Banish Foot Pain Now Learn How to Master the Tibialis Raise

What do you do on a rainy day in the summer with the family at home? Go find a great music concert! Check out Summer Jam at the Buskirk-Chumley Theater in Bloomington, IN. Rock out and dance the night away at this family-friendly show with loads of great music and talent. If you have painful bunions on the other hand, you may not want to step foot on a dance floor period. We don’t want our patients being hindered by foot pain, so here are some easy bunion exercises that you can do right at home.

Start by sitting in a comfy chair with your feet flat on the floor. Place twenty marbles on the floor and use your toes to pick them up one by one and drop them into a bowl next to your feet. Place a golf ball under your foot and roll it around underneath for a couple of minutes to help with cramping and foot strain. Massaging your foot with a frozen water bottle is also effective. Next, point and then curl your toes under ten times in a row for a good toe stretch. Bring one foot up over to rest on the other knee and gently stretch your big toe back into proper alignment. Hold it there for ten seconds and then repeat this four times on each foot. Now, wrap a towel or resistance band around your big toe and press down with your toe while you pull back. Last, press your toes flat against a wall to flex and stretch them. Hold the position for ten seconds and repeat several times before switching feet.

Bunions are often progressive and will get worse if you don’t care for your feet. Do these bunion exercises at home, wear good, supportive shoes, and see us if your pain persists. Contact Kevin J. Powers, DPM for conservative treatment options that will keep your feet healthy and pain-free on the dance floor, and all day long. Call our Bloomington, IN, office at (812) 333-4422 or use our contact page online to reach us.The moment one study links a certain movement pattern to a particular running injury, another study will come along and conclude there is no link at all. Such contradictions serve to strengthen the argument that although we all run, our individual physical and psychological makeup means that our bodies can react differently to the associated strains that running brings.

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It therefore often falls on coaches and therapists to use successful experiences they have with one runner as a potential way to help another, whilst avoiding the temptation of labeling any one strategy as the ‘magic bullet’ that will help everybody.

A good example of this is a strategy that frequently helps some runners (not all!) get over ‘ITB Syndrome’, the common pain on the outside of the knee where the Iliotibial Band (ITB) inserts on the lateral condyle of the tibia.

If when landing your foot/feet cross over this middle line, you are said to possess a cross-over gait, in other words a very narrow running gait.

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An example can be seen in the diagram below where the midline is on a treadmill. For each foot placement, both the left and right foot can be seen to cross the midline.

It is important at this stage to note that not all runners who experience ITB pain run with a cross-over gait. Likewise, not all runners with a cross-over gait suffer from ITB pain.

However, clinical experience does show that runners who are suffering from ITB pain and possess a cross-over gait can benefit from following a suitable ‘gate-widening’ program. In many cases, the pain is reduced if not eliminated.

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A study by Meardon et al. (2012) titled ‘Step Width Alters Iliotibial Band Strain During Running’ assessed the effect of step width during running on factors related to ITB syndrome. Fifteen recreational runners ran at various step widths including their preferred width, +5% of their leg length and -5%.

The study concluded: ‘increasing step width during running, especially in persons whose running style is characterized by a narrow step width, may be beneficial in the treatment and prevention of running-related ITB syndrome.’

This is where most articles would present you with a tidy table showing you which muscles you need to ‘strengthen’ and which muscles you need to ‘stretch’.

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Hip weakness is indeed linked to many running injuries, although the exact mechanisms of injury remain unclear. The gluteus maximus and gluteus medius are in particular regarded as key players in controlling the degree of hip adduction (leg moving inwards towards midline) and internal rotation, with poor control of these thought to lead to increased stress on joints, ligaments, and tendons.

Though a program of ‘strengthening’ certain muscles and ‘stretching’ others can lead to the targeted muscles becomes stronger or more mobile, experience and research shows that there is not always a sequential ‘carry over’ to when you are running.

Those of you who have religiously followed a stretching & strengthening programme only to find the pain is still there are testament to this.

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The thing is, although anatomy books present muscles to us as individual units with origins, insertions and functions, real life movement depends on global organisation of the body as a whole. The roles of muscles can change drastically according to where the joints they work across are in relation to each other, time and space. Also, overlooking and controlling all of this movement is the brain.

Running is a cyclical motion, as we saw in this article . Every part of the gait cycle is a product of what came before.

How your right leg moves whilst it is off the ground (the ‘swing’ phase) will directly effect how it later moves when in contact with the ground (the ‘stance’ phase). Likewise, how your right leg moves during the stance phase will have a direct effect on how the left leg moves during its swing phase, and so on.

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So, although a cross-over gait is indeed typically accompanied by a drawing in of the leg in late swing phase, just stretching the muscles on the inside of the leg (adductors) and strengthening the muscles on the outside of the leg (abductors, e.g. gluteus medius) may not automatically stop this drawing in from occurring when you are out running.

In the same way, the excessive pelvic drop we often see on the opposite side’s supporting leg during a cross over gait will not decrease just because we integrate some hip hikes into our conditioning program.

I am just saying that in order for the brain to select a new way of moving (and stop feeling threatened by the overload that our current way of moving is causing), we need to practice the new movement within its true context – in other words, we need to practice it whilst running. This is the essence of gait-retraining (considered in more detail here).

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Gait-retraining has many forms and ideally involves you making a modification whilst receiving some form of external feedback, e.g. from a coach or a mirror.

Find a line (e.g. one that marks a bicycle lane) and as you run down it notice if your foot / feet are indeed crossing over it on each landing. If so, take 20 seconds to widen your stride just enough so your feet do not cross the line.

We need to be careful not to overload muscles not used to this new movement pattern so always start with short intervals. Specific moments within your easy long run would be an ideal opportunity to practice this.

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As we saw in the article ‘Introduction To Running Biomechanics, ’ for a change of habit to become permanent it is generally agreed that the process of change needs to pass through four stages – a structured journey that sees conscious effort evolve into unconscious competence:

Efficient distance running demands optimum use of all available energy so the ultimate goal is for the brain to be able to select the right movements at the right time without the need for any conscious effort, for as long as possible.

In re-distributing the forces associated with running, we have to be careful that the newly receiving muscles do not get too much too soon. They need to be given time to adapt to the new demands.

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This is where the strengthening and stretching exercises that are typically done can help as they will aid the muscle’s tolerance to these new demands.

Though the exact reason for many running injuries is still unknown, most will agree that the repetitive nature of running plays a great part.

To ensure that the same tissues are not receiving the same overload every run, we encourage variety – rotate different types of footwear, vary the type of ground surface you run on, etc. With this in mind, something else I advise people suffering from ITB syndrome is try not to always run in a straight line. Mix it up, thread to the left and right like a meandering river.

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Maybe not during a race (unless you are in pain in which case I do recommend you try it) and

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