Foot or Ankle pain after running?

 

Runners are known for placing significant strain to their feet and ankles. Unfortunately this means that the running enthusiast is at risk of developing injuries. With the rise of marathon and triathlon practice, a similar rise of runners attending foot and ankle clinics is observed. We will discuss which are the most commonly encountered injuries in the article below.

 

What are the most common running injuries?

In my foot and ankle clinic, the top of the list goes to ankle sprains, very commonly seen in runners and athletes. They are actually the most frequently diagnosed lower limb injury during sports practice in the UK. Despite being highly prevalent they normally go on to heal well with the correct treatment. Ankle sprains however can be overlooked and in actual fact sometimes present with much more severe injuries when left untreated. Other common injuries in runners are tendinitis and stress fractures.

 

What are the risk factors predisposing runners to injuries?

Regular training and lower limb conditioning is possibly the most important factor assuming one is in good general health. This is why weekend warriors are unfortunately at higher risk of injury. The complexity of the ankle joint and its biomechanics call for appropriate attention and some tender love and care, especially for those that have higher demands like runners or sportsmen and women. 

Having sustained an ankle sprain in the past puts one at risk of having further injuries unless the right treatment is implemented in the first place. Being hypermobile or double jointed can make you more prone to injuries.

Finally, imbalances coming from higher up in the limb like the hip, knee or shin can indirectly contribute to muscle imbalance and ankle performance. 


What can be done to prevent running injuries?


Starting with a pair of good running shoes is a non-negotiable. Running style assessments are a fantastic way to address rather unnoticeable running patterns that can eventually predispose to injuries. 

Once an injury has already occurred, prevention of further injuries is key. Rehabilitation following an injury is highly important and should not stop at the time of being pain-free. The main areas to work on involve muscle strengthening, coordination and balance. An experienced sports physiotherapist is fundamental to guide this process towards a full and speedy recovery.


After sustaining a foot or ankle injury, how long should you wait before seeking medical attention? 

Quite often pain levels will determine the severity of an injury. But pain is very subjective and it is experienced very differently by individuals and so it may underrepresent what injuries warrant urgent attention.

Some injuries may require early surgery, such as fractures and tendon ruptures, and they have a small window of opportunity to heal well. A delay in treatment of 2 or 3 weeks may negatively affect outcomes, and to be on the safe side help should be sought promptly. For those less severe injuries a much wider safe margin exists and delays in treatment carry less consequences.

Generally, the sooner a treatment is implemented the better and faster the recovery. So seeking early attention is never a bad idea for the best healing and also for peace of mind.
 

What other injuries are common in the feet and ankles of runners and how to best treat them?

Tendinitis is also very common and can develop in many parts of the foot, some of the most frequently encountered are Achilles, peroneal and tibialis posterior tendinitis (or tendinopathy to use the correct term).

These are overuse injuries and frequently reveal a muscle or biomechanical imbalance that must be addressed either with physiotherapy or with insoles from the podiatrists.

Steroid injections around tendons are generally not recommended as they can predispose to ruptures making the cure worse than the disease. Other types of injections such as viscosupplement or PRP (platelet rich plasma) are safe and can be indicated in specific cases. Surgery is reserved as the last resort after non-operative methods have failed to improve symptoms. 

Scientific evidence backs physiotherapy up as the number one treatment option, with also convincing support for Extra-corporeal Shock Wave therapy – a non-invasive treatment that promotes healing. Stem cells have also shown promising results and are currently being studied further to assess what are the conditions that can benefit from them more effectively.