If The Shoe Fits…Run!

Daniel C. Farber, MD, Foot and Ankle Surgeon, discusses the importance of picking the proper running shoe and offers advice while going through the selection process. 

To avid runners, there is much more to the sport than simply lacing up any type of running shoe. They know that selecting the proper shoe is an incredibly important part of preparing for any type of competition.

Daniel C. Farber, MD

If you're wearing a shoe that doesn't fit your feet properly, you have a better chance of developing an improper gait or poor biomechanics. This added pressure on the heel or ball of the foot could lead to pain, plantar fasciitis, stress fractures, hallux valgus, (bunions) and lesser toe deformities.

When you're standing in the shoe store, most running shoes feel comfortable. Still, the true test doesn't come until you've pounded the pavement for several miles.

"Not all shoes are the same. Make sure you choose a shoe that fits your foot shape and running style," Dr. Farber recommends. "Remember that the most expensive shoe is not necessarily the best. The midrange shoes often have the more proven technology without the trendy price."

So, how do you sift through the many different brands and styles to ensure your feet stay happy and you stay pain-free?

• Try on all shoes. Sizes among shoe brands and styles tend to vary. Don’t select shoes by the size marked inside the shoe. Judge the shoe by how it fits on your foot.
• Select a shoe that conforms as nearly as possible to the shape of your foot.
• Have your feet measured regularly. The size of your feet changes with age. For women, it may change during pregnancy.
• Have BOTH feet measured. Most people have one foot larger than the other. Always fit to the larger foot.
• Get fitted at the end of the day. The best time to measure your feet is at the end of the day when your feet are largest.
• Stand during the fitting process. Standing allows you to check that there is adequate space (3/8" to 1/2") for your longest toe at the end of each shoe.
• Comfort is important. Make sure the ball of the foot fits comfortably into the widest part (ball pocket) of the shoe.
• Don’t expect them to stretch. Avoid purchasing shoes that feel too tight, expecting them to “stretch” to fit.
• Minimize slippage. Your heel should fit comfortably in the shoe with a minimum amount of slippage.
• Take a stroll. Walk in the shoes to make sure they fit and feel right.

Finally, remember that knowing when to replace your running shoes is just as important as picking the proper pair. Dr. Farber recommends that running shoes should be replaced every 3-6 months (or 300-500 miles) as they show signs of wear.

"With less activity, once a year is adequate Dr. Farber said. "If a shoe is in good condition, but has lost the cushioning of its insole, you can oftentimes simply rehab it with an over-the-counter insert."

"However, if the shoe looks and feels worn and doesn't support your foot well, replace it no matter what the age."

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What is Musculoskeletal Pain?

Let’s face it, “musculoskeletal” is tough to pronounce, let alone explain or fully understand.

Musculoskeletal disorders are actually one of the most common medical conditions, affecting approximately one-third of all adults in the United States. And that number is growing exponentially, thanks to an aging and still active population.

Musculoskeletal disorders are actually one of the most common medical conditions, affecting approximately one-third of all adults in the United States. And that number is growing exponentially, thanks to an aging and still active population.

People tend to explain it as their entire body aching or that their muscles feel as though they have been pulled or overworked with the most common symptoms being pain, fatigue or a disruption in normal sleep patterns.

Musculoskeletal pain can affect anyone and impact all major areas of the body, including the:

• Neck
• Shoulders
• Wrists
• Back

• Hips
• Legs
• Knees
• Feet

How is Musculoskeletal Pain Diagnosed and Treated?

Musculoskeletal pain and disorders can be treated by a number of different medical specialists. Diagnosing musculoskeletal pain requires a physician to take numerous things into account. They will begin by thoroughly reviewing your medical history, looking for possible causes of your pain (strenuous work conditions, sports, repetitive motions, etc.). Your physician will then conduct a hands-on examination looking for the source of pain. Finally, they will likely conduct various diagnostic procedures that may include X-rays, blood tests, CT scans and MRIs, to know the physical extent of that pain.

Once the cause of your pain and discomfort has been determined, your physician will go through the treatment options available to you. For acute pain, physical therapy, exercise programs, analgesics (such as acetaminophen), non-steroidal anti-inflammatory drugs and injections are all possibilities. For those suffering from more severe pain, surgery may be the appropriate treatment option. Surgeries could include: arthroplasty (or replacement), arthroscopy, soft tissue and cartilage repair.

The Region’s First Musculoskeletal Center

The Penn Musculoskeletal Center, the first of its kind in Philadelphia, is revolutionizing the way musculoskeletal care is delivered. The Center provides the latest diagnostic techniques and the most advanced surgical and non-surgical options for a range of musculoskeletal disorders, injuries and pain found in muscles, ligaments and tendons, and bones.

By bringing together multiple specialists as a seamless unit, the team works together to consider a wide range of treatments, not just surgery. This team-based model of care creates a seamless, integrated patient experience and the most efficient process of diagnosis and appropriate treatment.

Get back to living pain-free.
Schedule an appointment today.

Snow Shoveling Safety Tips

It didn’t take long for the first snowstorm of 2014 to hit. And, if the forecasters are correct, it surely won’t be the last of the season. While shoveling snow can prove to be a great workout, it can pose health issues if not done properly and if certain warning signs are ignored.

Put Less Pressure on your Back

Shoveling snow can be a real pain. The lower back is the most frequently injured part of the body during snow-shoveling. Musculoskeletal tissue, which supports the body’s bone structure, can become damaged by overexertion or overuse. Some tips to alleviate strain on your back.

• Pick a shovel that you feel comfortable with. Shovels that are too large or heavy will force you into unnatural body movements. Be sure to use the tool grip to enhance your leverage.
• Avoid shovels made from steel as added weight forces you to bend and twist, which could result in spinal injury.
• Rather than lifting the snow, try to push it in front of you. If you do lift, be sure to lift with your legs. Make sure you squat with your legs apart, knees bent, and back straight.
• Don’t try shoveling the biggest scoops of snow possible. Shovel in small amounts.
• Walk to where you want to dump snow. Avoid extending your arms out in order to try dumping snow far away from you. This will add extra strain to your back.

Get more helpful tips to reduce pain while shoveling.

Pace Yourself and Stay Hydrated

Although you may not feel as thirsty as you typically would in the summer, dehydration occurs quickly in cold, dry weather. Some tips on how to pace yourself and stay hydrated:

• Take frequent breaks and be sure to drink plenty of fluids.
• Try avoiding heavy meals prior to shoveling as digestion puts strain on the heart.
• Prior to shoveling it is good to warm up your muscles with light stretching.

Pay Attention to Your Breathing and Your Pulse

Shoveling snow is a strenuous exercise that can put undue strain on the heart. Factor in cold air, which constricts the blood vessels and increases blood pressure, and you have a dangerous combination for people with coronary artery disease or other forms of heart disease.

So before you go shovel your walkway or let a loved one shovel their own, take a few moments to review some heart attack symptoms.

On the Move: The Health Benefits of Running

Whether it's a 5K, 10K, Color Run, Tough Mudder or Marathon, it seems as though everyone is out for a run. Once reserved only for die-hards, more and more people are running for the experience and the fun than ever before. Many also see it as a way to relieve stress after a busy day, an opportunity to get a group of friends together or to simply help out a good cause.

Regardless of the reasons or motivations, there are many health benefits for those that pick up this sport.

Read the full article.

First Bilateral Hand Transplant in Region Performed at Penn Medicine

The first bilateral hand transplant in the Greater Philadelphia region was recently performed at the Hospital of the University of Pennsylvania. Under the leadership of the Penn Transplant Institute, the extensive 11 1/2-hour procedure was performed by Penn’s Hand Transplant Program in close partnership with the Gift of Life Donor Program.

Penn’s Hand Transplant Program is a joint venture of the Penn Transplant Institute, Penn Orthopaedics and Penn Plastic Surgery. The multidisciplinary team is dedicated to working together to restore independence to amputees who have lost their arms and legs

• Read more about the region's first bilateral hand transplant
• Learn more about Penn’s Hand Transplant Program
• Learn about the Gift of Life Donor Program

Summertime Injuries – Penn is Here to Help

Summer is finally here and with it comes trips to the pool, going to the beach, outdoor runs, tending to our gardens, and firing up the grill. Kids are out of school and begging you to play basketball, soccer or other outdoor activities.

For some, these extra activities are a kind of seasonal re-commitment to fitness, weight loss and relaxation. But for a few, some of these activities can lead to unexpected injuries and accidents, some even needing serious medical attention. And, as the motto goes, an ounce of prevention is worth a pound of cure. Which means, knowing where to go if anything does happen is a good idea to have in mind.

In case of injury, whether a sprained ankle, broken foot or any other musculoskeletal injury, the orthopaedic team at Penn Medicine is ready to help. In most cases, you can even see a physician on the same day.
Highly skilled and highly specialized, Penn Orthopaedic physicians treat each joint condition, spinal disorder or sports injury with a personalized approach. With ten orthopaedic subspecialties, physicians at Penn Orthopaedics not only treat more complex conditions — they are uniquely qualified to treat each condition individually.

Penn Orthopaedics offer same-day appointments for:

• Foot and ankle
• General orthopaedics
• Hand and wrist
• Joint replacement
• Neuro orthopaedics
• Orthopaedic oncology
• Shoulder and elbow
• Spine
• Sports medicine
• Trauma and fracture care

“You call with any musculoskeletal need and we’ll see you that day,” says L. Scott Levin, MD, chair of Orthopaedic Surgery.

Please be safe and enjoy this summer. If you need us, we’re a call or a click away.

Shoulder or Elbow Pain? Penn Orthopaedics Can Help You Live Pain-Free

Whether it’s the result of an injury or just from typical wear and tear, you don’t have to live with shoulder pain.



The Penn Shoulder and Elbow Service provides comprehensive care for shoulder and elbow injuries or problems. Penn’s nationally and internationally recognized orthopaedic specialists create and use the latest advances in shoulder and elbow diagnosis, treatment, surgery and rehabilitation to treat complex issues.

Shoulder and elbow problems can affect your ability to enjoy your favorite activities. Some commonly treated issues include:

• Dislocation/separation
• Tendinitis
• Bursitis
• Torn rotator cuff
• Fracture
• Biceps
• Tendon rapture
• Arthritis
• Golfer's elbow
• Tennis elbow

For more information about the Penn Shoulder and Elbow Service or the shoulder and elbow specialists, visit PennMedicine.org or call 800-789-PENN (7366).