Ask the Doc Forum is now a Column

[Barefoot TJ]

Hi guys,


With his apologies, Doc said he was unable to keep up with the demand of the Ask the Doc Forum, but would like to contribute to Ask the Doc Column. He will answer questions you submit through this thread that we forward to him (one or two a week for the column).


So, if you have an injury or medical question you would like answered, please post it here, and I will be sure Doc sees it.


Thanks,


TJ

 

[miker]

Wendy, TJ posted this about

Wendy, TJ posted this about the good doctor last week. So he's still here, just in a different capacity. Cheers!

Hi guys,

With his apologies, Doc said he was unable to keep up with the demand of the Ask the Doc Forum, but would like to contribute to Ask the Doc Column. He will answer questions you submit through this thread that we forward to him (one or two a week for the column).

So, if you have an injury or medical question you would like answered, please post it here, and I will be sure Doc sees it.

Thanks,

TJ

 

[BFwillie_g]

well, actually, I'd be very

well, actually, I'd be very interested in his reaction to my numbtoe problem. Here's the text of the comment I posted:



Hi there

I'm wondering if anyone else gets this problem. The 1st and 2nd toes on my right foot are often numb, like they've been given novacaine, after a longer run. I can work it out somewhat with heavy massage and stretching, but it doesn't go completely away for a few hours. I would say the problem is generated in the ball of my foot and extends out to those two toes, but that's a little conjectural on my part. Also, temperature seems to play a role, the cooler it is, the worse the numbness. And warming the area seems to bring the feeling back.

Oh, last thing, mobility is also affected, I can't curl my toes all the way inward.

Doesn't seem to matter if I'm BF or in my Huaraches.

Got me kind of concerned. Ideas?

 

[Barefoot TJ]

I'll send it on to Doc,

I'll send it on to Doc, Willie. Glad to see you're checking in with us. We've missed you!

 

[BFwillie_g]

Barefoot TJ wrote:I'll send

I'll send it on to Doc, Willie. Glad to see you're checking in with us. We've missed you!

pitter patter



and thank you TJ

 

[Barefoot TJ]

He's received it, and he is

He's received it, and he is working on it. Thanks.

Pitter patter? Does that mean you've had a baby?!

 

[BFwillie_g]

Great! Thank You TJ!

Great! Thank You TJ!

 

[stomper]

Ok, here's a question for the

Ok, here's a question for the doc. It's kind of loaded, because it's not about a medical problem, but instead about a medical profession... but really, I'm curious.

The short version: So what's the deal with podiatrists?

The long version:

When I was recently reviewing press about barefoot running, I saw some trends in the kinds of "expert sources" used and the kind of things they said. A typical story would have two sources, one pro- and one anti-barefoot running. A better story would have three or four expert sources to give more perspective, perhaps mixing in somebody like a coach or an orthopedic surgeon.

But the "anti" source was almost always a podiatrist, and, more interestingly, it was unfailingly podiatrists who said the most ignorant things about barefoot running. It was as if they had never tried it or observed it. For example, one said that running in a racing flat was just like running barefoot, which anyone who's ever run an inch barefoot could tell you is not true.

Curious, I spent a while perusing a long podiatry forum thread about barefoot running. While the attitudes among the podiatrists there were a bit more nuanced, the general theme I got was that there was a persistent belief that bodies could not change. Only people who had gone shoeless since birth or were blessed with perfect biomechanics should attempt running in in bare feet; everyone else was doomed to need shoes because they had always been wearing shoes. Again, this is something that anyone who has ever spent a week at the beach barefoot, or done a martial arts class, could disprove; such people know that their feet and their bodies can change, indeed, within a scale of weeks.

From this very small sample, I am getting a poor impression of the profession as somewhat disconnected from reality.

Is this impression accurate? And if so, why are things this way?

Cheers, stomper

 

[Barefoot TJ]

I'll send it to him,

I'll send it to him, Stomper. Thanks.

 

[Barefoot TJ]

Done.  I'll let you know when

Done. I'll let you know when he responds and I place it on the front page.

 

[twinkletoes]

BF Willie,Your post caught

BF Willie,

Your post caught my eye, especially about the cooler temp.. Do your toes turn white?

I'm new to barefoot running so this will be my first fall/winter and lately my concern is how am I going to manage BF because my toes and fingers go numb in the cold, but not until I finish- could be a blood pressure drop? I am pretty sure I have Reynaud's, which is a circulatory problem and it's really disturbing when the digits start turning white. The only thing that seems to work is drinking hot water or chicken broth and getting into a hot shower.

 

[Barefoot TJ]

Twinkle, please see my

Twinkle, please see my response to you on your other thread about this same concern,

Stomer, I heard back from Doc, and I will post his reply to you in about two days, if that's alright, since I have a couple articles ahead of yours. If it was injury or condition-related, I would put it up right away.

 

[Longboard]

Doc,I have a question

Doc,

I have a question regarding heel spurs. I have been under the assumption that a heel spur is the result of a plantar fascia that is not long enough for the task, so the body grows bone at it's attachment to the heel in an attempt to effectively lengthen it. Of course this leads to new problems, but at least it tried.

I understand that the plantar fascia losing elasticity with age is probably the most common etiology, and that mechanical issues such as over pronation can also lead to the condition.

I myself had a bad case of plantar fasciitis at age 45, but have never had a relapse which I attribute to daily stretching on an assortment of baseballs. I assume I caught it before developing any heel bone spurring formation of significance.

There is a well known member of the relatively small on-line community of barefoot runners who recently underwent bi-lateral heel spur surgery. He and his surgeon attribute the bony growth to a decade of barefoot running utilizing a heel strike form.

I understand that heel striking and it's associated soft tissue trauma could lead to an inflamation of that portion of the PF, hence a true fasciitis, but would it in itself cause spurring to develope?

My guess was that his improperly stretched unsupported over age 30 arch was pulling on the attachment at his heel bone, and would have caused spurring whether he landed forefoot, midfoot, or heel first.

Knowing that you have'nt examined the patient nor viewed his radiographs, any thoughts?

 

[Barefoot TJ]

Thank you, Board.  I will

Thank you, Board. I will send this to him immediately and let you know when he replies as well as put his reply on the home page.

 

[SaraLord]

Hi BF Willie,It's been a

Hi BF Willie,

It's been a while since you posted this, but you aren't alone. I experience the same thing. So far it hasn't created any problems but I hope the winter won't make it worse - very embarrassing to fall over with nothing to trip on.

Sara

 

[Hoofn'it]

 I'm new to the site.

I'm new to the site. Unfortunately, my first post is about an injury. I can't seem to find much information on the dull pain I have on the outside of my foot. It's located at the akward nub at the end of my 5th metatarsal. It's prevented me from finishing my last PR. I'm concerned that it's going to prevent me from running. If anyone has any info or treatments to help. I'm doing the best I can to ice, rest, IB profin and stretch it. Please help!

 

[Barefoot TJ]

I'll send your inquiry off to

I'll send your inquiry off to Dr. Mike and get back with you. Have you tried staying off of it for a long extended period of time to see if it would heal that way, as in complete rest? Hope you get well soon?

Welcome, Hoof!

 

[Barefoot TJ]

Hoof, this is what Doc had to

Hoof, this is what Doc had to say:

"It could be a stress fracture or peroneal tendon inflammation or tear."

 

[buzzie]

Here's a question... Dx is

Here's a question... Dx is broken 3rd metatarsal, near the base (closest to ankle).

10 weeks ago my foot "snapped" during a road half marathon - a distance longer and faster than I usually run on roads.

1 week post-injury (having taken a week off after the snap) I ran a 100-mile trail race - altering my stride to keep the not-too-bad pain away; finished with the foot feeling no worse than it started (the rest of me, not so much).

5 weeks post-injury was put into an aircast (4 weeks) and given crutches to use (2 weeks).

9 weeks post-injury was given the go-ahead to ditch the cast and don very stiff soled shoes.

11 weeks post-injury I can start running - 1/4 mile, working up s-l-o-w-l-y.



My Sports Ortho knows that I'm a barefoot/minimalist runner, and doesn't pooh-pooh this idea.

He says he wants me in a "supportive shoe - a trainer" when I start back.

While I'm all for starting slowly, I'm curious about his recommendation...

Seems this would be the perfect time to start up again in a minimal shoe (sorry, but it'll be December in Michigan - too cold for me!)... mileage will be terribly low and the build will be slow... a great time to build mileage "correctly."

But, I can also understand starting in a supportive shoe... things are weak (with the injury still healing and after all this time off) and I don't want to undo the healing that's been done. So, if I go this route, when is a good time to transition out of the shoe-shoes?

Right now, I'm thinking about the following...

• at the point that I can start running: switch back to living barefoot, but run in a shoe
• two weeks in: add barefoot/minimalist walks, but run in a shoe
• six weeks in: start adding barefoot/minimalist runs (short and no speedwork)

What say you?

 

[Barefoot TJ]

Liz, I will send your inquiry

Liz, I will send your inquiry off to Doc and let you know his reply shortly.