Foot pain stops a longtime runner

Fitness Q & A

April 15, 2005|By Gailor Large | Gailor Large,SPECIAL TO THE SUN

I usually run three or more times a week - not far - maybe two or three miles. I am 74 years old and have been running since I was 45.

This winter, I developed left heel pain to the point that I couldn't run or even walk comfortably. The podiatrist gave me a cortisone shot in the heel and said I have a heel spur. She showed me an X-ray of a bone protrusion.

The expensive customized shoe insert she gave me was not effective. I need to exercise and would like to resume running. Do I need an operation?

Jeffrey T. Brodie, chief of St. Joseph Medical Center's Foot and Ankle Surgery Division, says that the pain you're experiencing is probably not caused by the heel spur. According to Brodie, yours is most likely a classic case of plantar fasciitis - inflammation of the ligament that supports the arch of the foot.

"Approximately 95 percent of patients with heel pain do not end up needing surgery," says Brodie. "However, it can take up to six to nine months to resolve, so patience is important." He recommends these steps:

Aggressive stretching. Two to three times per day, perform standing stretches of the calf with the knee straight and flexed.

Good shoes. Choose a pair with a comfortable arch. Custom orthotics are usually not needed, but nighttime splints to stretch the calf while you sleep, and heel cushions, can help.

Injections. If after six to 12 weeks, these steps fail to ease the pain, you can consider cortisone injections, with a limit of two or three at most.

Surgery. It should be a last resort after about nine months of nonoperative treatment.

Resuming activity. Begin walking after you are pain-free, working your way back to running by gradually increasing time and speed.

I've heard that foods like soup that contain a lot of water fill you up fast so that you're less likely to overeat. Is this true? What foods are most jam-packed with water? And is it true that drinking water during a meal doesn't have the same fill-you-up effect?

Pound-for-pound (or ounce-for-ounce), water-rich foods have a lower calorie count than their denser counterparts. Therefore, you fill up faster while consuming fewer calories.

What are the best choices?

Aim for nutrient-heavy fresh fruits and vegetables. Oatmeal and cream of wheat are good breakfast choices, and soups and yogurt are great lunch options.

Foods with water contents that might surprise you include boiled eggs, pasta and fresh fish (all are more than 50 percent water). As for drinking water during your meal, it's great for hydrating, but studies show it doesn't make us feel as full as "eating" our water does.

Apricots, my favorite food, are back in season next month. In late spring and early summer, I go wild making apricot cobbler, apricot bread, apricot granola, apricot preserves, and dishes like honey-apricot chicken.

My sister complains that apricots are too sugary and I should cut back on feeding them so much to my kids, but I try to explain that they are really healthy. Will you settle this for us once and for all?

In your corner, apricots are packed with carotenoids like beta-carotene and lycopene, which keep your heart healthy by lowering "bad" LDL cholesterol. They are also rich in antioxidants. Like all fruits, they are definitely good for you.

However, your sister may have a point. The sugars in the fruit itself are natural and should not be an issue. On the other hand, you may want to take a look at foods like apricot desserts and preserves, which contain a lot of added sugar. Also, there is such a thing as too much of a good thing. Variety is important, particularly in the diets of growing children, so you don't want any single food dominating every meal.

Do you have a fitness question? You can submit questions via e-mail to fitness@baltsun.com, or online at baltimoresun.com/healthscience, or in writing to The Sun, 501 N. Calvert St., Baltimore, MD 21278.

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