INTERVIEW: DR. B OF PERFORMANCE FOOTCARE

Dr B 

Recently, my blistered and bloodied toes from marathon training led me to Dr. Bryon G. P. Butts, DPM, of Performance Footcare of New York, just a short limp away from the Flatiron at 36 West 44th Street (between 5th and 6th Avenues), Suite 1216 (212-768-0012). Not only did Dr. B hook me up with some gel toe sleeves and other advice, he was happy to answer a few questions and introduce himself to my running friends and colleagues. 

What makes your practice unique? Performance Footcare prides itself on providing the most up to date treatment methods for your sports medicine ailments.  We have in-office digital X-ray, diagnostic ultrasound, physical therapy modalities, and shockwave therapy.  We provide treatments ranging from physical therapy to surgical management.  Plantar fasciitis treatment has advanced as well.  The basics are the same: proper stretching, strengthening, icing, NSAIDs (both oral and topical), orthotics/insoles, proper shoe gear, night splint, and occasionally steroid injections.  Advanced treatments Performance provides include shockwave, Topaz, Tenex, and PRP.

What percentage of your patients are runners? About 40%. I’m busier before the major marathons and halfs.

Why this specialization? Are you a runner yourself? I grew up participating in many sports, track being one of them. I have always been passionate about athletics. I grew up idolizing track athletes like most people do football, basketball, and baseball stars (Carl Lewis, Evelyn Ashford, and Edwin Moses were favorites). Swimming was my first passion. I competed through my four years at Harvard where I ended up spending a good amount of time in the training room. I saw firsthand how rewarding it is to keep athletes on the track, field, court, or pool. I always knew I wanted to be a doctor, and sports medicine allows me to aid in the treatment of athletes. My college girlfriend actually broke her foot while competing in track. After casting failed to heal her fracture she ended up having foot surgery with a podiatrist. That was my first link to the profession.

In a survey this month thirty percent of our club members said they suffered from plantar fascitis. Is this an equally common ailment among your patients? What are your other most popular injuries? Plantar fasciitis is both the most common problem I treat and my favorite pathology to treat. It is very difficult to improve a foot problem when runners take over 10,000 steps a day on their heels. Other common injuries among my athletes: Achilles tendinitis, stress fractures, ankle sprains, painful flatfeet, Morton’s neuroma, blackened toenails, ingrown toenails, athlete’s foot/smelly feet.

Do you have any good tips for helping us find the right size and style of running shoe? First thing that most runners know: there is no perfect shoe for everyone. Runners must start by shopping at a reputable running shoe store. Running specialty stores can guide you through general ideas of which shoes will work for you. They can look at your foot type and gait to see which types will work best. I recommend shopping for shoes in the afternoon or evening. Your feet swell during the day, so it is not a good idea to try to fit yourself for shoes in the morning. You should try multiple pairs during the visit. I also recommend trying two different shoe on at a time if you cannot decide between two pairs. You should wear running clothes and try the shoes on the treadmill. People don’t buy cars without a test drive. I believe that same thing goes for you shoes.

Do you recommend having more than one pair in use at a time? I do recommend having more than one pair of shoes. Many runners have their distance work running shoes and lighter, speed work running shoes. Recent studies show that even having two pairs of shoes of the same type of running shoe can lessen the chance of injury due to small variations in the way the shoes support and protect your feet. I have a list of shoes that I provide my runners at the end of their initial visit with recommendations of shoes to try on their next visit to the shoe store.

In general do you think your patients wait too long before consulting you about a foot issue?  My experienced runners do a pretty good job of keeping themselves healthy through their routine: stretching, icing, NSAIDs, proper shoes, compression, taping/strappings, and supplements. Many of my runners come to their first appointment already knowing their diagnosis. I think my biggest difficulty is trying to SLOW THEM DOWN. I can manage some patients with treatment while they are training, but some require either a reduction of their mileage or a complete shut down for weeks or even months. This all depends on the diagnosis. My rule of thumb for my possible patients: if your home treatment doesn’t help a nagging mild/moderate pain OR if your pain continues to worsen or becomes severe, it is time for a visit to your sports doctor.

logo dr b

BACK ON THE PAVEMENT

I signed up for a 5k recently. This wouldn’t be a big deal, but it’s the most I will have run (assuming I run it all) in about two years.

I’ve never been a good runner and will never be fast, even if I somehow could switch bodies with Kara Goucher, but I was consistent, and persistent, going from barely being able to walk after a back injury (L5, I hate you) to the NYC Marathon in 2013. For 7 or so years, I ran.

And then, over the next post-marathon year, I stopped. Not because I was injured, or some other “honorable” reason.

I stopped in part because I couldn’t face another training schedule. In part because of an unexpectedly stressful new job. In part, honestly, because it felt nice to have more free time. Slowly, gradually, skipping runs until I wasn’t running, and until I couldn’t pretend I was. And until it was two years later since I’d run consistently, much less long. (To say nothing of how things fit.)

Enter August 2016.

Cheered/extorted by running friends, about two weeks ago I signed up for the Shoes4Africa fun run in September and laced up sneakers. I barely managed one mile, at a pace that was barely above walking.

There’s the added shame in restarting running after you’ve stopped for a long time, going from a point where 10ks barely counted as a run to one where one slow mile utterly kicks your ass. And that can stop you from restarting. And had in the past. But this time, despite that, despite the heat, I was happy.

Because I missed running. Jogging. Whatever. As bad and painful and just embarrassing as the runs these last couple of weeks have been, afterwards I’m happy I went out there, one step after another.

Running gives you mental space, not because you can’t think about other things during a run, like in martial arts or rock climbing, but because in fact that continuous repetition of one foot then the next then the next makes you think. And then makes you not think. And you’re better for it.

The 5k is next week. It will be slow and ugly, and will hurt, as will all my runs for the next few months. But it’s a start, and I’m glad to be back after too long. I’m remembering that I like running.

I found this ace of spades on this morning’s run. I’m taking it as an omen, especially as I’m in for NYC next year.

ace

 

Diana Gill just joined Tor Books as an Executive Editor, after working at HarperCollins and Penguin Random House. She’s restarting running after way too long, after getting a lottery entry to the NYC marathon.

 

SINK BATHS

When a shower, bath, or swimming pool is not awaiting you at the end of a running route, a sink bath is the bridge between your sweaty, smelly runner self and the clean and tidy version you probably like to put forward in polite society.

The phrase sink bath conjures up images of climbing into an actual sink and splashing around a bit. With one of those oversized farmhouse-style kitchen sinks you see installed for rustic effect on home improvement shows, this style of immersive sink-washing might be possible, at least for very petite, bendable runners.

But lucky for most of us, with frames too big for swimming in the various sinks in our lives, the sink bath hardly involves a sink at all.

In my run-commute backpack I carry the essential ingredients. A dry washcloth packed in a gallon-sized Ziploc bag; a second bag packed with a dry hand cloth. And one additional hand cloth.

Of course when I arrive at the office I am sweating like a beast. Once I swipe myself through security scanners in the lobby, my first task is to avoid offending any of my colleagues. If I’m lucky I find an empty elevator for a solo ride up to my floor; if I’m not, I will hoof it up the stairway for some unasked-for last-minute cardio work.

After I reach my office and dump my stuff, I turn on the air-con unit in my window and go get a big glass of cold water from the water cooler. I chug that and bring another back to my office. This is Step 1. The goal is to cool off my internal body temp while then standing in front of the air con to cool off externally. The clean up will only “take” if I’m not still perspiring like a fountain.

After I’ve stopped schvitzing I can proceed to Step 2. This involves a trip to the men’s room with my two bagged towels. I splash my face in the sink and maybe if I’m feeling frisky I douse my hair pretty good. I dry off with some paper towels. The purpose of all this is just a quick pre-wash.

Before I return to my office, I add enough water and soap to the one bag to get my washcloth good and bubbly. Next I get the hand towel in the second bag nice and wet. Now it’s time to return to my chosen changing area for Step 3.

The technique is obvious. With my clean and dry change of clothes handy, I strip off the togs, give myself a quick swipe with the soapy cloth, and then a “rinse” with the wet hand towel. A few quick buffs with the dry towel, a bit of deodorant, and I can pull on my office attire and be ready to boogie inside of three minutes. The wet running clothes get stuffed and sealed haz-mat-style into the Ziplocs along with towels, nice and tidy unless I forget about them for a few days and they become a stinky science experiment.

It goes without saying that my method is so quick and easy in part because of my short straight hair, which dries in seconds and requires no brushing or styling. I have received the following advice from a fellow runner about dealing with long, complicated hair: Sweaty long hair = towel dry worst bits, dry shampoo/let sit for a minute or so, brush through and style as you will.

A note on equipment: I prefer the thin terry cloth towels from cheap hotels. They are lighter and more compact-able, and do what needs to be done just as well as thick luxe towels. Their rough texture adds a little more zing to the cleaning and drying-off procedure, IMO.

And an additional note for entirely sink-free cleaning. Before you leave home, pre-soak the hand towel, and pack an already soaped-up washcloth, and now you are able to clean off pretty much anywhere. This adds a little more weight in your backpack, but such is the price of the total flexibility you have gained. I’ve employed this technique in all sorts of compromising positions, from behind a stand of trees during a relay race to the tiny cabin of a sailboat after being plucked off a Downeast dock in a rendezvous with some sailing friends. It works.

 

 Drawing: “The Men’s Bath” by Albrecht Dürer (c. 1496)

BLACK & BLUE (& PURPLE)

cast

I have a sad running story to share. I had a pretty successful summer of running until Tuesday, Aug 2. I had been getting up and out at 5:30 a.m. for a two-mile run before making it to my train and my desk at 8. Not super-impressive mileage, but I was in a good frequent running pattern several days a week.

I have not run since then, because that morning I tripped on the sidewalk about a mile from my house and broke my finger. I think this is a fall we have all had—one of those where you fly through the air, land hard, and hope like hell that no one saw you. This time, my fall was broken (literally) by my left pinkie.

I knew right away the damage was done. Immediately my finger started to swell and I was not able to move my pinkie away from my ring finger. The finger, along with all of the bloody scrapes on my left palm, shoulder, and shin were all stinging. One trip to the urgent care, then to a hand specialist, and I am still sporting a large cast two weeks later.

The real sad part (in addition to not running in 14+ days) is the timing of my cast. My family and I are going to Bermuda this Sunday and I am keeping my fingers crossed (ha) that my doctor will remove the cast and replace it with something smaller and more manageable before we leave.

So my advice, don’t break bones before tropical vacations and maybe pick your feet up a little higher than I did on that morning.  🙂

Christine Jaeger lives on Long Island with her (marathon-running) husband and two children.

VICTORIA’S (OTHER) SECRET

You might think that in 2016, after nearly forty years doing business, Victoria wouldn’t have any secrets left. Hold on to your over-priced skivvies, friends, because I’m about to drop a run-changing bit of knowledge.

The other secret is the pretty excellent line of activewear the brand has been ramping up promotion for over the last year. And I’m not just taking sport bras, I’m talking functional and pretty darn affordable T’s, tanks, shorts, tights, and outerwear for just about any athletic occasion.

Now, I was skeptical when I first saw VS pushing athletic apparel, but they got me in the store with a “buy a sport bra ($20-30), get a free ($65) sport pant” promo, and I’ve been a fan ever since. There are the expected frivolous and not-that-practical options (looking at you, high-neck mesh-top sport bra), but I have seriously loved all of the more basic options that have made their way into my wardrobe. The real trick is never paying full price for anything (c’mon, there’s always a sale or a coupon out there in this digital age)—that is, unless you’re on the hunt for the perfect pair of star-spangled shorts to try to win a Fourth of July photo contest among friends.

dp

Disclaimer: 90% of the material these clothes are made of is some shade of neon, and people are going to notice when your star-spangled or highlighter-yellow rear end goes flying past.

Danielle Prielipp lives and runs in New York City.