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Do research before buying shoe inserts

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It is common to experience some aches and pains with running, especially if you are a beginner.

If you decide to train for an event, the way you pace your running is important. Sometimes, more running can lead to pain in the inside of the foot, the shins or the knees. It is very simple to blame these problems on the way your lower limb is lined up, otherwise known as your alignment. However, there can be many potential explanations for your running discomfort, so it is wise to figure this out before you purchase custom shoe inserts (orthotics).


The way your foot is built

Orthotics can be used to help problems with your back, hip, knees and feet. The most common use is for foot pain. Some individuals choose to purchase orthotics for the way their foot is structured, even if they do not have pain. Towards the back part of your foot, your foot may sag inward (pronate), stay upright (neutral) or tilt outward (supinate).

You can check for this by slightly bending your knees so your body weight is pressing more into your feet. The majority of adults pronate, so this is not abnormal. Pronation without pain symptoms is not a reason to buy orthotics. In some individuals, pronation can lead to foot, knee and hip pain, especially when combined with other lower limb alignment problems. Supination is less common but it can lead to pain symptoms in some runners and orthotics may be helpful.

Pronation is not the same thing as fallen arches. Pronation occurs to the rear of the arch area. However, if you do have fallen arches and pronation, the combination can make pain on the inside of your foot worse.

Remember, check out other causes of your foot pain before you decide it is due to your foot shape. Consider your training program, your running shoes, your running technique, previous or current injuries and the surface you run on.


Look before leaping

Since orthotics are an expensive investment (about $400 a pair), it is important that they are made properly by a professional with plenty of experience in the area. Ask the practitioner how much experience they have in making orthotics and whether they have completed any prior training. Look for certified pedorthists, podiatrists and orthotists. Ask a physiotherapist, family physician or a sport medicine physician for suggestions on who to see. You may also know a friend, family member or colleague who had good results with their orthotics and could recommend a professional for you.

There are only a handful of sport medicine/musculoskeletal problems where orthotics are the first treatment of choice, so you should never feel pressured into buying them. You can always get a second opinion from a health professional who is not selling orthotics if you are unsure if you really need them. If you do have a running problem that can be helped by orthotics, it can ease your pain symptoms substantially.


Dr. Maureen Kennedy MD, CCFP, FCFP, MSc, PhD(c) Kinesiology, Dip. Sport Med., is a sport and exercise medicine physician at Pan Am Sport Medicine in Winnipeg.

Readers can ask Dr. Kennedy questions, but due to the volume of requests, replies are not guaranteed.

Republished from the Winnipeg Free Press print edition August 2, 2011 D1

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About Dr. Maureen Kennedy

Born and raised in The Pas, Dr. Kennedy graduated from the University of Winnipeg Collegiate, earned a BSc and BA from the University of Winnipeg and an MD from the University of Manitoba in 1994. After certifying in family medicine at the University of Manitoba, Dr. Kennedy was awarded a two-year fellowship in primary care sport medicine at the University of Calgary Sport Medicine Centre. She completed this fellowship along with a MSc in Kinesiology at the University of Calgary. Her research focus was exercise counselling by family physicians. Dr. Kennedy further explored the use of exercise in medicine with PhD projects examining aerobic exercise in individuals scheduled for total hip or knee replacement surgery. She holds a diploma in sport medicine from the Canadian Academy of Sport Medicine and has served on numerous provincial and national committees for organizations such as the Alberta Medical Association, Canadian Academy of Sport Medicine, College of Family Physicians of Canada and Canadian Society for Exercise Physiology.

For the past 11 years, Dr. Kennedy has practised as a consultant in primary care sport medicine.

Dr. Kennedy's practice focuses on the diagnosis and treatment of injuries, muscle, bone and joint problems, orthopedic triage, weight management, osteoarthritis and dance medicine. She has served as the head physician for Alberta Ballet for the last nine years and has worked with the national women's hockey team along with many elite and amateur athletes in various sports. She points out that sport medicine physicians provide a tremendous service to the general public and the health-care system by shortening orthopedic waiting lists and providing non-surgical treatment options. "It's great to be back home in Manitoba and Winnipeg is a fantastic city," she adds. Readers can expect coverage on a wide range of fitness and health topics, including insider's tips on how to navigate the health-care system.


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