A senior podiatrist at The Foot Practice, Timothy Maiden has been a practising podiatrist in Singapore since 2011. Prior to this, he was working in Cambridge and London – in England.
During this time, he has seen patients with plenty of foot related problems – including those of runners and other athletes.
COMMON RUNNING RELATED FOOT PROBLEMS
So what are some of the most common running related foot problems that he has seen as a podiatrist?
Said Maiden, 34, “This is one of the most common questions I am asked in my clinic. Runners face a broad range of conditions from bruised or ingrown toenails to plantar heel pain, chronic repetitive ankle sprains, medial tibial seres syndrome (shin splints) or even worse, stress fractures, as well as tarsal stress fractures and as far north as runners’ knee syndrome.”
Blisters, black toenails and corns are also other common problems that runners and other endurance athletes may experience during the course of their running journeys.
Said the podiatrist, “Blisters are a hugely fascinating area for me and I use a website by Rebecca Ruston for tips on these.”
He added “But lacing in a correct manner to minimise movement can stop bashing on the ends of the shoe and assist in reducing sheer. My favourite myth though, is that Vaseline helps prevent blisters; its doesn’t and it actually increases the risk of blisters. Corns are linked with excessive loading in a specific area; I suggest using foot orthotics to help redistribute the pressure and reduce the recurrence. And black toenails can be prevented by taping the toes and ensuring good lacing techniques.”
In short though, the list of runner related foot issues is pretty much endless, according to Maiden.
He said, “The list is endless but most of these conditions can be prevented if correct foot health is adhered to.”
MANY REASONS WHY THESE CONDITIONS OCCUR IN RUNNERS
Maiden feels that there are many reasons why these conditions may occur in runners.
He explained “I am finding more and more that improper preparation for running is the primary cause of many of the conditions. This could be, for example, suddenly increasing your running load, and increasing your body mass without gaining the muscle strength or starting running after years in the wilderness.”
The podiatrist also points out that many runners also often ignore small niggles and aches, which then can lead to bigger problems. He said “Most of us ignore it, when our body is trying to tell us there is an injury in the making; instead we think it as a niggle that we can run off. That’s a big mistake – we are often increasing the risk of injury by doing this.”
He added “Conditions such as Achilles Tendon pain have often been developing over long periods of time and by the time we take notice of the ankle stiffness in the mornings or the agony, it is too late.”
TYPE OF FOOT STRIKE DOES NOT HAVE ANY EFFECT ON RUNNING FOOT INJURIES
The type of foot strike, according to Maiden, also does not really contribute to foot problems among runners.
Said the podiatrist, “I have not seen any correlation in my clinic but I do read of others who have noted that different running shoes will increase risk of this injury or that injury. I am not convinced though, that increased forces of loading leads to increased stress which may lead to injury. The forces are pretty similar if you are a forefoot, mid foot or rear foot runner so it is an account of how these forces are dispersed in the body.”
He added “There is lots of publicity suggesting that forefoot running is better for you or rear foot running is more efficient but I think the jury is still out and the quality of research is often tailored to whoever is conducting it or the publication that is presenting the research. It is mostly dogma and people using anecdotal evidence and this is always dangerous.”
KEEP RUNNING PROBLEMS AT BAY
Nevertheless, to keep such running problems at a minimum, Maiden advises runners to speak to a running coach or specialist doctors.
He said “There are good certified running coaches out there, such as Coached. These guys will analyse your running and develop an algorithm for running. There are also physiotherapists and several podiatrists who can conduct comprehensive gait assessments and tests for body imbalances or weaknesses, which may be a precursor to injury.”
However Maiden points out that these issues are not specific to runners though.
He says, “I frequently see the same issues in both runners and non-runners but the cause of the conditions is different so the treatment plan has to be tailored to ensure effectiveness.”
RUNNING SHOES ARE NOT A CAUSE FOR INJURIES
However he feels that running shoes though, are not a reason for injuries.
Explained Maiden, “We have been sold a myth from the marketing departments of the shoe companies, however this is changing as the consumer wises up and follow science and research.”
He continued “Long gone are the days of a neutral shoe for a neutral foot and pronation shoe for a flat foot and so on. We now know that there is limited association between foot shape and pronation or supination, which would also suggest that just because you have a flat foot, does not mean you require a pronation control shoe.”
WEIGHT AND COMFORT TAKE PRECEDENCE WHEN CHOOSING A RUNNING SHOE
Instead, when choosing a running shoe, Maiden suggests that weight and comfort should be the most important criterion.
Said the podiatrist, “Pronation and supination are very difficult movements to measure so it is very subjective. Instead, the lighter the shoe, the better – this will tell towards the end of a long run or a race when the legs are tired; those extra ounces will start to get heavier.”
PICKING A SHOE SIZE
But for shoe sizes though, Maiden admitted that the old school principles still apply.
He explained “You should preferably buy the shoe at the end of the day as that is when the foot is the largest; as well you should expect the foot to swell slightly more after a run so having an extra centimetre in the shoe is often a good gauge.”
Doing minimalist running too, may also cause injuries, according to Maiden.
Said the podiatrist, “What if we are not using a running shoe though? As with minimalist running, it takes a long time to get used to it and requires lots of training to get used to it; most injuries occur when people go for example, from a 12mm heel pitch to a negative heel.”
He added “I still say, find a shoe that you find comfortable and try it or whatever works for you; just try to get out of the ‘barefoot walking’, maximalist, anti-orthoptics or pro this or anti that; dogma is dangerous in life and in running; try everything, keep an open mind and not everything works for all people all of the time.”
TIPS TO KEEP YOUR FEET WELL MAINTAINED
So generally what are some tips that Maiden can advise runners, in order to keep their feet well maintained at all times as they continue to engage in their running?
He said “If you have an ache on more than one occasion, you should see an expert. And change your running shoes when you notice compression on the EVA midsole.”
Continued the podiatrist, “And change your running route daily; not only will it reduce boredom but will ensure more thrills and you will reduce the repetitive loading on foot tissue and reduce injury risks. Also stop blaming over-pronation for your foot pain; start blaming your loading patterns… and not forgetting, moisturise your feet every day; they need love too!”
Maiden can be contacted at
67790660 (Rochester Park)
65322025 (6 Raffles Quay)