Running Shoes - Do they fit right and how to know?

Recent studies show that the cost of a running shoe does not assure satisfaction (http://www.nytimes.com/2010/10/23/health/23patient.html?_r=1&scp=1&sq=shoe%20fit&st=cse).  A recent article in the NY Times reports that athletes sometimes spend as little as $25 on shoes and are quite happy.  Although in my experience, a good middle of the line shoe (usually $80 - 120 retail), will give you great cushioning and support, you can often find that level of support in a less expensive shoe.  This may not work for everyone because not all feet are created equal, especially if they are flat.

The best and most advanced way to assure the best fit for a running shoe is to
1. follow my instructions on Howcast at http://www.howcast.com/videos/259469-How-To-Properly-Fit-a-Shoe.  Here are detailed instructions I published a while ago to make sure your shoes fit properly.
2.  Go to a running store with a treadmill - Stores like roadrunner sports or our local chain The Running Company can make the process more accurate.  You can see how you impact the ground using their treadmill and assure a better fit for your style of foot.  Different brands of shoes fit differently and sometimes the treadmill can save you money by helping you pick the right shoe for you.
3. If you have low arches or overpronated feet that flare out causing asymmetry in your gait, you can also use the treadmill to see the difference an insert makes.  Rather than buying a more expensive shoe that is stiffer and less comfortable, put in an insert and you will likely feel and run better.  Most stores will allow you to try them out.  I am personally unimpressed with some of the supposedly custom inserts some stores will upsell you.  Often, I find the less expensive off the shelf versions actually work better.  If you have a more severe foot problem, visit a professional such as a chiropractor or podiatrist and have custom inserts made. If done properly, they are more corrective and do last longer.

Cortisone - Does this cure make problems worse?

I recently came across and NY Times article which questions the wisdom of Cortisone Shots (http://well.blogs.nytimes.com/2010/10/27/do-cortisone-shots-actually-make-things-worse/?scp=1&sq=cortisone&st=cse). Often when people are in pain, they are irritable and also impatient because of what the pain does to their normal daily activities.  The cortisone shot has been used for the quick fix for heel spurs, knee pain, shoulder pain, bursitis and other maladies.  It is usually administered by an orthopedist or a physiatrist.

The problem with this solution is that while it can cause a significant amount of relief, it will also cause bone loss and problems with healing at the site of injection if overused.  The other problem is that this injection will resolve the problem because the problem is that the area is painful.  This misunderstanding is natural since most people believe no pain, no problem.  Since inflammation rarely just happens, and it is usually due to a mechanical problem, it requires a mechanical solution.  Injecting an area that is inflamed, even though we do not understand why is not a mechanical solution.  It really is a shot in the dark, with the hope that it gets rid of the pain.  If you and/or your doctor have little understanding as to the mechanism of pain (hint; rarely is inflammation a mechanism however it is a response to unusual stress and irritation), you are likely to have the problem continue to reoccur and develop other related problems at other times and think these are also just pain.  The reality is, symptoms are just a warning that something is wrong.  Years later, that degenerated joint warned you about what is eventually coming down the road.

In our office, we look at symptoms, dig for facts and try to understand and the explain the mechanism of inflammation and then get to the mechanical cause.  The benefits of this approach are:
1. Real long lasting solutions.
2. Your joints are less likely to wear out because we are resolving the forces damaging the joint.
3. You are less likely to develop other related problems because the true cause has been resolved.
4. You enjoy a better quality of life and fewer doctors office visits with less pain.
5. You will rarely ever need a cortisone shot.

High level activity in older adults is very beneficial - I see this with many of our patients

I came across this article (http://www.investorplace.com/20701/physical-activity-beneficial-at-advanced-ages/) regarding patients who are older.  Apparently, older people who stay active and are most likely to have better vitality later in life into their 80's and beyond a new study shows.

We have many people in our practice family who stay active and many still compete athletically.  This compares with previous generations who were more sedentary and as they got older, developed many health conditions secondary to deconditioning.  Check out the article.  Very thought provoking