I wanted to share a patient story with you that is quite common around this time of year. Clive came to see us at the clinic a few weeks back he had been training for the Virgin London Marathon and had developed shin pain (shin splints or as now called Medial tibial stress syndrome). He had attended the marathon exhibition the week before and after undergoing a video gait analysis by a well known sports company was advised that he had over pronation and was to ditch his Mizunos trainers and buy their product (and get a second pair for free!). There was no repeat video in his sparkling new trainers instead he was sent on his way a few pounds lighter after being told they would fix his problem.
On attending our clinic he felt the new trainers had made little difference to his shins and was now unable to run due to pain. We videoed him again and unsurprisingly to us his feet pronated far more in the new trainers! At this point I asked Ian Griffiths Sports podiatrist to take a look. Both Ian and I agreed the best step was for him to ask for a refund on the new trainers and continue with the Mizunos but add some orthotics into them to increase stability/control. Two weeks later feeling a lot better following reduction in running, some soft tissue work, ultrasound and taping Clive ran a half marathon (much to my own fears!). Good News – no shin pain. Bad news – fairly severe blistering from the orthotics.
At this point both Ian and I agreed he needed a change in trainer and suggested either an Asics or Brooks stability shoe which we felt would provide him with increased stability/control (decreased pronation) and reduced blistering. However we were reluctant for Clive to change shoes four weeks out from the Virgin London marathon for fear of making him worse or causing new injuries! Clive being more daring than us decided to do it anyway! So last week he went to Runners Need in Romford and bought a brand new pair of Brooks Adrenaline. While at the shop he had a further video gait analysis and he noticed a significant improvement in rear foot and ankle alignment even without the orthotic. With this in mind and ignoring all the rules regarding breaking in a new shoe he ran the Brentwood Half marathon last weekend in a personal best time without any shin pain or blisters.
The moral of the story is….
1. Big brand marketing at exhibitions are normally sales people without any medical /biomechanical training just trying to push a product that may or may not be what you need.
2. Always re-evaluate intervention – assess for changes good or bad after you receive treatment or change sports equipment or technique otherwise you will never know if you have improved what you set out to change.
3. A process of elimination is often required to achieve the perfect outcome. Rarely is there a simple fix.
4. You don’t always need orthotics to bring about improved biomechanical outcomes (sometimes a change in footwear is enough). That said in this case they clearly made an immediate impact.
NB: In addition to the footwear changes – Clive was advised on training regimes/rest, and received twice weekly physiotherapy to settle his symptoms.