Sports Medicine/Pain after running

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Question
Hello Dr. Arthur,

I have been running for almost a year now, and decided to challenge myself just over one week ago to a half marathon. Upon completion, I felt what I thought I would. My body was sore and tired. The day following, I noticed the outside of my left foot was tender. I think I was running on the outside of my feet towards the end, my fault. I favored it for the following days, also realizing it was swollen. I took ibuprofen and iced it, and it seemed to get better every day.

Six days after the race I woke up and my foot didn't hurt. It wasn't swollen, but my knee on the same leg was in pain. It gets worse as the day goes on, and is terrible if I go up or down stairs. What I noticed about it though is either my foot hurts, or my knee. One or the other. Could my favoring of my leg caused an knee issue, or is the feeling from my foot masking that of my knee. Should I be concerned about my knee if it's not always in pain? I'm not running currently, and it's a bit painful just to walk.

Thanks for your time.

Answer
Hello Jen!

Thanks for your note, and I will try to give you a simple explanation for your pain.  By the way, congratulations on your Half Marathon.  I'm sure that recreational running set you up for the endurance that race requires. As far as the left foot pain, it didn't have anything to do with the right foot.  What I realized might have happened was that as you approached the end of the run, you are tired, and your left foot might have stepped on an incline, a small stone, something that caused the foot to turn inwards.  This caused some tissue stretching, micro-tears, and in turn it swelled up.  Ice would have helped, and the swelling is caused by fluids and bleeding within the tissues.  Ibuprofen chemicals goes to the brain, and not the injury.  There was a time when everything felt pretty good until suddenly the left knee kicked in.

When a faulty step causes problems with the foot, it will transfer to the knee, and possibly to the hip.  What happened within those six days is unknown, but maybe while sleeping, moving into another position in your sleep might have been just the ticket to affect a weak area caused when the left foot was injured.
To check your knee for actual pain, I would suggest a 2" ace bandage wrapped around the knee in a figure "8", starting at the top of the knee, and wrapping it around the bottom to the top.  Do this maneuver for the entire roll....not too tight.......but snug.  If  you stand up, and it seems protective, then try a couple stairs. If it hurts as much as it did prior to wrapping it, then it's time to get an opinion from a good Orthopedic physician.  Your knee probably won't hurt if you don't put any weight on it.  But because you are experiencing pain, it needs to be looked at. Additionally, the left foot should be seen also.

Best of luck to you, and I hope you will let me know how you are doing.

Dr. Patricia Arthur

Sports Medicine

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Dr. Patricia B. Arthur, DC, MRC, CST

Expertise

As a 30-year practicing Chiropractic Physician, my specialty was Sports Medicine. For 8 years I had the distinct pleasure of working with the USOC, and traveled the world to care for the athletes in the Pre-Olympic venues for the Summer Games. When I wasn't traveling, I had a private practice, and a hospital practice, in Kamuela, Hawai'i. Questions I couldn't answer usually dealt with pharmeceuticals. This was not my expertise, but the simple questions pertaining to familiar drugs I was able to digress, or refer to someone that was knowledgable in that field. Most Sports Medicine field injuries were familiar to me, but I always aired on the side of caution. In my office practice, I would tend to see more patients with the weekend injuries who would try to self-treat, only making the injury worse than it should have been! Nevertheless, I never took anything for granted, and so it was my conservative approach to the "cause-and-effect" mechanisms that were vitally important to the healing process.

Experience

Following my competitive nature, I knew Sports Medicine would always be a part of my life. After graduation from Palmer University in Iowa, the old adage taught at the school dealt only with the spinal column......anything connected to the spine was outside our scope of practice. To me, this was too simplistic, because the complex body also had arms and legs! From this point, I developed specific technigues which would encorporate the body as a whole rather than haphazard segments. There is nothing traumatic that happens to a single ligament, tendon or joint that doesn't effect a secondary, or possibly a tertiary element in that area. In order for that space to heal, all the factors must be addressed. Volunteering my time teaching referrees, coaches, and interested parents about the realities of probable sports injuries was worth a thousand words!j

Organizations
American Chiropractic Association; Local Emergency Response Committee; Hazardous Materials Response Team; Urban Search and Rescue Team - Operations and Planning; Federal Corps of Engineers Committee; Earthquake Advisory Board; Big Island Wildfire Committee

Publications
Papers published focusing on the importance of proper care of sports injuries; Authored medical columns for the syndicated magazine "The People's Doctor "; Published papers in professional journals on Head Injuries in Sports; Published papers on Drug Abuse in Sports.

Education/Credentials
Robert Packer Hospital - Certified Surgical Technician - CST; Palmer University - Doctor of Chiropractic - D.C.; Wright State University - Masters in Counseling/Psychology; Wright State University - Masters In Couseling of the Severely Disabled.

Awards and Honors
Selected US Olympic Physician -1988; Graduated Wright State University with a 3.75 GPA; Graduated Palmer University with a 3.5 GPA; Faculty Appointment - Palmer University Post Graduate Education; Faculty Appointment- Hawai'i/Kapiolani Community College - Skills Team Tester;

Past/Present Clients
Cincinnati Bengals Football Team pre-season training; Summer Olympic Athletes worldwide; Kona Ironman Triathletes - Finish - line physician

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