Hi Neil:
I wrote you a letter requesting advice a couple of weeks ago. I understand that you cannot reply to all letters. I am writing to you now because I have overcome my condition, but it is so similar to so many reports I have seen in your column, I am sure it would help someone else- probably including yourself to know about my experience.
I have had this condition for four months and have seen a chiropracter, acupuncturist and the last 1.5 months and PT. I was treated for Piriformis condition - and that did relieve some discomfort but not entirely. I have not been able to walk more than a mile, cannot run, and not do any significant activity.
The symptoms are:
1. Pain in the right buttock - feels deep
2. Some pain in the right thigh just under the trochanter
3. Pain when walking normally , but no pain when walking on the balls of my feet
4 No pain walking upstairs , pain walking downstairs
5. Pain when I stand on my right leg alone and push laterally to the outside
6, Less pain with loafers than laced shoes
7. Less pain standing than sitting
Quite by accident I discovered it was not periformis but a tight ITB (brought on by a new pair of shoes at Christmas). In hindsight all the symptoms make sense - but no one could figure it out. Incredibly, one day of aggressive ITB stretching cured the condition. I was jogging in 2 days after being off for 4 months!!
Tom, Thanks for your thoughfulness. This is a perfect example of how a simple thing, like a change in shoes, can play out in one's biology. It is important to remember that when you change shoes, it might not be a bad idea to modify your initial training distances down for a short time of adjustment. It is best not to change shoe types if you are otherwise comfortable.
I generally offer people the following advice looking for shoes:
1. A rigid foot doen't like a rigid shoe.
2. Make sure the shoe is light up front.
3. Make sure the flex point in the shoe is forward rather than toward the mid foot.
4. Make sure the shoe is vertical when standing on a flat surface.
5. As far as the shoe last is concerned, if your foot is curved (ie you are a supinator) get a curved last. A pronator does better with a straight last.
6. A larger toe box is better.
7. Motion control shoes are usually shoes of last resort - you need motion to run.
