Few sports make one feel better than running: the challenge to go the next mile, to better your speed, to increase endurance. There are also few exercise programs better or more natural than running, except for perhaps swimming (gets the edge because of low impact on joints and it uses every single muscle).
“…studies show that experienced runners have about the same rate of overuse injuries as beginners. It is not that experienced runners never learn. Certainly some do not and constantly run, and rerun, into the same injury pattern. However, it is likely that a larger percentage cure one injury then develop and improve until they stumble into the next. This is probably because as one area gets stronger the stress load is subsequently re-applied elsewhere. Injuries, thus, tend to march along what is referred to as the “kinetic chain”. Each runner, however, tends to march to the beat of a different drummer. The specific location for an overuse injury is determined by a multitude of factors (e.g., genetics, previous injuries, training factors, etc.)… Knowledge and early warning are a runner’s best friends.”
Did you get that part in the middle? Strength conditioning doesn’t bring every muscle and tendon along at the same rate and the weaker parts tend to get injured. And it’s different for every runner. Here then, is a list of potential foot injuries you may experience when running. Forewarned is forearmed.
Heel Area Injuries
The most common source of heel pain for runners is Plantar Fasciitis, an overuse injury that inflames the fascia on the bottom of the foot. Pain is usually felt in the heel, but may also be felt in the arch. This may heal on its own with rest, ice, and pain medicine, but persistent pain indicates an injury that needs medical treatment.
Pain in the heel may also indicate a Calcaneal Stress Fracture, a thin crack in the heel bone. This is a more serious injury that needs attention from a podiatrist.
Pain from Achilles Tendon injuries typically appears in the heel area, but also may be felt behind the ankle. Mild pain could be the result of irritation of the tendon, but severe pain may be due to a full-on tear (rupture) needing surgery.
Bottom of the foot injuries
On the bottom of your foot, in the area commonly called the “ball” of your foot are the sesamoid bones, located just behind the big toe. The tissue surrounding these tiny bones can become irritated from overuse, a condition called sesamoiditis. Additionally, the bones may actually fracture. Pain can be anywhere from “just hurts a little” to “I can’t even take a step without screaming”. Just as with Plantar Fasciitis, minor pain can be treated with rest and anti inflammatory pain meds, but more significant, persistent pain needs the attention of a podiatrist.
Top of the foot injuries
If you feel pain in the top of your foot, right about at the halfway point, you might be experiencing Extensor tendinitis, an inflammation of the tendons that run along the top of the foot.
Pain in the top of the foot can also be due to a metatarsal stress fracture. The metatarsals are the five long bones in your foot that connect with your toes.
Toe Area Injuries
If you’re experiencing a “pins and needles” sensation between your 3rd and 4th metatarsals near your toes, you’ve probably irritated the interdigital nerve. This is called Morton’s Neuroma.
If you have a sore or discolored toenail, you may be experiencing a subungal hematoma, which happens when your toe is constantly jammed against the inside of your shoe. This action leads to bleeding underneath the nail, creating the discoloration. Buy running shoes that fit properly.
You usually know it when you’ve sprained your ankle. The tissue around your ankle discolors, and the joint is stiff and painful. This injury is not to be taken lightly – you should always have a sprained ankle thoroughly evaluated by a podiatrist. Sprains treated incorrectly (or not at all) may not heal sufficiently and are notorious for re-injury, weakening the ankle and leading to arthritis after middle age.
Soreness (without discoloration) on the inside or outside of your ankle could be inflammation of the Posterior tibialis tendon or the Peroneal tendon. With these injuries, pain may also be felt along the outside or inside of the foot.
Treating tendinitis and minor irritations
Treatment of a sore area with minor pain should always start with a period of rest, ice and anti inflammatory pain meds like aleve. When and if the pain subsides, don’t jump right back in to the same running routine, because you’ll probably injure the same area once again, but this time more seriously. A damaged tendon is a weakened tendon and needs to be reconditioned before placing maximum load on it.
To recondition the muscle or tendon, start with simple stretching exercises. If there is any pain at all while stretching, the injury is not yet healed and needs more rest. Only start running again when there is absolutely no pain in the damaged area. Warm up with proper stretching exercises and start with a light routine to get the foot and ankle working correctly again. Slowly increase speed and distance.
Whenever foot and ankle pain persists, or is severe, you should seek the attention of a podiatrist for a thorough evaluation and proper treatment. Take good care of your feet and you’ll still be able to run marathons into your 80’s. But much slower, of course…