1. 100 Miles in 100 Days Dr. Brandon Borer D.P.M. Columbus Orthopedic and Sports Medicine

2. 100 Miles in 100 Days DPM = Doctor of Podiatric Medicine Specialize in assessing, diagnosing and treating aliments of the lower leg and foot with surgical and non-surgical expertise Have completed 4 years of medical school and a 3 year surgical residency Live here, in Columbus, and I am accepting new patients

3. Congratulations Taking on the challenge Improve your health = Improve your life American Heart Association “Walking briskly can lower your risk of high blood pressure, high cholesterol and diabetes as much as running..” “All three are risk factors for heart disease and stroke..”

4. Recommendations American Heart Association “Adults get 30 minutes of physical activity per day, at least 150 minutes of moderate activity per week or 75 minutes of vigorous activity per week to derive benefits.”

5. Calories Burned Pedestrian and Bicycle Information Center “A simple rule of thumb is that a 160 lb person burns 100 calories per mile.” 100 miles = 10,000 calories! A pound of fat equals 3500 calories, so to lose 1 pound in a week, you need to burn 3500 more calories than you take in with food or drink. 500 per day = 5 miles a day

6. Achilles Tendonitis Achilles tendon connects the posterior calf muscles to the back of the heel. Too much stress causes an inflammation or tendonitis and results in pain or thickening of the tendon. Persons who dramatically increase their training are at risk.

7. Achilles Tendonitis Do not try to “push through” this as it may result in significant injury or extended time off. To rehab this, apply ice several times a day, strengthen your calves and avoid “high-impact” exercises. The elliptical, pool exercises and cycling are okay if not painful.

8. Equinus A condition in which the upward bending motion of the ankle joint is limited. Often people with this develop ways to “compensate” without ever knowing they had it. Forms of compensation include Flattening of the arch Picking up the heel early when walking, leading to excessive pressure on the balls of the feet Bending abnormally at the hip or knee

9. Equinus Several possible causes exist Tightness of achilles tendon or calf muscles Bone blocking at from of ankle joint Spasm of calf muscles Congenital or acquired Casting, crutches, high-heeled shoes, injury, diabetes

10. Equinus Can be linked to almost any biomechanical problem of the foot / ankle. Often treated with aggressive stretching / physical therapy / night splints May require surgical attention if contributing to other issues

11. Plantar Fasciitis Small tears or inflammation of the fascia along the bottom of your foot. Feels like a dull ache or bruise at the bottom of the heel or arch and is usually worse upon waking in the morning.

12. Plantar Fasciitis People with a high or low arch, or with excessive pronation or supination are at risk. Also, standing on hard floors without supportive shoe gear puts excessive strain on the plantar fascia.

13. Plantar Fasciitis Recovery is typically 6 months, but can take a year. You may have to stop walking / running to begin healing. Best treated with icing and aggressive stretching of the calf muscles and achilles tendon. Cortisone injection may be helpful

14. Shinsplints Term “Shinsplints” refers to medial tibial stress syndrome. An achy pain which results from small tears in the muscle along your shin bone.

15. Shinsplints Often affects those who do too much too early. Linked to excessive pronation or flat feet, but can affect anyone wearing the wrong shoe. When you first notice this pain, back off your walking routine until pain subsides. Then, you may increase by no more than 10% in a week.

16. Shinsplints Rest, Ice and anti- inflammatories are best for rehab Arch supports for over-pronators and a supportive pair of shoes Ice cup therapy

17. Stress Fracture Develop as a results of cumulative stress on bone. Common in shin, metatarsal and heel bones People who over-train are at risk. More common in women than men.

18. Stress Fracture Weight bearing exercises actually make bone stronger, so walking will help to prevent this from occurring. Once you have pain seek treatment. Once diagnosed it make take 6 to 16 weeks to heal, depending on severity. When you start walking again, start slowly.

19. Neuroma Thickening or enlargement of the tissue surrounding a nerve. Most common in the foot at base of 3 rd and 4 th toes. Causes tingling, burning, numbness or feeling that something is “bunched up under toes.”

20. Neuroma Symptoms begin as mild and occasional and end up severe and constant. Diagnosed during physical exam, with injection or MRI. Treated with injection or surgical removal. Proper shoe gear may help prevent this.

21. “Runner’s Knee” Patellofemoral pain syndrome Irritation of the cartilage on the underside or the kneecap Often flares up after long walks / runs or while going down hills and stairs

22. “Runner’s Knee” People with weak quads, hips or glutes are at risk. You can work through this by avoiding down-hill walking and instead use a treadmill at an incline. Cycling is also helpful to build strong quads. Elliptical and swimming are other knee-friendly activities.

23. “Runner’s Knee” Icing is best for acute injury Focus on exercises that strengthen the quads and glutes to prevent relapse.

24. Iliotibial Band Syndrome Irritation of the band on the outside of your leg. Often noticed on the outside of the knee Affects those with weak gluteal muscles or people with leg- length discrepancy.

25. Iliotibial Band Syndrome Often a stubborn, nagging injury requiring a reduction in mileage Swimming, pool walking and elliptical training can help to reduce symptoms.

26. Proper Shoe Fitting Make sure the heal counter is stiff and supportive. The upper of the shoe should be comfortable, stretchable and breathable. The toe box should be deep enough to accommodate your toes / sock / orthotics. The sole should be firm and supportive but comfortable.

27. Proper Shoe Fitting The shoe should bend at the normal crease of your foot but not at the arch. Shoe should be comfortable in the store. Don’t buy them and assume you can “break them in” later. Always buy shoes at the end of the day when your foot is largest due to swelling.

28. Helpful information Foothealthfacts.org Runnersworld.com Heart.org Pedbikeinfo.org

29. Columbus Orthopedic and Sports Medicine Dr. Brandon Borer 4508 38 th Street, Suite 133 Columbus, Nebraska 68601 402-562-4700