The Effectiveness of Foot Orthoses when Treating Runners with Lower Extremity Pain
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For those of us who have treated lower extremity pain in our runners, this article comes to no surprise. Running is very stressful, but its health benefits are undeniable. And while there is physical stress produced by speed, hills, terrain, shoes, and overtraining, the emotional relief of stress has runners seeking advice from health care providers routinely.
In my treatment of lower extremity injuries, I practice the Rule of 3 (which easily can become the Rule of 5). What is the Rule of 3 you may wonder?? In terms of treatment, the Rule of 3 means that you should treat an injury with at least 3 common therapies that tend to work. Let’s take an obvious pronatory injury like posterior tibial tendinitis or medial tibial stress syndrome.
The Rule of 3 tells us to correct the pronatory stress with good custom made foot orthotic devices and shoes in the stability or motion control categories. We already have 2 good treatments. Changes in training can also be huge and the 3rd option like running every other day, slowing the pace down when symptomatic, or avoiding downhills for a while. If we add icing while symptomatic on a daily basis, and gradually strengthen the posterior tibial tendon, now we are at 5 common treatments. Podiatrists love to stretch out any tight achilles found, or strengthen any achilles weakness found (these would be 6 and 7).
The moral of this story is that while foot orthotic devices make a huge difference when treating running injuries, this treatment should also be supplemented with other categories summarized here.
Categories of Treatment for Running Related Injuries:
- Custom or OTC foot inserts
- Shoe Selection
- Terrain Modification
- Distance Modification
- Speed of Workouts Modification
- Amount of Runs per Week
- Anti-Inflammatory Measures
- Strengthening involved Muscles
- Stretching Out Equinus Forces
- Bone Health Treatment (like Vitamin D deficiency)
- Other Modalities like shockwave, PT
- Even Short Term Cast Immobilization (like 4 hours per day to completely rest the area)
