Wednesday, April 9, 2014

Flexible Shoes Cause Running Blues

Here is another example of a running shoe that is too flexible. While not being one itself, the minimalist shoe movement has encouraged more mobility in running shoes. This patient is a recreational runner who runs several days a week. He developed achilles tendonitis and bursitis over the course of the last six months running with this shoe. Here is the picture of the ultrasound. The arrow indicates the micro tear in the achilles and bursitis.

Thursday, March 20, 2014

Treating Early

Bob Marley loved playing soccer. He had a recurring sore nail on his right foot that kept falling off that was thought to related to playing soccer at first. The nail bed was slow to heal. He was diagnosed with acral melanoma in 1977 and was advised to A. Have the toe amputated or B. have the foot amputated. The cancer was stage 3/4, the most deadly. Bob decided to let it be and then many months later have the lesion cut out and a skin graft placed on it. By the time the cancer had affected him physically it had already metastasized all over his body and it was too late to treat him. He died in 1981. If he had had at least the toe amputated on detection he would have extended his life probably for at least several years. A dark spot under the nail particularly in a darker pigmented person and particulary if it extends back to the cuticle is not something to be taken lightly.

Saturday, March 15, 2014

Nike Free not Always Mantle Worthy

The latest casualty on the shoe circuit is the Nike Free. A patient this month had pain on the outside of their foot at the end of his marathon. It turned out he had a tear on his peroneous brevis muscle that was visualized on ultrasound. I advised him to take 2 weeks off and reevaluate. He had trained without consequence in the shoe but reached a break point at race pace after mile 20. Stay tuned for how to detect injuries in real time with diagnostic ultrasound and you can see the injury.

Tuesday, February 25, 2014

Hype the Shoe, Take Two Aspirin and Call me in the Morning

So it's not just the minimalist shoes that get runners in my office. Here's the bottom lugs one the over-hyped Newton's. The idea here is it accentuate the "Pose" method or Forefoot running. I had a runner come see me yesterday who had been doing fine in the Saucony Ghost and was swayed into trying these out. The problem with the shoes is the crease line and lug distribution put a hot spot near the common location for a neuroma between the heads of the third and fourth metatarsals. She had not developed a neuroma yet but I saw swelling on my ultrasound that could develop into one if she continued with the Newton's. to much distribution to the forefoot. I told her to go back to the Ghost and and take some time to let the swelling reduce. Hype is what sells. Reality is the lesson.