4 Common Foot and Ankle Injuries Runners Might Encounter During Training

A runner massages her foot on a track

How to Treat and Prevent Common Running Injuries

Runners encounter all kinds of injuries during training—the repetitive stress of running can wear on your feet, ankles and the small muscles and tendons that support them. For many runners, there are several foot and ankle injuries that occur regularly.

But there is good news: These injuries are all easily treatable without losing weeks of training. Even better, when you’re armed with the right knowledge and good training, most overuse injuries are often preventable.

Here are four common injuries or conditions runners encounter.

A man laces up a pair of Karhu running shoes

Plantar fasciitis

Pain around your heel that’s worse in the morning and generally feels better throughout the day is likely plantar fasciitis.

The pain you feel is the band of connective tissue, called the plantar fascia, asking for support. This connective tissue extends along the bottom of your foot from your calcaneus (heel bone) to your toes. Its job it to help prevent your arch from collapsing during the gait cycle.

Plantar fasciitis can be painful, but it is treatable at home. Treatments for plantar fasciitis include:

  • Icing
  • Stretching
  • Massage
  • Anti-inflammatories
  • Orthotics

A rigid over-the-counter orthotic, like Superfeet insoles, could help alleviate the pain, but custom inserts might be necessary if you continue to struggle with plantar fasciitis.

A woman running in New Balance shoes on a trail

Achilles tendonitis

Achilles tendonitis is inflammation of the tendon that runs down the back of your heel.

The Achilles tendon is part of a larger system involving the calf muscles, which are notoriously tight in distance runners. Inflammation can occur where the tendon connects to the heel bone or within the tendon itself. Watch out for tendonitis here if you change footwear.

Many running shoes use a steep heel-to-toe drop to promote forward motion when you’re on the move. The drop, presented in millimeters, is calculated by finding the difference between the height of the heel and the height of the forefoot. So, a running shoe that has 20 mm of material under the heel and 10 mm of material under the forefoot would have a 10 mm drop.

The drop of some of the popular running shoes are:

When you switch from a shoe with a steep drop to a shoe with a shallower decline, it could strain your Achilles tendon in the short term. If you’re feeling discomfort or pain in your Achilles, the best treatment is to add an orthotic for support and a temporary heel lift to take some tension off the tendon.

Anti-inflammatories, stretching, icing and strengthening all play a role in treating this condition, as well. As always, let pain guide your treatment. If you don’t see improvement with these few tips, seek professional help with a foot and ankle specialist.

A group of runners on a dirt path

Neuroma

Pain in the forefoot can be the effect of a number of different causes. One of the more common conditions is the irritation or compression of a nerve as it passes between two long bones in your foot called metatarsals.

Burning, numbness, general pain and the feeling of walking on a bunched-up sock are common complaints of runners with neuroma. The condition is exacerbated by tight shoes that compress the foot from side to side, high-heeled shoes and poor biomechanics.

Treatment for neuroma usually involves adding support with orthotics. Foot specialists will often place a pad under the metatarsal bones to decompress the irritated nerve. If the problem persists, injections into the area can help alleviate the pain or solve the problem altogether.

Stress fracture

A stress fracture is a crack in a bone due to overuse. It’s a common running injury that will force you to take an unplanned six to eight week break from pounding the pavement.

Commonly affected bones are those that repeatedly bear weight, like the calcaneus (heel bone) and the metatarsals (bones in the forefoot), but fractures can also occur in the hips, back and leg bones.

Treatment for this is rest and immobilization in a boot or cast, though down time can allow you to work on other parts of your running. Continuing to train on these injuries is painful and will not allow the bone to heal, which can lead to bigger issues. A normal appearing X-ray does not rule out a fracture, since it won’t show up until about two to three weeks after the initial injury when the bone begins to heal. Some health care providers will recommend an MRI, though it rarely changes the treatment plan.

Speaking from my own personal experience with training and racing, I’ve found that runners have both high pain tolerance and determination to reach their goals. As with any injury, let pain be your guide. No race is worth serious or chronic injury.

Should you continue to have pain or any questions regarding problems during training, consult a foot and ankle specialist for formal evaluation.

By Jason Havey. Jason is a podiatric doctor who completed his three-year residency in foot and ankle surgery at Hennepin County Medical Center in Minneapolis, Minnesota. He's also a USA Track and Field-certified coach and a marathoner.

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