Ella Go Podcast

Foot Forward: Dr. Relation on Preventing and Treating Common Running Injuries Ep. 173

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Running injuries don't have to sideline your passion. Today, we're joined by Dr. Relation from Bluestone Podiatry to discuss the prevention of common running injuries like plantar fasciitis and achilles tendonitis. Dr. Relation is a board certified podiatrist providing surgical and non-surgical treatment of foot and ankle problems. He utilize curamedix shockwave therapy which includes EPAT/ESWT/EMTT therapies as a non-invasive, non-surgical treatment for many runners ailments involving no "downtime". 

Bluestone Podiatry is a newly opened practice in Slingerlands, however Dr. Relation has been in private practice for 9 years. Dr. Relation is also a surgical consultant at Family Foot Care in Valatie, NY. He is a Lapiplasty Centurion Center, having performed well over 100 Lapiplasty cases. 

Dr. Relations is currently on staff at Bellevue Hospital, Ellis Hospital, St. Peter’s Hospital, St. Peter’s Surgery and Endoscopy Center and New England Laser and Cosmetic Surgery Center. On his free time he enjoys being outdoors, and doing activities such as camping, biking, hiking and golfing as well as spending time with his wife, two children and dog.

If you're in the Capital Region, reach out to Bluestone Podiatry and schedule an appointment today!

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Speaker 2:

Welcome to Ella Go. My name is Lisa. Join me on the journey in having real raw and uncomfortable discussions about fitness, health and everything in between, because, let's be honest, this journey would suck if we don't get our shit together. Welcome back to the Elego Podcast. My name is Lisa, I am your host and today's guest is Dr Relation. He is a highly respected podiatrist and the owner of Bluestone Podiatry in Slingerlands, new York. In addition to his private practice, dr Relation serves as a surgical consultant at Family Foot Care in Volatia, new York. Welcome, dr Relation.

Speaker 1:

Hi, hi, lisa, glad to be here. Hi, I'm at least glad to be here.

Speaker 2:

I am so happy to have you here because you know, as a runner, okay, that our feet are so important to us, right? And you know we tend to have a lot of common injuries when it comes to running and it comes to our feet, so I cannot wait to pick your brain. So what are the common foot injuries that you often see with runners.

Speaker 1:

So runners come in with a variety of injuries, as you can imagine, and we see everything from just general capsulitis, metatarsalgia of the ball of the foot. Sometimes we see flare-ups of neuromas. Most common is plantar fasciitis, achilles tendonitis, also perineal tendonitis, which is a tendon on the outside of the foot, and posterior tibial tendonitis, which is a tendon on the inside of the foot. So we see all these things every day in the office.

Speaker 2:

Oh, okay, now I'm going to ask you another question. Well, that has to do with that, but we're going to wait, okay? So what is a common mistake runners make when it comes to shoes and or their feet that may cause some of these injuries?

Speaker 1:

I mean. Number one I see is not having the proper shoe for your foot right. So there are a lot of these specialty sneaker companies now, or shoe companies have shoes that are tailored to different foot types. And if you don't know your foot type and you're not and you're just going online and ordering whatever you see that that looks cool, you may not get the proper fit for you. So I usually recommend going to a reputable shoe store. Um, personally I know locally.

Speaker 1:

I sent a lot of patients over to fleet feet over on uh, wolf road and they tend to have a lot of staff that really can analyze the foot and make sure you're in the right shoe. Companies like Asics, hoka Brooks they'll have especially on their websites I know Asics does it they have a shoe finder, have a shoe finder so you put in your foot type, you put in if you're an over pronator, more of a neutral foot type or a supinator, and they'll list a whole bunch of shoes that'll actually match for you. Because if you're a supinator, which is a higher arched foot type, and you go into a shoe that's made for an over pronator, you're going to be tilted up way too much to the outside, more propensity to roll your ankle, more propensity to get the perineal tendonitis, and then opposite. If you're more of a pronator and you're going into a supinated shoe, you're just not going to get that support that you need, which will lead to more issues on the medial side of the foot.

Speaker 2:

Do you see that? Do you see runners that come in and then they don't even you're talking to them and they're like I don't even know what you're talking about, have you? Do you see that?

Speaker 1:

More new runners like that are just starting to get back into it or starting out for the first time. So yeah, experienced runners typically don't have that issue, but but those that are, that are just trying to get going with with a new new activity, then they may not know their their proper style, that they should be in for sure.

Speaker 2:

Okay. So besides having the right shoe, my next question was going to be like how can runners prevent foot injuries? I mean, you see so much out there like there's these stretches, there's these tools. I mean, do you cringe when you see some of these things?

Speaker 1:

these tools. I mean, do you cringe when you see some of these things? Yeah, I mean, there's so many gimmicks out there that you can find online or on your Instagram reel or wherever you happen to be browsing. Really, it's just proper stretching. That's really important. Starting slow. Don't just decide I'm going to run a 5K today when you haven't ran in three or four months or longer. It's always about gradual increases to activity to try and let the structures in the foot, and the rest of the body for that matter, kind of get used to the activity again and strengthen accordingly. Orthotics can make a big difference to making sure that the foot is protected more properly aligned during the activity and then recovery. So afterwards you know if you are having some pain, noticing it, listening to your body, not pushing through the pain, icing it afterwards, or anti-inflammatory if you need to or if you're able to. So really just paying attention to your body is really one of the big key features here.

Speaker 2:

Okay, yeah, that makes a lot of sense. So let's focus on plantar fasciitis and, of course, achilles tendonitis. So that's the common running injuries, and let's start with plantar fasciitis. Why does it happen and what treatment is available to help relieve this?

Speaker 1:

So plantar fasciitis, or heel pain in general, is one of the most common things that we see every day. The plantar fascia is a ligament that goes from the bottom of the heel, which the heel is a pretty large bone at the bottom of the foot. It has these two little tubercles that come off of the bottom and the fascia extends all the way from the heel bone all the way out to the metatarsal heads and it spans that whole area kind of like a truss system and every step you take it's pulling and stretching right at that heel attachment and that's the most common spot that gets inflamed. You get these little micro tears. Usually it's an overuse type injury from either lack of support or just a sudden increase in activity. Or if we're running and hit a pothole or drop rolled off a curb wrong, something like that can can spur it off too, but little. Usually it's multiple little micro traumas that'll happen and if you imagine that the ligaments kind of like a rope the same thing with the achilles it's like a whole bunch of strands of collagen that are wound together and you can get some fraying of those edges right. So little tiny tears, you get fraying of the rope. The body tries to heal it. So you get inflammation around that no-transcript that comes in. First visit we're usually getting an x-ray making sure nothing else is going on like a stress fracture in the heel or something else. That would be kind of off the wall.

Speaker 1:

But once we isolate that it's most likely plantar fasciitis, we'll start our typical regimen and we can go one of two ways with treatment. So the standard treatment protocol usually is some kind of support. So we tape the. We do a lot of athletic tapings strappings, so we'll do a low die strapping. We'll put a pad up in the instep and the tape itself will help to lock the subtalar joint, kind of lock the mid-tarsal joint, lift up and take some tension off of the plantar fascia so that it's not being stretched every single step. Let's the fascia rest.

Speaker 1:

We start you on a stretching and icing regimen. Usually I recommend get a 20-ounce bottle of Coke, pepsi water, whatever. When you're finished with it you rinse it out, you fill it three-quarters of water and you freeze that, put it on the ground and roll your arch right on there two to four times a day or whenever it's starting to feel uncomfortable, and that just helps loosen it up, massage it and ice it. At the same time, if the patient's able to, we'll start an anti-inflammatory regimen and kind of go from there. There are also night splints people can wear at night, while they're sleeping, to stretch the heel out. We dispense those in the office. There's about a thousand different kinds of night splints, so we have particular ones that we like more than others. If that isn't quite doing it or someone comes in and they're limping, it's really bad. Sometimes we'll do a cortisone shot.

Speaker 1:

But then we also offer non-invasive measures as well. So there's a whole other treatment algorithm called EPAP, which is shockwave therapy, and that's nice because it's non-invasive, there is no downtime, we don't have you ice it, it's kind, and shock waves to stimulate the healing process. So a shock wave utilizes um pulse activation therapy to stimulate the microcirculation to the injury, to a focused area, and it allows that the body's own regenerative properties to begin working on the healing process. So was developed for the treatment of plantar fasciitis and achilles tendonitis. It's been around for a long time, really popular in europe with soccer players because you want to keep the players on the field. It's in a lot of sports teams in the US now and I'm fortunate to have it in my practice as well to be able to provide it to my patients. So it provides a non-invasive option which people start feeling the benefit of after two or three sessions.

Speaker 2:

Okay, I'm already like sign me up, okay, so does it hurt?

Speaker 1:

We typically say it's uncomfortable. Right First session's always the most uncomfortable because we're putting a lot of energy into the tissue and the tissue is injured, so you're going to have some discomfort. But I can tailor it to the patient in the moment. So we start low, we kind of dial it up as we go and we get you around a five and a 10 on the pain scale. That's what I usually tell my patients. And then each subsequent visit because we usually do three to four rounds of treatment on average. Each subsequent visit we can typically get more and more energy into the tissue with less and less discomfort, and then by the end of our sessions most patients are not feeling much pain at all. And we offer both EPAT, eswt and EMTT therapy, which is magnetic therapy. So I usually combine the two treatments into one session. So I start with the uncomfortable part and then we finish with the relaxing magnetic therapy. So and that typically is a nice pain modulator as well. So that'll actually help to in the moment reduce the pain too.

Speaker 2:

Wow, okay, you mentioned something at the beginning where you said it was the side of the foot. So what was that called?

Speaker 1:

Well, there's. So you have the medial side, which is like the inside of your ankle bone. That's your medial side of your foot. There's the posterior tibial tendon on that side and on the outside of your ankle bone. That's your medial side of your foot. There's the posterior tibial tendon on that side and on the outside of your ankle and there's two tendons that come down around the outside, called your perineal tendons, and one attaches to the side of the foot, which is a little kind of a bump out on the side, and there's another one that goes under the foot. So either one of those can be uncomfortable, depending on which one you're asking about.

Speaker 2:

Well, let me ask you this Could someone because when you were talking about this I was like, maybe that's my problem, Maybe it's not, because it's the side Like could someone confuse it being plantar fasciitis, when it is really that?

Speaker 1:

Yeah, we see that all the time. So people come in and they they it says on my, on my schedule plantar fasciitis, and they sit down on the chair and we take a look at everything and it's absolutely not plantar fasciitis, it's posterior tibial tendonitis or it's perineal tendonitis. But they're totally different pathologies so they require different approaches to treatment as well.

Speaker 2:

And so that person? It could be either of those things, but yet they're feeling that heel pain.

Speaker 1:

You can have some pain radiate. Some people will say heel pain, but really it's the arch, or it's the inside of the foot. So what someone thinks is their heel may not be what I think is their heel right. And then there's also the back of the heel, which is your Achilles tendon. So there's several different structures right in that area.

Speaker 2:

Yeah, I mean, if you look at the foot, so many things going on.

Speaker 1:

Yes, I mean obviously A lot of structures in the foot.

Speaker 2:

Lots of stuff going on. Okay, so let's talk about the Achilles tendonitis. Now, what is that and how does that happen?

Speaker 1:

Well, your Achilles starts. There's two main tendons that make up the Achilles tendon your gastrocnemius and your soleus. The gastrocnemius actually crosses the knee joint and attaches to the femoral condyles. So there's two components there, and if they get tight, if you think about it, most shoes today have a decent heel on, especially running shoes. A lot of them have a pretty decent drop. So then a lot of you know, you think about women's high heels, men's work boots, so there's a lot of of heels on on shoes now. So people are functioning with their, their heel up, which is going to let that tendon get tighter and tighter. And so, as the tendon gets tighter and tighter, if someone gets into a shoe that has a lower drop, more minimalist style shoe we see all this a lot after COVID People are working from home, so they're not wearing shoes, and all of a sudden they're getting all these Achilles issues because now that tendon is being stretched repeatedly. We see it a lot with runners too. Especially if people start doing hill training, whether it's a trail running or just running on roads that have hills they're getting a lot more stress than that Achilles tendon as well, and it's the same kind of thing as the plantar fascia.

Speaker 1:

It's where the Achilles. There's two areas. There's the insertional Achilles tendonitis, where the Achilles actually attaches to the calcaneus on the back of the heel bone, and that's more like bump pain we call it. It's like it gets kind of swollen, gets hot down there, red right at the the back of the heel, or if you start having like some partial tearing, there's a zone about one to three centimeters above the Achilles insertion and that you can start to get tendinosis in that area like chronic damage, because the blood flow isn't as good there. Um, so as that gets again, imagine the rope starts to fray in that location you get that chronic inflammation that can kind of build up in there okay, so let's explain this a little further for those of you know people who are listening and they're like well, first of all, where's the achilles like?

Speaker 2:

so we're talking about right behind the.

Speaker 1:

So if we were to look at the foot and we're going to go look at it, look at it from the back of the foot and there's the heel and it's that it's a thick band, that thick band that you can feel in the back of your ankle that goes from your, your leg, from your calf muscles, that goes down towards the back of the heel. That goes from your leg, from your calf muscles that goes down towards the back of the heel and it kind of just meets up with the heel bone. And where it meets up with the heel bone is the attachment site. And some people that have like a chronic Achilles issue where they've had pain on and off for years, can actually start to get a bump that forms back there from a bone spur. That can start to happen. So again, we don't know that till we get an x-ray from a bone spur, that can start to happen.

Speaker 2:

So again, we don't know that till we get an x-ray. Okay, and you mentioned something about there is a muscle across the knee.

Speaker 1:

Yeah, so if you feel the back of your calf, the muscle back there is called your gastrocnemius muscle and then below that's the soleus muscle. But if you kind of feel up behind your knee, you kind of feel there's two bands that cross the knee joint that all goes down and attaches to your heel bone. So that's all part of your Achilles complex, right? So your gastrocnemius muscles. So when people are stretching it's really important to do two different stretches. You want to stretch out the calf muscle but you also want to stretch the hamstrings and get that whole posterior muscle complex stretched before and after you go on your runs.

Speaker 2:

Yeah, because it's all connected.

Speaker 1:

Everything's connected Absolutely.

Speaker 2:

I always tell my runners that Okay, all right. So orthotics, all right. So I have a love and hate with this because I was told to put orthotics. I tried them and I'm like they hurt. Forget it. I'm not doing it. What are your thoughts about that? Obviously, they're an insert that you would put in the shoe, but should someone wait a while Because it does feel uncomfortable and sometimes it does hurt?

Speaker 1:

Well, were they custom that you tried, or were they-?

Speaker 2:

Custom? Yeah, hurt well, were they custom that you tried, or were they custom yeah?

Speaker 1:

custom, yeah, so um, and then also, was it a chiropractor, or was it a podiatrist or an orthotist?

Speaker 2:

okay, because they're all different all different.

Speaker 1:

What's that?

Speaker 2:

I don't know, all right all right.

Speaker 1:

So there's all different kinds of orthotics. Um, there's your, your off off the shelf devices. You're going to get walmart or the drug store and those are going to be in Walmart or at a drugstore and those are going to be really not supportive at all typically. They typically are just foam. They don't do much for you. Then there's your middle-of-the-road, like a PowerStep or a Spanko, and even those are narrowed down based on your foot type.

Speaker 1:

So if you're not in the proper device for your foot or for your pathology, your problem that you're having it's not going to feel good. And then, when it comes to customs, you know it. Really it's a working relationship to try and get the right device for you. A lot of times we hit it right on the first try. But they're custom so we can do all different kinds of modifications. So if I get somebody to set up orthotics, they try them out and they go through the break-in period properly, because we typically do a break-in period with those. So as we dispense them, we say, all right, wear them an hour the first day, two hours the second day, et cetera, until you're in them for a full day with no pain. Then address them, Then introduce them into your running or your sport or whatever activity, Because it's like getting a new pair of shoes. You don't get a new pair of shoes and go out for a 5k. You're not going to feel very good the next day so you really got to break them in, because it's it.

Speaker 1:

if it's changing the alignment of your foot when it's functioning, so it's going to change the way that your foot's reacting to the ground and change the way that those structures are being affected as well. So if you had discomfort with them, we would have you back in. We could make some minor adjustments. If that wasn't enough, we would send them back to the lab and do additional adjustments. So it should never be painful to wear an orthotic. It's either not the orthotic for you or it wasn't done properly. Sometimes there's lab issues, especially with a custom, so I would work with whoever whoever doctor was that that got those for you to make it right. But you should never be having more pain with the device.

Speaker 2:

Okay, all right, that makes a lot of sense. So let me ask you this what is the point of it? Because you mentioned that it's to realign your foot, can you get into deep? Get a little deep with that.

Speaker 1:

So I like to describe them as eyeglasses for your feet. All right, so your foot if you need an orthotic, that is then your foot most likely isn't functioning in the proper alignment. So we look at the subtalar joint, the mid-tarsal joint, which are joints in the back of the foot, below the ankle and a lot. If you're, let's say, a person's flat footed, they're functioning over pronating and they're getting pain to the inside of the ankle or pain along the plantar fascia. What we do is when I, when I scan the patient so I use an iPhone, right, and I have my I actually will align the foot into the proper alignment. I'll feel the subtalar joint put the patient in what's called neutral, so that's where they have the maximum amount of supination and pronation available. So I put them right in the middle, where they're supposed to be hold the patient there in a locked position then take a scan of the foot.

Speaker 1:

So when the foot is scanned in that position, when we get the device made to the foot in that position, when the patient stands on that, they're going to be put into that neutral position which is going to have the most amount of play, both supination and pronation available to better accommodate the ground. And then we can also add modifications. So somebody has ball of the foot, pain like around the metatarsal heads or just before the toes you can get like neuromas or capsulitis metatarsalgia. We can put padding up in there to take pressure off of the metatarsal heads. If somebody has an arthritic big toe joint a lot of runners have arthritis in the big toe we can actually do accommodations to an arthritic to either promote or limit motion in the big toe joint. There's a couple of different modifications we can do which can make running a lot more pleasant if there's not as much grinding bone on bone going on right. So we can do things to keep patients active, keep them mobile, with some of these devices.

Speaker 2:

Okay. That's why, when I called your office and I said I have plantar fasciitis, but I'm not stopping running, I'm not going to stop running, and she was like no, of course not, that's right.

Speaker 1:

So when someone tells me that, then we look at the shockwave because you don't have to stop your activity. We usually have. You decrease it, usually about 50%, but we don't stop you, whereas some of the other treatments like if we were going to go with the anti-inflammatory route, the icing route, we would say okay, stop running, which people typically don't want to do.

Speaker 2:

Yeah, no. All right, so okay. So the orthotic really is teaching you to move your feet to the ground differently, in the way that it should be, in a healthy way.

Speaker 1:

Yeah, when they're made properly and depending on the patient, right. So if you have an arthritic foot, we're not going to be able to get you in that exactly neutral position. Let's say, the hind foot has arthritis in it, then we have to just accommodate. So there's different styles, right, and that's the benefit of the custom is we can, we can treat the patient in front of us, um, and the other thing that I usually do, I don't. Sometimes we don't just jump into an orthotic. The patient comes in. I usually don't just cast them or scan them on the first visit. A lot of times we'll experiment with the taping, right, so I can, I can do things with the tape and put different pads in and see how the patient responds. And if they say, if we try a metatarsal pad, let's say, and they come in the next week and they're like, wow, that was awful, I hated that. Well, I'm not going to put that in an orthotic, then right, so we can make modifications based on your response to treatment.

Speaker 2:

Okay, all right, so I was going to ask you do. All right, so I was going to ask you do you need a?

Speaker 1:

different orthotic for, like, running shoes versus your walking shoes, not usually for running versus walking, but if we're looking at running shoes, running, walking and boots, usually all will fit like hikers. But if we're looking at a dress boot or a hockey cleat, or hockey skate I mean, or a soccer cleat then, or even a high high heel, we can make orthotics for all different styles of footwear and they're not going to be the same because they're not going to fit in each individual device. Um, but there are ways to to make them fit in these different things. So so yeah, we wouldn't do. You would not have the same device. That's like a, a chunkier athletic device that's going to give me maximum control and put that into a loafer.

Speaker 1:

It's just not going to fit number one and number two. It's not going to be comfortable, so we have to. Usually what I'll do is have the patient bring whatever shoe they want the device to fit into, and that way I can take a look and we can make sure it's going to work Okay.

Speaker 2:

So at what point? You know you do all of that, and then there's surgery, so like how bad could it be to get to? The point of surgery.

Speaker 1:

For plantar fasciitis are we talking about? Um? So before I started using EPAT and the shockwave therapy, I would say I would do maybe two or three plantar fasciitis surgeries a year not very many and I would see plantar fasciitis every single day. Now I can honestly tell you I haven't done a plantar fasciitis surgery in a couple of years because we are so successful with the shockwave therapy and with our other treatments. So it's. I used to tell patients it was a 90% success rate to not have surgery without surgery, but I think we're even higher than that at this point.

Speaker 2:

Oh, my God, I'm so glad.

Speaker 1:

And you know if we, if we're looking at surgery, usually we're going to get an MRI first to make sure. Okay, are we missing something else here? Because we usually don't have to do surgery on this condition?

Speaker 2:

Okay, so you're answering my prayers. I am like super excited. That's so great to hear I, you know, it's amazing how much you know with science and research in this field has been coming up. I mean, I, you know, I interviewed a podiatrist back in 2021 and she was coming up with some like these things I've never heard of.

Speaker 2:

And to hear this shock therapy, I went on your website and I was like, what is this? And it's non-invasive, because obviously nobody wants to do surgery, because then that would mean no, running for a very long time to recover. So that's so great that there's so many things that are out there to prevent or to help us to not feel this pain, because that's like, the worst thing is this pain on our foot and we love to run. So, okay, with all that being said, what does it look like to work with you? Okay, so we would make an appointment, we come see you and you and it almost sounds like you really take an approach where it's like, okay, let's try the baby steps, right, let's try this first and let's try that first. And so is there like multiple visits, seeing you trying different techniques that get the relief that that client or patient needs.

Speaker 1:

It all depends on the condition, right. So I mean, some people come in and it's a pretty straightforward thing and we can address it with one or two visits. Other times it ends up being something where we have to do multiple shockwave visits or we're doing orthotics. But my goal is to get you better. I don't want you to keep coming back every week for the next 10 years. So I have a different approach. I don't try and just keep people coming in the door. I want to get them better and get them back out and doing their activities. So the first visit I tend to take a good amount get them back out and doing their activities. So the first visit I tend to take a good amount of time and really evaluate the problem and try and let's try and figure it out together. We take some.

Speaker 1:

We have x-ray right in the office so we can kind of get to the bottom of a lot of things right here. I am a board certified surgeon too, so if it comes down to it, we do have surgical options. I don't shy away from surgery, but it all depends on what the actual problem is. But we tend to take the time that we need to and I listen to each individual patient, because some patients they don't want to mess around with. Some people are afraid of shots. They don't want a needle, they don't want anything to do with a shot. So people can't take anti-inflammatories because of the medications that they're on. So we take all these things into account and then develop a plan that we both agree on and go from there.

Speaker 2:

Okay. So, Dr Relation, where can we find you? Because obviously I'm already on the schedule. I hope Sounds good. But where can we find you physically, as well as on social media?

Speaker 1:

So the practice is Bluestone Podiatry. It's at 1882 New Scotland Road in Slingerlands, which is not that far outside of Albany. It's about 15 minutes, so it's like you're heading towards Thatcher Park in that direction, a little southwest of Albany, right on Route 85. We're in a nice building that has a primary care in here as well, so it's pretty easy to find and the website has directions, which is bluestonepodiatrycom. We do have a Facebook and Instagram, linkedin. We have all the social media and it's just Bluestone Podiatry for each of those things and it's just bluestone podiatry for each of those things. And we we're my wife is very active monitoring those social media platforms and responding accordingly.

Speaker 1:

My staff we know where I'm in the office mondays, tuesdays and fridays. Currently I typically operate on wednesdays, so but we my staff we're growing. The practice is relatively new. We opened up in January of this year, so I've been in practice for about nine years, but I live out this way, so it was time to open up and do my own thing, and so we're growing. So we definitely have room, we're accommodating, we're still getting into some of the insurances, but we have this sculling to let people know once we're into those. We are in several at this point, and my staff is well-versed on where we are. So I would just say give us a call and be happy to help out whoever is in need.

Speaker 2:

Okay, and we'll put all those on the show notes, all the links to get a hold of you on the episode show notes. That's great yeah.

Speaker 1:

We also tend to do a lot with the community. We had a booth at the Sarah Lee formerly Fryhoffer's Run for Women. We have a booth at the upcoming Capital Sweatfest that's going to be over at Frog Alley, which we're really excited about to be involved with these different community events. I am the upstate New York clinical director for the Fit Feet program for the Special Olympics. So every year in the fall we go up into Glens Falls and we help out with the fall games and screen the athletes for any foot conditions. So we try to be very active with the local community and I've lived here my whole life.

Speaker 2:

Well, I appreciate you, dr Rilishan, because there's a difference when you are an athlete and you go seek help to a doctor, you know, to a doctor, and they are not. They're not in the realm of you know running, or they have no idea what's involved. I mean, they know your foot, they know your body, but there's no like understanding of your. The joy of working out and being fit and having you, you know, be so involved in that community makes us runners, athletes, feel more comfortable to be talking to somebody that understands where we're coming from. So that's why, you know, obviously, when I was talking to your wife, I was like she, you know, he definitely has to come on here, because a lot of people who are listening to the podcast are athletes, are runners, and we're always looking for ways to prevent injuries and find relief. So, thank you for doing what you're doing and I'm sure people are going to be reaching out to you on the local 518. And I'm so happy that you had the opportunity to be on here.

Speaker 1:

Oh, I thank you so much for having me. This was a great experience and I'm glad we could be of assistance. So thanks so much.

Speaker 2:

All right, until next time, everyone, bye you.