Runner’s Feet

Running is a great way to get a full-body workout, but runners can be prone to bad habits like ramping up their training too quickly, using worn-out shoes, and missing crucial cues that their bodies need a break. Running can also lead to a number of chronic foot conditions which, if not properly addressed, can keep athletes from achieving their fitness goals.

The following conditions are best diagnosed and treated as soon as possible. For minor running injuries, rest, ice, and anti-inflammatories can prevent further damage and return you to your running routine as soon as possible. More serious foot conditions may require physical therapy or even surgical intervention.

For the best results at any stage of injury, consult with the orthopedic specialists at New York Bone & Joint, who can provide you with personalized solutions designed to streamline your recovery.

Common Foot Injuries Affecting Runners

Stress Fractures

Stress fractures refer to small cracks in the surface of bone. This injury typically affects the metatarsals, which take the greatest impact while running. Bone can become stronger over time, like muscle, but it takes many months for this to happen. In fact, your bones can temporarily become weaker after a period of increasingly intense training. You are particularly susceptible to stress fractures during this time, as the bone swells or bruises in response to overuse. Stress fractures can also occur if you make the switch to a harder running surface. Additional risk factors are overpronation of the foot and low bone mass, particularly in women.

With a stress fracture, the pain will develop gradually. The area will become sore to the touch or painful when you put pressure on it. The surrounding muscles can feel tender and stiff, and your foot may swell, obscuring the veins.

Plantar Fasciitis

The plantar fascia is a band of collagen that runs between the heel and the base of the toes. Because it is a supportive structure with limited flexibility, an increase in workout intensity or running with an overpronation of the foot can easily lead to overuse. The resulting tiny tears in the band cause inflammation and a stabbing, aching pain deep in the heel or arch.

Tight calf muscles pull on the plantar fascia and exacerbate the pain, while wearing worn-out shoes or running on hard surfaces can make the condition worse. In particular, watch for pain as you “push off” during running. As the issue progresses, you may find that the first step out of bed in the morning, or after sitting for a while, is especially painful.

Morton’s Neuroma

This painful condition is typically caused by wearing small or narrow shoes. It is characterized by the thickening of tissue around a nerve, often between the third and fourth toes. As the tissue becomes inflamed, the nerve no longer fits between the metatarsal bones, causing further irritation.

Patients suffering from Morton’s neuroma often describe it as feeling like a pebble is in your shoe. There is a sharp, burning pain in the ball of the foot, while the toes may sting or feel numb. If you have other foot deformities, like bunions, you may be at greater risk of developing a neuroma. When diagnosing this condition, your doctor will first rule out a stress fracture or bursitis.

Achilles Tendonitis

The Achilles tendon connects the two major calf muscles to the back of the heel. It allows you to push off the ground when running or jumping, and stabilizes you as you land. Tendonitis occurs when the tendon becomes inflamed due to overuse and begins to swell. Over time, this condition may progress so that the tendon begins to degenerate. The resulting scar tissue or bone spurs may limit flexibility and cause a rupture.

Watch for Achilles pain if you have overly tight calf muscles, tend to overtrain or hill run, or if you quickly increase your daily mileage. It is more common in men, as well as anyone who trains only intermittently. This is a common type of runner’s pain, as around 50% of runners will experience Achilles tendon pain at some point. If the condition progresses, it can limit your ability to walk and climb stairs.

Symptoms of Achilles tendonitis include a dull or sharp ache along the back of the tendon, limited flexibility in the ankle, and a burning sensation. You might feel bumpy scar tissue in the area, or hear a cracking sound as you move your ankle. This injury can quickly worsen, so it’s a good idea to stop training if you experience any symptoms. You should contact a doctor immediately if you feel a lump in the tendon or pain in the lower section of the Achilles.

 

Treatment Options

Conservative

The first line of treatment for runner’s feet injuries is rest — you should stop running temporarily, in order to give the body time to heal. When an injury is still fresh, apply ice to reduce swelling and blood flow. Anti-inflammatory medications can provide pain relief while reducing symptoms. If you suspect your issue is due to overpronation, an orthopedic specialist can have you fitted for custom orthotics.

In order to diagnose your exact condition, your orthopedic specialist will take your medical history and perform an external exam, along with an X-ray, bone scan, or MRI. In some cases, a brace may be appropriate to protect the area and prevent further damage. If the condition doesn’t improve within a few weeks, your orthopedic specialist will likely recommend physical therapy. Stretching and strengthening exercises can relieve pain and help prevent recurrence. A physical therapist can also help you with your form and technique. If the pain and inflammation persist during this treatment, your doctor may suggest cortisone injections.

Surgical

In most cases, conservative and non-invasive treatments will be sufficient for the majority of conditions affecting runners. However, some conditions may progress to the point where surgery is the best option. Many of today’s procedures are minimally invasive, involving targeted arthroscopic incisions. However, surgical treatments and recovery time for foot conditions vary widely. For instance, recovery from a surgical plantar fascia release can take fewer than six weeks to heal, while Achilles tendon surgery may require you to limit your activity for over six months.

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