Treat your feet.
It’s a fact: running is one of the activities that’s hardest on your lower limbs. Data in the British Journal of Sports Medicine shows as many as 79% of runners get struck down with a lower limb injury every six months. Of all the points on a runner’s body that are susceptible to pain, the foot is an injury hotspot, with 30% of runner’s reporting a history of foot niggles. “Foot and ankle injuries are common in runners, second only to knee injuries,” explains Alex Hunter, director at Six Physio. “You’re transmitting a huge load (several times your bodyweight, in fact) through your ankles and feet when you run, and most lower limb injuries stem from decreased stability and increased stiffness higher up the leg.” But why do your legs get stiff and your ankles get sore? Do you need to fine-tune your running form? Is an unsuitable pair of trainers to blame? Perhaps, you just need to do more conditioning work. According to Alex Drummond, sports physiotherapist and movement specialist at Drummond, it’s likely you need to look into all of the above things. As Drummond explains, “foot and ankle injuries occur for three reasons: poor technique, the wrong footwear and paying too little love and attention to your body.” It’s time to undo the damage.
“Running creates a load on the body and, if the body isn’t ready to accept that load, compensation occurs – you get a little bit of an ache or feel stiffness,” explains Drummond, “If you ignore this, the body will get to a point when it can’t compensate anymore and pain, swelling or tissue damage occurs. The key thing is not to ignore these signs in the first place.” Preventative treatment measures are known as prehabilitation programmes and they’re usually devised by a physical therapist. The aim of a prehab programme is not only to look at a runner’s body but also to examine the training schedule and shoes, and then iron out imbalances. “The top tip for recovery is prevention, and to prevent overloading the foot we have to ensure the whole chain of muscles and joints is in good shape,” explains Hunter. Can’t afford a specialist? Fortunately, an increase in preventative injury science means that it is possible to devise your own prehab programme. Most experts agree that the three preventative measures are: (1) condition your body for running with core and strength training; (2) invest in the right shoes, and (3) do running drills and take time to hone good technique. “It’s important that you incorporate strength and core work into your training,” adds Hunter. “Having the correct footwear is important but it must suit your foot type, as there isn’t a one-size-fits-all approach. The most common weakness in foot and ankle injuries is the calf, so keeping this muscle nice and strong will prevent issues arising.”
Sarah Ivory JANUARY 2015 RUNNINGFITNESSMAG.CO.UK
- ECCENTRIC HEEL DROPS
A great move for strengthening the calf muscles, this exercise forces the muscles to contract as they lengthen. Stand on a step with heels overhanging. Raise the right leg off the step and bring the left leg up onto tip toes. Slowly lower the left heel down below the level of the step. Rise and repeat 10 times, then switch feet. Aim for three sets on each foot.
- MEXICAN WAVE RAISES
Work the intrinsic foot muscles by doing a Mexican wave with your toes. To do this move, raise the big toe on its own and then repeat with every other toe until you reach the little toe. It takes time to get this exercise right, so remember that practice makes perfect.
- TOE SCRUNCHES
This exercise will also work the deep muscles of the foot. To do it, place a piece of paper underneath your toes. Try to scrunch the piece of paper up with your toes, and then flatten the paper with your hand and repeat.
- PLANTAR FASCIA ROLLS
Rolling the plantar fascia tissue under the foot is a secret trick for greater hamstring flexibility. Stand with a tennis or massage ball under the arch of your foot. Roll the foot forward and backwards, from heel to forefoot.
Common Foot problems.
Also known as runner’s heel’, is an inflammation of the strong ligament that connects the heel to the base of the big toe-the plantar fascia. It’s a common complaint among striders and around 10% fall victim to this injury. Problems higher up the leg, such as tight calves or weak glutes, can lead to plantar fascia problems, as can dong an excessive amount of running. Hunter claims that prognosis is variable, with some runners looking at a 6 week lay-off and others facing 18-24 months recovery. The most common symptoms are burning, stabbing or aching pains in the heel, and the heel may also be painful when pressed. It is most painful in the morning, as the tissue of the foot tightens during the night. The most common treatment is to roll the base of the foot with a tennis ball or massage tool. Consider following a rehab programme to strengthen the gluteal muscles and stretch the calf muscles. Applying ice to the heel will also help to reduce inflammation.
Achilles teninopathy, which includes Achilles tendinitis and the more severe Achilles tendinosis, makes up 11% of running injuries. The strong Achilles tendon, which runs down from the heel to the lower calf, isn’t very flexible and over-stretching it can lead to inflammation, ruptures and tears. The tendon also has a poor blood supply, so problems arise when previous damage fails to heal and scar tissue builds up. When treated properly (this means not running on pain), Hunter says it takes 12 weeks to recover but running can usually commence after six weeks. Acilles tendinopathy causes pain in the back of the ankle that eases when you warm up but increases during running. The tendon is painful to touch, and thickening of the tendon, lumps or bumps may be present. Insertional Achilles tendinopathy is a similar injury but affects the point where the tendon meets the heel bone and may require slightly different treatment.
If you suffer from Achilles tendinopathy experts recommend following an eccentric strengthening programme. Don’t attempt to run though the injury and seek medical advice. Wait until the pain completely subsides and then slowly re-introduce running, avoiding speed training and hill running at first.
Amazingly, 5-15% of all running injuries are stress fractures, which are tiny cracks in the bone. And of those injuries, nearly half occurred in those running 25-44 miles per week. This makes sense as runners are most likely to suffer a stress fracture when increasing the intensity, volume or frequency of runs. Wain claims this is because fatigued muscles don’t support and cushion the bones efficiently and increased pressure is exerted directly on the bone. Around 25% are in the metatarsal (or toe) bones, and most stress fractures require several months of rest. Stress fractures are often painful and you can normally pinpoint the area of pain on the affected bone. This injury often manifests as a soreness that gets increasingly worse in the affected area. It may also cause stiffness in the injured zone.
If you suspect you have a stress fracture, stop running immediately and seek specialist advice. Left untreated, these tiny fissures can develop into a full-blown fracture.
A sprained ankle is the most common ankle injury, accounting for up to 75% of ankle injuries. It is a result of over-stretching or tearing the ankle ligaments. According to Dave Wain, of Carnation Footcare, you are most likely to cause an ankle sprain if your foot pronates or rolls inwards. Uneven terrain and weak muscles can also lead to ankle sprains.
The most obvious sign of an ankle sprain is pain when you put weight on the foot. The ankle may also swell or show signs of bruising.
The treatment of the sprain will depend on the severity of the injury. Firstly, stop running and try to limit how much weight you put on the ankle. If the ankle is swollen, treat it with an ice pack and over-the-counter ant8i-inflammatory medicine. Acute sprains will require a gradual return to walking and then running. Sever sprains will require a trip to your local physiotherapist.
Haglund’s Deformity, also known as pump bump, is a condition characterised by a bony lump at the back of your heel. As Dirk Nowak, consultant orthopaedic surgeon for the European Foot institute explains: “the Haglund’s deformity is a congenital deformity or a very pronounced help bone.” It occurs when you have Achilles tendinitis and Achilles tendon bursitis (inflammation of the heel bone bursa) at the same time. For this reason, it can often be mistaken for either of the lone contributing injuries. You may also experience a constant rubbing on the bone by your running shoes. Wearing high heels, shoes with high arch or stiff-backed shoes can contribute to this condition. Treatment can vary depending on the cause and severity. Rest and apply cold therapy to the painful area, and invest in soft backed, well fitted trainers. Stretching the Achilles tendon may also help. Sever cases may require surgical removal of the prominent bone, so always seek expert advice.