10 quick fire questions with runner David McNeill - two time Australian Olympian

Dave McNeill lives and trains in Melbourne’s inner north, our favourite part of town.

Get to know our local legend here, and perhaps try his famous breakfast smoothie after your next lap of Princes Park or Yarra Bend!

1. What event did you compete in at the Olympic Games and which year/location did you compete in?  

• London, 2012 - 5000m

• Rio, 2016 - 10,000m

2. Favourite running session to do in training? 

Anything on the track involving reps of different distances and paces.

3. Preferred shoe to race in/train in? 

• For training: Nike Pegasus turbo and Nike Infinity React

• For racing: Nike Matumbo on the track & Nike Vaporfly Next% on the road

4. Go to breakfast before a hard training session (or after, if you eat your big meal after)?

Always two breakfasts (before and after). Before would be porridge with a little maple syrup. After would be a smoothie with blueberries, bananas, protein powder, yoghurt and milk (to keep on top of my bone health!), and a breakfast burrito with scrambled eggs, veggies, cheese, and hot sauce. Tea or coffee accompanying each.

5. Tip for managing the stress, frustration and worry that comes with being injured.

Make a plan early, including a rehab plan, cross-training plan, recovery plan, dietary plan, etc... and invest your mental energy into the plan rather than worrying about what might be lost through injury. Then start investing emotional energy into productive pursuits that have been put on hold because of the focus on athletic endeavours. Go and have a drink with friends, go for that weekend getaway, spend more time with people that lift you up and make you smile.

6. Race you would love to run but haven't had the chance?

Any of the many Diamond League races I haven’t competed at (only been to Pre Classic and New York).

7. Favourite location in the world to run? 

Flagstaff, Arizona.

8. What do you do/eat/drink in the days after a big race to celebrate the goal being accomplished?

I try not to deprive myself of too much in preparation for a race. But an extra beer is probably in order after a good race. 

9. Pump up song to listen to before a training session or race, either driving there or during a warm up?

I prefer not to get too pumped up before training or racing. I like music with a relaxed rhythm that I can hum during the session, and that I can match my breathing and stride to. Petit Biscuit, Shallou, and Bonobo regularly get a play in the car ride to sessions.

10. Aside from the physical benefits, what does running do to enhance your life?

It really does it all for me! It’s a routine, it’s exercise, it’s a mental health check, it’s a connection to nature, it’s a perspective builder, and it’s a metaphor for most other things I put my mind to!

Thanks for that insight Dave! You can follow Dave’s journey to the Tokyo Olympics via instagram: @rundmc_neill

My gym is closed and all I have is the footpath. But I’m not a runner….

Let’s face it, 2020 is not what we planned. Everything seems to have been flipped on its head, even our exercise routines. Many of us turn to exercise and physical activity to manage stress, however we may not have access to our trusty spin class, weights session, or local swimming pool.

Enter the footpath.

What was once a useful piece of public space is now crowded with joggers, prams, bikes, dogs, and neighbours you've never seen before who now politely smile at you.

This useful piece of public space is now a means to keep fit, stay active, and move our bodies during this time of physical distancing and self-isolation.

But if you’ve never run before, and you’re starting to realise this might be one of your only options for exercise out of the home, you might be feeling apprehensive. As a podiatrist and long distance runner, I say embrace it! Although before you don that active-wear, consider these helpful tips.

Footwear

You don’t need much gear, but the right shoes for your foot type and biomechanics will help. A visit to our friends at The Running Company Clifton Hill will get this sorted. A teleheatlh consultation with our great podiatrists to discuss your current shoes, are both great first steps.

How do I start?

We crawl before we walk, and we walk before we run. Once you’re walking comfortably for 45-60 minutes a few times each week, your joints and tendons will be ready to handle the stress of running. Head out for 20 mins and within that time, alternate between walking and running. Keep the run interval to about 2-3 minutes, and walk in between to catch your breath and “re-set” before going again.

How to recover

Stick to 3 or 4 days per week in the beginning and ensure a rest day in between your running days. Remember the 10% rule: never increase your volume or mileage by more than 10% of what you did the previous week. For example, if you run 20 km in one week, don’t run more than 22 km the following week. A short stretch of your calves, glutes, quads and hamstrings post-run is also a great habit to get into.

Happy running . . watch out for that pram!

Nail salons. Keeping podiatrists busy

A lot of people visit nail salons, which is fine. However, a growing number of the people who visit nail salons are leaving with ingrown toenails, fungal infections, or more serious foot conditions.

There is no requirement for people who work in nail salons to hold a qualification, use sterile instruments, or adhere to quality and safety standards.

Podiatrists are university trained practitioners with skills and expertise to prevent, diagnose and treat conditions of the foot and lower limb. Podiatrists are foot health experts and are the safest and best qualified professionals to deliver care to patients with foot problems. Registered podiatrists are also required adhere to registration standards including strict infection control guidelines.

I hear you say, "but it's cheaper than a podiatrist so I'm going to keep going." This is fair enough, so here are a few tips to reduce your chance of running into trouble.

1. Don't let the salon attendants use a scalpel to remove callus. It takes many years of training to learn to use a scalpel appropriately, and many people who visits nail salons leave with large wounds from improper scalpel use.

2. To reduce your risk of a fungal or bacterial infection, take your own set of instruments.

3. Discourage nail attendants from digging around down the sides of your nail. We see a lot of ingrown nails due to this.

4. Remember nail salon attendants are not health professionals and you should not reply on their advice regarding foot conditions.

What on earth is shockwave and why will it help my plantar fasciitis?

The word 'shockwave' sounds more like a '90s music festival than a medical treatment, but it can be an effective method to reduce pain for certain conditions.

How does it work?

Excellent question. No one knows for sure but there are a number of leading theories. Shockwave is not actually a shockwave but is an acoustic wave (sound). This acoustic wave can help tissue growth and increase blood flow, which can be important for chronic conditions. It can also reduce pain by changing neurotransmitters that are responsible for sending signals to the brain.

Is it safe?

Yes shockwave is a very safe treatment for most people. If you are pregnant, have a blood clotting disorder, a metal implant, or for children, shockwave is not a treatment option.

What does it feel like?

For this treatment a wave or pulse will be delivered approximately 2000 times. You will feel a slight 'hit' on the part that is being treated. I find that people often report different sensations. Some people think it feels amazing, like a massage. Other people report some discomfort that feels like an electric shock.

What conditions can shockwave be used to treat?

Shockwave is excellent for tendon and fascia conditions. In the foot and ankle, these will include Achillies tendonitis and plantar fasciitis. There is good evidence that supports the use of shockwave to treat these conditions.

More information

The podiatrists at Fitzroy Foot and Ankle Clinic have been using shockwave for several years and have treated hundreds of patients. It is a very effective treatment for plantar fasciitis and Achilles tendonitis, as part of an overall treatment plan.

Make an appointment with one of our podiatrists if you would like to chat about shockwave, or follow this link to our page to find out more about shockwave.

4 tips for avoiding running injuries

As a podiatrist, and a runner, I see many patients who present with injuries of the foot, ankle or lower limb because of errors they have made in training. For that reason, I am going to share the most common training errors I see in clinic, and advise on how best to avoid making the same mistakes.

1. Too much, too soon

Let’s say your mate at work has signed up for a 10km fun run in 8 weeks time and you think it sounds like a great idea. So, you sign up too! The only problem is you haven’t been doing much running so you “cram” in some training, just like you cram study, before exams. The issue with this is that study and running aren’t the same thing and the cramming philosophy doesn’t really work when it comes to preparing for an athletic event. You might feel great for the first two weeks, maybe even four, but if your weekly mileage or intensity (often both!) increases too quickly you will almost certainly break down and never make it to the start of the 10km run!

2. Introducing intensity . . . prematurely

For athletes just starting out, or those returning to training after significant time off, establishing a large “base” is absolutely critical. This is achieved by easy running, A LOT of easy running. The idea of commencing work-outs or sessions (e.g. speed work, fartlek training or any kind of interval training) should not be considered until a substantial amount of easy running (8-12 weeks) has been achieved without injury or a break in consistency. As they say, “if you can’t do the easy stuff, you can’t do the hard stuff.” Hold back, run easy and build the base before you even contemplate introducing the faster stuff.

3. Little or no “strength and conditioning” and stretching

Full-time work, children, a social life, life admin, the list goes on! I know, I know, it’s lucky you can even fit a few runs in each week…so how or why on earth should you squeeze in low intensity activity to complement your running and assist in preventing injury? The unfortunate truth (for some) is that without strength and conditioning, stretching, the foam roller or tennis/spikey ball, your time spent out on the trails may not be as rich and plentiful as you’d like. In order to prevent injury by building a robust body it’s critical to spend some time each week on the “one percenters.”

4. Striving for unrealistic goals

You wouldn’t turn up to a house auction and bid on something substantially out of your price range, so why sign-up for a half marathon when a 5 km walk will have you reaching for the ibuprofen? It’s great to set the bar high, to dream a big dream, and go after a goal, but be realistic. Can you really put in the time to train for it? Has your body completely recovered from the last niggle? Have you taken into consideration your past performances and set a realistic goal that you can achieve, or at least come close to? Striving for something unrealistic will almost always lead to both the “too much too soon” error and the “introducing intensity prematurely” error mentioned above. So keep it real. Don’t compare yourself to others, nor the person you were 12 months ago. Don’t sell yourself short but be honest with what you can achieve, both in training, and on race day.

To discuss any of the common errors outlined above, or any other podiatric issue related to the lower limb and foot, book an appointment with Sophie or Glen at Fitzroy Foot and Ankle Clinic.

Evidence shows orthotics may help reduce plantar fasciitis pain

As a part of my PhD comparing orthotics and corticosteroid injections for plantar fasciitis, I have just published a review of the effectiveness of orthotics. The article has been published in the British Journal of Sports Medicine, and found that orthotics are effective at reducing pain, but not immediately. We found that they were most effective approximately 2-3 months after starting to use orthotics.

Clinically, this may indicate that it is important to combine orthotics with another treatment that is effective at reducing pain in the short term, such as shockwave therapy.

A short video summary of the findings is below:

Whittaker et al. (2017). Foot orthoses for plantar heel pain: a systematic review and meta-analysis. Br J Sports Med. doi: http://bjsm.bmj.com/content/early/2017/09/21/bjsports-2016-097355.

5 tips for avoiding plantar fasciitis

There are many forums and blogs that discuss plantar fasciitis and its treatment. What we don't really understand is what causes plantar fasciitis, however we do have a good idea about the main risk factors for getting plantar fasciitis.

1. Keep your weight down

This is easier said than done, however one possible causes of plantar fasciitis is compression of the plantar fascia under the heel bone. If there is too much weight coming from above the plantar fascia can get overloaded and the tissue will break down. Often people with plantar fasciitis will report recently gaining weight, and the plantar fascia does not have the capacity to deal with this increase in weight. People who have a high BMI are more likely to experience plantar fasciitis, and in most randomised trials for plantar fasciitis, the mean BMI is 30 kg/m2 (which is classified as obese).

2. Stretch your calves

Decreased ankle joint range of motion is another important risk factor for plantar fasciitis. When we walk our body needs to move over the foot, however if there is insufficient motion at the ankle, the motion will be found at the next joint. This will lead to flattening of the arch and increased stress being placed on the plantar fascia. So maintaining good ankle joint range of motion by having flexible calves is an important method of preventing plantar fasciitis, and other type of foot pain.

3. Avoid flat shoes

Plantar fasciitis is more common in warmer weather when people are walking around barefoot or in flat sandals or thongs. When standing barefoot, there is increased tension placed on the plantar fascia, plus the body's centre of pressure is located toward the heel. When wearing shoes with a heel lift the tension on the plantar fascia reduces, and the centre of pressure moves toward the toes.

4. Avoid standing for long periods

Another big risk factor for plantar fasciitis is the number of hours spent standing. People who have jobs requiring long periods of standing on hard floors (e.g. nurses, teachers, chefs) tend to experience plantar fasciitis more often. Rather than quit your job and work in an office, trying to break up long periods of standing may help to reduce the chance of getting plantar fasciitis.

5. Modify long distance running

Any respectable running blog or forum will be plastered with posts about plantar fasciitis, because it is common in those who run long distances. Similar to those who have high a BMI, there is either a repetitive compression of the plantar fascia into the heel bone or an excessive pulling of the plantar fascia where it inserts on the heel bone, or both are happening at the same time. If you are prone to experiencing plantar fasciitis, and can't deal with the pain, modifying your running may make a difference. This may involve reducing the number of sessions per week or the distance you run.

Is toe-walking in children something to worry about?

Concern for a child toe-walking is a common reason that parents consult a podiatrist or other health professional. Children who toe-walk usually fall into one of four broad categories:

1. Neurological conditions such as cerebral palsy;

2. Autism spectrum disorder;

3. Clubfoot;

4. Idiopathic (meaning no definable cause) toe-walking.

The first three categories are usually picked up in early childhood, however toe-walking may be one of the first clues for autism spectrum disorder. Children with autism spectrum disorder may prefer to walk on their toes as they receive less feedback when only a small part of their foot (i.e. their forefoot) is touching the ground. Children are placed in the final category, idiopathic toe-walking, once the first three categories have been excluded.

Idiopathic toe-walking

This is the most common cause of toe walking, with idiopathic meaning that there is no definable cause. Often, children will walk on their toes out of habit or a preference to walk this way. After toe-walking for a long time, children may experience shortening of the calf muscles, and it is also important to consider the social or emotional impact of toe-walking on the child.

Treatment usually focuses on encouraging the child to walk on their heels through games, certain footwear, plus stretches to lengthen the calf muscles. Often the toe walking will reduce with age, however in some cases more invasive interventions are required including botox injections, casting or bracing, or surgery.

If you are concerned about a child that is toe-walking, The Podiatrists at Fitzroy Foot and Ankle Clinic are experienced in assessing and managing this condition.

3D laser scanned orthotics

The podiatrists at Fitzroy Foot and Ankle Clinic use 3D laser scanning to create custom-made orthotics. 3D laser scanning has a number of advantages, including:

• more accurate impressions of the feet;

• no need for messy plaster casting;

• the orthotics are returned to patients faster as the laser scan of the foot will be uploaded to the orthotic laboratory's servers immediately;

• reduced time as the laser scanner takes a few seconds once setup;

• the scan of the foot is electronically stored for easy retrieval in the future;

• allows more accurate placement of offloading padding

We have invested in this technology as we feel 3D laser scanning allows us to create better custom made orthotics in a faster time-frame, which ultimately provides a better service to our patients. We are able to provide this extra service without any extra costs being passed on to our patients.

What is plantar fasciitis . . .

Plantar fasciitis is a pathology that affects the plantar fascia. Your plantar fascia is a structure, similar to a ligament, that attaches on the bottom the the heel and connects under the forefoot. Commonly, people will experience pain where the plantar fascia inserts onto the bottom of the heel bone, which is the called the calcaneus. The plantar fascia is primarily responsible for assisting propulsion when walking and running.

People with plantar fasciitis will report symptoms such as sharp or stabbing pain, especially when standing after a period of rest. This pain may return at the end of the day, but may feel more achey and dull rather than sharp with the first steps after standing. This is a common presentation of plantar fasciitis, however people may have plantar fasciitis but experience different symptoms. When exercising, plantar fasciitis tends to warm up and then feel less painful. If you have a pain that is constantly increasing with activity, it might be a different pathology.

Plantar fasciitis is a common condition in the community, with a prevalence of approximately 10%. It tends to be most prevalent in people aged 40-60 and in athletes. It may occur in one foot or both feet at the same time. The main factors associated with plantar fasciitis include high BMI, increased time spent standing and a restricted ankle joint range of motion.

Often people will have a bony growth on the bottom of the calcaneus that is commonly referred to as 'heel spurs'. People with heel spurs are 8 times more likely to experience plantar fasciitis (McMillan 2009), however not all people with heel spurs will have pain.

Finally, plantar fasciitis is referred to as a 'self-limiting' condition, which means that it will go away eventually. However, in the time that it is painful it can have a significant effect on quality of life (Irving 2008), and can increase depression, anxiety and stress symptoms (Cotchett 2016). Therefore, it is important to effectively reduce pain to prevent these reductions in quality of life.

References

McMillan, A. M., Landorf, K. B., Barrett, J. T., Menz, H. B., & Bird, A. R. (2009). Diagnostic imaging for chronic plantar heel pain: A systematic review and meta-analysis. Journal of Foot and Ankle Research, 2(32). Journal Article. http://doi.org/http://dx.doi.org/10.1186/1757-1146-2-32

Irving, D. B., Cook, J. L., Young, M. A., & Menz, H. B. (2008). Impact of chronic plantar heel pain on health-related quality of life. Journal of the American Podiatric Medical Association, 98(4), 283–289. Journal Article. http://doi.org/http://dx.doi.org/10.7547/0980283

Cotchett, M., Munteanu, S. E., & Landorf, K. B. (2016). Depression, anxiety, and stress in people with and without plantar heel pain. Foot & Ankle International, 37(8), 816–21. http://doi.org/10.1177/1071100716646630