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Put Your Best Foot Forward

Orthotics can be an important component to healthy jogging.
By
WebMD Feature

Where their running shoes are concerned, runners may need to think beyond the blinding myriad of colored stripes and swooshes. It's no longer just a question of shock absorbent gel or strategically placed air pockets.

When you're considering premium footwear to prevent injuries, sports medicine physicians say that orthotic insoles, or "orthotics" -- custom-made to support your particular feet -- may be the way to go, especially if your problems are connected to the type of foot with which you were born.

"There are foot structure issues that seem to have a relationship with lower extremity injuries," said Commander Richard Shaffer, Ph.D., of the Naval Health Research Center in San Diego, Calif. Shaffer and his colleagues have studied how foot structure is related to overuse injuries in Navy SEAL recruits during training. Their results were published recently in the American Journal for Sports Medicine.

Shaffer's team found that recruits with flat feet or high arches were more likely to suffer a stress fracture -- one of the most common injuries among runners -- than those whose arches have an average curve. His study could have bearing on the estimated 10 million runners in the United States, up to half of whom will experience some kind of foot injury.

But while orthotics may be the solution to the woes of some runners, the specialized insoles aren't a necessity for everyone.

Identify the Cause

Physicians first need to go beyond foot structure and hone in on the source of the problem, says sports podiatrist William Olson, D.P.M. Olson is President of the American Academy of Podiatric Sports Medicine and Podiatrist for the University of California, Berkeley athletic teams.

Identifying training errors -- which can compound the effects of an athlete's body structure -- is the first step in evaluating fitness injuries, Olson says. The most common training mistakes are cranking up the intensity, duration, or frequency of training too quickly; not properly rehabilitating old injuries; and failing to warm up and stretch adequately before working out.

The next thing to look at is the athlete's particular body structure and motion -- or "biomechanics" -- and how they may have contributed to the injury. Podiatrists use a simple examination technique: They watch their patients walk, both barefoot and in the shoes they use while training.

Even if the patient's foot has some biomechanical abnormalities, it could be the ground surface or the patient's shoes that are actually causing the problem.

"One fellow ran a marathon on a crowned highway, so one foot was turning in for 26 miles," Olson says. "To make orthotics for that person would be a mistake. I told him why he was injured and to avoid circumstances like that."

Worn-out shoes can cause similar trouble. Most people don't wear down their shoes perfectly evenly. As times goes on, the uneven wear causes the whole foot to tilt, and could lead to an injury.

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