3 causes of foot pain and how to fix them

3 causes of foot pain and how to fix them
3 common causes of foot pain when runningurbazon - Getty Images

Your feet take a pounding as a runner. Even with the most technologically advanced midsole cushioning available to humankind, injuries are extremely common as each foot strike has been shown to produce a force equal to between three and seven times your bodyweight.

That all equates to a huge amount of pressure, and inevitably injuries do occur – something that no runner wants. Here, Pete Talbot, physiotherapist for P3RFORM, runs through the three most common foot injuries from running, and how to treat them if you're unfortunate enough to pick one up.

1.Plantar fasciitis

Plantar fasciitis is one of the most common causes of foot pain in runners and often presents as a sharp/stabbing pain in the heel – often the pain is worse first thing in the morning.

The plantar fascia is a thick ligament that lies just beneath the skin and runs along the bottom of your foot from the calcaneus (heel bone) to the base of each toe. Plantar fasciitis occurs when too much pressure and stretching damages the ligament and it becomes inflamed or even tears.

Causes: It can be high-arched feet, wearing trainers/shoes that do not support your foot adequately or sudden changes in training load or starting new activities.

Prevent it: Follow a structured training programme with no sudden spikes in training load and perform strengthening exercises alongside your running. Also, wearing the correct footwear is key not just for your training but also if you spend a large part of your day on your feet.

Treat it: Initially, rest and ice to help with pain management and use a tennis ball or frozen water in a bottle to massage the sole of your foot. Anti-inflammatories can also be taken, but it's best to get advice from a pharmacist or your GP prior to taking them.

2. Stress fracture

Stress fractures are small breaks in the bone that cause sharp, localised pain, tenderness, swelling, walking/running differently to avoid putting pressure on the injured area and bruising. Any bone can be susceptible to a stress fracture, but the metatarsals are the most common.

Causes: Stress fractures occur as a result of repetitive overuse and, similar to plantar fasciitis, they can result from a sudden increase in work/training load, doing too much running on hard surfaces or wearing footwear that is not correct for your foot type or biomechanics.

Prevent it: If you experience any pain that you suspect to be a stress fracture it is important you stop impact activities and get a medical diagnosis to confirm the specific nature of the injury. This is best done by a sports medicine physician.

Treat it: Unfortunately, the treatment for stress fractures is rest with no impact activities and you may even need a period of six 6 to eight weeks in an immobilisation boot, but this will be discussed once you have an accurate diagnosis.

3. Tendinopathy

Tendons are responsible for transmitting forces from muscle to bone. Tendinopathy is a clinical syndrome, often but not always implying overuse tendon injuries, characterised by a combination of pain, diffuse or localised swelling and impaired performance.

There are a few common locations around the foot where tendinopathies can occur: the lateral side of the ankle is peroneal tendinopathy, and around the heel is Achilles tendinopathy. Symptoms are described as a gradual onset of pain during running which can become more frequent and start to be a problem in everyday activities. The tendon itself can be painful to touch and symptoms are often worse in the mornings or after periods of sitting.

Causes: Causes differ depending on the location of the tendinopathy, but they are mainly changes in work/training load or changes in running surface.

Treat it: It is always best to seek medical advice, but treatment will revolve around optimal loading of the affected tendon both isometric and eccentrically. An example of this would be to do a calf raise but go very slow on the lowering part of the movement and complete three sets of 15 reps. It’s best to avoid painful higher-impact activities and ensure your return to activity is gradual.

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