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Lighter shoes for faster running?

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Article by: Margot Manning (intraining podiatrist, runner and coach)

Can lighter shoes really make me run faster?

This is such a common question. You need to know that there is no substitute for consistent training and a great running program… BUT… the correct pair of running shoes for you and a second, lighter weight pair of running shoes can definitely make a difference to how easily you can run.

The four main benefits of a lighter shoe for faster running are

  1. More responsive feedback from the ground
  2. Less cushioning thickness for your foot to work through
  3. Co-ordination – the faster you run the more co-ordinated your body moves, and the less structure you need at your feet.
  4. You feel light, fast and ready to go!

“Put these four factors together with the shoe and you could soon be running new PB’s.”

Choosing your second shoe can be daunting where there are so much to choose from. Every footwear brand has a range of shoes from the long run shoe, lightweight training shoe, down to the racing shoe.

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How do you choose the right shoe?

Most recreational runners would use a lightweight training shoe rather than the racing shoe as their second shoe. When buying your first, second, third or any pair of running shoes it is important to follow these steps to ensure you minimise the chance of injury

  1. Try before you buy: It is good to always try and run in the shoes before buying them to feel the difference between different brands and shoe types and which pair you feel the most comfortable.
  2. Heed the advice of industry professionals: If a shoe is making excessive noise when running, you are over-pronating or simply does not suit your running gait, then take the advise of your local running specialist.
  3. Comfort is key: Ensure you feel comfortable in the shoes before purchasing.

How intraining can help?

At intraining Running Centre, our staff are all runners and have understand how each of the lightweight running shoe alternatives can not only help you run faster, but will also complement your current training shoes.

Our trained footwear experts analyse your running style, outside, in real world conditions, to ensure you are comfortable and the shoes are the best fit for your feet. There is no charge for our comprehensive footwear fitting service with our footwear experts when purchasing shoes. We want you to be comfortable with your choice and enjoy your running.

Whether you are looking for a lightweight alternative to your training shoe or are keen to purchase a second pair of training shoes, let the experts at intraining Running Centre take care of you.

Note: Bookings are not required when visiting the to purchase shoes


Importance of good running form

Emily Donker
Article by: Emily Donker (intraining podiatrist, coach and runner)

Running form – Why is it important?

Everyone can benefit significantly from learning more and practicing good running form. Developing good running technique encourages better motor patterning and muscle recruitment. This will help improve your running efficiency and reduce the risk of fatigue including overuse injuries – particularly with longer and more frequent running.

However, there are very few situations in which you should actually try to change your running technique. Everyone runs differently, and should run differently because of their body structure (amongst other factors).

So… you might ask, why would I participate in a running form workshop?

Learning about good running form, and practicing various different running drills and techniques will provide you with an understanding of the factors that contribute towards good form. Although you might not change your technique per say, you can learn and implement relevant changes to improve your running form and longevity.


intraining Running Form Workshop

Running form can be complicated, but it doesn’t need to be.

Three key concepts of good running form:

  1. Body position/posture
  2. Foot strike position
  3. Cadence

Gaining a better understanding of the natural variation in these concepts and how you can make changes (if you need to), provides the basis for our intraining Running Form Workshops.

The three concepts are closely linked, and influence one another. If you can learn good body position, you are much more likely to develop a good foot strike position and cadence.

plyometrics drill
Running drills: Form part intraining Running Form Workshops

Body position and posture

Running drills are great for learning and developing specific simple muscle activation and teaching good running posture. They will help you to feel how you are running and how your limbs and body are moving through space. The progression of drills teaches good body position and posture, co-ordination, strength and power.

“Over time, through learning and practicing specific drills, you will gain a much better sense of your own running technique and any form faults that may develop as you fatigue.”

Good foot strike position

Developing a good foot strike position is all about where you strike the ground in relation to your body’s centre of mass (COM). Regardless of whether you strike on the heel, midfoot or forefoot, your foot should strike the ground underneath the body. Landing infront of your COM is known as overstriding, and is a common form fault. It creates braking forces which slow you down and significantly increase the amount of force transmitted through your joints – thus also increasing injury risk. Having a loud foot strike can indicate overstriding, but may also be linked to other issues.

Running cadence

Ideal cadence (stride frequency) is different for everyone and is strongly determined by the length of your limbs, but is also affected by other factors. Essentially your cadence should remain relatively constant regardless of what pace you’re running. Your stride length should be the factor that changes, and will be longer for faster running compared to slower running if the same cadence is maintained. A common fault amongst runners is to maintain stride length, and decrease (slow down) cadence as they fatigue. This increases the likelihood of overstriding and developing injury.

Generally, your running form is much better when running fast compared to running slowly. This is not to say that slower runners have worse running form – just that for your given ability, your technique is likely to be best when running at tempo pace (approx. 10km race pace) compared to your long run or easy pace. Running slower increases ground reaction time, and decreases your ability to generate power from tension within the tendons (eg. Achilles). This is why it can be better in some cases to run faster when returning from injury, but you need to be cautious with load.

Group Running Form1
Correct posture, foot strike and cadence can reap benefits in improvement in your running speed and injury prevention.

Running form and fatique

Running form also tends to worsen with fatigue. Being aware of how you run, and the form faults that you tend to develop as you tire is very beneficial, because you will learn to identify and feel when you are not running ‘properly’. You can also learn simple cues to help address these form faults whilst out running. Learning about running form and practicing running drills is a great way to find out which drills resonate most strongly with you, and which help you to develop cues to assist with maintaining your own running form.

intraining Running Form Workshop

Everyone is different

There are many different theories proposed about what is ‘ideal running form’ and the ‘best way to run’, but as stated, there is no one way to run that will suit everyone. It’s important to discuss and learn about running form with experienced professionals, with knowledge of running biomechanics, and also of potential structural issues that may prevent certain movements from being possible. The intraining Running Form Workshops are run by a team of podiatrists, who are all runners themselves. They bring a lot of experience in dealing with running-specific injuries, and teaching running form.

intraining Rehab logoBy participating in the intraining Running Form Workshop you will improve your knowledge of the three main concepts of good running form and learn specific running drills, which will provide you with a better understanding of your own running form and form faults, and help you to develop the confidence and skills to adjust your form on the run for more efficient and enjoyable running.

The coaching and clinical team conduct running form workshops throughout the year that can help you improve your running form.

The next intraining Running Form Workshop is coming up soon.

Click here for more information.

How to treat shin pain

How to treat shin pain?

Shin splints are a generic term that many runners use to broadly cover shin pain. Sports medicine practitioners have needed to develop more specific terms to differentiate conditions and treatments required when addressing shin pain.

These terms try to reflect the tissues affected and their different causes. Whilst some shin pain may present similarly, it is important to correctly identify the pain and provide appropriate treatment. Below are common shin pain issues we see at intraining Running Injury Clinic.

  • Medial tibial stress syndrome
  • Stress fracture
  • Compartment syndrome
  • Nerve entrapment
  • Muscle and tendon strain

Below we briefly describe; how to diagnose shin pain, common symptoms and how to treat the injury appropriately. If you have shin pain that is holding you back from enjoying your running, click the button below to make an appointment to see one of our podiatry or physiotherapy team.

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Steve Manning (podiatrist, coach and runner)




The most common cause of shin pain is medial tibial stress syndrome. This pain hurts along the inside of the shin most commonly in the lower half and isolated to the medial border of the shin bone, the tibia. It is an inflammation of the tibial skin, called the periosteum, where the fascia of the leg attaches. The fascia is the stiff layer of tissue that holds all the muscles in place. Little tears occur along this attachment causing inflammation and pain.



The pain can sometimes hurt after waking or rest but most commonly hurts at the beginning of a run before warming up. When bad it can begin to hurt again at the end of a run and will hurt a lot afterwards.


Treatment involves a direct icing technique for a few days with the addition of a gentle distraction massage after that time. Screening for any underlying biomechanical causes may be necessary if continued running aggravates the injury. Extended rest is not recommended as the scar tissue may become more entrenched and harder to resolve in the long run.


Prognosis is generally quite good with a significant (greater than 50%) reduction of pain within a week and complete resolution within a month.



Medial tibial stress syndrome that goes untreated may lead to more severe injuries to the bone like bone stress or stress fractures. Stress fractures are most commonly found on the inside (medial) border of the tibia but may also occur on the front (anterior) border. It is often overtraining that is the culprit, where it has occurred more than a month prior to injury onset.

MTSS Pain1Symptoms

Pain usually occurs at the start of a run and gets worse without going away. It can ache afterwards and sometimes the pain will wake you at night. Pain is usually localised to a spot on the bone and may hurt on both borders and the shaft. Normal x-rays may pick up a stress fracture after 3-4 weeks but an MRI is the best scan to use.


Unfortunately bone injuries are one of the few injuries that require complete rest from activity. If it is bone stress than after a week there will be significant improvement in point tenderness while a stress fracture will take at least three weeks. With bone stress you can return to running when the pain is gone but stress fractures require 6 to 8 weeks of no running. Once the stress fracture has healed adequately there is less chance of recurrence in the same location.



A compartment syndrome can be defined as the increase in pressure within the limited anatomical space of a fascial compartment which compromises the circulation and function of the tissues within that space. If compartment volume is limited or decreased due to tight or thickened fascia then compartment pressures can increase upon normal muscle swelling during exercise. The anterior compartment muscles are most commonly affected in running.


Generally there is no pain at rest or at the start of a run. Pain comes on at a certain distance of each run and is quickly too severe to continue. The muscle feels tight and may be firm to the touch. Within a few minutes of stopping the pain has gone completely. If the anterior compartment is affected, the foot may ‘slap’ excessively when running. This is because the purpose of the anterior compartment muscles are to control ankle movement as the runner lowers the forefoot to the ground after heel strike.


Non-surgical treatment includes changing biomechanics through form modification, change in footwear or orthotics. Avoiding hills or rough surfaces may help as will a reduction of training below the threshold distance of onset of symptoms. Icing and Myofascial release massage techniques can help to release the adhesions between fascia and muscle that may be causing the compartment syndrome.


While immediate improvement can occur complete resolution can take a very long time. In some cases surgical intervention is the only successful treatment.



There are more rare forms of shin pain may mimic some of the more common injuries as described above. Entrapment of the popliteal artery has the same symptoms as compartment syndromes but the onset seems to be more related to intensity of activity rather than duration. Neural entrapments can feel like stress fractures but have less consistent symptoms.


Arterial entrapment will give a lack of pulses at onset which does not occur with chronic exercise induced compartment syndromes. The symptoms of neural entrapment can be reproduced by palpation or percussion of the affected nerve.


Physiotherapy is the best initial treatment however surgery may be required.



The posterioral tibialis muscle is the most common strain in the shin. This muscle acts to control pronation in a similar way that the anterior compartment muscles control ankle motion. The peroneal muscles on the outside of leg, control supination of the foot (roll out), to prevent ankle inversion sprains. Peroneal muscles may also be strained. Pain is usually related to activity and may last for a long time after a run. Pain may occur during other activities of daily living.


Damage may just be normal delayed onset muscle soreness (DOMS) caused by unaccustomed activity or it may be more severe rupture of muscle or tendon. More commonly there was a traumatic event that occurred to cause the injury.


Treatment requires rest and icing for 72 hours. Massage, stretching or heat during this time will make the injury significantly worse. After the 72 hours then a gradual return to activity with massage, stretching and continued icing should see most strains resolve within a week. If the tendon was damaged, or if it was a chronic strain, then a much longer rehab period will be needed.


From these brief descriptions of some of the more common injuries you can see how important correct diagnosis and treatment can affect the outcome and subsequent return to exercise. Incorrect diagnosis can prolong the healing period and can also lead to further injury and increased delay in return to activity.

Steve Manning is the owner and CEO of the intraining Running Centre and works as a podiatrist at the intraining Running Injury Clinic in Milton.

If you have shin soreness and want to get back out and running as soon as possible, visit the intraining Running Injury Clinic. Our podiatry and physiotherapy are all runners and understand how important it is to correctly diagnose and treat your injury to ensure you can return, pain free, to running as quickly as possible.

For bookings, please call us at the intraining Running Injury Clinic on 3367 3088, or book online.


Heel pain and kids

Don’t let heel pain stop your kids from running

with Margot Manning, Podiatrist, running coach, and a mum.  

Heel pain in children, often called Sever’s Disease, is one of the most common injuries experienced in active kids today. Heel pain usually occurs because of the repetitive loading with active play.   The vertical attachment of the achilles tendon to the back of the heel bone (calcaneus) is right where there is a large bone growth plate.

The growth plate is the area where new bone cells are generated and is present until between the ages of 13-16 when children stop growing, and the bone fuses, to make the completed heel bone. During this time, running, jumping, kicking and rapid changes in direction that children do while playing sport exert an incredible amount of sheer force and pulling onto the growth plate. This pulling can create soreness which can be quite debilitating for children and interfere with their ability to play without pain.   Being aware of this process enables you to take a few steps to minimise the chance of your child developing heel pain.

Early detection of heel pain and being proactive can reduce the severity of heel pain and help your kids get back to being kids and enjoying being active. Below are three of the most successful management strategies for treating heel pain in kids.

HeelPain4 Tips to manage and minimise the onset or severity of Sever’s Disease:

  1. Fit their shoes properly – Get the right size
  2. Teach your kids HOW to put their shoes for play
  3. Match the right shoe for their feet needs
  4. Change their shoes regularly

Get the right size…  Make sure their shoes fit properly   2. Teach your kids HOW to make their shoes fit to play, 3.  Match the right shoe for their feet needs  4.  Change their shoes regularly

If heel pain catches you out, don’t worry come and see us to creating a management plan to help both you and your child know what to do before and after playing sport.

Have you noticed any of the following with your child?

  • Limping when walking or when active
  • Favouring one leg over the other
  • Adversity to activity due to pain in the heel
  • Complaints or comments about soreness in the heel

Kids training groups

If you are unsure whether your child has Sever’s Disease, or have noticed any of the above symptoms it is time to take action. Don’t let your kids suffer in pain any more. Our team of podiatrists and physiotherapist at the intraining Running Injury Clinic can help diagnose, assess and provide management strategies to help your child return to activity – pain free.

Make an appointment to see one of our podiatry team today. Often there is minimal out of pocket expense with private health cover claimable on the spot. We recommend you bring all your child’s shoes with you to the appointment so these can each be assessed and possibly modified to help relieve pain.

To make a booking call intraining Running Injury Clinic on 07 3367 3088 or click the button below to make an appointment online.

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 Article by Margot Manning (podiatrist, kids coach and runner)


Children running too hard?

Steve Manning (podiatrist, coach and runner)
By: Steve Manning (podiatrist, coach and runner)

How much should my child train?

It is very easy as parents to live vicariously through our children’s performances.  It is tempting to think that it is a reflection on our parenting.  The reality is that kids will often do the best in the long term if we get out of their way and just support them with whatever they accomplish.  By exerting overt or subtle pressure on them we can spoil their love of running and drive them away from reaching for their potential.

However short-term results are often what we are excited about as athletes and parents.  It takes patience and planning to be the best we can be at the right time.  The journey towards excellence passes by the early developers and burnt out over trainers.

Is winning at an early age a good thing in the long term?

Top 10 tips for young runnersDevelopmental ages for children vary extensively.  In general girls mature earlier than boys but within a gender the variance can be many years.  Early developers gain a confidence boost by easily beating late developers early on.  However in the long run there is some evidence that it is physically better to develop as late as possible.   

For psychological reasons it can be better to excel when older.  Kids who are winning nationals in grade 4 when they first compete often are not participating by grade 12.  Early success can sometimes cause complacency and then frustration when later developers start to catch up.  Late developers have to initially struggle and deal with losing which builds resilience and persistence.  Tactical skills are honed with tough races rather than easy wins.

In my experience over many decades as a running coach I believe that hard training at a young age is not beneficial to children’s long term development as a distance runner.  However I can accept that hard training in upper primary school may be of value if a child is trying to attain a sporting scholarship for high school.  This will be at the possible cost of their long term success but could save parents many thousands of dollars.  That is a value judgement that the parent and child must make.

Can running physically damage my child?

Parents often worry about damaging growth plates in children with too much running.  While active kids are more likely to have growth related injuries like Osgood’s of the knee and Sever’s at the heel the only evidence for growth plate damage is with maximum power resistance training.  Children may have less capacity to train in the heat than some adults due to surface to volume ratios.  Because they have less experience they are unlikely to be able to train long distances as it can take years to safely progress total weekly mileage.  Like with adults overtraining can lead to injury, illness or burnout.

What does hard training involve?

To achieve early success requires frequent intense speed sessions.  Total training load or distance covered has a reduced cost benefit especially for pre-pubescent children.  That is the more kilometres they run the lower the quality of their race performances will be.  So if your goal is for your primary school child to race at their best at a young age then the focus should be on speed sessions rather than mileage.  I always tell my athletes that they should aspire to be running at their best in grade 11 and 12 and to be patient when they hear their peers are doing long intense speed sessions.  While they may not be as competitive in primary school and early high school in the long term they will be better off.

What are the guidelines?

The Australian Sports Medicine Federation’s Children in Sport Committee (ASMF) recommends conservative guidelines “in the absence of evidence of the detrimental effects on children training for distance running”.  These guidelines recommend maximum race distances of no more than 8km at age 12 to 14  and half marathons at age 15 to 16.  They recommend weekly maximum training distances of three times their competitive distances.  Interestingly there is no recommendation about the amount of intensity that is appropriate at different ages even though that is the more likely cause of training burnout and a child leaving the sport.  

For a girl racing cross country at age 14 over 4km that is only 12km.  Even if you used their 8km maximum race recommendation that would be only 24km a week. Even at a slow 6 minutes per kilometre that would only be just over 2 hours a week.  In comparison with other sports like gymnastics and swimming this is not even the amount an elite junior would train daily at age 14.

Should a child run long and slow?

Long slow running benefits children in the same way it does adults: by Improving heart stroke volume and aerobic efficiency (to transport oxygen to muscle); by increasing the capillary network (that delivers the oxygen); and by increasing myoglobin concentration and the number and size of mitochondria so that muscle fibres can use the oxygen when needed.  The result is a higher MaxVO2 and better lactate clearance rates.  Children who run long and slow will not learn to push for long at their maximum speed but they will feel much easier at close to their maximum compared to their intensity focused peers.

Haile Gebrselassie reported that he ran 10km to school every day carrying his books.  His daily running distance was more than the suggested weekly maximum guidelines by the ASMF.  I do not think it would be an exaggeration to say that no Australian child runs as much as he did.  We are so worried about children training too much that I wonder if
our conservative guidelines are preventing our children from achieving their maximum potential as adults.

Children vs adults

intrainingKidsEver since legendary coach Arthur Lydiard started the running boom in the 60’s, distance running training principles for adults have started with base training of easy running followed by the gradual introduction of specific intensity.  Why don’t we let our children follow the same proven pathway to performance success?  I believe that part of it is the climate of overprotectiveness in society.  Children can not be left home alone if they are under 14.  Very few kids make their own way to school by walking, running or cycling.  This then expresses itself by always following the short term conservative approach to childhood risk.  The result is skyrocketing obesity rates in children and they may be the first generation that does not live as long as their parents.

Who do the guidelines target?

Athletics officials are concentrated on the success of elite athletes and their transition from talented children to medal winning adults than they are of the health of society.  But very few children will ever achieve elite success as an adult.  

The great benefit of running to the vast majority of people is improved health and longevity.  Long easy running develops a lifelong love of running while intense speed sessions often create a hatred of hard training as evidenced by the number of previously elite young adults who quit exercise as soon as they finish school.

My recommendation for children’s training loads

IRIC17_RehabLogoV2My recommendation “in the absence of any evidence of the detrimental effects on children training for distance running” is to drop the current guidelines around maximum distances of racing and training.  Instead research should be conducted on safe levels of intensity involving number of intense sessions a week, the total volume of intensity and the proximity to maximum effort in training.

An easy run is like a meditation session.  You get into a rhythm and enter a zone of peace and clarity.  Before you know it your run is over and the physical and mental benefits are obvious in the afterglow.  This is what creates a love of running and a lifetime habit of health and exercise.  This is what should be the focus of running as a child.  If they do go on to become an elite athlete then this love of running will be a great base to launch their career.  Even if they don’t become elite the benefits of learning a love of running early on will continue for the rest of their lives.

If you think your child may be over-reaching and may be heading towards burnout, make an appointment for a FREE 15 minute consultation with one of our experienced running coaches who can help nurture and guide your child to long term success and ultimately enjoyment of running. Click the button below.

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About Steve Manning

Steve Manning (podiatrist, coach and runner)
Steve Manning (podiatrist, coach and runner)

Steve has been coaching children for 35 years since he was 18.  He has coached multiple national champions in cross country, athletics and the triathlon.  His favourite achievement as a coach is when three of his athletes swept the places in the 3000M national schools championship.

He coaches an elite junior squad on Thursday mornings and is available for individual coaching programs through the intraining Running Injury Clinic.  Steve is a podiatrist and sessional academic for fourth year podiatry in sports medicine and paediatrics at QUT.  Steve is the current chairman of the Sports Medicine Australia Queensland Council and is a past chairman of the board.

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Runner heel pain

Emily Donker (podiatrist, coach and runner)
Emily Donker (podiatrist, coach and runner)

Runner heel pain

Injuries aren’t always caused by running, even if that’s when you feel the most pain. Your everyday lifestyle and footwear (or lack thereof) contributes significantly to injury risk. Unfortunately, many people (both runners and non-runners) develop heel pain during their down time, particularly during the hot summer months when wearing thongs and being barefoot becomes almost second nature for many Australians.

Footwear choice and injury risk

When barefoot or wearing unsupportive footwear (including thongs, slides, ballet flats and many other casual shoes), the soft tissue structures within your feet and lower limbs work much harder to maintain good foot position and dampen impact forces, because there is no help from footwear.

Think about a typical day. How much time you spend wearing your running shoes or supportive shoes vs unsupportive shoes or barefoot? Balancing this to suit your foot type and strength is important in managing and preventing injuries, particularly heel pain.

Oofos thong
A better option for a thong – Oofos. Made for runners.

Many injuries cause heel pain, with Plantar Fasciopathy, Achilles injuries and fat pad injuries being the most prevalent. Each of these injuries affects a different region of the heel, so can usually be differentiated by determining the primary source of pain.

Which heel injury is holding you back?

What is Plantar Fasciitis?

ED_Image3_Plantar FasciopathyPlantar Fasciitis is one of the most common complaints addressed by podiatrists among both runners and everyday individuals. Fasciitis refers to an acute presentation, whereas Fasciosis refers to more chronic pain. Pain is typically localised to the medial plantar heel (inside of the heel) at the insertion of the plantar fascia, and sometimes also extends through the medial (inside) arch of the foot. Although the plantar fascia is a soft tissue structure, it’s very inflexible and is responsible for containing the muscles of the foot, maintaining arch integrity and stabilising the foot during both stance and gait. The plantar fascia can quite easily become strained and overworked if your footwear is offering insufficient support, because the plantar fascia is working much harder to maintain it’s function.

Plantar Fasciitis and Fasciosis respond very positively to wearing supportive footwear. Your shoes should offer a more structured arch contour and more rigidity through the midfoot. They don’t need to be over-controlling, but more rigidity will help to prevent excessive arch collapse and movement through the midfoot. Arch contour can also be beneficial for providing more proprioceptive feedback (sensitivity to foot position). Supportive thongs and enclosed shoes with an arch contouring insole are more ideal options, whilst sometimes the addition of a specific orthotic or more supportive insole will be necessary for more support.

ED_Image4_AchillesPosterior heel pain (Achilles injury)

Posterior heel pain (back of the heel) is most commonly caused by Achilles Tendinopathy and related injuries such as Achilles Bursitis. Tendinopathy is a generalised term encompassing both acute (tendonitis) and chronic (tendinosis) pain. Pain may affect the mid-potion of the tendon and/or the tendon insertion lower on the back of the heel bone. Symptoms, including the type of pain and palpable feel of the tendon, vary between these injury presentations.

The Achilles is a common tendon for the calf muscles, and is responsible for pointing the toes and pushing off the ground during walking and running gait. Compared to wearing high heels or conventional running shoes (10-12mm heel pitch), being barefoot or in flat shoes places significantly more stretch and strain on the calf muscles. There is subsequently also more strain through the Achilles tendon. Injury occurs when loading and strain is greater that what the tendon can withstand, either from inappropriate footwear choices, excessive running, or a combination of both factors.

Footwear’s role in Achilles injuries?

Tightshoes_TinglingtoesFootwear again plays a significant role in resolving Achilles injuries. Structure and support are important, but targeting shoes with a higher heel pitch (difference in height/cushioning under the foot between the heel and forefoot) is most important. Increased heel pitch will reduce strain and stretch on the calves and Achilles, and promote active recovery during every day walking and standing without excessive load. Sometimes the opposite approach can be employed.

Wearing shoes with lower heel pitch is suggested to help by passively stretching the calves and Achilles to developing strength. However, with this approach most people are more likely to suffer in the short term due to overload and increased strain. It depends how your body responds. The most suitable approach will be dependent on your specific symptoms and injury presentation.

Plantar heel pain (fat pad injuries)

Injury of the fat padPlantar heel pain (underneath the central heel) can be caused by a number of injuries, with most being related to the calcaneal (heel) Fat Pad. The fat pad is designed to dampen impact forces and work as the body’s self-defence cushioning system. Fat Pad injury causes structural damage and jeopardises function, meaning that the heel bone is subjected to much larger impact forces in stance and during gait. Contusion (partial damage) or complete rupture may occur, with the later typically resulting from a sudden traumatic event such as landing very heavily (usually from a significant height) on a hard surface. Excessive load on the fat pad from long periods of standing or repetitive landings on an unforgiving surface can lead to contusion, particularly if footwear is not providing additional protection.

Fat pad injuries respond best to plenty of cushioning underneath the foot, so again barefoot and unsupportive footwear should be avoided. Your shoes are required to work for the fat pad and prevent excessive force to the heel. Having a structured heel counter can also be beneficial in helping to contain the fat pad soft tissue underneath the heel.

IRIC17_RehabLogoV2So how do you avoid runner heel pain?

Whilst the presentation and treatment required for each of these injuries is different, wearing more sensible and supportive footwear is an essential part of the treatment plan. Being barefoot or wearing unsupportive shoes can be a primary contributor to injury in each case, so whether you’re trying to prevent injury or resolve heel pain, think about your footwear choices and make changes to ensure you are comfortable in your running shoes and your everyday shoes.

If you need assistance to overcome your heel pain, or would like footwear advice, click the button below to book an appointment with a podiatrist at intraining Running Injury Clinic.

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Holiday footwear top tips

Holiday footwear top tips

Podiatry clinics are often busiest after the holidays with many people complaining about their feet that became sore during their time off. All too often, the holiday period sees us trade a suit for beach attire and business shoes for bare feet. While this feels comfortable initially, feet that are used to support and cushioning quickly feel sore and irritated.

Podiatrists will commonly see injuries such as plantar fasciitis (heel pain), and forefoot pain that often arises from holiday makers spending extended amounts of time in unsupportive footwear or bare feet. 

Prevention is better than the cure. This holiday period make sure you are wearing comfortable and supportive footwear. This doesn’t have to be a running shoe (though it is usually a good choice), as sandals and slides such as Birkenstocks are a great option, providing plenty of arch support. You may find the firmness of Birkenstocks can be a bit uncomfortable (and they are best to avoid getting wet), so consider Oofos thongs and slides as an alternative which feel like you are wearing your running shoes.

Made from highly cushioned materials, Oofos thongs and slides are great for casual wear – be it at the beach, or around the home. Whether you are getting away this holiday, or simply enjoying a ‘stay-cation’ at home, make sure you look after your feet with Oofos. intraining Running Centre stock a wide range of colours and styles of the Oofos range. Visit the intraining Running Centre this holiday season and give the gift of happy feet.

If your holiday feet are experiencing pain and soreness, book an appointment to see us at intraining Running Injury Clinic. The sooner you are able to address your symptoms, the sooner you will be back out having fun on your feet this holiday season.

Holiday footwear top tips

Interested in reading more articles written by our running injury expert clinicians? Click here to read more ‘From the Sole’

Comfy feet are happy feet

Article by Emily Donker. Podiatrist, coach and triathlete
Article by Emily Donker.
Podiatrist, coach and triathlete

Comfy feet are happy feet

How much time do you spend in your running shoes each week? And how much time do you spend in work shoes, casual shoes and barefoot?

When assessing and treating running injuries, optimising comfort and function in your running shoes is often a key component of the resolution. However, a majority of runners will only spend 2-10hours per week training and wearing their running footwear, and comparatively will work 40+ hours, walking many incidental km’s wearing inappropriate footwear or being barefoot at home.

Together with your podiatrist, you should consider your everyday footwear choices. Simple changes can make a big difference to improving injury symptoms and prognosis.

Many different instances of forefoot pain can be more effectively managed with sensible footwear. Below are a list of common injuries with tips on footwear choice to help you manage pain during your day to day life.

Common injuries and footwear choice tips

Inflammatory injuries

Inflammatory injuries such as bursitis are aggravated by increased plantar pressure, so it’s important to avoid being barefoot and ensure shoes are soft, cushioned. Running shoes and Oofos thongs are great choices.

Neuroma injuries (eg: pins and needles)


A spacious and non-restrictive fit is essential for relieving neuritis issues and Neuroma because tight-fitting shoes will increase pressure to the inter-digital nerves and aggravate symptoms. Footwear should not have any tight straps or lacing across the broadest part of the foot.

Bone stress

Bone stress to the metatarsals should be offloaded with correctly positioned support, and in some instances a specific boot. Alternatively, footwear choices should be as rigid as possible to prevent excessive flexion and torsional strain.

Forefoot pain

High heels are a particularly damaging choice for all instances of forefoot pain because they significantly increase force and load through the forefoot, so should be avoided when possible.

Make appointmentRemember – comfortable feet are happy feet! If you have a running injury that is causing you pain in your day to day life, make an appointment to see a podiatrist at intraining Running Injury Clinic. Interested in reading more articles written by our running injury expert clinicians? Click here to read more ‘From the Sole’


Groin pain and strains

Article by Doug James (intraining physiotherapist and podiatrist)

Groin injuries – What you need to know

Groin injuries are an increasingly common injury in distance runners. Previously it was predominantly footballers that would develop these injuries due to the forceful nature of the kicking movement, however, runners are now reporting more injuries in this region. Despite being a ‘personal’ area of the body, assessment and treatment of these injuries should occur promptly to reduce the likelihood of it developing into a more severe and chronic injuries.

There are a large number of injuries that can cause groin pain. While the pain can be due to injuries to tendons, muscles or ligaments in the groin itself, groin pain may in fact be referred from an injury elsewhere which makes diagnosis more difficult.

Acute groin injuries

Doug_GroinpainAcute groin injuries are those that start suddenly and are usually due to muscle strains in the adductor muscles on the inner thigh. Adductors attach to the central part of the pelvis and pain can be felt anywhere from the knee to the groin. These injuries often feel like a tightness, however, attempts to stretch the injury can exacerbate a mild muscle tear into a more serious injury. Continued bouts of stretching an adductor tear may induce adductor tendinitis which can cause long-term discomfort that is difficult to settle.

Adjacent to the adductor tendon insertions is the pubic symphysis which is where the two halves of the pelvic girdle are joined together with cartilage. This cartilage can become irritated from adductor tendinitis – an injury known as Pubic Symphysitis – and can also be triggered by running on hard surfaces with poor shock absorption. If poorly treated, a more severe version of this injury, Osteitis Pubis, may emerge where part of the pubic bone is eroded, and a much longer recovery time is needed (including up to a year off running).

Osteitis Pubis is not the only groin injury that involves damage to the pelvic bone. Pelvic stress fractures are a dangerous injury, and shouldn’t be ignored. These often start as dull, non-specific groin pain that will become sharper with running and exercise. A stress fracture can develop and requires a substantial amount of time to settle.

Imaging can be useful to help accurately diagnose groin injuries.

  • Ultrasound can identify soft tissue injuries such as adductor strains and tendinitis
  • MRI is often more effective to detect any damage to the bone.

When imaging fails to detect a problem in the area where the pain is reported, suspicion of referred pain arises. It is important to have your injury assessed by a podiatrist or physiotherapist.

Referred pain

Referred pain that is felt in the groin can originate from many sources including the hip joint (in the form of cartilage tears or joint inflammation), abdomen (abdominal muscle strain), and lower back (tightness and/or disc injuries). Due to the magnitude of potential areas of concern, a thorough examination is necessary with a podiatrist or physiotherapist.

Most groin injuries respond well to resting from activities that cause pain. Care needs to be taken with cross-training as even non-weight-bearing exercises such as swimming can exacerbate the injury. There is often a link between weak core and glute muscles and groin injuries. Improving core and lateral glute strength is useful as both a prevention and (at a suitable time) rehabilitation of the injury.

Be proactive in seeking help. Early diagnosis and management may avoid prolonged time out of training. If you have lingering groin pain, make an appointment and start moving towards pain-free running again.


Book an appointment here or Call 07 3367 3088.

Feet up or hips down

Article by Emily Donker. Podiatrist, coach and triathlete
Article by Emily Donker.
intraining podiatrist, coach and triathlete

Feet up or hips down

Our podiatry team cover injuries from hip to toe

Injury management is all about perspective. Whilst podiatrists are known for dealing with foot complaints, our scope of practice extends much further than many people realise. Yes – we address all sorts of foot issues, but we are also well versed in the anatomy, injuries and management of issues affecting the ankle, lower leg, knee, upper leg, hip and even the lower back. Seeing one of our intraining podiatrist’s about your hip injury might just provide you with the answers you need by looking at things from a different angle.

Proper movement and function of the lower limbs requires a synergy between all the musculo-skeletal structures, so when movement is compromised or compensation occurs during gait or stance, which can be a tell-tale sign of injury. The structure and function of the feet and legs can contribute towards hip injury in many cases. The opposite can also be true, whereby hip injury leads to a secondary injury further down the chain. Both reasons necessitate a more comprehensive podiatric assessment of the entire lower limb structure and gait.

Foot_MassagePodiatry treatment should always be much more than just orthotics. Particularly when addressing hip injuries, a multi-faceted approach is necessary.

At intraining Running Injury Clinic, our goal in dealing with athletes, is to ensure long-term injury resolution. This requires a more holistic injury assessment and treatment plan, with aim to address the underlying cause of injury, in addition to the acute symptoms.

If you have niggling hips and need a “feet up and hips down” assessment, click on the button to see one of the intraining Running Injury Clinic team. It’s time to get back on the road and running pain free again.

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Stronger Achilles for faster running

From the Sole

How to make a stronger Achilles for better performance.

Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic
Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic

One of the best ways to run faster with less effort is plyometric drills.  These drills exaggerate a part of the running action while having a forced dynamic stretch component before springing back.  They include mainly jumping, skipping and bounding.

Research has shown that these drills have the greatest effect on running performance in the least amount of training time.  The downside is that they have an increased injury risk while doing them.

The reason that these drills are so effective is that they work on the elastic component of the muscle.  That is the part of the muscle that stores the energy from landing and then returns that energy like a spring as you push off.  This elastic component is critical to distance running efficiency.

The Achilles and deep fascia connective tissue that surrounds the calf muscle are the most important elastic tissues for runners.  The thicker and stiffer the Achilles the better it is able to store the energy from landing.  Plyometric drills are able to increase the strength of the Achilles by changing the size and strength of each fibre in the Achilles as well as its overall width and resistance to stretching.

Bounding – Plyometric drill for strength

Three ways to incorporate plyometric drills into your training

  1. Initially only do the drills for 10 to 20 minutes once or twice a week and for a training block of 6 weeks.  This will reduce injury risk.  After that you only need to incorporate a few minutes of drills with each speed session.
  2. These drills need to be dynamic but controlled.  Do not strain or reach while doing the drills.  Focus on staying on your forefoot and having as short ground time as possible.
  3. Warmup properly before doing the drills with a run of at least 10 minutes.  Doing some coordination drills like high knees and bum kicks can also help warm up the Achilles for the harder plyometric drills.

Plyometric drills can be a very effective way to faster running through a stronger Achilles.  Our podiatrists at the intraining Running Injury Clinic can instruct you on how to use the best technique to do the drills for the best result with the least injury risk.

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600x600-workshops-logoKeen to take it a step further? The intraining Running Injury Clinic conduct running form workshops on a regular basis.

If you are interested in improving your running technique, reducing risk of running injury or keen to learn more about running form, find out more about the Running Form Workshops available.

For more From the Sole injury articles click here.

Achilles injury and footwear

Article by Doug James (intraining physiotherapist and podiatrist)
Article by Doug James (intraining physiotherapist and podiatrist)

Achilles injuries and your footwear choice

Footwear can be a contributing factor to many injuries, and Achilles tendon injuries are often affected by your shoe choice. If you are currently suffering from an Achilles tendon injury (such as tendinitis / tendinosis, or bursitis) there are a number of footwear factors to consider.

Heel pitch

Many running shoes have a 10mm heel pitch (ie the heel cushioning is 10mm thicker than the forefoot cushioning). This tends to help reduce stress on the Achilles tendon by raising the heel higher towards the calf muscle. Running in shoes with very low or no heel drop can increase the discomfort felt in the tendon, particularly if you have tight calves.

Heel and ankle cuff height

DJ Shoe hee cuff height
Heel cup height on left may aggravate your Achilles

The height of the ankle cuff can impact an Achilles tendon by placing undue pressure directly on the tendon . While a higher ankle cuff often feels more stable, it may also exert pressure on the tendon, exacerbating symptoms.

Heel cup shape

While a narrow heel cup may help reduce heel slippage inside the shoe, it may result in pinching of the Achilles tendon. Compare the angled and rounded heel counters in the two shoes shown below. An irritated Achilles may find relief in a more rounded heel cup.

Notice width of heel cup between two shoes
Notice width of heel cup between two shoes


This was a brief snapshot of some footwear considerations to look out for that may impact your Achilles. If you have injury concerns or experiencing Achilles tendon pain, it is worth seeing a podiatrist at intraining Running Injury Clinic to have your injury, footwear and gait assessed.

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Is your gait causing shin pain?

Article by Doug James (intraining physiotherapist and podiatrist)
Article by Doug James (intraining physiotherapist and podiatrist)

Gait related shin pain

Running injuries are common. In a given year, runners have a 70-80% likelihood of developing an injury that will prevent them from running pain free for at least a week. While there are many different types of injuries that can occur, some people may be more prone to a particular injury while seemingly resistant to others. There are a lot of different factors that can account for this including age, sex, training history, biomechanics (and more) however of these, running technique is one of the few factors that can be changed.

It needs to be mentioned that no particular running technique can guarantee that you will be injury free. Different, and sometimes worse injuries can develop when people attempt to change their running style. The aim of this article is understand the types of shin injuries that can develop from running, and the factors influencing them.

Shin injuries are commonly lumped under the umbrella term of ‘shin splints’ by some medical professionals. This rather obtuse term neglects the specific location, onset and severity of the injury – all factors required for correct diagnosis and subsequent treatment.

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Running can cause injuries to muscle and bone in the shin
Running can cause injuries to muscle and bone in the shin

 Antero-lateral shin pain

Pain on the outside part of the front of your shin is usually related to the Tibialis Anterior muscle. This long muscle is responsible for lifting your foot upwards at the ankle joint. The muscle can become overworked if subjected to more exercise than it is used to and tends to become sore after the run, with pain disappearing a few days later. This injury is frequently seen in those that are new to running, or returning after time off from the sport. People that tend to heel strike (i.e. land heel first) are far more likely to be affected by this injury, and athletes are also more at risk if running in incorrect footwear – particularly if the shoe is too stiff (resulting in foot slapping), or lacks adequate pronation support.

Heel striking occurs when the runner’s heel lands on the ground first – usually in front of their centre of mass – and the further in front, the more of a problem this poses. In this position the Tibialis Anterior muscle is working to have the toes lifted higher than the heel to prevent tripping. The forefoot then rapidly lowers putting further strain on the Tibialis Anterior as it is responsible for the controlled descent of the foot. Once the foot is flat on the ground, the Tibialis Anterior may be subject to further strain if the foot heavily and/or rapidly pronates (rolls inwards).

The Tibialis Anterior can be put under even greater levels of strain when running downhill as this tends to amplify the slapping movement of the heel-to-toe progression.

Key points you should know

  • Your running technique can predict the type of injuries you get
  • “Shin Splints” is a commonly used term but utterly innaccurate
  • A running assessment can help identify faults leading to shin injuries

Postero-medial shin pain

Pain felt on the inside part of the shin along the edge of the tibia (shin bone) is often diagnosed as Medial Tibial Stress Syndrome (MTSS), or more recently known as Medial Tibial Traction Perisostitis (MTTP). Irrespective of the nomenclature, the injury usually begins as a broad area of discomfort along the inside part of the shin. This usually starts as a mild discomfort at the start of the run, but resolves after a few minutes. The pain is usually a response to an increase in loading along the edge of the tibia causing swelling around the periosteum (outer lining of the bone) initially, which can progress to bone damage thereafter. The increased loading is usually from higher running volume or intensity (or both) than is usual. Conjecture exists as to whether damage is due to force generated at foot strike, associated muscle tension from the Posterior Tibialis muscle, or some combination of both.

Training load plays a large role in the development of this injury, however there are certain gait factors that may increase the likelihood of developing it. Over-pronating can play a part in increasing the tension in the Posterior Tibialis muscle, which in turn exerts a traction force on the tibia. Overstriding (landing too far in front of the centre of mass) increases the initial impact forces transferred through the lower limb and shin that can also damage the tibia. Additionally, running in shoes that offer insufficient cushioning (i.e. are worn out, or offer less support than the athlete is accustomed to), and under-pronating can increase shock that also affects the tibia and lower limb.

Worse still…

Overstriding and heel striking are two common factors in shin pain
Overstriding and heel striking are two common factors in shin pain

With both of the injury areas mentioned above, after a sufficient reduction in training (and in some cases complete rest) for a suitable period, the injury will recover and heal. There are two notable exceptions to this however – shin injuries where pain becomes worse with running need to be investigated immediately. Sharp localised pain (on the front or side of the tibia or fibula) can be the sign of a stress fracture and should never be run on as this will steeply increase the injury severity and healing time required. Management usually involves rest (the amount of which can be calculated somewhat more precisely with the aid of an MRI scan), a fracture boot (in some cases), and a considered return to exercise plan.

The other critical shin injury not to miss is compartment syndrome. This is a dangerous injury where pressure builds up in the muscle sheath persisting for hours after exercise and can lead to permanent damage to the muscle and nerves in the leg and foot. This often requires surgery. If you suspect you have a stress fracture or compartment syndrome this should be investigated immediately.

For the injuries mentioned earlier, specific changes in running gait, footwear, and training can help to reduce the severity and reoccurrence of these injuries and possibly lead to better performance as well. If you’ve been dealing with running related shin problems, contact the intraining Running Injury Clinic for an appointment.

600x600-workshops-logoIf you are training more without realising the benefits of increased performance, it may be a simple modification to your running form that will result in the benefits you are looking to achieve. The intraining Running Injury Clinic conduct running form workshops on a regular basis.

If you are interested in improving your running form or reducing your risk of injury, sign up for the Running Form Workshop on 8 October or 3 December 2017.

For more From the Sole injury articles click here.

Run right with gait modification

Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic
Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic

Gait Modification and Drills

Your key to reduced injury and running faster

There are a few circumstances where running technique can be a cause of injury. However most times it is only a contributing factor to injury. Gait modification drills can be used to correct running form faults and improve control while running.

Drills are categorised by the type of change you are seeking. The initial drills are about Coordination and include drills like high knees and bum kicks. Their goal is to create a coordinated and flowing movement between the upper and lower limbs.

plyometrics_drillAnother group is focused on reaction time. Their goal to develop the body’s ability to react and alter its position quickly using sensation, perception and response.

The final and hardest group are power drills, incorporating plyometric training, with the aim to reach maximum muscle force in shortest period of time. Plyometric training creates a pre-stretch of the muscle before contracting forcefully. These drills include, skipping and bounding.

While improving strength and control through running drills may also improve performance, the main goal is a reduction in injury risk. Running drills create greater strength outside the limited range of motion that running usually involves. They are an exaggerated movement of what you want to do when running. That way if you are in a high injury risk movement like when spraining an ankle your body will be able to recognise what is happening and automatically change what you are doing to avoid injury.

600x600-workshops-logoIf you are training more without realising the benefits of increased performance, it may be a simple modification to your running form that will result in the benefits you are looking to achieve. The intraining Running Injury Clinic conduct running form workshops on a regular basis.

If you are interested in improving your running form or reducing your risk of injury, sign up for the Running Form Workshop on 8 October or 3 December 2017.

For more From the Sole injury articles click here.


Stay injury free

Want to stay injury free?

Here are three things you should know.

You may have just run your first major goal race. While this is an exciting running period, it is the time when you are most vulnerable to developing an injury. To help you stay on the road, here are three reminders to keep you running happily running towards your next goal race.

1.Long runs vs racing

If you have multiple races planned such as the Gold Coast Marathon, Brisbane Marathon Festival and Twilight Bay Run, you should be changing your long run focus in your training plan. This phase of training is called the competitive phase so the emphasis is more on the racing. Long runs will still occur but less frequently to allow maximum benefit from each of the races you have done.

2.Pace control

Successful races and improvements in training times are amazing motivators. But it is now that you need to exert even more control in managing your speed sessions and weekend races so not to let your enthusiasm override your goal training pace. Planning your speed work and long run paces in advance can help to avoid overtraining. It can be useful to sit with a coach and plan these paces for each session to help keep you on track. Our podiatry team are also coaches and can help you write an individual program with personal pace targets.


3.Refresh your footwear

It is 7 months now since you may have set your 2017 goals and purchased your training shoes. If your legs are feeling a little more tired or the shoes are feeling soft, now is definitely the time to replace them or add the new shoe into the mix. Don’t let a dying or worn out shoes be the cause of an injury that will interfere with the rest of your year’s racing. If you aren’t sure, or think you may need new shoes come into the intraining Running Centre at either Milton or Indooroopilly locations and have our footwear experts assist in providing you with advice on selecting the right type of shoe to suit your running needs.

Article by: Margot Manning podiatrist and running coach
Article by: Margot Manning podiatrist and running coach

Remember these three tips, and take action early if any niggles get worse. At intraining Running Centre, we love running and share your passion, and will work hard so you don’t miss a minute of it.

Have a question for our coaches? Click here to email us your question

Need help with an injury? Email our running injury specialists at intraining Running Injury Clinic.

Lateral knee pain

Lateral Knee Pain

Lateral knee pain on the outside of the knee is most often ITB Friction Syndrome, however the rarer types of lateral knee pain should not be missed as the optimum treatment will differ between them.  Lateral knee pain is one of the most common injuries for runners.


The Illiotibial band (ITB) is a long tendon of a small muscle from the hip – the Tensor Fascia Latae.  Gluteus Maximus also partially attaches to the ITB but at an oblique angle so that it has less mechanical advantage then the Tensor Fascia Latae.

The purpose of the ITB is to add to the lateral stability of the knee.  Through most of its length the ITB is a flat thickening of the deep fascia that holds the muscles in place.  However it becomes more like a thick cord as it approaches and passes the knee joint to attach to the main lower leg bone, the Tibia.


The pain in ITB friction syndrome is rarely within the ITB itself.  It is more commonly caused by inflammation or irritation of a bursa on a bump on the thigh Bone (femur). Bursa’s are lubricating sacks that help to reduce the friction between a tendon and the bone.

Excessive compression force from the ITB as it slides past the bursa during gait can cause trauma to the Bursa triggering the injury.  This usually happens just after footstrike at about 20 degrees of flexion.  The pain from ITBFS can be sharp and intense or aching.  It will usually not warm up as you run but get worse the longer you go.  Downhill running with its increased impact forces are more painful than running on the flat.

Are you experiencing ITBFS? Click here to see one of our podiatrists at intraining Running Injury Clinic


One interesting factor in ITBFS is that it can be caused by two opposite motions.  Excessive pronation or rolling in of the foot causes a stretching strain of the ITB as the pronation results in internal rotation of the knee.  Lateral instability and rolling out of the foot also puts tension and strain on the ITB.  It is critical that the biomechanics that is causing the tension be identified as any orthotic or footwear intervention can make the problem worse if misdiagnosed.

Foam rolling

Tightness of the ITB or adhesion’s to the deeper muscle are a factor in the risk of ITBFS.  Stretching of the ITB has not been shown to be effective.  Mechanically stretching the ITB with massage is much more effective at increasing flexibility and reducing adhesion’s.  Regular use of ITB rollers will reduce recovery time and the risk of recurrence of the injury.  Icing and anti-inflammatory gel will quickly reduce the severity of symptoms.


One injury often misdiagnosed as ITBFS is tendinopathy of Biceps Femoris one of the hamstring muscles.  It usually hurts just before its insertion on the head of the smaller leg bone the Fibula.  The symptoms can be very similar to ITBFS however the location of pain is distinctly different being more posterior.  Sometimes tension from Biceps Femoris affects the fibrous joint between the two lower leg bones requiring mobilisation.


Pain on the knee joint is often from trauma or degeneration to the lateral meniscus.  The knee sometimes gives way when there is a tear in the meniscus.  It is sore along the joint line crossing under the ITB and below where the ITB usually hurts.  Clinical tests can often identify meniscal abnormality but an MRI may be needed.  Osteoarthritis in the lateral knee compartment can also cause joint line pain.

Lateral knee pain is one of the most common injuries for runners.  It is important that you have an accurate diagnosis in order to recover from the injury and reduce risk of it recurring.

Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic
Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic

The podiatrists at the intraining Running Injury Clinic are experienced at treating lateral knee pain. All of our clinicians are runners and share your passion. Our team of clinicians can help plan a safe return to running with a specifically designed rehabilitation training program to get you back running, sooner.

If you have had lateral knee pain that lasts longer than two weeks or is severe enough to make you limp then you should make an appointment to see one of the podiatrists at the intraining Running Injury Clinic – Milton and Indooroopilly.

For more From the Sole injury articles click here.

Calf injuries and you

Calf injuries during race season

By: Doug James (intraining podiatrist and physiotherapist)
By: Doug James (intraining podiatrist and physiotherapist).

There are few things more frustrating than spending months training for a race, only for an injury to prevent you from being able to run it. Calf and lower leg injuries are responsible for a good number of these ‘DNS’ (Did Not Start) type injuries, but many of them are preventable.

Your calf muscles and lower legs are like barometers for how well you are handling your training load. Pain and muscle tightness are often signs of overuse and may signal an oncoming injury. The biggest cause of running injuries are errors in your training approach. At this point of the season errors may be due to not allowing sufficient recovery time between hard sessions, and failing to heed warnings that you are pushing too hard.

Optimal performance comes from finding a balance between a decent volume of training, while allowing enough time to recover. Your recovery can be aided through ice baths, and manual therapies such as massage, dry needling and foam rolling. When these things no longer relieve symptoms, a more serious injury may be presenting.

Common calf injuries include muscle tears, tibia stress injuries and Achilles tendinitis. Muscle tears can arise purely from bad luck (though over exertion is usually a factor), but as with the other two injuries, they may be a result of overuse and/or bad biomechanics. If you’ve trained for much of the year, you would likely have worn through at least one pair of running shoes by. Having a relatively new (but worn in) pair for your goal race is a sensible idea. Dramatically changing the type of shoe however, isn’t.

The heel pitch (height of the heel compared to the forefoot) can affect how much strain is placed on your calf and Achilles tendon. The average running shoe has a heel drop of about 10mm (meaning the heel sits 10mm higher than your forefoot). If you were to suddenly start running in a shoe with much lower heel drop – which a lot of racing shoes do – you may find yourself with a painful calf and/or Achilles.

Heel to toe drop example

Wearing a shoe that has too much, or too little pronation support can also be an issue. Pronation support is a feature in shoes that may help to reduce strain on parts of your foot and leg – assuming you need it. Wearing a shoe with an unnecessary amount of pronation support and stiffness can result in excessive force on your leg, Achilles tendon and calf muscle.

IRIC17_RehabLogoV2In cases where correct footwear prescription alone isn’t sufficient to remedy an injury, it may be necessary to consider a foot orthotic. A podiatrist can design a shoe insert to improve your foot biomechanics which may help lessen the impact on your leg and calf.

If you are having issues with your calf (or want to avoid them) contact the intraining Running Injury Clinic for an appointment. Our team of podiatrists are able to prescribe the ideal training or racing shoe for you (and custom made orthotics if necessary). Additionally, physiotherapy can be useful for pre-event massage and dry needling to get you running at your best.

Good luck with your winter running season!

Racing for training

Article by Emily Donker. Podiatrist, coach and runner
Article by Emily Donker.
Podiatrist, coach and runner

Racing for Training

Training allows you to focus your attention on specifics in a much more controlled and relaxed environment, which certainly has many benefits. But nothing can prepare you for racing quite like racing itself.

Racing is by far the best way to condition yourself for racing – however, you can’t race all the time. Regular racers need to race smart to ensure they can achieve their goals and continue to improve without being overcome by the stresses of racing too much.

Racing hard challenges your physical and mental limits. Regularly pushing yourself in the more pressured environment of racing allows you to become more familiar with the situation, and become more equipped to respond better during future races thanks to the experience.

RacingPacing is something you can practice over and over and over again in training, but race day is always different. The adrenaline and nerves always challenge your levels of restraint and often people will start their race too fast. By racing regularly you will be become more familiar with judging your pace, even when amped up and ready to go.

Nutrition and hydration are extremely important and greatly affect performance in longer events. Again, you can practice your strategies in training, but only race practice can give you a true feel for how you will respond to taking on fluid and nutrition in stressful conditions.

Whilst there are many benefits to racing and using racing as training, it also requires much more down time post-event to properly recover and recharge. Ideally, you should race regularly – the frequency will be different for everyone and dependent on the season, but should always ensure you take adequate time to recover, otherwise you risk physical and/or mental fatigue, and increased chance of injury.March Recovery foods

A good strategy is to target only a handful of goal races during each season. Other events should be seen as training races and be treated as such, with less focus on results and more attention on the process of getting things done and working towards your next goal event. parkrun and Brisbane Road Runners are great local examples of regular events where you can get race practice – with proper timing and racing conditions, but without the same focus on performance outcomes.

Take a look at your racing calendar. Don’t be afraid to throw in a couple more relaxed races to ensure you’re ready for your next goal.

Keen to learn more about running injuries? Check out our monthly ‘From the Sole‘ newsletter, written by intraining Running Injury Clinic podiatrists, physiotherapist and dietitian.

Neuritis of the foot

Article by Margot Manning Podiatrist, coach and runner

Neuritis of the foot

Are you experiencing unusual sensations in your feet such as pins and needles, numbness, a burning pain or the sensation of a rock inside your shoe?  If so, there is a good chance that you have a developed a case of neuritis.

What is neuritis of the foot?

Neuritis of the forefoot is where the nerves between the long bones (the metatarsals) become irritated from increased pressure.  The symptoms tend to start later in the run and may go as soon as you take your shoes off.

Neuritis imageCauses of neuritis

The most common cause of neuritis of the Forefoot is from shoes that are too tight.  This could be from across the width of the shoe, the length and even the depth of the shoe. As the foot exercises for a longer period of time normal swelling will occur due to increased blood flow.  If the shoe does not have enough space to accommodate the enlarged foot, the nerves become entrapped and cause pain.

If the foot is quite flexible the small arch that goes across the foot (the transverse arch) from the 1st joint to the 5th flattens to create increased splaying of the toes.  This can be harder to identify as it is not until the foot is fully loaded with running or walking that this splaying becomes visible. Repetitive loading of the transverse arch with the long runs of marathon training can contribute to neuritis.  This may not present  until the very late stages of a long run or even in the marathon itself.

Fitting shoes to prevent the pain

Ensuring you have the correct fit with room for the foot to expand should prevent these symptoms from occurring. Most shoes are shaped to have a tapered and slightly rounded toe box, but if a foot is not this shape then it is going to be put under pressure in areas that it is not used to.  Typical variations in foot shape that can lead to neuritis include wide or square shaped feet, bunions, long second toes, high arches, and very flexible feet.  More care is required when fitting a shoe to these foot types and luckily there now is a good range of shoe shape designs and widths to accommodate them.


For bunions, many shoes now are seamless across from the big toe joint to the 5th toe joint. Some shoes have offset the lacing path to alter the line of tension while deeper toe box designs have become a more traditional to allow for more toe room.  For the high arched foot, a shoe with increased depth through the laced area is important.

Modifying the shoes to suit

When a perfect fit can not be found or a shoe has been worn for a while and can’t be returned, there are ways to modify the shoe.  Re-lacing is an easy way to take pressure off different parts of the foot.  Stitches around features attached to the uppers can be unpicked.  Metatarsal domes are commonly used by podiatrists to prevent flattening of the transverse arch.  For more complicated cases where the biomechanics of the runner are contributing to the injury, insoles or orthotics become useful to fill help fine tune the fit of the shoe and adjust movement patterns.

Neuritis of the foot can be a very unpleasant sensation, but in most cases, remedied relatively easily.  The first step is to ensure your footwear is the correct fit.  If this does not resolve the pain, book in to see one of the podiatrists at intraining Running Injury Clinic for more thorough investigation and management plan.

Keen to learn more about running injuries and training articles? Check out our monthly ‘From the Sole‘ newsletter, written by intraining Running Injury Clinic podiatrists, physiotherapist, dietitian and experienced running coaches.

Pain is your friend

Why pain is your friend?

Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic
Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic

You should not be trying to ignore pain but instead should be embracing it. Pain tells you when you are pushing enough and when you are pushing too hard. Pain is the leveler. It is your companion on a run and after a hard effort. Pain keeps you on track to achieve your goals and lets you know when they are unrealistic. Pain is not your enemy but is your friend.

When people first start running every step is an effort that requires focus to keep running with the pain. After a few weeks of regular running, suddenly they find it no longer hurts to run and the absence of pain lets them know their running has moved to a new level. It gives them the confidence that better times are ahead.

When you are running hard in a speed session or race the level of pain you are experiencing at different stages of the run helps you keep on a pace that you know you can maintain. The most even pace you can run will give you the best potential result. Your sensation of comfort or distress is the cue that you are running at your best potential pace.

Painrunning1One research study was looking at the effect of NSAIDS on training adaptation. They had their subjects run fast downhill which created a lot of delayed onset muscles soreness (DOMS). Half of the group was given pain medication for a few days after the run. A few weeks later they did the same downhill running session. What they found was that the runners who had taken the NSAIDS had more pain after the second session than the runners who just suffered with the pain of the hard training. The conclusion was that pain was a required variable in the adaptation of the muscle to be able to cope with the stress. By taking the pain relief medication the muscle adaptation was disrupted and compromised.

Pain_smallOver 60% of runners become injured badly enough each year that they need to take a break from running. The most important benefit of pain for running is to let you know when you are at risk of a niggle turning into an injury. The severity, duration and effect of the pain directs you to ease back on training or to seek advice. If you are limping from the pain or it sticks around for more than two weeks or is getting progressively worse then you should see one of our podiatrists at the intraining Running Injury Clinic. The pain actually helps reduce the time you may be off running by following the best treatment plan right from the start.

So make pain your friend and you will be able to understand the great benefit that it can bring to your running.

Keen to learn more about running injuries and training articles? Check out our monthly ‘From the Sole‘ newsletter, written by intraining Running Injury Clinic podiatrists, physiotherapist, dietitian and experienced running coaches.