Monday, January 10, 2011

Ask the Doc

Dear Doc,

So..I am looking into getting some new shoes. I went to the running warehouse and did that test on the treadmill. I run 'normally" but I have major IT band issues. I had been running in NB 100s and they said that wasn't enough support for me which I agree with because Im pretty sure the pain started when I switched to those shoes. They recommend about six different pairs of shoes and I ended up with Brooks Ghost ... what I really wanted was a pair of nikes that she said would be too much support for me. Is that true that you can be in a shoe with too much support and get injured?? 


Runner-

There is some debate about how shoes may contribute to ITBS...the basic premise is that shoes which may tend to cause excessive strain on the outside of knee by contributing to running bow-legged may have some causal effect on ITBS--based on this theory it is somewhat possible that overly supportive shoes may have an effect on the IT bands as they well essentially prevent a "normal" amount of pronation and may even cause some supination in extreme cases wherein you ankle may tend to roll outwards and put extra stress on the outside of the knee causing the rubbing of the IT band at the knee joint to lead to swelling and ultimately discomfort...picture running on a crowned road where the middle is higher that the sides and each of your foot falls lands on an off camber portion of road and you may be able to picture better how the stress is transmitted to the outside of the knee. 

My guess however would be that the development of pain in your knee was not directly related to your change in shoes so much as it was pure coincidence. Like I said, there is some debate about shoes and ITBS (there is in fact a large debate in the running community about shoes in general...which ironically enough is somewhat summed up the NB100's that you have been running in to date). The NB100's were developed under the guidance of a very neutral and exceedingly efficient mountain runner known as Anton Krupicka and were introduced to the running world as one of the first minimalist shoes on the market...they broke with great success and many people have enjoyed their benefits while others might have seen a rash of injuries which most likely resulted from a combination of things which the shoes maybe only amplified. 

I have struggled with ITBS over the last couple of years and have started to finally hone in on what exactly is to blame...the culprit? Weak hips. That's it. ITBS most often rears it's head in those with weak hip flexors and poor core strength. I have spent hours on foam rollers, massaged my legs till black and blue and all it ever seemed to do was treat to some degree the discomfort. It was not until I started doing some very simple exercises aimed at strengthening my hip flexors and chiseling my abs that I have seen some long term relief. 

Go to runnersworld.com (http://www.runnersworld.com/video/1,8052,s6-1-0-5,00.html) and check out the videos they have...these are pretty much the exercises I do...I usually just do them laying in front of the TV every night, they take about 10 minutes to do 3 sets of 20 all around and I might pick 1 or 2 specific movements. 

Anyways, hope that helps and if you have any more questions or want any more info let me know and I can hopefully point you in the right direction...the people at Runningwarehouse are great but they are just sales people working on rules of thumb. I am sure the brooks shoe they put you in is a great shoe but at some point it comes down to splitting hairs and different people would see different things in your mechanics. I will tell you though that you will notice a difference in support between the brooks shoe and the NB shoe that you are used to...most likely you will feel the increased support at the inside of your heel that you are not used to feeling. It may take a little getting used to but for an everyday trainer you will for sure be more comfortable in the brooks, don't bail on your NB's altogether and use them as a training tool for your faster runs when you are running more midfoot and don't need a whole of heel support.


Look here for some more info: http://www.itbs.info

Let me know how it all shakes out...

The Doc