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Runners and Foot Injuries
The foot is a complex structure. It has 26 bones, 33 joints and 112 ligaments. All these help the foot support the weight of the body while standing, walking and running. In spite of all this, when there is excess strain on your foot, you can suffer damages. This is especially true in cases of runners who over-train for their achievements.
Runners very often suffer from stress fractures. Stress fractures are cracks in the bones resulting from undue stress. Stress fractures are also described as fatigue fractures; the normal bone is subjected to repeated abnormal stresses. Stress fractures of the foot commonly involve the heel (calcaneus), the 2nd , 3rd and 4th long foot bones (metatarsals), and the non-vascular bone.
Foot injuries in runners include the following :
This is an inflammation of the plantar fascia. Plantar fascia is thick connective tissue that stretches from the heel to the head of the metatarsal bones. Plantar fasciitis is probably caused by a tear in the attachment of the plantar fascia or the deep plantar ligaments to the calcaneus(heel). Patients with plantar fasciitis experience pain in the foot while walking and running. This is usually foot pain that is worse in the morning and one is usually unable to walk comfortably when getting up from bed. About 70% of folks develop a bony projection, called a heel spur, in the heel bone.
· Stress fracture of the heel bone
The symptoms of stress fracture include heel pain which worsens with weight bearing activities, swelling around the fractured area, and tenderness to touch. Like any other stress fracture this occurs due to over -activity, especially in runners.
· Metatarsal stress fractures
Metatarsals are the 5 long bones occupying the mid-part of the foot. Stress fractures are common in the 2nd , 3 rd and the 4th metatarsals. These injuries are common in military recruits and runners.
Sesamoid bones are the tiny bones found in the tendon of the muscle. In the foot, sesamoiditis is common in the tendon attached to the great toe; it is the inflammation of this tiny bone, and is usually seen in runners and dancers. The symptoms include pain in the ball of the foot. The bone may even get fractured.
· Morton’s metatarsalgia
This is a painful condition affecting the 4th metatarsal, and less frequently the 3rd . The pain is localized to the space between the 3rd and the 4th metatarsals. The pain is described as ‘pins and needles’ foot pain and sometimes as electric shock. It is due to the entrapment of the intrametatarsal nerve which gets damaged. This injury is common in runners.
Tendons are structures which attach muscles to the bones. Two tendons are commonly injured causing pain in runners. The peroneus longus tendon is attached to base of the 1st metatarsal and the medial cuneiform bone. It crosses from the outer side of the foot to reach the inner side before getting attached and this injury can be especially prone to runners , who experience pain along the outer side of the foot. Posterior tibialis tendon passes on the inner side of the foot and gets attached to the tarsal bones. When this tendon gets injured, you feel pain along the inner side of the foot.
Management of foot injuries in runners
Avoiding over-activity is the first and the foremost thing in the management of foot injuries in runners. Paradoxically, this is usually the contributing factor of foot injuries that can progress from minor to a more severe problem, because athletes often try to ‘work through’ the pain. A visit to your podiatrist can be invaluable, not only to help with problems you already have, but to prevent runners’ injuries. Knowledge is power.
Your podiatrist can show you how:
Immobilization of the foot and strapping may help relieve pain and heal fractures.
Pain relief may also obtained by taking over-the-counter medications.
In persistent cases of tendonitis, local injection of steroids may help.
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