Leo DiCaprio with a Cane!

Did you recently see Leo walking around with a cane? Apparently he was showing his architect a design and wound up popping a few ligaments, spraining his ankle. Besides his upcoming premier of The Wolf of Wall Street, DiCaprio doesn't seem to be phased of his ankle injury. Luckily he looks pretty good, even with a cane!

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So how do you sprain your ankle? Well, just as DiCaprio experienced, it's caused by stretching or tearing one or more ligaments on either or both sides of the ankle. Many patients are seen in the winter with ankle sprains due to weather related injuries and of course a plethora in the spring as kids are starting up their sports and running starts up again with the warmer weather.

In order to prevent ankle sprains:
- always wear proper footwear
- warm up prior to exercise
- carefully run or walk on uneven terrain

Treat ankle sprains with RICE therapy- Rest, Ice, Compression and Elevation. If you are experiencing pain or swelling even a week after the incident, give our office a call! We are accepting new patients in both our Blacksburg and Troutville (North Roanoke) offices!

Are You Wearing the Wrong Shoes?

Tone It Up (#TIU), a website dedicated to educating people on fitness and nutrition, features a member of their "community" every Tuesday. One of the questions the TIU team asks the members on the feature is "Did you have any setbacks along the way? How did you overcome them?" A recent members response is as follows:

"I did actually have a pretty big set-back. In May 2012, I ran the 500 Festival Mini Marathon, but I ran in the wrong shoes (minimalist shoes). Shortly after finishing, my left foot began hurting badly. I went to the doctor and found out that I had two stress fractures in my foot, which forced me to stop just about all types of exercise for several months. I've just recently reintroduced running back into my routine. Even though it's been over a year, still bothers me. Now, I'm a huge advocate for making sure people wear the best shoes for their body!"

As this member states, you do need to find the best shoes for YOU. A doctor or shoe salesman can't say, "this is the perfect shoe for all runners, walkers, etc." Each person needs to be evaluated in a few different ways and seeing a podiatrist is the first step in a successful exercise regimen.

1/2 Marathon Training: Week One

My plan for the Hokie Half is to follow Hal Higdon’s 10K novice training plan. Once I complete this plan, I’ll move on to the ½ marathon plan. I decided to do this because once I started looking at the ½ training plan I realized it was not for my beginner status. This seems to be much more feasible! Here’s what was on the schedule for this week and how I completed each workout:

Starting on Tuesday my achilles tendon on both legs felt soooo tight (and still do) which started to stress me out. Yesterday, Dr. Kate and I were driving to Kendal at Lexington for a talk and I mentioned this to her and she said to make sure you rub the tendons, ice them after each workout and of course stretch. Stretching has definitely been put on the back burner (minus Monday since it was on the plan) which I need to make a priority.

All in all, I'm really happy with how the week went! I'm SO elated we worked out everyday- after work Monday through Wednesday and before on Thursday since we had a softball game that night.

½ Marathon Training: The Decision

April 20^th is the day I decided to start training for a ½ marathon. Lately I’ve been seeing a lot of
advertisements about the 1^st Hokie Half Marathon (and 5K) coming up in September and decided I need to push myself a bit. My fiancé, Kevin, and I are getting married in October and typically along with wedding planning is wanting to get in shape (hello pictures!).

My favorite part is the ½ is a few weeks prior to the wedding and it’ll give me more opportunities to de-stress! However, someone did tell me this is either the best decision I’ve made or the worst, so I guess we’ll find out!

Register!

So about my background of athleticism:

I played sports including t-ball, softball, lacrosse and field hockey from elementary school to my last year of high school. Once I left for college, playing sports was out of the question (too much of a commitment!). It crossed my mind having an intramural women’s lacrosse league at VT but there weren’t enough fields for that to happen.

Since then I’ve been working out on a very irregular basis. Now you know my background and reasons for signing up. This is the first post of the series I’ll be writing until the Hokie Half Marathon! Hopefully the next one on the schedule will be the Disney Princess Half Marathon!!!

Up next: 1/2 Marathon Training: Week One

Take It Easy on Those Resolutions!

We all love the new year, it gives us a fresh start, hope and motivation for what's to come. Of course, this is the best part of the first of the year, especially since most people's resolutions are to lose weight and workout. Good for you! We can't encourage this enough. BUT we do have some suggestions- ease into the workouts!! Don't go all out- completing circuits, diving head first into crossfit, running 8 miles right off the bat. This is how you get injured! Start off by heading to the elliptical or do some modified HIIT training on the treadmill (or outside if it's warmer than Southwest VA-brrr!) or even rotations on the weight machines.

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We are so glad you want to hit the gym- just be cautious! Here are a few common injuries by doing too much at once (over use injuries).

• Achilles Tendonitis- Symptoms of Achilles tendonitis include mild pain after exercise or running that gradually worsens, a noticeable sense of sluggishness in your leg, and episodes of diffuse or localized pain, sometimes severe, along the tendon during or a few hours after running. Other symptoms can be swelling, morning tenderness in the Achilles tendon, or stiffness that generally diminishes as the tendon warms up with use.
• Plantar Fasciitis- You may feel pain in the bottom of the heel, especially when first getting out of bed or after sitting for long periods of time. Usually the pain subsides but returns after spending long periods of time on your feet. Sometimes, it just hurts all of the time.
• Stress Fractures- Symptoms can include pain and swelling.

Don't be the person who says, "these won't happen to me" because they might and they're not worth it! 

People Running Backwards?

Apparently a new technique to avoid injury and to help recover from common injuries is to run in reverse. You might have tried this (by walking) on the treadmill a time or two to work your calves a bit more or even on the elliptical but this is suggesting flat out running backwards!

Some other benefits are:

• Burning extra calories (2.5% more body fat is burned)
• Sharpen balance
• Mix up daily routine

A study at the University of Milan (in Italy) “found that...the runners struck the ground near the back of their feet when going forward and rolled onto the front of their feet for takeoff. When they went backward though, they landed near the front of their feet and took off from the heels. They tended to learn slightly forward even when running backward. As a result, their muscles fired differently.”



Backwards Running!

Since running backwards causes far less impact to the front of the knees, it is a good option for those runners with knee complications.

Personally, I am going to start doing it a little. I like the idea that it decreases body fat by 2.5% versus running forward the same amount of distance! I do recommend running with a partner in case someone falls and hurts themselves. I see a bit more runners in our Blacksburg office versus our Roanoke office, and will keep it in mind to bring up to patients who seem to be interested in a challenge!

Dedicated to your healthy feet,

Dr. Kate Steklachich

Foot Surgery Impairs Marathon World Record Holder

Paula Radcliffe, winner of the 2007 New York City Marathon, photographed at mile 14. (Photo credit: Wikipedia)

Paula Radcliffe realizes she may not be able to continue her elite running career as she recovers from complicated foot surgery. The marathoner had to withdraw her position in the 2012 Olympics because "Radcliffe had so much cartilage damage in her left foot that her bones were rubbing against each other..."

This was Radcliffe's dream to make an appearance in her home country. "In August, she had three operations on her foot, including a bone graft to correct a stress fracture. She’s still not back to running, though she hopes to do light sessions before Christmas."

Radcliffe has such a fascinating career, that unfortunately might be behind her:  She's won the London Marathon three times, the New York City Marathon three times and even the Chicago Marathon once.

Outrun Injuries

Zurich Marathon (Photo credit: Wikipedia)

If a nagging ache is keeping you off the treadmill, track, or trail, the fix may be in your feet. Research recently published in Medicine & Science in Sports & Exercise found that runners who land on the ball of their foot are 40% less likely to have repetitive stress injuries than those who touch down heel-first.



"I don't recommend minimalist shoes if you have a history of chronic injuries or if you run extreme mileage. Runners can still run in adequate running form in regular running shoes, minimalist shoes aren't always necessary," Dr. Kate Steklachich, D.P.M.

Following the strategies listed to (slowly) switch up your strike:

• Touching down with a stiff leg ups the force of impact, so keep a slight bend in your knee
• Bend your back knee more than usual, and don't let your rear leg lag behind. This will help you take short, fast strides (aim for 165 steps a minute), lessening your injury risk.
• When your foot hits the ground, it should be aligned with your hip.
• Angle your foot slightly down and land on the outer ball of your foot, behind the second-to-last pinkie toes. After the front of the foot hits, let your heel naturally touch down, then push off your toes again to begin the next step.

source: Shape Magazine August 2012 Issue

Foot Problems? Get them in shape for summer!

Come learn ways to get your feet in tip top sandal shape for summer! Dr. Kate will give suggestions on ways to treat bunions, hammertoes and heel pain as well as running tips (are you a heel striker?) to reach your PR!!

Bring your questions and get answers!
No pre-registration required, this is a FREE event!

Running Advice from the APMA

Running and Your Feet

Nowhere is the miracle of the foot more clear than watching the human body in motion. The combination of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels all work together to establish the graceful synergy involved in running. The balance, support, and propulsion of a jogger's body all depend on the foot. But before entering a fitness regimen that includes jogging, don't forget to make certain your body's connection with the ground is in proper working order.

See Your Podiatrist

It is a good idea for a beginning jogger to visit a podiatric physician before starting an exercise program. Your podiatrist will examine your feet and identify potential problems, discuss conditioning, prescribe an orthotic device that fits into a running shoe (if needed), and recommend the best style of footwear for your feet.

Frequent joggers ought to see a podiatrist regularly to check for any potential stress on the lower extremities. During a 10-mile run, the feet make 15,000 strikes, at a force of three to four times the body's weight.

If you are more than 40 years old, see a family doctor before starting any exercise regimen. The doctor will perform an electrocardiogram, check for any breathing problems, high cholesterol levels, and high blood pressure before giving the go-ahead for a vigorous exercise program.

Anyone, regardless of age, should check with a doctor if a cardiac condition, weight problem, or other medical complication already exists.

The Importance of Stretching

Before beginning an exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.

Stretching exercises should take 5-10 minutes, and ought to be conducted in a stretch/hold/relax pattern without any bouncing or pulling. It is important to stretch the propulsion muscles in the back of the leg and thigh (posterior) and not forget the anterior muscles.

Some effective stretching exercises include:

•The wall push-up. Face a wall from three feet away, with feet flat on the floor, and knees locked. Lean into the wall, keeping feet on the floor and hold for 10 seconds as the calf muscle stretches, then relax. Do not bounce. Repeat five times.
•The hamstring stretch. Put your foot, with knee straight, locked, on a chair or table. Keep the other leg straight with knee locked. Lower your head toward the knee until the muscles are tight. Hold to a count of 10 then relax. Repeat five times, then switch to the other leg.
•Lower back stretch. In a standing position, keep both legs straight, feet spread slightly. Bend over at the waist and attempt to touch the palms of your hands to the floor. Hold the stretch for 10 seconds and repeat 10 times.

Proper Footwear

Shoe choice should be determined by weight, foot structure, and running regimen. Keep in mind that all shoes have a different shape, and sizes and widths are not uniform from shoe to shoe.

Consider whether an orthotic device will be placed in your shoe and whether your running style is flat-footed or on the balls of the feet. Shoes should provide cushioning for shock absorption and ought to be able to fully bend at the ball of the foot area. Visit the shoe store in the afternoon, when the feet are slightly swollen, and wear thick running socks when trying shoes on.

Training Tips

Systematic exercises must progress slowly from easy to rigorous to prevent debilitating muscle strain or more serious injury. The best and safest way to start a running program is with a four-day-per-week conditioning program for 12-16 weeks.

Begin with two sets of two-minute jogs interspersed with five minutes of fast walking. If muscles are stiff, walk only; have an "easy day" if you're in pain. As the weeks progress, gradually increase the number of minutes jogged per set to 20 minutes. Spend at least five workouts at each new level attained.

By the 16th week, you should be able to run two sets of 20 minutes each, with a five-minute walk before, between, and after. Make adjustments for heat and altitude, and don't be frustrated if you think your pace is too slow. Remember, a disciplined regimen will decrease your chances of injury.

Proper foot hygiene can also prevent injuries. Keeping feet powdered and dry is important, especially to the jogger suffering from blisters. Blisters can be prevented by application of petroleum jelly or creams to the places where they tend to occur.

Aches and Pains of Running

Even with the best preparation, aches and pains are an inevitable result of a new jogging regimen. If the pain subsides with slow easy exercise, you may continue, but if it gets worse, stop the activity and rest. If it persists, see your podiatrist.

The most common pain associated with jogging is known as runner's knee, a catch-all for jogging-related knee pain. One of the most common causes of runner's knee is excessive pronation, or rolling in and down, of the foot. Orthoses (arch supports -- shoe inserts) prescribed by your podiatrist are the best way to alleviate the problem. Occasionally, rubber pads in the arch of the shoe will help.

Shin splints, which are painful and appear at the front and inside of the leg, are caused by running on hard surfaces, overstriding, muscle imbalance, or overuse. Treatment includes changing running technique or insertion of an orthotic device in the shoe.

Running Tips

•Start easy and build up your distances slowly
•Don't forget to stretch regularly
•Use sport specific shoes
•Fit your shoes with the socks that you plan to wear during your running.