A Heel Up
By: Nathan Koch, PT, ATC
Triathlete Magazine, April 2011
You would think that after centuries of heel pain plaguing the endurance athlete, we would have a clear diagnosis and course of treatment. Diagnosis continues to be in the eyes of the beholder, and treatments can lead down a variety of paths-and occasionally to dead-ends. Consider these four common possibilities for heel pain.
Plantar Fasciosis: No longer called plantar fasciitis since it is a degenerative condition, not an inflammatory condition (imaging studies show “thickening” of the plantar fascia, not inflammation). Key indicators: Severe medical plantar heel pain in the morning that will improve as the day progresses or pain at the beginning of a run that improves. Try: Stretching, self-massage, bracing at night, strengthening, physical therapy (ASTYM soft-tissue treatment), dry needling and perhaps PRP (platelet rich plasma injections.
Calcaneal-Cuboid Syndrome:Restriction in joint movement that may come on gradually or the result of trauma. Key indicators: Lateral plantar heel pain that increases in proportion to walking and standing duration; pain and weakness with push-off. Running is usually not possible. Try: Physical therapy or chiropractic help.
Nerve Entrapment (tibial, plantar and calcaneal nerves):Compression of a peripheral nerve from poor foot/ankle mechanics. Key indicators: Burning pain or numbness. Try: Physical therapy, neurology, podiatry, or othotics.
Calcaneal Stress Fracture: Caused by significant increase in running volume, poor running mechanics and dietary issues. Key indicators: Localized swelling and pain when squeezing the heel, pain that increases as walking/weight bearing increases. Try: Rest and immobilization.
All of the above can be diagnosed by a skilled sports medicine clinician with foot and ankle experience. Diagnostic Ultrasound, MRI, bone scan and nerve conduction studies may be necessary to complete the case.
Old College Tri
By: Courtney Baird
Triathlete Magazine, April 2011
If you measure success by national championships then the University of Colorado at Boulder is the most successful collegiate triathlon team in the U.S. Its 2010 overall collegiate national title is its 11th title in total-nine more than any other university.
Coach Mike Ricci heads up the squad, which is run as a club team out of the university. Because triathlon is a club sport and not an NCAA sport from which students can receive scholarships, none of the squad’s practices is mandatory. Nevertheless, there are about 100 athletes on the team, with a core group of about 50 who consistently practice. “My quote is always, ‘Nothing is mandatory but some things are highly encouraged,’” Ricci says.
Athletes of all abilities are welcome, as the team includes everyone from a newbie with $150 mountain bike to an experienced racer with a top-of-the-line Trek.
As a club sport, team members take care of all of the logistics. “The kids do everything. Hotel, travel. That’s part of the club sport system-teaching them the leadership thing,” Ricci says.
Look for the team when it attempts to defend its title on April 9 at the Collegiate National Championship in Tuscaloosa, Ala.