ANSWER
The pain you are feeling under the ball of your foot could be metatarsalgia, which is inflammation of the bone under the big toe. This is normally caused due to overpronation of the forefoot on toe-off, or excessive forefoot pressure.
Asics Gel Nimbus is a well cushioned neutral shoe. If you overpronate, it may be worthwhile getting an anti-pronation shoe, which could offer you more support. The well cushioned shoe may be great for shorter distances but not necessarily for longer distances, depending on your biomechanics and weight.
To decrease the inflammation, an orthotic or plantar cushion could be made by a podiatrist to reduce the pressure under the first metatarsal head, or to reduce the pronation, which should alleviate the stress on the first metatarsal head.
Under the first metatarsal head, you have two small bones called sesamoids. They reduce the load on the first metatarsal head when walking or running. They can sometimes become inflamed, and this is called sesamoiditis. Again it would be best to see a podiatrist, who would be able to assess and treat this.
The best thing to do initially is to get your gait assessed. This way you will know whether you need a neutral, stability or motion control running shoe.
Modern Athlete Expert
NATASHA GALLOWAY
Podiatrist in private practice at Dunvegan Medical Centre in Edenvale, Johannesburg.
Are My Worn Shoes the Cause of Injury?
I joined a club and started running four months ago. I even ran a 10km in 64 minutes. Then I got flu and stopped training for two weeks. Since then I have been struggling with a sharp pain in my calf, on the inside of my legs next to the bone, halfway between my knee and ankle. It usually starts about halfway into a run, and gets so sore that even walking is painful. The pain subsides after a run. Later I barely feel it, but it is tender when I massage the spot.
I am 35 years old, 1.61m tall, weigh 71kg and am trying to lose weight. I run 6km three times a week with a rest day in between. I wear Asics stability shoes, but I know I need new shoes as this pair is about four years old!
I don’t want to change too many things at once as this might aggravate it. Do I need to adjust my distance and pace, or do I need good old fashioned rest and a pair of new shoes? – ELANDA LOUW
ANSWER
The two deep muscles on the inner side of your calf next to the bone are called tibialis posterior and soleus, which can cause pain in runners who tend to overpronate.
These muscles are overused when running with old shoes which don’t give your feet the stability and support they need. This leads to weakness and/or excessive tightness in the calves and shin muscles. It may also lead to chronic compartment syndrome, a condition when some muscles in the lower leg expand so much against a sheath covering them, that it compromises nerves and blood vessels running through them. This may cause cramp-like pain and even lead to changes in the sensation of the soles of your feet. It may also lead to shin splints or tibial stress fractures when left untreated.
These conditions can be prevented and treated by:
• Buying new stability running shoes every 800-1000km.
• Proper warming up and stretching of the calf and shin muscles to maintain optimal flexibility.
• Alternating sides of the road when running as the camber may cause one leg to work harder.
• Correcting imbalances in your shin and calf muscles.
Try aqua jogging, swimming or cycling for a while and go see a sport physiotherapist for deep tissue massage and/or dry needling.
Buy new shoes before returning to the road and always halve your distance for the first week’s running after a rest period of two weeks and more. Increase your time and distance gradually by about 10% per week after that, and ice the painful area for 10-15 minutes after each run to decrease inflammation and pain.
If the above conservative treatment fails, go see a sports physician for compartment pressure testing to confirm the diagnosis and possibly to perform a surgical procedure to relieve the pressure.
Modern Athlete Expert
DAVID VAN WYK
Sport physiotherapist with private sport and orthopaedic practices in Elarduspark and Faerie Glen, Pretoria. David is a sub-45min 10km runner.
Novice on the Block
I have never run the Two Oceans Marathon before. Do I need to have a permanent license to register and do I need to belong to a club? What is a good qualifier for a beginner and is there a training programme I can follow to prepare? Currently I’m doing 40km-50km per week, but my longest distance thus far is 15km.- DU TOIT VAN DEN BERGH
ANSWER
Yes you will need to join an official running club and get your road running licence. To train for “Oceans” means you are becoming a serious long distance runner and you will benefit enormously from the structures that are in place at most established running clubs. Clubs of this calibre will have tried and tested training programmes that you can work to. You will need to get your weekly distance up to about 90kms with your long runs on the weekend moving steadily longer and peaking at about 45km. You will need to qualify on a standard marathon and there are some relatively easy events on the calendar. Two marathons that you could consider are the Johnson Crane at the end of January and the Sasolburg Marathon in mid February.
Good running clubs usually have extremely competent Club captains and you will find that these folk are very willing to help and advise new runners.
Good luck with your training and welcome to a wonderful sport. Who knows, after running the Two Oceans maybe the Comrades will loom large on the horizon.
Modern Athlete Expert
BARRY HOLLAND
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