2644: Running Pains - Avoiding Injury and Preventing Knee Pain & Plantar Fasciitis When Jogging

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[00:01:08] episode 2644. And I'm Dr. Neal Malik. Hey there, happy Friday and welcome to another Q&A edition of Optimal Health Daily where I answer your health questions related to fitness, diet and nutrition and lots more. You send in the questions and I answer them for you.

[00:01:25] Oh, and if you do send in a question and you're in the US, we'll mail you a copy of our hardcover workbook. If you're outside of the US, we'll email you a PDF version. Now what's the easiest way to

[00:01:38] send in a question? Just email it to health at oldpodcast.com. Now today's episode and next week's Q&A are going to be kind of a two-parter. Today, as you'll soon hear, is going to be all

[00:01:52] about preventing running injuries. Next week, we'll talk about how to properly fuel the body while going on those longer endurance runs. So with that, let's hear today's question as we optimize your life. Hi, Dr. Neal. I love your podcast.

[00:02:12] A question I have is I recently got into running. First though, I developed plantar fasciitis, which took me a little while to recover from. Now I have some knee pain, so I'm taking a little

[00:02:25] break till that feels better. But I want to know how I can run safely and avoid injuries while still doing significant mileage. I am going for a half marathon. So those kind of numbers and how to avoid plantar fasciitis, knee pain and other common running injuries. Thank you.

[00:02:50] Thank you, Jekko, for listening to the podcast and taking the time to send in your audio question. As someone who once experienced the worst case of plantar fasciitis I've ever had, I can absolutely relate to that part of your question. So I'll start there. I'll share some

[00:03:07] of the knowledge and experiences I gained as I sought the advice of experts and went through the healing process. So let's start by talking about what plantar fasciitis actually is. Plantar fasciitis is a fancy way of saying that there's inflammation happening in the foot.

[00:03:23] The itis in plantar fasciitis is a fancy way of saying inflammation. Plantar fascia is referring to a specific part of the foot. Across the bottom of the foot, we have this long band of connective tissue that's referred to as fascia. This fascia or connective tissue

[00:03:42] connects the heel to the toe and this fascia is located on the bottom of the foot or the plantar area. Just like any connective tissue in any other area of the body, the fascia can become inflamed.

[00:03:56] Now besides connecting the heel to the toe, the plantar fascia also acts as a shock absorber. So when you walk or run for example, this connective tissue on the bottom of your feet helps maintain the arch in your foot and absorbs some of the impact. But sometimes,

[00:04:13] little tears can happen in the fascia which can lead to inflammation. I should also mention that many times, plantar fasciitis can happen for unknown reasons, meaning you weren't doing anything out of the ordinary but for some reason, you wake up with plantar fasciitis. Now speaking of waking up,

[00:04:31] plantar fasciitis pain is usually worse in the morning. That's exactly what happened to me in my case. One morning, I woke up with blinding pain in my right foot. I couldn't put any pressure on

[00:04:43] it. I felt like my foot was in a permanent flexed position and these are all common symptoms of plantar fasciitis. Alright, enough talk about what it is and how painful it can get. Let's

[00:04:54] talk about treatments and how we can prevent it. One of the keys to preventing plantar fasciitis is finding an appropriate shoe. Now the keys when looking for a shoe are comfort first and heel

[00:05:07] support second. The reason I spent so much time discussing the causes of plantar fasciitis is because if we know the causes, we can usually figure out what an effective treatment might be

[00:05:17] or an effective way to prevent it. So in this case, if we understand that the plantar fascia helps to act as a shock absorber then having more shock absorbing support in a shoe may help

[00:05:29] prevent a future case later. The problem when it comes to finding an appropriate shoe is that everyone's comfort level is different. So when you're looking for an athletic shoe, take your time and find something that actually feels like the perfect fit. I'm very picky about shoe comfort.

[00:05:46] I'm one of those people that has to try on like 10 different pairs of shoes just to find the right one. When I do find a shoe that feels comfortable, I usually wear them for a long time because I

[00:05:56] don't want to have to spend half a day shoe shopping all over again. But this is a problem. Wearing out your shoes to the point where there's very little heel and arch support can increase

[00:06:07] the risk of developing plantar fasciitis and this may have been what happened in my case. Now when I went to receive treatment, I made an appointment with a doctor that specializes in feet, a doctor of podiatric medicine which is a fancy way of saying a podiatrist.

[00:06:23] I think George Costanza on the sitcom Seinfeld called this medical professional a chiropodist. Chiropodist, podiatrist, they all mean the same thing. Again, a person that specializes in feet and ailments that affect the feet. So that would be the first person I would speak to

[00:06:40] if you have any issues with your feet, plantar fasciitis or otherwise. Now after running some tests and careful assessments, my podiatrist recommended that I begin using shoe inserts for more arch support. The podiatrist felt that a shoe insert that provided medium arch support

[00:06:58] would be most helpful for me. This is important. The amount of support the shoe inserts provide will make a huge difference when it comes to healing and preventing this from happening again.

[00:07:09] Some shoe inserts provide just a little bit of support and feel a bit softer. Others feel like you just slipped a wooden plank into your shoe. The one my doctor recommended was in between those

[00:07:21] two. So it's always wise to get the advice of a foot specialist so that they can determine what your needs are. Something else my podiatrist recommended was to periodically massage the fascia.

[00:07:32] Here's how to do it. Using both thumbs, press directly on the plantar fascia in the middle of your foot. Then while maintaining pressure on the plantar fascia, slide your thumbs to either edge of

[00:07:46] your foot. Imagine you're trying to flatten and spread the fascia using your thumbs to supply the pressure. Spend 5 minutes every morning performing these foot massages. Why in the morning? Because again, that's usually when plantar fasciitis flares up. Now what do we do about knee pain? In general,

[00:08:05] joint pain like knee pain can be reduced by following some general guidance. First, shoe support. Second, stay hydrated. Water helps to cushion the joints. Now you don't need to overhydrate but just try to avoid being dehydrated for long periods of time. Again going back to the comfort

[00:08:24] level of your shoes, yes this is important here. Also something to consider is your running technique. It's possible that your plantar fasciitis and your knee pain are related to the quality of your shoes but it's also possible that your knee pain could be due to your running technique.

[00:08:40] For example, if while running, your feet strike the ground with a lot of force, learning to soften that landing may help. Having a healthcare professional that specializes in assessing and diagnosing sports injuries like a medical doctor with a specialty in sports medicine

[00:08:57] or a physical therapist can help you get to the root of the problem. Please note, a massage therapist is not the same as a physical therapist. So if you decide to look for a physical therapist

[00:09:10] for guidance, be sure that physical therapy is their specialty, not massage therapy. It's possible that your body also may just need a break from the routine. So instead of running, consider performing different exercises or modifying the intensity or duration of your workouts. Maybe perform some

[00:09:29] lower impact activities like cycling for a bit until the knee and feet feel better. Performing exercises in a pool or in water or receiving hydrotherapy can also help. Also to avoid further pain, the American College of Sports Medicine recommends both cardiovascular and resistance

[00:09:47] training but with some modifications. Yakov, since you've already been running regularly, it sounds like you have the cardiovascular part covered. But as you perform your cardio, something else to consider is to avoid any jarring activities that may be hard on the joints like jumping moves,

[00:10:04] like box jumps and plyometrics. That's why cycling, especially on a recumbent bike, may help relieve some of that pain. If you can and haven't already, consider adding in some resistance training too.

[00:10:16] You don't need to lift heavy weights but aim for a weight that you can lift 10 to 15 times and instead of hitting just one body part each day, perform exercises for all the major muscle groups. This will prevent repeated stress injuries. And lastly, something that's really fascinating and

[00:10:33] something that many in my experience don't know, researchers have found that performing your cardio or resistance training at the same time every day can help minimize muscle soreness, discomfort and even prevent injury. So if you like to work out at let's say 9 a.m, try and stick to

[00:10:51] that 9 a.m workout as often as you can. Don't work out Mondays at 9 a.m, then Tuesdays at 3 p.m, then Wednesdays at noon and so on. Instead, make 9 a.m your official workout time. By working out

[00:11:07] at the same time every day, researchers believe it may help ease some of the pain you're experiencing. And I wish you all the best as you continue to heal! And of course, thank you again for taking

[00:11:22] the time to send in your audio question, Yucco! Now, if you want to send in a question to be answered right here on the show and get a copy of our workbook, you can email one to health

[00:11:32] at oldpodcast.com. Or if you want to hear your own voice on the podcast, just like on today's episode, come by oldpodcast.com slash ask. Right on that page, you can record straight from your

[00:11:46] computer's microphone. It's really easy. You can even play back your message and do retakes before sending it in. Or you can do it the old-fashioned way and call in your question. The number is 1-61-ILOVEOHD.

[00:12:00] That's 1-614-568-3643. Thank you so much for doing that. Answering your questions is my favorite part of the show. All right, that'll do it for another Q&A edition of Optimal Health Daily.

[00:12:15] Thank you so much for listening every day and all the way through. I hope you have a great start to your weekend and I'll see you back here tomorrow where your optimal life awaits.