Dr. Jonathan Hook
Common Foot Injuries Among Runners
Running has been called “the world’s most accessible sport” and that’s a good thing, because running is good for you. If you’re a runner or jogger, you’re probably already aware of the health and well-being benefits you get from your sport, but you may also experience aches and pains now and then. While there are times when pain is just a fleeting problem, at other times it might indicate something substantial. That’s why you need to pay attention to any symptoms you may have.
Running can bring about or exacerbate a wide range of injuries. The most common of these are stress fractures, tendonitis, and heel pain.
All of these injuries have two things in common. First, they’re typically considered “overuse” injuries—that is, they’re caused by the repetitive weight-bearing involved in running. Too much repetitive motion can cause inflammation or nerve compression, and that’s especially true for people who have a certain type of foot structure. If you’re a runner and you start having pain, it’s possible your body is responding to overuse and saying: “Whoa, I’ve had enough for a while! I need a break.”
That brings us to the second thing these injuries have in common: They all require a period of rest—sometimes for several weeks—to allow the injury to heal.
Let’s take a look at these injuries individually, starting with stress fractures. A stress fracture is a hairline break in the bone. Among runners, stress fractures are common in the metatarsal bones (the five long bones leading to the toes) and in the shin bone (which is called the tibia). Runners can also get stress fractures in the tarsal bones in the back of the foot and in the heel bone. The symptoms are pain at the site of the fracture and sometimes swelling in that area.
What should you do if you experience these symptoms? You can start by taking some simple steps at home that include cutting back on your running mileage or schedule for a while, icing, taking ibuprofen or another anti-inflammatory, and changing your shoes if they’re worn out. If your pain doesn’t go away or if it comes back, it’s time to see a foot and ankle surgeon.
The foot and ankle surgeon will give you a thorough evaluation and may order x-rays or other imaging tests. If a stress fracture is diagnosed, your treatment will include a period of rest and you may be placed in a walking boot or might need crutches for a while. The important thing is that the injury is protected and given enough resting time to heal.
Now let’s turn to another common running injury: tendonitis, which is an inflammation of a tendon. Several tendons run from the calf to the ankle and down to the foot, and these can become inflamed from running. The symptoms of tendonitis include pain and sometimes swelling in the path of the tendon. The pain is especially pronounced after you’ve been resting for a while.
As with a stress fracture, you can try home treatment to see if your tendonitis resolves. This includes reducing your running for a while, icing, taking an anti-inflammatory, and changing your running shoes if they’re worn out. If you still have pain, see a foot and ankle surgeon.
The foot and ankle surgeon will evaluate your pain and order tests, if necessary. If it is determined that you have tendonitis, your treatment will include rest, compression, ice, anti-inflammatory medication, and sometimes immobilization through a cast or walking boot.
Heel pain is very common among runners. It can be caused by a variety of problems, such as a stress fracture, tendonitis, arthritis, nerve irritation, and even, rarely, a cyst. By far the most common cause of heel pain in runners is a condition called plantar fasciitis, which is an inflammation of the band of tissue that runs from the heel to the toes. This tissue becomes inflamed because of repetitive stress. The symptoms include pain on the bottom of the heel. The pain is typically worse when arising in the morning or after resting for a long time, and it might go away after walking for a few minutes. If left untreated, the pain will increase over a period of months.
If you’re experiencing these symptoms, it’s important to see a foot and ankle surgeon to find out the cause of your pain, get a proper diagnosis, and start effective treatment. Various treatment options are available for plantar fasciitis. First-line options may include shoes inserts, stretching exercises, shoe modifications, rest, icing, and anti-inflammatory medication. Other initial options include pads in the shoes, strapping the foot, or wearing a night splint. If the pain still persists after several weeks, additional strategies include physical therapy and a corticosteroid injection. More recent treatments for unrelieved plantar fasciitis include shockwave therapy in the heel or injecting platelet-rich plasma, known as PRP, into the heel. In some cases, surgery may be necessary.