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If you’re feeling your daily jogs or runs in your feet, calves or knees more than you used to, it may be time for a footwear tweak. As you approach 50, gradual changes like the diminishing fat cushion in the balls of feet can add up to palpable aches and pain, says Paul Langer, a podiatrist who specializes in sports medicine at Twin Cities Orthopedics in Minneapolis.
Along with the shrinking of this plantar fat pad, the natural loss of foot and leg elasticity — combined with the repeated pounding of 1,000 to 1,500 steps each running mile — can result in a variety of foot and lower extremity problems. They include plantar fasciitis, which causes heel pain; Achilles tendinitis in the tendon that connects the calf muscle to the heel bone; arthritis in the big-toe joint; and metatarsalgia of the forefoot, which causes pain in the ball of the foot.
The good news? Proper temporary orthotics can ease or eliminate pain from most of these problems, and they can also help those whose lifelong flat feet or high arches start to create later-in-life aches. Permanent in-shoe aids can also help runners who have body irregularities, like one leg being longer than the other.
Finding the right fit for you
That said, finding the right insert may take a little trial and error. “I always tell my patients that prescribing orthotics isn’t like prescribing medication,” Langer says. “We don’t know the right dosage, and that’s partly because we can’t tell when the patient is comfortable. And we don’t know what kind of pressure relief or correction is needed to make someone’s pain go away.” He adds, “Each person is very individual, as far as how they might respond to footwear changes, or what we call ‘biomechanical intervention.’ “
To get started, you’ll want to visit a podiatrist — ideally one practicing sports medicine. The American Podiatric Medical Association (apma.org) website lists podiatrists who are also members of the American Academy of Podiatric Sports Medicine. Take your current pair of running shoes and socks to your first appointment. A study done in Australia pointed out that between 68 and 78 percent of the population are wearing shoes that don’t fit them properly. A podiatrist can check yours to see if they are the right fit for your feet, notes Kathleen Stone, a podiatrist and former APMA president.
What a pressure mat can tell you
From there, diagnosing runners’ foot problems has become much easier and more accurate with the computerized pressure mat, which most sports podiatrists are now using to check their patients’ barefoot walking gait and running gait — both shoeless and in their running shoes.
Movement patterns, Langer says, “are as unique as our signature.” Our bodies are programmed to move in a way that is most metabolically efficient and least painful. Changing a patient’s natural running pattern isn’t practical for older runners, experts agree. “I’ve had lots of patients come in with metatarsal tissue issues, or stress fractures, because they changed their running form,” Langer says. “Sometimes I use the computerized pressure mat to help educate my patients about why and when they are having pain.”