Put your best foot forward

For a runner, what’s more disheartening than getting injured is medical advice to stop running. In the first of a two-part series, let’s take a look at common running injuries of the foot and ankle. The foot is a complex anatomical structure, with multiple bones and ligaments that absorb an impact of six to seven times the body weight, repetitively, for more than a thousand times every kilometre. No wonder, the foot is among the most commonly injured parts of a runner’s body. But first, let’s dispel the myth that all foot injuries are due to heel striking or flat feet. Dynamic muscle weakness and poor shoe choice are more common causes.

Some of the common foot injuries are:

Plantar fasciitis

Plantar fasciitis is a gnawing pain over the heel, on the sole of the foot. The pain is usually most severe following a period of rest, or while you take the first few steps of the day. Common causes include ill-fitting footwear, and increasing mileage too quickly or when the calf muscles are tight. If the pain occurs after a change of shoes, try breaking in the pair over shorter distances, letting your foot adjust to the different biomechanics. Ice soaks after the run and warm water soaks later in the day, along with a proper calf-and-plantar fascia-stretching programme provide relief. So does running your foot over a tennis ball.

Achilles tendinitis

Achilles tendinitis is pain over the back of the heel, where the calf muscle forms a tendon and inserts into the bone. A specific reason to develop tendinitis is when the top edge of the counter of the shoe rubs against the tendon. Another common reason is when runners move to a shoe with lesser heel-to-toe drop. In the early stages, scaling back mileage, and calf strengthening, along with icing, foam rolling and ultrasound therapy help. Worsening pain may require you to stop running, and go in for massages and injections.

Stress fractures

March fracture, named so after it was commonly noticed in fresh Army recruits, or a stress fracture of the metatarsal, commonly occurs due to a combination of ill-fitting shoes and sudden, excessive mileage in beginners.  

A stress fracture requires up to a two-month break from running, followed by slow building of base mileage. This and shin splints occur because of a similar repetitive stress, and icing may help in the early stages. Studies have shown that runners who land with high-impact forces are more at risk.

Some people end up with metatarsalgia, common in runners with flat foot, who choose to run in shoes with a narrow toe box.

Toe nail injuries

Black toenails and falling toe nails are fairly common running-related injuries. They do not require special medical attention.

They may indicate a smaller-than-required shoe size or poor lacing, leading to the foot sliding inside the shoe. A swollen and painful toenail, however, warrants medical attention.

Foot injuries are closely related to the biomechanics of the foot, which are affected by the type of shoe, as well as the muscles stabilising the ankle and foot.  Poor running form due to weakness of the core will definitely impact the foot.