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Posts for tag: Podiatrist Charleston

We hope everyone had a safe and injury free walk/run during the Cooper River Bridge Run this past weekend! We would like to get back to basics with proper running form so that you remain injury free for the spring and summer months. Here are some nice tips to help avoid injury and keep you on your feet.

Starting with the foot: Where should you contact

Some say to run on the ball of your foot, others say contact the ground with the heel. I take a middle of the road approach. Studies have shown that good long distance runners usually contact with the midfoot. Slower runners contact between the midfoot and the heel, faster runners a bit further forward. Only sprinters or short to middle distance runners should contact the ground with their forefoot or the ball of the foot. While there may be exceptions to the rule, this is a good way for most beginning and intermediate runners to start out. It allows for better shock absorption, less stress on the calf muscle and Achilles tendon, and better rolling forward onto the next stride. Your muscles will then be used in a manner that is similar to how you walk, and this is the pattern of muscle firing and contact pattern which the muscles are accustomed to.

Hips & Head

This part is hard to think about: Where are your hips when your foot hits the ground. Some people have suggested that your foot should be under the center of gravity of your body when it strikes the ground. A line from your head through your hips should end up at your foot. Keep the head fairly straight and look ahead. Turns to the side should be done carefully and usually mostly from the neck up to avoid twisting your body and making you unstable in your forward progression.

Arm Carriage

This is what you use when you haven't obtained a jogging baby stroller. Actually, it is where you allow your arms to swing. First, and most importantly, don't tense up and carry them stiffly with your hands balled up into a fist and your elbows completely bent. Relax. Carry your arms at your side somewhere between your waist and your chest. Make sure they are not too high or too low. One arm swings forward while the other one goes backwards. This occurs opposite to the foot and leg motion. Sprinters on the track move their arms in a straight forward-backward motion. Most longer distance runners use a slight arc as they swing their arms, but the better ones don't waste motion by moving too much from side-to-side. In other words, they don't swing their arms excessively in front of their body.


The knees do not have to come up very high for long distance runners. Only sprinters or those of us chugging up a hill have to left our legs high.

Stride Length

One of the biggest problems of form in long distance running is overstriding. Make sure that you don't do this, it can lead to a host of problems including Achilles tendonitis, ITB pain, and iliopsoas muscle pain.


While some like to tell you how to count your breathing in seconds both in and out, we will just tell you to keep breathing, deep and regular. In most cases your breathing will take care of itself, as you run faster, you'll breathe faster. And yes, most runners are mouth breathers or at least nose and mouth breathers. It would be impossible to take in adequate oxygen just breathing through your nose.

Uphills and Downhills

Slow up a bit on the uphills. In general it is a bad idea to try going faster. Move your arms a bit more to help you imagine that you are cranking your way or pulling yourself up hill. Shorten your stride and chug on up. You can think of the little train that could and repeat "I think I can" on the way up a big hill.

On the downhill, be careful. Go slow. The biggest risk, is to your knees. Your quadriceps do the bulk of the braking and be overworked without you being aware of it. If you are racing, then you may lean forward a bit and fly down the hill in a short race, but certainly be more careful in training. In fact many runners who use hills as part of their training will walk down the hill while recovering to run up the hill once more. This is a good way to rest and recover while avoiding the excessive knee stress that downhill running can cause.

If you have any lingering pain in your feet after the Cooper River Bridge Run please contact us at:


PRP (Platelet Rich Plasma)

Do you suffer from Chronic Heel Pain?

If so Carolina Foot Specialists will begin to offer a minimally invasive option for chronic stubborn plantar fasciitis.

A new state of the art treatment for chronic heel pain that our practice will offer is PRP (Platelet Rich Plasma) injections. The procedure is in the office setting under local anesthesia and involves taking a small amount of blood from the patient, similar to giving blood for a routine test. The vial of blood is subjected to very high speeds in a machine called a centrifuge. A yellow material is obtained containing cells called platelets, that are very abundant with factors that aid in healing. These growth factors are believed to decrease the inflammation causing plantar fasciitis. The platelets from the patient's own blood is injected into the area of pain in the heel. Patients are then fitted for a removable walking boot with light weight bearing to prevent putting excess weight on the heel for one week or less. After that, they advance to sneakers, and although the range of time for pain relief is variable, it can be appreciated as early as 10-14 days.

For more information please contact our office at

Hope everyone is getting ready for the upcoming Cooper River Bridge Run. We are going to focus the next month on the various foot injuries that we see in running as well as prevention. If you have any questions please post to our facebook page so we can answer all you question. Today's post is on "Barefoot Running." This article was in the News and Courier and featured Dr. Brown in 2013. Nice article about his opinion on Barefoot Running.

Morton's neuroma is a common diagnosis that we see in our practice. A neuroma in the foot presents most commonly with pain in between the third and fourth toes with pain in the ball of the foot. Pain is usually burning, tingling, and shooting pain that radiates into the third and fourth toes and sometimes into the 2nd and 3rd toes. A neuroma usually feels like a sock rolled up in the shoe and feels better upon taking off the shoe and sock. We most commonly see neuromas in women that wear high heel shoes which places much force on the ball of the foot which can irritate the nerve. Neuromas develop over time as well when the fat padding on the ball of the foot reduces as we age.

Dr. Brown and Dr. Saffer practice philosophy has changed over the years regarding the treatment of neuromas. At the most recent American College of Foot and Ankle Surgeons lecturers this year support more conservative treatment for neuromas versus surgical excision as in years past. The one dreaded complication of neuroma surgery is a "stump neuroma" which is a regrowth of the nerve which can cause painful symptoms.

Dr. Brown and Dr. Saffer have had much success with conservative treatment with eventual resolution of neuroma symptoms. Conservative tx options that our practice follows are: NSAIDS, ice, offloading with pads and Orthotics, cortisone injections (max three per year), and the more state of the art treatment alcohol sclerosing agent injections. These type of injections deaden the nerve and reduced symptoms and up to six to seven injections if needed per year can be given. This type of treatment has really helped our patient population that has either suffered through complications of previous surgery or who have not had relief with other conventional treatments. Cryotherapy which is freezing of the nerve is another option as well. Surgical excision is typically the last option for our patients.

Dr. Saffer has suffered from a neuroma several years ago and had relief and resolution with conservative treatment. It is also very important to know if you have pain on the ball of the foot it is not always a neuroma. It could be bursitis, capsulitis, stress fracture, or arthritis. Please refer to our website for more information on neuromas.