I basically limped after every soccer game, pain when sleeping, and PT. It eventually went away once the growth of the bone caught up.

Just rest it for the time being and try to do some of the PT on your own.

and i'm assuming you use orthotics but if that not that should be one of the first things you do once medical facilities are re-opened.

Have you had an X-ray? What about the navicular bone is freaking you out so badly?

I'm in a similar situation - I've been a long distance runner for a few years now. Last summer I had an IT band issue, this winter I had an extensor tendonitis/plantar fasciitis issue. Still coming through that one as I was recently wrapping up PT (canceled my last two appointments and follow up with the doctor due to the virus). I feel like the extensor tendonitis is healing well, but now I have more pain on the bottom of my foot that is indicating associated plantar fascia issues.

I bought orthotics yesterday from Superfeet to help with daily/running support, hoping I can get back into running in the next week or so and then mitigate any pain/issues with daily stretching exercises for my hips/calves/feet.

My first couple of years of distance running I wasn't very proactive about stretching or anything like that and it definitely caught up with me. I've learned that this is critically important to avoid the common running injuries and it simply can't be avoided.

Good luck to you. Maybe try some home PT remedies (they're all over the internet) after a telemedicine consultation with your orthopedist? This may help continue the progress you were making and calm your nerves about whatever you're reading about the navicular bone!

I've been running in Brooks adrenalin also. As a matter of fact I had just done a half marathon last October and had a few shorter distance races on my calendar but that ain't gonna happen now

and someone with arch issues typically did best in ASICS Gel Kayanos. But even still you’ll need a good orthotic, off the shelf might get you buy but you should spend the few hundred and get custom ones once you are able.

compared to the Kayano which should have more arch support for over pronators

I haven't had an X-ray. As for the navicular bone if there is a fracture it doesn't typically show up on an x-ray. The information I've been reading is it may require an MRI or some other type of scan to see if a fracture exists. The fix might require inserting screws and a walking boot for like six weeks. This is probably the worst time of year because i have alot of people I take care of their yardfs and it requires being on my feet a lot. Plus I'm an avid runner and it's killing me not to run.

I'm flat footed. I used to run in Asics but they didn't work for me as well as the Brooks. Brooks has never given me a problem. In you opinion as someone who is flatfooted how much arch support is too much.

In comment 14855858 blueblood'11 said:

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I'm flat footed. I used to run in Asics but they didn't work for me as well as the Brooks. Brooks has never given me a problem. In you opinion as someone who is flatfooted how much arch support is too much.

+1

I dealt with same issues during my marathon running days...ran in the Asics Kayanos for a couple years and was constantly in agony.

I went to a podiatrist and then a top end running store to do the whole run on a treadmill/video my stride routine, and the recommendation was that I needed a shoe with LESS arch support, not more

I switched to Saucony Hurricanes, and I've had very little trouble ever since.

I guess the point is, all of us have different feet, different stride, etc. There's no one size fits all solution.

It's tough when we're all on lockdown and can't get out to a quality store or doctor...but if you have any other shoe options at home, maybe experiment with something else for a little bit.

In comment 14855858 blueblood'11 said:

Quote:

I'm flat footed. I used to run in Asics but they didn't work for me as well as the Brooks. Brooks has never given me a problem. In you opinion as someone who is flatfooted how much arch support is too much.

Curious if you were running on the Adrenalin 19's? Adrenaline shoe has remained largely the same since 14'-15' but they made a pretty big shift in design for the 19's and that is when my problem began.

I really don't wanna hijack this thread, but I have been very frustrated with running lately because my right shin just knots the hell up. I call it "shin splints" but I'm not sure that is correct term(?)

I've had this problem literally since I was a teenager, so maybe I'm just not built for running and need to move on from it, but... Anyway, I'm 54 and have tried running intermittently over the years, and always the same thing -- no amount of stretching or warm up helps, after a few hundred yards my shins just knot up and hurt so bad I just have to stop. (I end up walking and jog a little along the way to get the exercise). Weird these latest attempts, though -- left shin is OK and only the right acts up.

I really think I should just hang it up and take up biking instead -- don't need to be banging my aging joints anyway -- but if anybody can shed some light, I'd like to hear it.

It is odd only the right shin is affected. Nevertheless, if you are not a consistent runner having sore shins is not uncommon.

Give some attention to how you run...try to avoid stepping out in front of your body and increase your step rate. Both are easy fixes that may work for you.

Couple of posters above note Brooks runnings shoes which I switched to 2 years ago. They are great.

Brooks put in a rail system as it relates to the arch support. I actually felt more stable when running in it but now it makes me wonder if the shoe didn't cause the problem. What's also interesting, and I wonder about too much arch support, is as someone who is flat footed and now having this issue I have much less discomfort when walking around without any shoe on. It's as if the pressure pushing into the arch is irritating the situation.

yes, shoes will fell different for everyone. I've had good luck with Kayanos, I also have a narrower foot and feel that's partially why they fit great for me. Wider, flat footed people will likely get more relief from something lower profile (Brooks Beast, NB 990's, etc).

That said its been a good while since I've done a comparison as I don't work in that realm anymore, so some of the models have likely changed a lot over the past 5-10 years.

Go to a store where you can have your gait and pressure points measured and try on the recommended shoes that will hopefully relieve that pressure.

As a matter of fact with that new design there was a bit more space to the front on the shoe which I wasn't to sure about but once I got used to it I really liked it because as a long distance runner you know how our toes take a beating and that little bit of extra space took a lot of the wear off the toes.

it could be, and what works for someone may feel like shit for you anyway. A good store will let you take them for a run and return them if you don't like them so I'd find someone like that. If you were located in Fairfield county i'd recommend going to see my friend who has a machine and a trial period policy.

is the only true inverter in your foot. It inserts into the navicular bone. Some people have an accessory navicular, meaning they actually have the navicular and a separate joint with a secondary bone. When you have this, you can have a more pronated foot (pes plano valgus) because the posterior tibial tendon inserts into the accessory and is not as strong and can get overpowered by your only true everting tendon in you foot (the peroneus brevis which inserts into the base of your fifth metatarsal ). Because radiographs only show bone and only in two dimensions, if you want to get the guesswork out, get an MRI. It will not only tell you what you have, sometimes, more importantly, it will tell you what you don't have. As mentioned previously, Brooks Adrenaline (or Beast 18) are great sneaker sfor overpronators as they have a 3 degree varus (inverting) tilt to them. If you want to immobilize it, don't spend three hundred dollars on a CAM boot at your physician. Amazon has good ones for 39.00. It will stop you from frontal plane motion (pronation/supination), but, while an MSK ultrasound will show you the posterior tibial tendon viability, an MRI will give you all the information you need.

In comment 14855902 UConn4523 said:

Quote:

yes, shoes will fell different for everyone. I've had good luck with Kayanos, I also have a narrower foot and feel that's partially why they fit great for me. Wider, flat footed people will likely get more relief from something lower profile (Brooks Beast, NB 990's, etc). That said its been a good while since I've done a comparison as I don't work in that realm anymore, so some of the models have likely changed a lot over the past 5-10 years. Go to a store where you can have your gait and pressure points measured and try on the recommended shoes that will hopefully relieve that pressure.

I do have wider feet, probably in part why a shoe with less support worked for me. A lot of runners I know swear by the Kayanos (or other Asics models), turns out just wasn't the right one for me

The store I go too is very accomodating and I've taken shoes back many times in the past if I didn't think they were working for me. So as far as getting me in the right shoe they've always worked with me to that end.

my arches started to flatten (more on one foot). I tried different Asics and Brooks running shoes mostly, until I went to Super Runner's World and did a test of my gait. They recommended a New Balance model a few years ago. I had been buying the updated model each year of the 1260, which they discontinued last year. The replacement, Rubix, has been great. It supports the arch and the heel box, and has a good overall fit. It is also lightweight. I don't need any support inserts with this model.

Are you a specialist? That was impressive and informative.

When I was running (NYC marathon in '79) I filled a one-gallon paint can with something like plaster of paris while retaining the wire holder for the can itself. Then, before each training run, I'd dangle the can in turn from each foot while raising and lowering my toes.

Worked well for me in two ways:

1. no foot problems

2. training regimen(alternating six and twelve mile runs) meant early to bed and early to rise reduced wife time during the period when that marriage was deteriorating.

and thank you :)

Will I ever run again

on what is actually wrong, but, yes, in general, there is likely a 98 percent chance that you'll run again. Mind you, you may have to shut it down completely for a while, possibly even be strictly non weight bearing with crutches or a knee walker for 4-6 weeks, but its doubtful that you ruptured your posterior tibial tendon and it needs primary repair with a CONEXA graft (but you may have torn it). You also, likely don't have a stress fracture of your navicular (but, if you do, non weight bearing will allow it to heal with relative certainty). Most oftentimes, it's posterior tibial tendinitis and tenosynovitis (tendon and tendon sheath inflamed). The fact that the PT helped means it's likely nothing nefarious. The old adage R(est) I(ce) C(impression) E(levation) and a NSAID topically (like Voltaren) and immobilization in a boot and then either orthotics with a 4 degree varus (inverted) rear foot post and/or Brooks anti pronanatory shoes take a lot of stress off of the posterior tibial tendon. Of course, all this is anecdotal because you don't have an MRI yet. But in meanwhile, get a CAM boot online and wear it at all times for three weeks except when you sleep, shower and drive (if its your right or you drive a manual) Very, very small chance that your running days are over.

My angst right now is that because of the restrictions due to the virus I can't get into to see a specialist. What would my symptoms be if I had a fracture.

Also, with regards to a CAM boot, I know this sounds crazy, can I cut grass when wearing

A stress fracture would normally have edema (swelling) at and around the area and, if not immobilized would continue to get worse, not improve. Because you improved with the PT, it is likely not a fracture. Pinpoint tenderness is seen with tendinitis, tendon tear, fracture, etc, so, if it's sore to direct pressure on it, it doesn't necessarily mean its fractured. If you invert your foot and have someone try to move it out of inversion by trying to evert your foot while you resist, if you can resist, its not ruptured. If you have literally no inversion ability, it might be (its not going to be btw). If it hurts to resist there is a good chance it's tendinitis. Keep in mind fractures usually are painful 24/7 and get worse if not immobilized. The PT would not improve a fracture. Immobilization, bone stimulators, etc do. AND, yes you can mow the lawn with it on but keep in mind, the more you're on it, the greater chance that you may be making something worse and subsequently take longer to heal.

Well I certainly don't have any problem with strength and I can resist without it hurting at all. It's usually achy when I get up in the morning and I have to gimp around at first but gets better as the day goes on. It usually gets cranky when as my therapist termed it as loading up on it. It's very hard to stay off it because I have so much to do. It doesn't hurt when I'm off it. As a matter of fact I can press on the entire area on the bone and around it without any pain. Just a hint of some soreness. It's confounding.

It sounds most consistent with posterior tibial tendinitis. The reason it would hurt more the first few steps out of bed, is because your body cools when you rest and the tendons, ligaments etc, cool and contract, and then when you stand on your foot, the area begins to warm up and stretch out and feel better after being on it a bit. It might make sense, given that you're on your feet a lot, to pick up an ankle sleeve online to give you better proprioception at the area. Rest it as much as possible, ice it twice a day for 15 minutes, use the sleeve for compression. Pick up a pair of Brooks Beast 18 on Amazon or on the Brooks website. They will invert your foot and take the pressure off of the posterior tibial tendon. Before you get out of bed, while it sounds silly, draw the alphabet with your foot. It will warm up all tendons and takes 60-90 seconds. I'd shut down any thought of running for two weeks, hold on the CAM boot and MRI but if not improved markedly in two weeks and you try a short run and it hurts, get the MRI (sorry took so long to reply, I was on call for emergencies...just got home).