When Should You See the Foot Doctor?


~By Jared Frankel, DPM

The human foot and ankle are a marvel of creation. Being one of the most difficult apparatus to recreate with a prosthesis for amputees, it is understandable why injuries of this complex torque converter develop.  That being said, injuries of the foot and ankle for runners can be avoided or prevented for the most part. Whether you are a novice or a long time runner a Graduated Adaptive Program (GAP) is essential. Your body is a very adaptive structure and stresses applied to it properly will cause change so as to prevent injury. Too much too soon is what leads to injuries such as tendonitis, heel pain, metatarsalgia, stress fractures, shin splints, etc. Develop a program that lets you modify your performance gradually, whether it would be running longer or faster. An experienced sports medicine practitioner can help you develop such a program.

 Develop a stretching program and stick to it. Why is it important?  In running, we tend to move our joints and tendons through a constant range of motion. Due to the nature of this activity this lends itself to irritation. Stretching forces you to move the joint and tendons through their full range of motion. This tempers the stress found in running. I recommend following the programs outlined in Bob Anderson’s book call Stretching.

Change your shoes frequently and don’t run on the treadmill all of the time.  Constantly running on the treadmill can result in overuse injuries. The same foot plant over and over, especially in the same shoe, is conducive to these injuries.  If you must run on the treadmill day after day change your shoe brand and alternate them.  Changing your shoes and replacing worn out ones (replace them after 400 to 500 miles) changes the stress just slightly through the bones and joints.  Your foot and ankle will bear weight slightly differently. This will do a lot to prevent fractures and tendonitis. I usually recommend three pairs of shoes of two different brands with different lasts for runners who run more than 30 miles.  Get three pairs of shoes, two pair of your favorite brand and one pair of your next favorite brand and put them in rotation. You should run with your favorite shoe making sure it is well broken in and then move to the second shoe in the rotation. As the first shoe wears out replace with the second shoe of a different brand and then move the new pair of shoes from the box into the rotation as the “breaking in” shoe. Alternate the lasts and the shoes that you are wearing.

 Don’t panic if you have pain. Running injuries tend to be of a chronicity and overuse and not acute. Swelling and discomfort usually occur gradually and not as a result of acute trauma.   RICE (Rest, Ice, Compression, and Elevation) is the obvious immediate treatment.  This should be done for the first 24-48 hours when the injuries keep you from running. Anti-inflammatory medication may also be helpful. Don’t run- you can’t run through it.  I know, I have tried it. Four to seven days of not running is a start. Begin running slowly if the pain and symptoms subside. Skip a day in between and cut down your mileage. Try to assess what may have caused the injury.

  • Do I always run on the cant of the road?
  • Am I running in new shoes that may not fit properly?
  • Have I increased my pace too soon?

If you can identify the cause, change it.  If all else fails, see your podiatrist when the following exists:

  • An acute injury. For example spraining or twisting your ankle with results in obvious ligament tear; black and blue or ecchymosis, swelling, or tenderness.
  • Redness and swelling and pain over a significant area of a significant nature-“I can’t get my shoes on”.
  • When RICE has failed to alleviate the symptoms.

As indicated earlier, most running injuries are of overuse and not of an acute nature and can be sensibly treated and alleviated with these simple recommendations. If persistence of pain exists, see your foot doctor.

Dr. Frankel is a podiatric surgeon who practices in Elmhurst, Illinois. He is actively involved in athletics and is the past consultant to the Fort Lauderdale Road Runners and the Fort Lauderdale Strikers professional soccer team. He has run the Boston, New York, and Orange Bowl marathons and is an avid cyclist.

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