Keeping the feet in good shape and avoiding common foot problems can improve the performance of runners at all levels, from casual joggers to competitive marathoners, according to the American College of Foot and Ankle Surgeons (ACFAS). Common problems to be alert for include:
Heel Pain: The most common runners’ complaint is heel pain, caused by inflammation of the ligament that holds up the arch of the foot. Heel pain can result from poor running mechanics and overpronation, which puts unequal pressure on the inside of the foot. It can also be caused by running shoes that are worn out or too soft.
The most common heel pain is plantar fasciitis. Plantar fasciitis is inflammation of the tissue (fascia) connecting the heel bone to the base of the toes. Plantar fasciitis often starts as heel pain, but can intend along the arch of the foot. You’re more likely to develop plantar fasciitis if you’re female, overweight, or have a job requiring standing or walking on a hard surface. Tight calf muscles that limit how far you can flex your ankles are also a contributing factor.
Plantar fasciitis is often worse in the morning when getting out of bed, or after sitting for a long period of time. Pain lessens after walking for a few minutes, because walking stretches the fascia. Some suffers may find morning relief by wearing a night sprint, which maintains an extended stretch of the plantar fascia.
At the first sign of heel pain, ACFAS doctors recommend stretching exercises, icing for 20 minutes several times a day, and wearing sturdier shoes with proper arch support. Anti-inflammatory medications, such as ibuprofen, are helpful. In worse cases, orthotics, steroid and/or numbing medicine injection, and physical therapy may be prescribed.
Neuromas: A neuroma (also called Morton’s neuroma) is a pinched nerve between the toes that can cause pain, numbness, and a burning sensation in the ball of the foot. Morton’s neuroma most occurs between the third and fourth toes, and runners will feel pain during the foot’s “push-off.” Neuromas can be caused by overly flexible running shoes, wearing high heels, and tight, narrow shoes which pinch the toes. Treatments include switching to wider shoes with lower heels, custom shoe inserts, and corticosteroid injections.
Tendonitis: Tendonitis is a common over-use injury, affecting the Achilles tendon posterior tibial tendon (PTTD), or other structures of the foot. Achilles tendonitis and PTTD are caused by a sudden increase in a repetitive activity (like running) that involves the tendon. The tendon is overly stressed and cannot repair itself.
Symptoms include pain within the tendon, tenderness, and swelling. With PTTD, the arch of the foot starts to flatten, and the ankle rolls inward. If left untreated, the arch continues to flatten and arthritis may develop in the foot and ankle. Treatments include custom orthotics, an ankle brace, icing, anti-inflammatory drugs, and physical therapy.
Broken Bones: You might think you can’t walk or run with a fractured bone in the foot. Think again – stress fractures can be slow to show symptoms like pain and swelling. If a fracture or sprain is suspected, remember RICE – Rest, Ice, Compression, and Elevation. If pain and swelling continue after RICE treatment for several days, see your health care provider for an x-ray.
In honor of the Austin Marathon, ACFAS has created a quick-reference infographic for runners on preventing common foot and ankle injuries. Foot and ankle surgeons from ACFAS will be on hand at the finish line of the Austin Marathon on February 14 to offer ice packs for runners as they complete their runs.