Running and Foot Pain
by: Jen Lausten PT and Amy Smith ATC
Why do my feet hurt?!
You may assume it’s the structure of your feet and it’s partly true. Both flat feet and high arches can cause problems in the soft tissue of feet.
One more wonderful part of middle age is the wearing away of the fat pad that provides cushion on the heel (calcaneus). The body also becomes less forgiving to the wear and tear because your high arches are too inflexible or your flat feet are overly stretched.
Often, in the clinic when we have patients complain of foot pain, it’s from a recent change in lifestyle, such as starting to RUN. It doesn’t seem fair that we want to make a healthy decision to improve our fitness and than get hurt and discouraged. It is usually due to increasing the running distance or the intensity too quickly. Another aggravator can be the surface on which you are running, such as downhill or on uneven ground.
Here was an interesting blog by a scientist who happens to be a runner. He began very unfit, only able to run 50 yards, and now can do 50 km! He wrote out a safe progression from walking to running. His program uses good common sense, and references several running experts.
In a nutshell, get good at walking before you run!! Walk 30 min a day and make sure you feel pretty good the next day too.
“The starting point doesn’t matter. Being consistent matters. Getting out for your next workout matters.” –Grumbine Science
Here is why your feet hurt from running from a Physical Therapist viewpoint:
The plantar fascia is a celery-like structure that connects the heel to the ball of the foot. It is like a band that connects a tripod that consists of the heel and the bones of the ball of the foot. The goal of the plantar fascia is to stabilize and support the arch, assist with pressure distribution across the foot, and to transfer the strength of the Achilles tendon to the forefoot by helping propulse the foot from heel to toe motion.
Another reason for your foot pain could be foot wear. Your running shoes may be worn out or not fitting properly. So, if you are about to start an exercise program, make sure you get the correct shoe for your foot shape (high arch=supinator or flat feet=pronator). It is also important to get the correct type of shoe for the activity you are planning to do (i.e. running vs. cross training).
How do you know if you have plantar fasciitis?
The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.
The pain is usually worse:
- In the morning when you take your first steps
- After standing or sitting for a while
- When climbing stairs
- After intense activity
The pain may develop slowly over time, or suddenly after intense activity.
What can you do about it
- Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation
- Heel and foot stretching exercises
- Resting as much as possible for at least a week
- Wearing shoes with good support and cushions
Other steps to relieve pain include:
- Apply ice to the painful area. Do this at least twice a day for 10 – 15 minutes. A good way to do this is to freeze a water bottle, and roll it under the arch of your foot.
- Try wearing a gel heel cup. These can usually be found at your local sports store or pharmacy.
- Use night splints to stretch the injured fascia and allow it to heal. You can use a traditional splint, or a Strassburg sock (pictured below) may be more comfortable to sleep in.
If these don’t work should see PT to treat with modalities to decrease inflammation, as well as to possibly provide deep soft tissue mobilization in the areas of the calf that may be providing too much strain to affected area. Sometimes, immobilization is what it really needs, and a walking boot is issued for 6-8 wks to calm down the inflammation.
Next month we will discuss how to assess your computer posture and to improve shoulder and neck pain caused from forward head and slouching!