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It's that time of year; pre-Marathon season in New York City.  We're really seeing our fair share of running injuries as people work on increasing speed and mileage in the final few months leading up to the New York City Marathon.  Here are the top five running-related injuries that we see and treat in our practice and some practical advise on how to manage and prevent them.

Plantar Fasciitis

Plantar fasciitis is a painful inflammation of the plantar fascia; a fibrous band of tissue in the bottom of the foot that extends from the heel bone to the toes. This tissue can become inflamed for many reasons, most commonly from irritation by placing too much stress (excess running and jumping) on the bottom of the foot.

You can prevent plantar fasciitis by stretching both before and after every run. Proper stretching is gentle and should not be painful. Wearing supportive running shoes that are appropriate for your foot type, as well as shoe inserts, can also be effective. Make sure to not over-train, gradually increasing how long or far you run.

If you have plantar fasciitis, the immmediate treatments should include icing the area to help with inflammation (several times per day if possible), stretching, and taking OTC anti-inflammatory medication and resting (refraining from running). I did a complete review of plantar fasciitis and how to treat it in this video.

Achilles Tendonitis

Achilles tendonitis is an irritation or inflammation of the large tendon in the back of the leg where the calf attaches to the back of the heel. The condition is often caused by lack of flexibility, wearing higher heels for long periods of time and/or overpronation.

This is easily prevented by stretching regularly. Shoe inserts such as heel cups, arch supports and custom molded orthotics may also help to correct faulty foot mechanics that can predispose you to this injury.

If you have Achilles Tendonitis, icing and over the counter anti-inflammatory medications can be taken in the short term with great immediate relief. Resting the affected limb is vital for quick recovery. Often, depending on the severity, we recommend immobilization in more severe cases (such as a walking boot) to allow the area to heal faster.

Morton’s Neuroma

A Morton’s neuroma is often described by runners as a burning, stinging pain in the forefoot (commonly in the third and fourth toes). Other symptoms include pain in the ball of the foot and a feeling of “pins and needles” and numbness in the toes. Runners who wear tight-fitting footwear often experience this condition. Technically speaking, a neuroma is a benign tumor of the nerve, although entrapment of the nerve will give the same symptoms.

Wearing proper running shoes that fit well and have a roomy and wide toe box is essential in healing an inflammed neuroma,. Do not lace your shoes too tightly in the forefoot. Runners should wear shoes that feature adequate forefoot cushioning, and fit shoes with running-appropriate socks (those with a poly-cotton blend).

In treating neuromas, sometimes a cortisone injection can provide relief. More often, a series of sclerosing injections of medical-grade ethanol work well in shrinking the enlarged nerve tissue. Still, treatment always includes modifying shoe gear to wearing wider running footwear. A professional gait analysis, paired with customized foot orthotics, can often prevent the condition from reoccurring. Thankfully, surgical removal of the neuroma is rarely necessary.

Stress Fracture

Stress fractures in the lower limbs are quite common among athletes in general, and are commonly caused by repetitive forces on these areas. Symptoms include localized pain and swelling that grows worse over time. Stress fractures can occur over a period of days, weeks, or even months.

Modifying running equipment or training regimens can often prevent these painful injuries. Replace your running shoes on a regular basis (about every 500 miles).

Stress fractures are like any other fracture in the body and require 8-10 weeks to heal completely. Treatments may include complete rest and icing, immobilization using casting or bracing of the affected area.

Shin Splints

Shin Splints are also referred to as “tibial stress syndrome,” and they affect runners of all ages and are commonly experienced as a shooting pain felt near the front or sides of one or both tibia bones (the shins). Performing stretches such as toe raises and shin stretches, and replacing running footwear often goes a long way to preventing these injuries.

Shin splints can be treated immediately with ice and anti-inflammatory medications. I almost always recommend a physical therapy program for this, as well as testing to determine if prescription orthotic inserts could prevent further injury.

The bottom line about running-related injuries is a simple one. It's natural and common for runners to get aches and pains but they should be transient and should resolve in a matter of days. If you're having pain in your foot or ankle and it's not going away after a few days, or if it's spreading and increasing in intensity, stop running immediately and get it checked out.

 

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Are you having any of the above mentioned issues? Remember; foot pain is not normal.  Please feel free to call us at (646) 929-4149 and make an appointment and get checked out today.