Rehabilitation of Common Runners Foot Injuries
Dr. Larry W. McDaniel, Callin Haar, and Matt Ihler discuss rehabilitation of common foot injuries
Whether you are a weekend warrior or a serious athlete most runners fear the possibility of being injured. For those who run, healthy feet are important. Feet are the primary method of participating in physical activities. Olympic conditioned runners spend many hours performing foot maintenance to prevent unnecessary injures. Some of the common foot injuries are: Plantar Fasciitis, Metatarsal Stress Fractures, blisters, Metatarsalgia, Morton's Syndrome, Turf Toe, and Sesamoiditis. This paper will provide suggestions on how to properly care for common foot injuries in runners.
Plantar Fasciitis is characterized by pain in the inferior heel or origin of the arch ligament when weight is placed on the foot. This inhibits the runners' ability to flex the foot because the pain is too great for the individual (Cole 2005). However, there are various methods to rehab this injury. The most important issue for a quick recovery would involve decreasing the amount of swelling and inflammation in the joint. This may be done by reducing the amount of exercise and resting the injured foot (Cosca 2007).
While the runners are reducing the quantity of exercise, recovering may be expedited by placing the foot in ice or cold water. The individual may choose to use anti-inflammatory medication to assist in the reduction of swelling in the injured foot. Anti-inflammatory medication may assist in the process of preventing injuries to the other foot (Plantar Fasciitis Rehabilitation 2008)
Heel lifts should be used to prevent further damage to the foot. Since the runner developed Plantar Fasciitis in one foot, the other foot may be susceptible to the same injury. The injured person should stretch each foot by dorsi flexing both feet at the same time. This process should be followed by alternating one foot at a time (Plantar Fasciitis Rehabilitation 2008).
The rehab therapy also includes plantar flexing both feet using a towel to assist in the process of stretching the Achilles tendon. To increase muscular strength and muscular endurance to the injured area swimming, running in the water, or using a stationary bike is recommended (Cole et al. 2005).
The above recommended exercises increase muscular activity in both the foot and calf muscles.
Metatarsal Stress Fractures
Metatarsal Stress Fractures are caused by overuse of the foot. The treatment for these injuries reduces the amount of activity and pressure on the injured foot. Since this is a fracture of one of the metatarsal bones walking or jogging will cause pain. In some cases crutches and wearing a protective boot will reduce pressure on the metatarsals.
Biking is recommended to maintain strength and endurance in the lower body because it places less pressure on the metatarsal bones and the increased blood flow may expedite healing. The healing process usually takes from 3-12 weeks in order for the individual to fully recover.
Blisters are generated by constant friction against the skin, which causes a fluid filled pocket to form on the affected area. Blisters are the most common injury among runners, athletes, and other's who exercise. Blisters are caused by shoes that are not built just for their feet; but are mass produced, and most people do not take the proper time to break in their shoes correctly (Mitnick n.d.).
In early blister formation, pain relief may occur by removing the shoe to allow the area to cool down. The runner may cover the area to help reduce the friction on the foot. Second skin, tape, and other forms of bandages may be applied to help protect the blister from becoming worse (Mitnick n.d.).
After a blister has formed the runner should decide if it makes walking painful. If the blister does not inhibit walking, then the blister should be allowed to heal on its own and the runner may use a form of second skin to help prevent the blister from getting worse.
If the blister has reached a point where it hurts while one is walking and doing daily activities, then it is recommended to puncture the blister and allow the excess fluid to drain (Mitnick n.d.). The runner should not remove the skin of the blister because by doing so the blister may become infected.
Metatarsalgia is mainly caused by the shape of your foot. The reason that the shape of the foot causes Metatarsalgia is unclear, but researchers and therapists know how to reduce the incidences of Metatarsalgia. This is an easy injury to take care of as it is localized in the metatarsal joints that are inflamed and causing pain. Since this condition involves inflamed joints the best advice would be to rest the foot, ice, and take pain medication that reduces inflammation (Cohen 2007).
Other treatments to prevent Metatarsalgia from occurring are to change running shoes and increase padding. Shoe inserts may also be used to relieve pressure on the metatarsals (Cohen 2007).
If discomfort in the foot still exists it may be necessary to consult their local physical therapist for other options such as ultrasound, a form of deep heat, to help fight off the pain and inflammation.
Morton's Syndrome is the inflammation of a nerve found between the third and fourth metatarsal producing pain in the toes causing inability to move the toes. Treatment for this injury varies with the degree of severity. Surgery for Morton's Syndrome is a last resort. Rather than surgery, therapy is recommended involving experimentation with various modalities to assist in the process of recovery.
Techniques for therapy involve changing the type of shoe wear and increase the padding on the injured area. The medical specialist may prescribe orthotic inserts to relieve pressure on the inflamed nerve (Morton's Neuroma 2008).
Therapy may include icing the foot and taking non-steroidal anti-inflammatory drugs. These chemicals decrease swelling of the foot.
Turf toe occurs when the great toe is severely hyper-extended. Turf Toe is a sprain of the Metatarsophalangeal joint. Therapy related to Turf Toe includes rest, ice on the injured foot, and the use of crutches to reduce pressure on the foot (Edell 2006a)
To maintain strength and increase circulation in the injured area many experts recommend the use of an exercise bike. If the individual's goal is to increase overall strength exercises may be performed that do not involve pressure on the injured toe. Pressure on the injured toe will cause more damage to the injury.
To relieve pain and allow the injured athlete to begin running the toe may be strapped with tape to decrease flexion in the range movement of the injured toe (Edell 2006b).
Sesamoiditis is an inflammation of the Sesamoid bones and related joints, which are located near the great toe. The injured runner will experience difficulty flexing or bending the great toe. In some severe injuries the Sesamoid bones may be fractured (Sesamoid Fracture 2008). Surgery related to this type of injury is rare however in some cases surgery may be the primary method to expedite recovery.
To reduce pain and inflammation in the Great Toe rest the foot, take over-the-counter pain medication, and apply ice to the injured area. During the recovery period wear shoes with low heels that have extra padding (Sesamoid Fracture 2008) Aucouturier.
Tape is often used to immobilize the Great Toe which may decrease recovery time. Rest and ice may be the most important therapeutic modalities. Sesamoiditis injuries may have a huge impact on runners.
Hopefully after reading this information runners will be able recognize common runner's injuries and seek properly care.
Runner's Foot Injuries
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About the Authors
Dr. Larry McDaniel is an associate professor and advisor for the Exercise Science program at Dakota State University, Madison, SD USA. He is a former All-American in football and Hall of Fame athlete & coach.
Matt Ihler and Callin Haar are students enrolled in Exercise Science at Dakota State University. Both are interested in careers related to Sport Medicine.
The following Sports Coach pages provide additional information on this topic: