Wednesday, May 6, 2009


"Suspected Mechanisms in the Cause of Overuse Running Injuries: A Clinical Review"; Ferber, Hreljac-Sports Health May 09".
This is not the first article asking the question, "What constitutes a normal foot?", & states, "minimal and conflicting experimental evidence supports excessive foot pronation as a contributing factor in the cause of injuries."
The bottom line is be cautious when recommending orthotics for your athletes with MTSS or PFSS. As far as I'm concerned, the majority of the time a customized felt insert works just fine. Things like training progression, work-rest intervals, variety, overall body strength/fitness, pelvic hip mostibility are more important.


JH said...

You seem to almost always hit on something that I happen to be dealing with.

Right now I've got a female former DI cross country runner that still trains like she's gonna lose her scholarship. We are seeing her for a torn posterior tib. Interesting, during the eval, her arches were almost exactly the same on both feet. One side she's had multiple stress fxs, plantar fascitis multiple times, etc. The other side, she's never had an injury. However she has always had orthotics in her shoes since her early years in high school.

Oh did I mention that her navicular has migrated medially and her talus pronates extremely bad.

If the feet were the problem, and she ahd orthotics in both the left and right shoes? Then why is one side never injured while the other is frequently injured?

Joe Przytula said...

MD's leave the tough stuff to us. Regional interdependence issues require a full body screen, that takes time & patience. Have you ruled out a leg length discrepancy (structural or functional?)

JH said...

Not yet. Per Dr.s orders, we are doing ionto right now and that's it. She was told that she may have to have surgery to fix the post tib tendon. I'm gonna do my best to prevent surgery. She's an avid runner and she would be devistated if she couldn't anymore. It's only been a week and she's already having withdrawals from not running.

I'll let you know what I find next week as far as LLD.