Dr. Campitelli is a podiatrist in Akron, OH specializing in foot and ankle surgery with an interest and enthusiasm for running as well as helping runners with injuries. For the past several years he has been treating running injuries in patients by fixing their form and transitioning them to minimalist shoes. Having treated runners with all types of injuries through conservative measures with orthotics and shoe gear changes to reconstructive foot and ankle surgery, Dr. Campitelli has brought what works best and is most current to his practice as well as the Akron and Cleveland running communities.
Since 2007, Nicholas Campitelli, DPM, FACFAS has set the pace for leading edge foot and ankle care in Akron, Fairlawn, and Streetsboro Ohio. Dr. Campitelli’s credentials put him in a select category of few physicians in the Akron area providing care of both the forefoot and rearfoot as well as the ankle. Dr. Campitelli, certified by the American Board of Foot and Surgery in forefoot and reconstructive rearfoot and ankle surgery. He completed his medical degree from the Ohio College of Podiatric Medicine in Cleveland Ohio in 2001 and a three-year foot and ankle surgical residency in 2004 at Millcreek Community Hospital in Erie, PA.
Dr. Campitelli is respected for his leadership in podiatric medicine. In 2015 Dr. Campitelli was elected Vice Chair of The Department of Orthopedics at UH Portage Medical Center where he also has served as Chief of Surgery in Podiatry at UH Portage Medical Center. Since 2009 has served as Adjunct Clinical Professor at the Ohio College of Podiatric Medicine. He also serves as an Attending Physician for the Alliance Community Hospital Podiatric Residency Program as well as the Mercy Health Foot & Ankle Residency. Dr. Campitelli is often called upon as a speaker on topics related to foot and ankle surgery where he has lectured throughout the United States for various events. Before becoming a podiatrist, Dr. Campitelli was a Nationally Certified Athletic Trainer.
Dr. Campitelli has extensive experience in Sports Medicine and is a recognized authority on the subject of running and running related injuries. He has published literature in the Journal of the American Podiatric Medical Association as well as been featured in Men’s Health, Competitor Magazine, Natural Born Runner, and many other periodicals and books on running. Most recently he was featured in the book, Ready to Run by Dr. Kelly Starrett.
This blog is intended to provide the most up to date and comprehensive information on running and training for endurance events.
Have a question about a running injury or training program and live to far away to see Dr. Nick? You can reach him by commenting in the box below and Dr. Campitelli will do his best to respond to your question. By using the comment section, others can also benefit from ongoing dialogue.
Speaking Engagements
Dr. Campitelli lectures nationally on running injuries, shoes, running form, and training regimens. For more information or to discuss scheduling a lecture, direct all inquires to:
feet@me.com
Visit Dr. Campitelli’s Office Website at www.drnickcampi.com
Dr. Campitelli recommends consulting a physician prior to starting any exercise program and the information provided here is not recommended to be advice in place of seeing your doctor for a medical problem.
Hi Dr Nick…….this is an awesome read,thank you. I have had PF for about 8 months now but not just from running. i am a fitness leader and zumba instructor and a part time runner. I have been teaching 6 x 1 hour classes per week for over two years now and 8 months ago I started wearing zumba brand shoes which have minimal arch support which I thought was the cause but after reading your blog am not so sure now. I went back to a ‘normal’ asics running shoe for all classes and am seeing a physio who is working on releasing my hip, glute and calf with dry needling. I wear my runners all the time thinking that by going barefoot I will damage it more!! Can you please give me some advise on whether I need a minimalist shoe taking into consideration that my feet move in all directions not just in a forward running stride and should I be barefoot or in minimal shoes more often? Thanks for your help. Viv
Viv,
Tough to answer. My advice would be to gradually adapt to being barefoot at home – 30 minutes a day and increasing gradually weekly. Do the same for minimalist shoes. Wear one hour a day and increase weekly by an hour. Wear the other shoes your used to rest of day. Give it 6-8 weeks and you should see a difference. Keep us posted here!
I recently taped myself running on a treadmill. I noticed that my left foot is turned out about 10 to 15 degrees on landing. I land with a mid foot strike. When I looked at the video one frame at a time, I noticed the foot does the turning out as soon as it starts moving forward after reaching its highest point in the backswing. My left foot almost hits the right calf as it comes forward. The right foot moves and lands fine. Any ideas on what is causing this? I love your book and the website.
Hi Dr. Nick! It’s Wendy from http://thescarredrunner.com. I have a question for you. I have what I believe to be a hammer toe (the 4th toe on both feet). It is genetic as my dad and some of his siblings have it. The problem is that the one on my right foot is bent in and down so that the top right corner of my toe virtually hits the ground with each stride. This is causing my nail to turn black and blue and generally is uncomfortable. Should I consider surgery or is there another way to remedy the situation? Thanks!
Wendy,
Thanks for reaching out!
It sounds like a congenital curled fourth toe. You Temporarily reduce it by using a buttressed pad. My advice would be to fix it surgically though a simple procedure that releases the flexor tendon to this toe. A small incision is made on the plantar aspect of the toe, the tendon is released, and a single stitch is placed into the toe. It is then splinted for five days at which time the stitch is removed and a band aid is used. These are done in the office. Here’s an example of a before and after photos on my website. It’s approximately the ninth photo down.
http://www.drnickcampi.com/Akron_Podiatrist/Akron_Podiatrist_Before_and_After_Photos.html
Good luck!
Thank you for your reply! I had no idea that this was a real syndrome. I will seek out a podiatrist in my area to see if I can have this fixed, as you suggest. Many thanks!
Hi Dr. Nick!
I hope I’m not being too forward but I’m being treated for a small heel spur/Plantar Fascitis. They’ve given me orthotics but I’ve found that when I wear the VFF’s they just feel so much better. Do you think running with VFF’s would be better? I haven’t reallly tried to yet but it’s soooo tempting because they felel so good. My foot Dr. didn’t recommend it but I listened to Born To Run and my instincts say that minimalist running would in the long run (no pun intended) benefit me. What would you recommend or advice do you have? Thanks A MILLION in advance.
Dan
Dan,
Thanks for reaching out. I can’t really give medical advice through emails but ill make some comments.
Plantar fasciitis is secondary to overuse and not a bone spur on your heel bone. The weaker your foot muscles are, and the more you stress it, the more likely you are to get plantar fascitis. With a gradual change to a minimalist shoe (10% each week and per run) you will develop strength in your feet which could help to resolve your plantar fasciitis. What you have to remember is that you have an inflammatory response occurring so you do need rest combined with strengthening to see an improvement.
Good luck!!
Dr. Nick
Dr,Nick,
Would like to get your opinion on having a lateral sesamoid removed in a young 16 yr old female softball pitcher.She was diagnosed with a fracture and it does not seem to be heeling.Everything I been reading about the procedure is weighing heavy on me. Any thoughts would be greatly appreciated. After reading your site I feel like there are other options, your proof of that!!
Thanks Tom
Probably would treat conservatively first. Try strengthening her intrinsic muscles. Building a stronger foot takes the pressure off the toe joint. It takes time and lots if strengthening Which can come by functioning barefoot. I would hold off on surgery as it could make it worse.
Hi Dr. Nick
I took up running as a leisure activity to deal with stress at work and freedom it gave me.. I want to run in a maarthon next year. Is there any advice you could provide for me to train correctly. I have spoken to many people, but i have received very mixed advice. The info i am looking for is what i should monitor from a health perspective – pace, distance, heart rate etc and what these ideally should be..
Thanks
Sarah
I would train with a heart rate monitor. Read more on my blog about HR training and specifically the Maffetone method. Let me know if you have more questions.
I’m a runner myself and I just wanted to say that this blog really helped me better my knowledge in everything about running. Everything you have provided is very useful information. My favorite thing about your blog is the information about injury, training, and stretching!
Dear Dr. Nick,
Sorry this is so long:
My name is Ian and I’m currently dealing with some confusing heel pain, which has been diagnosed as PF by my local podiatrists. The reason I’m seeking help online here is because I ran competitively for years, through high school and college, and this is my first time having any issues of this kind, all while my approach to running has been more conservative and careful than ever.
Since graduating three years ago, I’ve been running casually on and off with no more than maybe a handful of 30+ mile weeks. Also, I spent the first two years after graduating SLOWLY transitioning into more minimal footwear, and for almost all of this past year I’ve been running very comfortably in Brooks T5 Racers – neither racing nor doing any kind of strenuous workouts. For probably a year now, I’ve also been doing about 5 minutes of mellow barefoot running after every other run on a grassed area near my apartment. I also didn’t wear shoes anywhere except for on the trails and at my workplace.
So anyway, all was well this past summer until one night at the very end of August. I was walking barefoot (which I do all the time) at backyard party and all of the sudden I felt a very sharp, deep pain in the center my right heel. I thought maybe I stepped on a rock and bruised myself pretty good, so while I was off for a week from work (where I stand on my feet most of the day), I rested and iced pretty religiously. After a few weeks, it felt better – less like sharp focused pain, but still generally dull, deep, and achey through my whole heel, with the majority of the pain being right out of bed in the morning and at the very end of my work day. After about three months, I went to two different podiatrists. The first one took an xray and saw the “very beginning” of a heel spur and said I had classic PF and needed orthodics to heal the spur and eventually prevent PF from coming back. The next podiatrist, before I even described my symptoms, diagnosed me with PF and said the same thing, and said that walking barefoot at all until my PF and spur were gone would be very dangerous.
Anyway, I’m not a full-on barefoot enthusiast but I am kind of skeptical of traditional podiatry and these diagnoses, especially because I’ve never had any PF before when I was running far more miles and at more intensity. Additionally, while dealing with this heel pain, I did experiment for a week or two with some light running and my heel didn’t hurt at all; in fact, I felt that my heel would temporarily feel great for a few hours after runs. Really, my pain is the worst only when I’m standing for a long time in shoes at work (both in dress shoes and trainers) or walking around my house barefooted after a day of work. Though my heel feels bad during my first few barefoot steps out of bed, it generally feels better barefooted in my house than when in shoes.
With all this said, do you have any recommendations about how to heal this or any ideas about what could have caused this pain? I’m a little desperate to get correcting all this, but I’m willing to take my time with doing it right, as I don’t have any races or anything in my future. It just seems like there is just so much conflicting information about stretching, icing, wearing orthodics, etc.
Thanks! Hope to hear from someone!
Ian,
Thank you so much for reaching out and I will try to do my best to answer this. Dealing with chronic planner fasciitis is a tough situation. It is not uncommon for patients who come to see me with chronic plantar fasciitis to have already been told to not go barefoot, wear orthotics, and wear stability motion control running shoes. I make a point that it’s pretty simple, if they have been doing this for 6 months to a year and now they’re here seeing me, then it’s probably not working so its time to try something else. I see this scenario over and over again. I’m not saying the orthotics are bad or that the motion control shoes are bad, the problem is they should only be temporary. I do not treat chronic player fasciitis with orthotics or shoes. I will use them in acute situations where the patient needs to be off their foot but when the condition is chronic the foot needs to be strengthened. In this situation my advice to you would be that you need to learn how to function and walk and run again while dealing with this pain or inflammation. I’m assuming that you don’t have a fracture or acute situation occurring. What I tell my patients is to begin barefoot activities a half hour each day. I also want them doing calf raises, towel curls with their toes, and any strengthening exercises for the foot arch and lower extremity. I stress that these need to be performed barefoot. When you perform these in a shoe you will cheat and not isolate the muscles to your lesser digits and arch. Many times when performing calf raises with shoes on you will perform this on the ball of your foot meaning the great toe joint and eliminate using all the other muscles that control your toes. The idea is that you want to strengthen the musculature in your calf which supplies tendons to your foot and toes creating a more stable base for your foot. Even though these muscles are in your calves, they supply the tendons to the arch of the foot and toes which are very crucial in maintaining a stable base of support. Here is a link to a video I recently posted on YouTube demonstrating strengthening exercises for runners http://www.youtube.com/embed/DZ4ikkbQ2RE?rel=0. When you begin feeling stronger and have less pain I would advise doing these three or four days a week.
The other point that I mentioned is learning how to walk again. Our society has been tainted with shoe gear in that it allows and creates a different gait of ambulation for us. Our bodies were designed to walk and run however not with shoes on that have high heels and arch supports. When we walk in shoes with higher heels we tend to have a different gait and stride in that we swing our foot to get the heel to clear the ground and land on our heal. This translates into taking longer strides which increases the impact force on our foot and more importantly to the heel with each step. When I’m describing this two patients in my office, I make the analogy that it’s almost as if you’re walking on ice. You want to take short steps and try not to accentuate your stride length. This will decrease the impact forced to your foot.
Another scenario that you want to try to do is when standing do not lean on one foot and then the other foot in attempt to give the opposite foot a rest. You want to stand with your feet approximately shoulder width apart and with a gradual forward lean to your midfoot and forefoot. We were in shoes that have a slight angle or increased heel height, we tend to lean backwards to accommodate for this and put more force and pressure on her heels eliminating the muscular contractions of our foot and lower extremity.
In summary, you need to learn how to walk again, run again, and function in a manner that will strengthen your foot. It’s going to take time for this change to occur and for you to see a reduction in pain. It may they take 4 to 6 weeks before you start to see a difference however you should begin noticing changes in your symptoms. Keep in mind that while performing these activities and lifestyle changes you will still need to wear shoes. In other words if you’re going barefoot and functioning when doing these exercises you may want to complete the rest of your day and a pair of cushioned shoes to give your foot rest. Remember when you hear the statement that going barefoot strengthens your foot, it also works your foot harder. So it does help to rest the foot the remaining portion of the day with a shoe. Eventually you will become stronger and not need to rely on a shoe as much.
Dear Dr. Nick,
I’ve been dealing with a foot injury for 7 months and I’ve seen several doctors. 3 weeks ago, it was finally correctly diagnosed as a neuroma, but because it was misdiagnosed several times, it’s grown into a bad one. I understand what a neuroma is and what my non-surgical treatment options are, so I’m taking steps to finally start the healing process, including replacing all of my footwear. My athletic shoes are now Altra (zero drop, wide toe box). I’ve been using toe spacers and I just bought some Correct Toes (I’m a female and I have bunions too).
However, last week I was diagnosed with a new condition, Tarsal Tunnel Syndrome, in BOTH of my feet. Lots of strong tingling and pain, it’s really done a number on me. I got a second cortisone injection into the neuroma, and also 2 injections for the TTS. I’m perplexed by TTS, why it came on suddenly (I haven’t run in 4 months), or what my non-surgical treatment options are. I miss running terribly! I’ve been swimming a lot and I hope to add biking soon. My goal is to get back to running, but now I need to walk without pain first.
Any advice you could provide on TTS is very much appreciated!
If you truly have a TTS then most likely your best options would be to have it surgically released. Many times there are varicose veins wrapping around the tibial nerve which creates the compression leading to the TTS. Sometimes we get an MRI to see the extent of the involvement of what is compressing the nerve. This can reassure the diagnosis. If you have the surgical release I’d have the neuroma removed at the same time. As for conservative therapy, do what you’re doing now for about 3 months to see if its successful. Thanks!
Dr. Nick.
Hi Dr. Nick,
An update on my situation….Further tests (MRI, EMG, nerve conduction study) do not support Tarsal Tunnel Syndrome. Blood tests are in process to see if there’s a systemic issue causing small fiber neuropathy in both feet. I’m in constant pain. It spikes in the evening. Standing still or resting makes it worse. Staying more active seems to help (probably because of increased circulation to feet). Symptoms remain strong tingling on the soles of my feet, and pain on the tops of my feet which is now going up my left leg.
My frustration is that every doctor I’ve seen asks me if I’ve tried orthotics. Yes, I’ve tried them recently, and they kill my feet. My feet have always been sensitive to any shoe with an arch, and my current symptoms make my arches extremely sensitive. I’m starting physical therapy soon with a new PT and she’s already asked about orthotics.
How can I work with all of these doctors and physical therapists to heal while also refusing the orthotics they say are a primary part of their treatment and I won’t get better without them?
Thank you!!
just because an EMG or NCV is negative that does not mean you do not have tarsal tunnel syndrome. sometimes it is a clinical diagnosis.
I knew TTS wasn’t completely ruled out and I have a sneaky suspicion it may ultimately be the correct diagnosis. Hopefully blood work might show something systemic that would have a non-surgical fix. Maybe I just have to give orthotics one more try.
I feel for the person wondering about TTS. I am deathly afraid of the EMG test and have not had it and have not been told I need it as of yet. Not wanting surgery. I have PTTD and started 4 months of class 4 k laser after I injured my PTT July June of 2014. Treatments that I believe kept some inflammation down previous to that I did not have the right shoes or support and was not staying off my foot enough. I went to foot doc sept 2014 after realizing this was getting worse since injured the Post Tib tendon by over use. I was scared away because the doc saw me for a 1/2 hr and suggested a $800 Ritchie brace and then if I didn’t want to try that there was custom digital $400 orthotics. They looked hard and had a small heel on them I thought No. But then he said then there’s surgery which I like to do!! I was shocked and never went back. I went to a running shoe store and got Foot Balance custom insoles and put them in Brooks adrenaline shoes. It helped but I needed to be off my foot longer to let the tendon heal. It would feel better then i would overdo activity. I do not run but would like to walk again without pain. I had cool laser treaments and I guess just the right amount of activity to make it feel like I was on the mend. For two weeks I was pain free! However an MRI in March 2015 showed I have a split in my tendon. I was on my feet too long one day and moved a certain way and the pain came back. went to foot doc out of my state April 2nd 2015 and he told me surgery was not a good option for this and people had had results with prolo therapy. I had one session of prolo therapy and realized that it would take months of it and it may still not work. I am looking into getting Stem cell and Prp to heal the split and tendinosis. I have a good foot doc here at home now and he gave me a walking aircast boot to wear for a couple weeks to give my poor tendon a break. But regenerative medicine would be out of the state of Alaska. I have arches they are not fallen. and my bones in my feet are fine. but since march I have had about 4 episodes in my left foot (the good one) where it would feel like TTS but it has gone away with proper rest support and soaking. Not severe shooting pains up my leg but heel pain intermittently and navicular and medial malleolus area and below it. Once I felt the electrical feeling after I had laid down but that was back in May2015 after being on my feet too long. I recently June13th 2015 got hiking boots for more support with a good wide foot box and put my foot balance max + in them (got them afert a couple months in the regular foot balance). I went back in my tennis shoes when I felt symptoms calming down and used them some around the house and yard. and also walked barefoot a bit too give my feet a break. I have had massage treatments and do contrast therapy and use epsom salts.
I had an ultra sound on June 27th which showed possible vascular entrapment or swelling in the area of my right foot and have noticed myself that the veins are swollen when I am on my feet ( in both feet)too long. I do not want an EMG sounds like a nightmare and my new foot doc says I may not need one right now. But another doc I saw on June 8th was all about surgery to suture the split and emg to see if there is TTS. I would like to treat my feet without surgery and hope I can. My left calf is about 1/2 “smaller than my right since last December and I assumed that was because I have been favoring my right leg and making my left leg the dominate one. I do not want to have problems with both feet. I can walk barefoot and have more before just around the house. but have not been as much since I saw the foot doc on June 30th. I do have some Vionic flip flops that I will put onto make short trips in the house or to the pool. I will begin physical therapy when I am told its ok. I have been pretty active on my feet off an on thru this and did not have the proper rest period after the injury to keep myself from making things worse. I feel my only hope to heal without surgery. I have to be very careful about what I do I know. I am thinking I would like to get correct toes , but may not be able to jump into Altra tennis shoes as they would not provide that stability to keep the tendon in the right foot from over stretching or strain. Slowly I must rehab. Any suggestions or thought you may have are appreciated. Sorry for the long foot saga. My prayers go out to all people dealing with foot ailments. Thanks
Hi Dr.
I have a discovery that proves what you are trying to demonstrate the importance of the foot muscle, on top of that, I have demonstrated that there is a mechanism locks up the ankle naturally.
Please let me know if we can discuss this.
Hi Dr. Nick – I read your post about arch height in minimalist shoes. My ten year old has very flat feet. He did have orthotics when he was very young – they said it might build an arch. Nada. He looks like the top picture, but his knees are in good alignment. He can do a squat and his knees and hips look good. I want to make sure I do the right thing for him. He never complains of any pain in his feet. He does say his feet get tired in soccer cleats. Should I be doing anything specific to strengthen his feet muscles? I know if I take him to anyone in our area they will want him in orthotics.
Thank you
Kristen
I just read about the lawsuit against Vibram in the States because even in Europe it hit the newsstands today. So i Allready wrote to a newspaper and tv station here in Luxembourg where i live and while surfing on the net i found your blog where you write also a lot about minimalistic running. What will interest you perhaps is that i do run races in Vibram Five fingers, i had an accident with the bikila modell during a trail where a stone broke my second metatarse. That was 1 year and a half ago now i still run with my five fingers but with trek sport models because that sole is a little bigger an i fell more secure with those. I run my 10k races in 36minutes. But what you may not know i do wear toe sock too from a brand calles knitido from japan. In Luxembourg i do sell them for several months now in several stores and the sales are rising because they make severall modells esspecially for runners in normal shoes. If you are interested go check my blog or the knitido store in germany. on the japanese internet site they have a page in english.
Dear Dr. Nick,
I am thrilled to read about your experience and advice and that you are a runner yourself.
I believe I have sesmoiditis in both feet but more of an issue in my right. I have had this pain for a year. Went to three different specialists (including a podatrist and orthopedic surgeon) I didn’t have surgery. I had an MRI and still haven’t gotten any concrete answers.
I’ve tried moon boots, crutches, metatarsal pads, custom orthodics, cortizone, aleve. I ice all day at work and that has calmed down the inflamation. I tried running a few days ago for 30 minutes and walked intermittently. First time I tried running in a year. I want to get back to it asap. I ran half marathons. I think the problem was walking in flip-flops and improper shoes that were worn out. I honestly don’t know if it was a stress fracture because I had the MRI a few weeks ago as a last resort after everything else didn’t work. I’ve learned more doing my own research than from any of the doctors I”ve seen.
Listened to your podcast about Vibram Five Fingers/ minimalist shoes and strenthening the whole foot to prevent injury. It made sense. I may buy a pair of Five Fingers. I already have a pair of New Balance Minimialmist shoes. I currently use Brooks Ghost. What do you recommend to kick this injury? – Kristen
Hi, I was reading some of these old posts and came across this comment. I struggled with sesamoiditis for awhile, starting during a long road run in preparation for a half marathon. I can now say I completely resolved this, though at the time it hurt a ton and I didn’t think it would ever get better! I went through some physical therapists and finally found one who gave me some great exercises to strengthen my gluteus medius (side of the butt). I did these RELIGIOUSLY and it got better! My feet don’t roll inward anymore on that part of the toe. I’d recommend an appointment with a PT. Lemme k ow if you have any more questions!
Hello Dr. Nick…
Been wearing custom orthotics for 10+ years and was diagnosed with sesamoiditis about a year ago. It’s been off and on this past year and recently flared up when I stopped wearing them recently. I also just saw a podiatrist who is “barefoot friendly” in hopes of weaning myself out of orthotics. I’m been referred to PT for this but many of the lower leg strengthening exercises involve being up on the balls of your feet which is very painful for my condition. He asked if I ever had a cortisone shot to reduce inflammation which I had not. I took the shot in hopes of reducing the pain/inflammation so I can perform the exercises and begin transitioning out of orthotics into more minimal shoes. Would love your thoughts on the approach I am taking here. – ray
Hi Dr. Nick!
I’ve got a question. I’ve been exclusively wearing VFF for 7 years, to work, out, everywhere. I have not owned a “regular” pair of shoes in 7 years. I work at the Cleveland Clinic and the other day the chief nursing officer approached me with concerns of safety about my wearing VFF in our clinical setting. I’ve worn them since my hire there without issue (I just don’t think she cares for them, because they are not the norm). She asked me to try “regular” shoes. My first question is: what shoe would you recommend? I have a lot of concerns about the toe box of traditional shoes. I’ve got a congenital curled fourth toe on each foot, that has truly benefited from the VFF. The VFF seem to have straightened them out. I’m worried that a traditional shoe may make that fourth toe curl again. I do have the option of obtaining a letter from my podiatrist stating that it would be more beneficial for me to continue wearing my VFF. Do you think that is the route I should take instead of trying to transition my feet back to the traditional shoe?
Thank you!
-Brittany LaManna
Thanks for reaching out! There have been issues at one hospital that I operate in where some members of the staff were told they could not wear them. I went to bat and this was no longer an issue. I agree that it’s more of a not the norm issue.
As for what should you could wear besides them? There are a lot if shoes in the market now that offer a wide toebox. Altra Running Company is one that I would recommend. The Cleveland Running Company in Shaker Heights has them as well as many other minimalist shoes you may like.
As for the congenital curled fourth toe, there is a simple procedure that releases the flexor tendon to the digit that can straighten the toe. Is relatively painless and done in the office. See some before and after pictures on my website.
Good luck!
Dr. Nick
Hi Dr Nick,
I’ve had flat feet for years (I’m 37) 3 years ago I had them “corrected” using the hyprocure system (http://www.hyprocure.com) My feet no longer collapse, my knees point forward (finally!) and I have a small arch. However my left foot didn’t heal properly – we think scar tissue grew around a nerve as I get a shocking pain sometimes in the area of the stent (in my sinus tarsi) I started running last year using a neutral ASICS with my custom orthotics. I don’t have any pain when I run but I’m wondering if I should make the transition to minimalist and if this will help strengthen my feet.
Do you think the hyprocure implants will affect my ability to run in minimalist? Or do you think by strengthening the foot it will only help? Oh and I also have mortons neuroma and bunions…..fun!
Thanks 🙂
http://www.kinderfuesse.com/pdf/biomed_artikel.pdf
an austrian study commisioned by the aistrian health department.
Thanks!
Hello Dr. Nick
I sell toe socks from Japan which are also sold in the only store they have in Berlin. I have already several stores in Luxembourg and in France who sell them too. Now injinji is the most famous seller of toe socks but they lack a special thing which knitido is the only one to have a anti slide layer under the sock to prevent from moving inside the shoes. Would you be interested in testing one of those? Right now none seems to be interested in those toe socks in the States mainly because injinji is wide spread. You can contact me if you have more questions. Thanks
Ralph Reinesch
Hello Dr. Nick,
I first heard about your work in a Triathlon Training podcast a few months ago (I can’t remember which one). I am ecstatic to finally find an expert that is putting legitimacy to what I’ve been wondering for the past few years as an endurance athlete and coach! When I was in high school I was having hip, knee and hamstring pain (along with uneven hips) and was told I have one leg longer than the other, and was given orthotics and suggestion for a highly stable shoe. After going through college and earning a BS in Exercise Science, and being certified in personal training and corrective exercise, I started experimenting with myself. I came to the conclusion that it was muscular imbalance the whole time, and the orthotics were never necessary. Along with that, I have been researching a lot about minimalist shoes lately, and I would love to read “Running In a Minimalist Shoe”. However, the link is not working for me… please help!
Thank you for all of the great literature and advice!
Sorry!! The link must have gone inactive when we updated the office website! Here’s the active link from iTunes.
https://itunes.apple.com/us/book/running-in-a-minimalist-shoe/id579473455?mt=11
If you are still having any issues let me know. If you have any questions or want some advice with running or transitioning etc, or simply want verification about what you already believe, please reach out! It also helps if you just place a comment here so others can read our dialogue. Thanks for reading Dan and good luck!
Dear Dr Nick,
Firstly thanks so much for your blog! Secondly I wondered if you might have some inisght than non barefoot experienced podiatrist might.
I’ve been running in barefoot shoes (Merrell Trail Gloves) on / off for almost 2.5years. I use them for all traing, circuit training, plyometrics etc and love them. However I’ve training for a marathon and decided to look a slightly more cushioning. In checking out some shoes is seems with cushioning i have over pronation and it’s really obvious. I checked in my barefoot shoes and I do it in them too. However it got me thinking, I’ve had no seeming injuries since transitioning to my barefoots but I have had a bit of a hip problem that started causing me issues around 4 months after transitioning. I put it down to cycling, since around the same time as getting barefoot shoes I also got cleat cycling shoes. I’ve been to two physios about it, explained both changes and neither checked my running. But now with both their methods not being particularly successful I wonder if it’s because of my OP?
In short then, could OP cause a hip problem (It started as a pinch on the inside, sometimes and ache on the outside, now its mainly an ache on the outside of the hip, i feel maybe the top of my IT band. My right foot over pronates more but it’s my left hip that I have the issue with.
I’m tossing up who to go and see about this but fearing no ones understands the barefoot thing I wanted to ask you first, sorry for such a ramble!
Secondly regarding the marathon shoe I was after, I got put in a Brook Pure Cadence which has a 4mm drop (i wish it was 0) and mild arch support but it does seem to correct the OP, if you think its a good idea I would consider switching to these or other shoes with a low drop but mild arch support.
I have no idea if you can answer this but it would be amazing if you had an insight.
Hi Dr. Nick
I am hoping to hear your opinion on my circumstance. I have spent a great deal of time and money with no help up to this point. I’ve been a runner since childhood, switched into road running during college. Took two years off post college before training hard in the 09 road season. By July of 09 I couldn’t run without falling from sudden onset knee pain. Figuring I had over done it because the pain was bilateral, so I quit. Fast forward 4 years and I can’t squat, run, cross my legs or sit too long without pain. After 10 weeks of pt and several othro appoints I was told it looks like a patellar tracking disorder. I mentioned to the md I had worn orthotics and a cho pat strap as a growing kid, he didn’t care and recommended exploratory surgery because post pt test didn’t point to PTD. Needless to say, I left and haven’t been back to a doc in one year. My question to you is- what’s are your thoughts? Get fitted for new orthotics or is this beyond a running mechanics issue? Do you recommend anyone in the pittsburgh? Akron is far:) thanks so much
Rae
Does your pain stop if you stop running? If it does, than its the running causing your pain. In that case changing your form and training patterns may help. If it doesn’t stop and you have knee pain all the time, there may be some other issues occurring as mentioned such as chondromalicia or patellar tracking issues.
Hi Dr. Nick,
I am in the process of transitioning from stability shoes to minimalist and also changing my running style from heel strike to forefoot (Pose Method). I also have flat feet (bone issue rather than muscle). I understand that the change should be gradual. For my first pair of minimalist shoes, would you recommend that I go zero drop (e.g. NB Minimus Zero or something like a 4 mm drop, or…???
Hi Dr Nick, love the blog, keep it up…however not loving the emails, for a very specific reason…..I cannot whitelist your emails (nor could anyone else I suppose) and this is because your “from” email address is shown as “donotreply@wordpress.com” please fix this so that I can keep you out of my SPAM folders and in my in-box where your mails should be 🙂
Many thanks
Mat
Hello!
In a week I am facing a anterior ankle Arthroscopy for an impingement due to a massive bone spur on my talus bone, right ankle. According to the doctors, it seems to be a pretty simple procedure as the spur is located in a “easily accessible” place. They do not need to distract the ankle, and there is no damage to the cartilage or tendons, and there are no floating bodies in the joint area.
I am trying to understand the mechanisms behind this process to be able to recover better
What is the main concern during the recovery period, and what is it exactly that one is trying to avoid.
As i understand it from the ibuprofen and ice loving doctors (that seems to be the only kind of doctors here in Belgium), the congestion of the area post surgery is the main issue.
The main task seems to be to deal with swelling and the obvious process of healing the wound form the procedure. Are there any other aspects that you could think of need to be taken in concern in order not to screw up the rehabilitation process?
Proper form when executing rehabilitation exercises as well as every day movements, careful attention to mobility and overall tissue health, not pushing too hard, too early, and careful attention to a clean, anti inflammatory diet are of course already taken in account
Any thoughts about the subject would be greatly appreciated!
All the best
Erik
Sounds like you have an anterior tibial impingement syndrome. Usually it’s a 3 week recovery in a walking boot then progress as tolerated after that. Be patient because you’ll have swelling and tenderness for several months.
12+ years ago, while teaching and on my feet all the time, I developed plantar fasciitis. About 8 years ago I started running and 3.5 years ago converted to barefoot running–all my woes went away (including IT band stuff). I changed to a forefoot strike, and was able to run a half marathon and 17 miles of a Ragnar in my VFF’s without pain the next morning (well, PF pain) and have been following you on FB since that time. I was the biggest proponent of minimalist shoes that ever existed.
And then last fall I started teaching again. Guess what has returned?
(The other thing that changed is that I lost training time, and so I hadn’t been running quite as much as I had been a year ago, though still in my VFF’s). I am in so, so, so much pain.
I’ve been seeing a physical therapist since the end of December and have been dutifully stretching. (He’s also been doing graston massage, and the pain and tightness isn’t just in my feet/heels (both left and right), it has extended into my calves.)
I’ve been resistant to returning to maximalism in my shoes, but last week he suggested, as a last ditch effort, that I do, in fact, go for a more traditional running shoe, and wear sandals that are more structured than I had been doing. And while I don’t know if it’s the cause, almost a week later, it sure feels like it’s getting worse.
I’m tired and frustrated and angry and the thing that makes me feel better (running) is elusive. Even just getting around is tough. I have an appointment with an orthopedic surgeon on August 4, but I will try everything I can from now until then to avoid surgery–or, at least, go into his office telling him of everything I’ve done.
Please, please, please tell me what to do?
What kind of shoes are you wearing to work in? When you stopped running and then returned, how long did you not run, and how many miles did you run when you resumed.
Thanks for responding!
Good question. I’ve tried very hard to find minimalist dress shoes–for awhile, before things got really bad, I was in some soft star Mary Jane’s. That gets a little more difficult in the winter, though, nor did I ever really love them (http://www.softstarshoes.com/adult-shoes/adult-merry-jane-ocean.html). I have also worn Tom’s and my minimalist Merril’s, both with and without OTC insoles, and I’ve worn a pair of Merril’s that are zero-drop and wide toe-box, but with more cushioning, as a way to appease the physical therapist.
I wasn’t running consistently for a period of about a year, though I would still go out and do 2-3 miles about every other week. At this point, 2 is the max I can do, no matter what shoe I’m in, without cramps and major pain.
I’ve been wearing my VFF’s almost exclusively since first posting here, and I’m also on break for the summer. I’m not healed, there’s still a fair amount of pain on waking, but I’m better by maybe 5%, and it doesn’t last quite as long in the mornings as it was doing a couple of weeks ago. Still, I’m camping and stuck here at the campground while the family goes on a 3-mile hike. I’m so over this. . .
To clarify, I stopped teaching 13 years ago. Also, I’ve been icing and rolling, and all that other stuff. . . .
Hi
I’d like to SLOWLY start transitioning into a zero-drop shoe. I currently wear orthotics for Morton’s foot. These ones to be exact: http://www.mortonsfoot.com/prokinetics.html
I currently wear these inserts in a 12mm drop neutral shoe. Should I still wear these inside my zero-drop shoes? Or would foot strengthening, mobilizations exercises be enough for me? I have the classic calluses in the 3 spots, as well as the shortened 2nd metatarsal. Thanks!
Hi Dr. Nick,
We’re looking to put together a useful guide to help advise people on how to avoid running injuries – and we thought it would be a great idea to ask knowledgeable running bloggers like yourself for your best tips.
It could be a common tip to avoid injuries, or something more specific you’ve picked up during your running life.
We want to collate all these great tips and ideas into a big resource, and if you would like to take part in it you can just reply to the above email address and let us know your top tip – or tips if you have a few!
The resource we publish will include a link to drnicksrunningblog.com as well as your Twitter profile. We can also include an image of you, so if you have a specific image you would like us to use just let us know when you reply.
Thanks for taking the time for reading this, I look forward to hearing from you soon.
Yours,
Luke Glassford
Cute Injury
Sure. Is there an email I can reach you at?
Hello Dr. Nick! I’m the Marketing Manager for Speedy Sneakers Racing in Columbus. I send out a weekly newsletter to our Central Ohio clients (primarily 5k runners/walkers) with our race calendar and different features such as our charity partners, participants and blogs. We would be very interesting in spotlighting one of our blog posts. If you would like to be featured, please email me at info@maxoutevents.com.
Dr. Nick,
My son is a soccer player and has been having big toe pain since last December. He has been working with his trainer and orthopedic surgeon trying all sorts of things (immobilization, rest, and surgery). He had “exploratory surgery” in May to see if there was joint damage and everything looked fine. The Dr. scraped the top of the bone to help with mobility. He took 8 weeks off and is trying to get back for his senior season. It is still bad and time is not something we have. He has not seen a podiatrist….do you think we should. He has tried accupuncture and now they have ordered an orthotic for him. He has other pain in his back and knee from overcompensating. Any advice is helpful.
Hi Dr. Nick,
Just want to say I’m glad I came across your blog a few years ago when I was struggling badly with plantar fasciitis. I was always told that I need to run in stability shoes and used insoles in all my shoes. After I took a year off from running and still suffer from PF, I came across your blog and started running in Skechers go runs and after more than a year of adjusting I was able to complete the Marine Corp marathon last week without PF. I’m totally convinced that my PF issue has to do with foot strength, and that my feet got weaker over the years wearing “regular” shoes and insoles. Again thanks for your insights.
Dr. Nick,
I have OA in both knees, medial. My knees ache during the day, but feel much better when I get home and go barefoot. Could a zero drop help me with my arthritis? If so, what shoe do you recommend for casual wear – I am a teacher, not a runner.
Thanks!
Jean, Thanks for reaching out! It’s difficult to give medical advice via email, etc, but I can offer this. There have been several studies published shoeing stresses placed on the knee are lessened by wearing shoes without heels or any type of medial posting with orthotics. With that said,there is definitely some validity to your statement that functioning barefoot at home makes you feel better. I would try wearing a flat shoe at work with a wide forefoot. It will take some time getting accustomed to this, but it should help. You’ll see a difference in your back as well if you get low back soreness. If you were to ask me what’s the best shoe to wear when you’re standing in one position all day as in when I operate, it’s none! A flat shoe allows the feet and the rest of the body to assume a natural biomechanical position which reduces abnormal stress. My wife is also a teacher and now realizes what shoes she can and cannot get away with wearing!
Thanks! If you have more questions let me know!
Dr. Nick
Hi Dr Nick,
I have rigid flat feet and weak ankles. I am currently seeing a physio who has me doing ankle (intrinsic), quad (smith machine squats) and hip (clam shell) strengthening exercises, as well as calf and hamstring stretches to try and help alleviate shin splints, knee and lower back pain.
I have the above pains using custom orthodics and specialist foot wear recommend by my podiatrist.
Do you perform rigid flat feet surgery and what is the general expected outcome from said surgery?
Great Article Dr. Nick. I would appreciate if you can shed some light on:
1) My shoe already has superb cushioning (nike zoom in Lebron 12), how much more cushioning do I need for the insoles? Example would be, do I need a thick pair of insoles to make me feel like walking on padded mats, when I have the base of the zoom air + internal thick cushioning insoles?
2) I am a diabetic and I purchased a pair of Vasyli Red and Blue, will they offer less cushioning (they seem very rock hard for arch support) compared to the default thick Nike ones if replaced in my basketball shoes?
1) if the shoes are comfortable, no insoles needed. Go with what you have.
2) it’s hard to answer a question regarding insoles on line being that you are diabetic. You would need to be evaluated and assessed for peripheral neuropathy as you may require an extra depth shoe with plastizote custom molded inserts
Thank you!
I am a distance hiker and XC skiier, but not runner. I have chronic PF and a very high arch which I measure at about 1 inch. I do have custom orthotics. If i gradually strengthen my feet and legs as you advise, can I expect to eventually not need the orthotics? If so, how do you advise moving away from them?
Just because you have a “high arch” does not justify the need for shoe orthotics. In fact, you would probably see more relief by gradually transitioning to a flat shoe with cushion. To transition away from orthotics, I’d try an hour or two each day earlier in the day and then put them back in shoes for rest of the day. Listen to your body?
Hi Dr. Nick. I was diagnosed with TTS via EMG and clinical exam and today had a cortisone injection (actually two injections) into the tunnel. The injections were very painful (shooting, sharp), but I didn’t feel any numbness in the sole of my foot. I have read that numbness along the medial and lateral plantar nerves (both of mine were abnormal on EMG) is indicative that the injections were done in the right place. Is it possible they were in the right place without experiencing numbness or tingling (had shooting pain into heel with one). Thank you!
Dear Dr. Campitelli,
Sorry because I’m a Spanish boy and my English is regular.
In my country your work about barefoot running is known by many runners. My congratulations because I think that you are changing runners culture.
I’m writing this email to you because I have a question and my doctors have conventional thinking. I have been diagnosed with plantar fasciitis and tarsal tunnel. I will have a tarsal tunnel surgery the next month, and my question is… after surgery, will I have to wear orthopedic insoles? According to my podiatrist, I have abrupt pronation when I boost my feet (walking) and, if I don’t want to tarsal tunnel experience again, I will have to wear orthopedic insoles the rest of my life. If I train my muscles, can I go barefoot or with minimalist shoes?
Thank you and sorry to bother you
Have you tried to go to a rolfer to maybe have your injury get treated? Just google myofascial release or deskbound or go straight on youtube looking up kelly starett or maybe naudi aguilar on functionnal patterns.. so much stuff to do in order to avoid a surgery..i speak of experience as a barefoot runner…
Hi Reinesch,
This week I will start with neural mobility (neurodynamic treatment), my last cartridge. Rolfing is interesting, but I have been looking for in my city and I have not found any specialist. It’s frustrating because my compression nerve is mild. However, it doesn’t react with any treatment. Today I will start with myofascial release using a foam roller…
Thank you for your advices
Look for a rolfer it will change your life! Besides the foam roller you can also use massage balls “yoga tune up”. I had achilles tendinosis on bith feet and my stiffness was the main issue. My orthoped asked me to do a deep squat…i failed miserably…so since i can do it again after 10 months of regular training i feel great again!
Hello Dr. Campitelli,
I have been following your blog and love how you highlight common foot problems developed from running and running shoes. You have a nice layout, good info, and good resources. I was looking around at a few different sites and I definitely thought yours was one of the best.
That being said, I am very interested in exchanging links with you. In its years of existence, http://www.Luckyfeetshoes.com has become an online destination for feet solutions and quality shoes, with a huge audience interested in the running shoes. In addition to our informative website which is heavily updated every day, we offer the best running and walking shoes to common foot problems.
Lucky Feet Shoes, both online and in physical retail stores, helps people improve their quality of life with comfort shoes, arch supports and custom orthotics. We help people find the best footwear solutions that combine comfort with style. Therefore, I thought that you might find some of my article topics interesting and can appeal to your audience. I have covered common foot problems that active runners face such as plantar fasciitis, heel pain, bunions, flat feet, and other common problems. In addition, we offer quality comfort shoes for every foot problem.
Links to a few articles I’ve written in the past:
• http://luckyfeetshoes.com/heel-pain-symptoms-causes-treatment/
• http://luckyfeetshoes.com/fallen-arches-symptoms-causes-exercises/
• http://luckyfeetshoes.com/best-exercises-plantar-fasciitis/
Lastly, I can provide infographics to help support your blog. I’d love to know what you think!
Thanks,
Mayra Casas
Hello,
We’re interested in advertising on blogs, like Dr. Nick’s Running Blog.
Are you able to let me know the different advertising options you offer? We’re specifically interested in guest posts.
Thanks for your time
Sophie Fenns
Dr. Nick,
I am a building trades worker (electrical technician) that is about to take a job which requires safety boots.
Do you have any recommendations as safety boots are concerned? Ideally a minimalist safety boot (like the Belleville mini-mil, but with a composite/alloy/steel toe).
Any information would be helpful. I have been doing minimalist shoes for the past 5 years, and they have absolutely changed my life. I don’t want to sacrifice my livelihood for my feet however….I wish that someone out there would make a healthy boot for us tradespeople….
Hello Dr. Nick, it has been a long time since we chatted! Do you have any advice on getting rid of or preventing side cramps for a new young runner? My daughter recently started cross country and always has severe cramping in first mile of a run. Any advice would helpful. Look forward to seeing again sometime.
John R.
Hey John. Great hearing from you. Most cramps that runners get (whether it’s their side or legs) is from fatigue or overuse without being trained. So side stitches are usually the muscles between your ribs as well as your diaphragm that are being over worked from breathing heavy. With more and more running the muscles will adapt over time and by becoming more fit the breathing will improve leading to decreased side stitches or cramping. I’d tell her to walk/run more to help with them during practices, and just “know” it’s safe and they’ll go away during a meet. Also, trying stretching the muscles by raising the arms up when they occur. Hope this helps!!!
Hi Dr. Nick, I’ve been dealing with some form of Achilles Bursitis for just over a year. Started as tendonitis, then it seemed to improve but not 100% so I went to a podiatrist who did an MRI and said it was more bursitis and PF. The bursitis is probably down to a 1 or 2 pain level, but the PF is still at about a 4-5 and I can’t seem to get it to go away. I’ve also had some issues in the other lower leg with posterior tibial tendonitis that has flared up twice in a year. One PT i went to gave me new orthotics that had a huge arch that i ended up just not wearing because it hurt my foot. So i ended up going to a Chiropractor that does some biomechanics evaluations and he said that my foot is not functioning correctly and is weak. The issues have gotten better over the past 3 months but has not gone away yet. I’ve qualified and am entered in the 2017 Boston Marathon this April and just want to be able to run healthy. I’ve considered starting to run in the Altra 0 drop shoes, would you suggest this with my conditions? Any other strengthening things i could do also?
Hy do some one leg strengtheining exercises with a cushion under the foot for 2m each day..some leg or hip raises on a box or a step in the house..and practice less sitting and more walking during the day..deep squat or asian squat with the feet looking straight in order to get more strength and balance in your achilles…some ankle exercises with massage ball under the foot..
Hello, Dr. Nick –
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We have invented the next hook&loop. Our fabric feels like fleece — soft & non-snagging. Can you imagine a fabric that is comfy on your skin, yet adheres over entire overlapping surface? Kind’a mind-boggling. May I send you a sample for review?
We have applied it to hot-cold compression, and the result has major advantages over pre-exisitng products.
We are now raising funds on KickStarter, and would much appreciate your help in publicizing our still-unknown invention.
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Thank you very much & hope to hear back from you.
TGIF & Cheers ~
– jack kou
jackkou@mac.com
+886 929707509
FB: https://www.facebook.com/okBon.care/
PS: below is our first project, consummated May 2016. You can check out the User Comments to ascertain that this is the real-deal.
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Any tips for getting back to running following tarsal tunnel release surgery? I am 11 weeks post-op tomorrow. Not cleared to run yet, but my ankle/foot feel a bit more stable and normal every day. I entered my name into the lottery for the 2017 Chicago Marathon (which will hopefully be my second full marathon) and am trying to come up with a plan of attack for both (hopefully) that race and the 500 Festival Mini Marathon in May.
Any advice would be greatly appreciated! Thank you!
Stacey–I had this same surgery about 7 weeks ago, and would love to connect to talk about experiences.
Came across your post about sesamoid fractures: I’m a full-time yoga instructor and was just diagnosed through X-ray by a podiatrist with a sesamoid fracture. It’s irregularly shaped and pretty displaced. I’ve been teaching on it for months thinking it was just tendinitis there.
In yoga, we dorsiflex our big toe joint often. As a former dancer and sometime runner, and a 45 yr old mom of 6, I’ve put a ton of pressure on this place. Add to it very high arches and no wonder this came about.
The podiatrist put me in a removable sandal/shoe and asked me to teach in it. I have been. But I’ll take it off sometimes to teach some things and then put it back on. I never dorsiflex that foot and put little to no pressure on it. But after, my swelling is very bad and it is quite painful.
Will the swelling stay like this if I continue teaching? I have cut my movement by more than half and am resting it at all other times of the day (which is supremely challenging for me). It’s just that if I don’t teach, I will lose income and may even lose the classes permanently.
I saw you helped an athlete heal even though his sesamoids never unionized. Is it possible to avoid surgery?
Thanks for all this information!
I was diagnosed with PF from my Podiatrist about 2 years ago and have undergone multiple steroid injections, orthotics and PRP treatments with minimal results. I ran two marathons in that time period (probably why my foot still hurts). I’m currently transitioning to Altras and walking barefoot a little each day. I’ve noticed an increase in pain in my PF. Any advice on transitioning? Will it get better?
Hello, I am a high school runner a d I recently had to stop running for a week because I had pain on the top of my foot. I went to a podiatrist and he said that it was a stress response, and not a stress fracture or extensor tendinitis as I thought. He told me that because the bone of my big toe is too short and that I have an arch that is too rigid to absorb the impact of running barefoot. I had not been doing barefoot runs, but I had been doing my dynamic drills and form drills barefoot. He gave me insoles and I will wear them, but my thinking is that insoles are the bane to barefoot running’s existence, so I think I should taper out of them after 2-3 weeks. What do you think? And is there a way or drills or exercises that I could do to make my arches more flexible? And is there any other drills to work on making each step distribute the force on my foot evenly? Thank you so much, I very much appreciate it.
Hi Dr. Nick, I was hoping for some brief advice. I used to run exclusively in five-fingers (never terribly long distances – a couple miles at a time). I really liked them. But I had bunion surgery two years ago, and my large toe joint has been intermittently inflamed and painful ever since, and I’ve never been able to get back into my vibrams. I recently had a second opinion from a foot and ankle orthopedist who looked at an MRI of my foot and determined I have a degenerated medial sesamoid on that side; who knows if it’s even related to the bunionectomy. He said not much he can do, and I should wear stiff-soled shoes to minimize movement of the joint. I wear combat boots in the military, and it took me a long time to find a pair that were truly flat and also had an anatomic toe box (Tactical Research does make a “minimalist” boot). There’s no way I’ll find some that ALSO have a stiff sole. So, my question is, is the stiff sole really key to rehab? It sounds like, at this point, the sesamoid isn’t going to heal really, but I’d like to at least prolong the periods in between my pain flares… Thanks so much for your time!
Hi Dr Nick,
I’m currently going through Achillies Bursitis, am training for a marathon, which is 8 weeks away, I have been injured for the last 4 weeks, so have reduced mileage, pace and now doing some exercises to help, while slowly Tring to build mileage back up.
Last week, I got 32km done, 16 of which was a long run. I can now feel the calf and ankle tender again.
Can I keep slowly trying to increase mileage in 8 weeks to try and get to a 20 mile run, or should I let this maeration go at this stage? I’m feeling very frustrated.
Thank-you and kind regards
How do you know this bursitis and not an Achilles issue? If you’re getting calf tenderness there is either something more severe with Achilles or you’re really favoring and your gait has changed. Regardless, sounds like rest and cross training with a bike is what you need. Then bike/run or walk run to get back to a Pai free state.
Hi Dr Nick, I’m happy to find your website, with emphasis towards minimal shoes and reducing use of orthotics. Unfortunately, I can’t being my “flat-footed”, orthotic wearing, plantar fasciitis suffering husband to see you, as we live in New Zealand! Do you know of any podiatrists in New Zealand who have the same views as yourself? Many thanks, Julia
Dear Dr Nick,
I sustained an ankle injury a little more than 15 years ago that left me with peroneal tendon subluxation. Initially the pain was excruciating, but over time the injury has become less painful and more a nuisance, with my peroneal tendon rolling over my ankle bone rarely.
Lately I’ve been experiencing lower back pain on the left side, and it was a PT who suggested I get my ankle evaluated after noticing the subluxation. Clinical evaluation shows good strength in the ankle including laterally, but an MRI revealed a vertical split in the peroneal brevis tendon beginning approximately 2cm above the fibular groove to its insertion on the base of the fifth metatarsal with subluxation of the medial segment.
I’m still young (in my early 30’s) and was wondering whether this is something you’d recommend being aggressive about treating, i.e., surgically, or if there are other approaches I should consider. As it’s been presented, my options are surgery or wait-and-see. And it’s still unclear whether or not my ankle is contributing to my lower back pain.
I’d also very much appreciate a recommendation for a specialist in NYC.
Best regards,
Aaron
From what described, it’s unlikely you’re getting back pain from your ankle. While it’s possible, I would expect you to have more symptoms coming from you ankle. Split tears in the peroneal tendons as well as subluxating peroneal tendons are an easy fix surgically, but it doesn’t sound like you’re having symptoms from it.
Thanks for responding! It’s difficult for me to determine whether the symptoms I’m experiencing can all be directly attributed to my ankle, or whether they’re an artifact of my back pain, assuming the back pain isn’t attributable to the ankle. The symptoms that bother me are all on my left side (same side as the split PB and back pain). I would describe them as: (1) perceived lateral instability of the left ankle during certain sports (e.g., I handicap my left leg while skiing due to the levered lateral forces), (2) a slight imbalance in my normal day-to-day body mechanics–my left leg feels less “springy” than my right as though my knee almost locks and is a bit peg legged during my stride, and (3) occasional stiffness in my left knee and soreness in my left glute med/min and piriformis.
My gut tells me the severity of these symptoms don’t outweigh the risks of surgery. However, I’d be curious to know if you are aware of any data that indicates whether surgery earlier on saves the PB from trauma/degradation over time, even if symptomatically the patient is fine. This is all to say, if symptomatically my ankle is worse in 30 years, will I have wished I got surgery now as opposed to then?
Nick,
Your Piriformis article isn’t working. I was hoping to send it to someone. Thanks and keep up the great work!
Thanks Golden! Can you send me the link? I’m not sure which one you’re referring to
http://www.drnicksrunningblog.com/category/injuries/piriformis/
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Dr Campitelli, I am a runner in Maine, who is 8 months post op Haglunds resection. I am slowly returning to running, but have a lot of pain still. Have you had runners return to the sport after this surgery? Am I trying too much too soon? Right now my limit seems to be 3-4 miles at a time.
Hello
My name is Ivana and I am seasoned writer who is passionate for writing.
I noticed your unique website and I would love to be a part of your community. Here are some topic ideas I can write about that I think will interest your readers:
1. 5 Wearable Devices Set to Change the Way You Run/Exercise/Swim/Hike
2. The Latest Trends in the Sporting Industry
3. What are the Best Running Shoes you Can Find in Expos
Please note, the article will be written exclusively for you website. Also I can incorporate some video in the article regarding the theme you will choose.
Which of these topics do you like? I can always send some more ideas if none of the above interest you or maybe you have an idea I could further develop.
Let me know what you think!
Thanks,
Ivana
I’ve followed here for a while and am a minimalist shoe runner. I’m also a PT but have been off for many years and all experience being in Neuro rehab. That said I’m recovering from cuboid dysfunction as a result of the last half marathon I ran which was hillier than anticipated causing my form to be altered. I’ve been manipulated by my chiro and was using tape. I’m trying to slowly get going again but I’m not quite sure what a proper protocol is Help!
Hi Dr Nick!
I’ve had flat feet for years (I’m 30). 2 years ago I had them “corrected” using the vilex system.Tendon plasty.Do you think the implants will affect my ability to run in minimalist? Or do you think by strengthening the foot it will only help?
Many thanks!
Hi Dr. Nick,
I am runner, but I also am a rugby player and soccer player. I am in the process of transitioning into a zero drop running shoe. I am in the market for some new soccer cleats. What are your suggestions on what I should look for in a cleat?
Hi Dr. Nick,
I came across your blog when searching for information on sesamoiditis. I’ve been suffering with pain for almost a year trigger by lots of hill running while pushing a stroller and a lot of HIIT cross training. I’ve been through steroid injections, MRI, a boot, carbon fiber insert and now orthotics. I was having some improvement and able to ease into small, slow runs in Altra Paradigms, but orthotics make them slip on my heels. I have since tried Hoka, Altra Torrin, and Topo Magnify all to no relief of pain and some making it worse. I’m starting to learn more about natural midfoot strike vs heel strike for many injuries, but is that possibily making the sesamoid hurt more now? I previously have done several marathons in traditional NB with no problem. I love the minimalist idea, but is it not for me right now?
Hi Dr. Nick!
I wanted to show you my new product that I think is great for runners. Please check it out
Hello,
I’m a Bloggers Outreach. I’ve contacted you to get information. What is the cost of posting on your site? If you have more sites, please send me a list with post prices. Identify prices at the same time with full discounts for time savings. Let us know as low as possible. We have many regular clients, We’ll add your site to our daily list and show it to our clients and give you regular posts in the future.What is the post price of this site?
My requirement.
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I have plantar facilities and as well hip and back pain. Skechers shoes for heel pain are the best! I can walk in the sandals for hours without pain. They are well worth the money. I wish they could design some nice low heel pumps. If I had those, my feet would be in heaven.