Dr. Breslow's Guide to Healthy Runner's Feet
Over the course of a training cycle, many runners will deal with one or more of the common runner’s foot ailments. I hope some of the tips below will help you navigate these.
Common Foot and Ankle Problems Experienced by Runners
Below is a brief description of some of the more common foot and ankle injuries that may befall you:
· Plantar fasciitis: Inflammation/degeneration of the thick layer of connective tissue on the bottom of your foot. Experienced as pain beneath the heel.
· Achilles tendinitis: Inflammation of the large tendon that connects your calf muscle to your heel bone. Experienced as pain at the back of the heel or the back part of the ankle.
· Tibialis posterior tendonitis: Inflammation of the tendon of one of your deep calf muscles that is responsible for supporting your arch and pointing your foot. Experienced as pain on the inside of your foot/ankle.
· Peroneal tendonitis: Inflammation of the tendons of the lower leg muscles important for stabilizing your ankles. Experienced as pain on the outside of your foot/ankle.
· Metatarsal stress reaction/fracture: Injury to the bones of your forefoot that results from repeated impact. Can be experienced as pain on the balls of your feet. Very commonly affects the 5th metatarsal, which is located on the outside of your foot.
· Blisters: Caused by friction, a fluid-filled bubble on the skin.
· Black Toenails: A bruise underneath the nail caused by friction, ill-fitting running shoes, or toe curling. Can lead to loss of toenails.
A Brief Word on Running Shoes
Deciding which kind of running shoe is best for you can be confusing and is a broad topic in its own right. Should you go minimalist, maximalist, or pick one of the numerous choices that fall somewhere in between? The literature on which type of shoe a runner should choose is conflicting. However, the one thing that has been shown convincingly is this: shoes that are more comfortable are associated with less injury frequency and less work of running. Your best bet is to simply stick to your own “comfort filter” and choose a shoe that feels good when you run in it.
Foot Mobility
I know you probably stretch your calves, quads, hamstrings and glutes, but do you ever think about stretching your feet? Good foot mobility is so important, especially for proper shock absorption, but it’s something we generally don’t do much to maintain. In fact, when we jam our feet into shoes and socks all day we make our feet even stiffer. Running strength guru Phil Wharton of Wharton Health has some great active isolated flexibility routines to help restore mobility in your feet. Check out his website for some examples.
You can also use toe separator devices such as Yoga Toes or Correct Toes to stretch your feet; stick them on while you’re lying on your couch reading a book or watching TV. Wearing Ininji Socks, which have specific compartments for each toe, instead of regular running socks can help maintain good toe separation, and many swear by them for blister prevention too.
Foot Strength
A regular foot-strengthening routine is an important tool in a runner’s arsenal. You don’t have to spend a lot of time to give your foot strength a real boost; a few simple exercises after running a couple times a week should do the trick. Some foot/toe coordination work you can do is:
· Practice spreading your toes. If you can do this easily, put a rubber band or piece of resistance tubing around your toes and spread your toes against the resistance.
· Practice curling your toes. Can you curl your great toe in the opposite direction of your small toes?
· Grab a towel up off the floor with your toes, or try picking up marbles
· Try making the arch of your foot more pronounced (referred to as “doming”). Do it seated, and then try to do it standing up.
· When you come in from your run, take off your shoes and spend a few minutes toe and heel walking.
Foot Flow
Regardless of how healthy your feet are or how well you take care of them, the fact of the matter is if you run a lot, they will take a beating. They are bearing your full weight, and are the first-line shock absorbers of the ground forces you subject yourself to when you run. Blood flow there isn’t as good as it is to your more proximal body parts (glutes, quads, etc), and waste products can build up and are tough to flush out.
There are a few things you can do to help with circulation, and one is self-massage. Rolling a lacrosse or tennis ball under the bottom of the feet works well for arch pain or plantar fascia pain. You can also use a trigger point tool, such as the Muscle Angel Massager, or your own fingers to rub out the tight sore spots and promote blood flow.
Another tip is to use contrast bathing. The protocol is as follows:
· Make an ice bath and a warm bath in two pots, tubs or basins. For additional relief, dissolve Epsom salts (which can be bought at any drug store) into the warm water bath.
· Stick your foot or feet into the warm bath for 4 minutes, then quickly submerge in the ice bath for 1 minute. If you are injured and there is swelling, increase the ratio of cold to warm (ie 3 minutes warm, 2 minutes cold).
· Repeat for a total of 4 times (20 minutes total), ending on cold, then elevate your feet for 10-15 minutes.
You can use this method to help heal a foot injury, but it also works just for rejuvenating tired, sore, beaten up feet.
Foot Skincare
Blisters and calluses are an inevitable part of long distance running, and many of you will be dealing with them. If you already know you are prone to these problems, consider purchasing a powder or lubricant product designed to reduce friction within the shoe. These are available online or in specialty running stores, and can be especially useful for longer runs.
If you do develop a blister or hot spot, moleskin can make running more tolerable. Cut out a piece that is larger than the lesion, then cut a central hole by folding in half. To apply, align the central hole over the blister; the surrounding moleskin will prevent your shoe from rubbing against the already irritated area. If you develop painful black toenails, moleskin can also be used to provide extra cushioning and protection against your shoe’s toe box.
Keep your calluses to a manageable size by filing them down regularly with an emery board or callus file. This is easiest to do after soaking your feet in warm water. Apply moisturizer after filing to soften the skin. Calluses themselves are your body’s way of protecting a stressed area, but if blisters develop beneath them this can be exceedingly painful, so beware!
Foot-care Resources
If you want to learn more, there are some excellent resources out there with information on how to take care of your feet. Two books I recommend on this subject are Fixing Your Feet: Prevention and Treatment for Athletes by runner and fast-packer John Vonhof, and Injury Free Running: How to Build Strength, Improve Form and Treat/Prevent Injuries, by the well-known sports chiropractor Dr. Thomas C. Michaud. Both are full of useful tips, from how to properly prep your feet against blisters, to an exhaustive review of the most common foot injuries and how to address them. They are written in accessible language so are relatable even to the less medically savvy.
I have also garnered some useful information from the blog of California podiatrist Dr. Richard Blake. There are posts on a multitude of conditions and treatment protocols. A wealth of information to be found here!
Foot Experts
Finally, I have to put in a plug for seeking help when you need it. If, no matter what you do, your nagging foot or ankle injury won’t resolve, get a medical opinion. You may have a structural problem that can be remedied by extra support, such as orthotics, or you may have a more serious injury that requires rest and cross-training, such as a stress fracture. A medical professional can help sort things out to get you healthy and back to running as soon as possible.
**Disclaimer: I do not officially endorse and have not received compensation for recommending any of the products mentioned in this article.