collapsing arch

Discussion in 'Ask the Docs' started by eddierogers2002, Mar 13, 2012.

  1. eddierogers2002 Barefooters

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    hi,
    so I have an injury and am seeking advice. I have accessory naviculars (flat feet) and valgus ankles. unfortunately the arch on my left foot has collapsed more than the right creating a leg length discrepancy and of course the left foot has planter fasciitis and metatarsel stress fractures to go with the collapsing arch. I am a competitive triathlete and have been running in minimalist shoes, vibrams, merrils, and invisible shoes. I'm reasonably fast in minimalist footwear (40 minute 10k at the end of an olympic distance triathlon so after the 26 mile bike and 3/4 mile swim in merrils and 1:30 1/2 marathon in vibrams). I built up all last summer peaked in september keeping up with a guy that does 36 minute 10ks uphill in our local running races but then i completely fall appart on the downhill (basically start limping.) It got to where I would run fairly fast times but be unable to walk for several days after any race over 6 miles. I stopped doing training runs in september and have only competed in about 3 races since: a five miler, a 10k, and a 5k all were pain free but I am afraid to start training hard again. I have been seeing a certified strength and conditioning specialist/ physical tharapist/ massage therapist. Every few weeks my pelvis tilts laterally due to the leg length discrepancy and causes me quite a bit of back pain (makes deadlifts almost impossible, and makes me squat funny.) The guy I have been seeing is very good at straightening me out and fixing my back, he also fit me for orthotics and gave me a pair of oversized super supportive shoes the brooks beast. I try running in these shoes but am extremely slow and get lots of ankle pain also I am very uncoordinated and trip over my feet (I'm also good at spraining ankles when I try to run in shoes.) I have spent the last few weeks trying to build up mileage completely barefoot, adding 1/8th of a mile every other day, I do live in a skitown in colorado so I've been running barefoot on snowpacked roads in february but have actually found it to be quite pleasant. I need to start training hard though, anyone have suggestions.

    Thanks,
    Eddie
  2. eddierogers2002 Barefooters

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    a little more information: I work as a lifeguard so last summer I was barefoot almost every day walking around on concrete, and transitioned to minimalist running fairly quickly, started running in march at 225 lbs in vibrams. ran an 1:35 half marathon june 5th also in vibrams but down to 195lbs limped for about a week with calf pain on the right side. ran in our local running series about 2 weekends a month all summer did a few more half marathons with less limping and faster times. until september I was down to 175lbs and very fast but i would get hurt on every competitive run it seemed(calf pain, arch pain, and metatarsal pain). Over the winter I have mostly been doing strength training which I do barefoot but have been lifeguarding in orthotics, am back up to about 190lbs. last weekend I did a pentathlon (alpine skiing, snowshoeing, skate skiing, biking, and running.) The run portion was 5 miles that I ran in merrils, I felt slow like I was running on wooden legs but had no pain afterwards. I have been wearing my merrils at work every since and my legs feel great (had some ankle pain with the orthotics) but it feels like my arch is under strain so i'm afraid to really run hard.
  3. rickwhitelaw Barefooters
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    Hi Eddie,
    I am not a doc, just a concerned runner (and also a skier), the most obvious suggestion is to stop competing. You have good speed and probably placing at races, but you need to ask yourself if it is worth the injuries. You have got a lot of things going on, so it might be the running, it might be many other things. Back everything off and try to pinpoint where the problems are coming from. Also, the weight fluctuation is concerning. That is a lot of weight to lose and then gained back in one year. Your body might be having a hard time adjusting. Good to see that you are barefoot running. I think it will help, and if you found running in the snow "quite pleasant", you will really love it when it warms up. Take things slow of course. Good luck and hopefully some of the docs or more experienced runners will give you some tips.
    Rick W.

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  4. Barefoot TJ Administrator
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    Dr. Andrew should be by shortly.

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  5. jldeleon Barefooters
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    Just wondering -has anyone ever had you add arch exercises to your physical therapy regimen?

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  6. eddierogers2002 Barefooters

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    I do towel pulls and trace the alphabet while holding a marble with my toes about twice a week.
  7. eddierogers2002 Barefooters

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    any suggestions as to the frequency intensity and duration of these arch strengthening exercises and should they be done on the same day as my barefoot runs and before or after
  8. eddierogers2002 Barefooters

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    I'm very curious to find out whether the orthotics are good or bad. It seems to me the positives would be that they allow my foot to rest while not being actively trained, and they train my foot to hold its proper shape. The negatives are that my feet already feel weaker, less painful but much weaker, and going back and forth between orthotics in a raised heel shoe and minamalist shoes or completely barefoot can't be good for my calves. I'm betting they shorten while wearing shoes and get strained when I go barefoot. last year I was either barefoot or in minimalist shoes all the time which probably caused some overuse type issues. Does anyone have experience with this?
  9. jldeleon Barefooters
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    My naturopath suggested the "o" word (orthodics) to me the other week, because...my left foot is overpronated...because...my left arch is weak. It has been at least since I was 14, when my chiropractor prescribed a shoe lift for one of my feet.

    My ND is a minimalist runner and so understands my "need" to be barefoot while exercising. He said he would only want me to wear it when I was not exercising. And, like you, I suspect that may cause additional issues, switching back and forth and all -but also depends, in large part, on how much of my time I split between exercise/non-exercise, which as things stand now, varies greatly from week to week.

    My instant reaction, when I heard "weak arch" was to look up arch exercises and do them, to see if I could make a difference that way. It's been 3 weeks and I have definitely noticed a distinct difference in how my muscles on the entire left side of my arch/foot/ankle/calf/abductors/glutes/even my quadratus lumborum, when I do my exercises, when I walk, and when I run. However, it will take months before I will be able to see the effects on my over-pronation.

    I've always thought of the hip as the "source" of all imbalances in the body, but as he pointed out to me, (what should have been obvious to me), we STAND on our feet -basically inferring they are of at least equal importance to the imbalances in the body, perhaps moreso. Hence, my intense suspicion of my arch.

    And...interestingly, I fractured the outer edge of my left foot when I was 12. I suspect that this is how my weak arch began, setting off a chain reaction of imbalances all the way up the left side of my body (my hips are twisted horizontally, vertically, and flared in different directions) that then naturally reinforced the weakness in my arch. Since I was 12, I don't recall if the doctors had me do strength exercises after 6 weeks of having a cast on. Though, even if he did, what 12 year old would ahere to those instructions anyway??? :)

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  10. eddierogers2002 Barefooters

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    wow i think we have a very similar problem. I broke my left ankle when I was 19, was running and stepped in a pothole, i didn't know it was broken so i just ace bandaged it and limped around for a couple of weeks, it still felt weak so i went to the doctor found out it was broken but had already started to set. The doctor said it wasn't perfectly lined up but was close enough that it wasn't worth rebreaking to fix. He gave me a boot and sent me home.

    About a year later I sprained the same ankle again, went to the doctor and was diagnosed with a grade 3 sprain to two ligaments on the outside and given a boot. Another year passes and I'm way over weight about 260 lbs so I decide to start running and working out. A couple of weeks in I sprain my left ankle, ace bandage it rest a couple days, feel good go for a run sprain other ankle, repeat 2 or 3 more times. Eventually I got mad and wrapped both of my ankles in duct tape and ran between 5-12 miles everyday like that for the next two weeks. And continued to wrap my ankles while running for the next few months. Over about 3 months I lost 80 lbs through running and lifting.

    I got down to about 180 lbs and slowed way down on the running for another 9 months or so then started back up with just running, no lifting, and I ran allot often 3 times a day and up to 120 miles a week. I went from 180 down to about 155 in a few months, at which point friends and family started telling me I was too thin and looked sickly, basically I looked like a lot of runners. I wore out my running shoes and started just using sneakers, then switched to sandals and figured out i could run faster and was way less injury prone (ankle sprains) . Then I completely stopped running and gained back up to about 260 over the next couple of years at which point I started lifting and dropped down to about 240 in about a year, I then decided to start running again but was plagued by horrible ankle pain in both ankles so I had to stop. Kept lifting for another year dropped another 20 lbs, gave vibrams a try, like an idiot went out and ran 3 miles, calf pain for two days, ran 5 miles, 2 more days of pain, ran 5 miles again, no pain, ran 7, pain, continue pattern. Join triathlon club, buy road bike, wetsuit, and merrils (five fingers take too long to put on in a triathlon,) ex fiancee stops having sex with me. Run injury free for a couple of months, run 1/2 marathon in vibrams, notice knot in my left calf at mile 8, doesn't seem to effect my form or speed as I come in @ 1:35 and feeling great except for the knot in my calf, the next day I am barely able to walk, my left knee buckles when I put weight on it. Next day same story, get permission, or rather get told to supervise the lifeguards from a chair. That night I try riding my bike as I'm already signed up for a race the next day, no pain on the bike! but afraid of what might happen if I have to put my foot down. Next day I win my category in the mountain bike race. Still limping.

    I was finally able to run again the next weekend but didn't think it was wise to do a race so I skipped the cog run. The following weekend I did a duathlon the first 5k in vibrams and the second in merrils, both were around 20mins. I kept training and racing pain free in smaller races but had problems with the longer ones. I switched to the vibram bilikas and experienced lots of metatarsal pain after a few races as well as some heal pain (pf). switched back to my treks and had no issues, also no metatarsal issues in merrils but some heal pain, rested it and was able to successfully train for and compete in my "A" race at the end of the summer: an olympic distance triathlon in which I did fairly well and experienced no pain during or after.

    From there it was all downhill, I did nothing the week after the triathlon and then raced a four day stage race the following weekend, ended up middle of the pack with better finishes the second two days (road slowly in the TT, got dropped in the first crit, finished decently in the road race, and finished with the pack in the second crit.) The next thursday did a trail run in invisible shoes, after not running since the tri, I felt great and hit it pretty hard even going barefoot for about a mile but keeping my shod pace (bad idea, i learned that in a later run.) I had some heel pain that night but not too bad, that saturday I did a trail race in invisible shoes, it was a 7 mile loop to the top of a hill 2000 ft maybe, I held second place to the top of the hill, on the decent I was dropped to sixth and had considerable calf pain with every step, the next day I felt like I did after the first half marathon but with pf pain that would almost drop me to the floor added. Thats when I got my orthos and immediatly twisted my pelvis during a deadlift.

    I recovered and moved to more winter and foot friendly activities for the most part only running in three winter races all pain free. I did a couple months of adaptation and rehab type work, a couple months of hypertrophy work, and I'm a month into strength training which will be followed by a power and speed phase and then an endurance phase. So at this point I've been doing some running over the last month, did a sprint workout in a couple feet of snow (thought it would be a good running specific strength builder) and I've been building my barefoot mileage slowly but i need to start going hard was hoping to start into some hill repeats and weighted runs.

    A problem I have is that the guy that fitted me for my orthos has ordered I only work out with them, and he works at the same gym as me so I have to sneak around to workout barefoot, and apparently he is applying to be our triathlon clubs running coach this year. Also he is teaching me the olympic lifts so I can build more power and makes me do them shod so I'm doing part of my lifting barefoot and part in orthos.
  11. migangelo Barefooters
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    fire him then.

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  12. jldeleon Barefooters
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    Yep, fire him then. Any barefoot friendly docs in your area? We do have a map that shows where barefoot friendly docs are.

    I think you should ditch the shoes completely when running. I have Vibrams - the bikilas - and I wear them only for work now. Even then, I get weird (calf and heel) pains from them occasionally. The ONLY time I incurred a semi-serious injury was when I ran with them. I have not had a serious injury since I've been barefoot. And when I need to wear something due to it being too rough or too cold, or on an unfamiliar route, I wear huaraches. I have not had any problems with them -no weird pains. I also wear them when I am not at work to go into restaurants, etc. where I know they are going to tell me to wear shoes. Or when I don't want to embarass my husband. :) Lol.

    In my opinion, I think you need to take a good couple of months off of ALL exercises and let your body "settle" so that you (and your future doctor) can better assess where you are really at -without interference from all the other variables caused from running, etc.- so that they can then plot out a better course of action for you. Since you are obviously extremely competitive this will obviously be torturous for you, but I think it's very important that you do so if you intend to recover.

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  13. DNEchris Chapter Presidents
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    I agree with Jen's advice about resting - I also sent you a PM Eddie!

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  14. eddierogers2002 Barefooters

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    but he's so good at fixing my hips
  15. Dr. Andrew Klein Barefooters

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    Eddie,

    You have a lot going on! I don't have the answer for you that will solve all your problems. I'm going to give you my "folksy wisdom" speech. It seems to be the only thing that a few of my patient's will listen to, and then not always. First, you don't need to start training hard. You need to start healing hard. You are heading for a world of hurt. You need to slow down. If a race causes you to not be able to walk for days afterward, that race was a bad thing.

    I'm not going to go back through your timeline, but it sounds like you have had 100+ pound weight shifts in a matter of two years all while powerlifting, competing through pain, and generally beating the crap out of yourself and not taking the time to heal. Your body is telling you that you are doing too much. You are refusing to listen.

    I drive an old jeep. I like it because it is loud, bouncy, and my wife won't drive it. A couple years ago, I heard a loud crunch when I hit a bump. I couldn't find the offending piece but it continued to make the noise when I hit a bump. It was telling me something was wrong. I wasn't doing anything about it because I couldn't see the problem, though I knew it was there. Eventually the problem presented itself as a broken sway bar link. The sway bar keeps a car level as it goes around a corner, quite important for an old bouncy Jeep. Dangerous when it is not functioning. It had to be fixed or I risked a rollover. I fixed it.

    Something in you is broken. You are risking a rollover. I do not think the orthotics are the answer, but I am biased. I didn't fix my Jeep by taping the piece together to support it. I rebuilt the piece. It was difficult unsticking rusty bolts that were tightened 12 years before. It caused me pain and frustration and loss of knuckle skin. Find a barefoot friendly doc and start there. Rebuild your pieces. Come up with realistic training goals for this season while you heal, and hit it hard in competition next season.

    I hope that you take this message seriously. I present it to you with no sarcasm. I am serious about seeing people heal, even myself. That little piece of blue tape on my left heel in my profile picture was due to Achilles Tendonitis after pushing too hard in a race. I was off for two weeks for a little heel pain, treating it the whole time. Take some time for your body. Don't destroy your temple by smashing in the foundations.

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  16. migangelo Barefooters
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    Eddie,

    you're here asking for advice and it's been given. you yourself know what this guy wants you to do doesn't feel right for you yet you're doing it anyhow. listen to your gut. it tends to be right. do you want to live a long life full of exercise or be constantly broken down from your hard races? the choice is yours.

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  17. jldeleon Barefooters
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    This is why I love my naturopath. He trusts that I know my body at least as well as he does, and in some ways more. It doesn't mean I don't follow his advice, but when I say something is not working, he supports my decision and would NEVER put pressure on me to do something I didn't feel was right.

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  18. jldeleon Barefooters
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    Dr. Klein,

    I LOVE you analogy!

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  19. eddierogers2002 Barefooters

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    thank you for your help, so where I'm at is I knew I was injured last fall, and basically have taken the last 6 months off. switched to mainly strength training no running, swimming once a week and riding my bike on the trainer also about once a week, and started learning to skate ski, also one session per week. I did see a podiatrist a month ago, and the diagnosis was bleak, told me I should never run again, and probably need surgery. I'm an uninsured lifeguard single parent, and running saved my life and is my life. Also I've been told that I may have a real chance at going pro in triathlons. The single most valuable piece of property i own is my triathlon bike. I would very much like to see a barefoot friendly doc but cannot afford it. I am hoping to find someone with the same condition who has been through this, I found a picture of someone with this condition:
    that isn't me but that is the same problem I have. What I'm looking for is something to the effect of roll out your calf and arch for x minutes y times per week. do these exercises z times per week and use the orthotics at these times. do the barefoot runs after this warmup, do one very short but intense track workout per week in order to keep my edge (or actually rebuild it at this point.) something like that would make my day.
  20. eddierogers2002 Barefooters

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