Ankle pain with running is very common. The more we pound the concrete, the more likely we are to have some nagging pain pop up. However, running related ankle pain, does not tend to get the fast track treatment that “runners knee” or “IT Band syndrome” gets.
With every stride a runner takes, the ankle absorbs a high amount of load. Depending on a runners form, that load can be smaller if the hip and knee are doing a good job, or it can be an overload amount if we see break down at other joints. There are 29 muscles that contribute to movement of the foot and ankle, while there is a plentiful number of muscles, these muscles are small and get get overworked fast!
As a sports physical therapist, I often see runners who have ignored minor foot or ankle pain until the point that they can no longer walk without pain. This sets the runner up for a longer road to recovery, or the risk of an underlying stress fracture that can sideline a runner for quite some time. This is why this months blog post is dedicated to common foot/ankle issues in runners and some quick and easy things you can do to help keep your feet and ankles strong!
Common Foot and Ankle Injuries:
Calf Strain/Achilles Tendonitis: The gastrocnemius and the soleus make up our “calf complex.” These muscles are the biggest and most powerful of the muscles that connect to the foot and ankle. Often we see calf strains occurs with a quick ramp up of speed work or plyometric training. To avoid this, runners should consult a physical therapist or strength and conditioning specialist to help them with speed and power based training. Both speed and power training are beneficial for runners but how quickly we add them in or increase the intensity can make the difference between injury and performance!
Peroneal Tendonitis: Your Peroneal muscles are on the outside of your lower leg and attach to the outside of your foot. They are an ankle stabilizer and perform the action of ankle/foot eversion. These muscles and their tendons can be injured due to an acute ankle sprain but can also develop tendon irritation in runners who have high arches. Peroneal Tendonitis usually causes outside ankle and foot pain, as well as stiffness in the lateral portion of your lower leg. Typically, pain associated gets worse with weight bearing activities.
Posterior Tibial Tendonitis: The main role of the Posterior Tibial muscle is to support the arch of the foot with weight bearing. This muscle also assists with both plantar flexion (pointing your foot down) and inversion (pointing your toes inward). This muscles gets a lot of stress with running to support the arch as the foot contacts the ground. Runners will typically experience pain along the inside of the ankle and down into the foot, especially with weight bearing or activity. If ignored, this can cause arch collapse if the tendon fully ruptures.
Shin Splits: Also known as medial tibial stress syndrome. Pain along the anterior shin is caused by micro tears in the muscles that attach along the medial aspect of your tibia. This syndrome is typically caused by a rapid increase in intensity of activity (i.e. runners ramping up too quickly on mileage or speed). If ignored, this injury can lead to a stress reaction on the bone and could ultimately culminate into a stress fracture.
Plantar Fasciitis: Caused by inflammation of the plantar fascia. Typically occurs due to a sudden increase in activity, chronic overuse or certain foot types are prone to developing plantar fasciitis. Most commonly, pain increases gradually and is most prominent near the heel of the foot. Although condition is caused by overuse or increase in stress, pain typically tends to be at its worst first thing in the morning or after inactivity.
What should you do if you think you have one of these conditions?
1) First and foremost, stay active. Modify your activity to a non-painful amount of load (for all you runners, think biking or swimming as an alternative to running).
2) Assess your training volume. Did you recently add in speed work? Did you recently bump up your mileage quite a bit? If you answered yes to either of these questions, let’s modify by pulling back a bit and seeing if pain resolves.
3) Get a running assessment done. The way you absorb load when running can cause unnecessary stress on your foot and ankle if there is form breakdown above this area. At Imagine Performance Therapy, we perform running gait assessments often to help keep our runners training at the volume and intensity they prefer!
4) Take care of your ankles and feet before there is a problem. Below are some of our favorite foot and ankle exercises to add into your strength training! And if you are not strength training as a runner, you definitely should be!
Runner Foot/Ankle Health Exercises:
A) Toe Yoga: Set 1:00 clock; alternate lifting big toe and little toes. Rest for 30 seconds. Perform 3-4 sets.
B) Banded Side Steps with band at arch: Take 12-15 steps one direction, followed by 12-15 steps the opposite direction. Rest 30-60 seconds; perform 3-4 sets.
C) Single Leg Balance with 3 Direction Reach: Reach each direction 5 times, switch and perform on opposite side. Rest 60 seconds between sets. Perform 3-4 sets.
D) Eccentric Heel Raises: Use 4-6 inch step; raise up with 2 legs, lower down on 1; slow and controlled. Perform 8-12 reps per leg. Rest 60 seconds between sets. Perform 3-4 sets.
E) Single Leg RDL: Standing on one leg, hinge forward at your hips. Maintain contact with ground on your big toe, little toe and heel. Assume standing. Perform 8-12 reps, repeat on opposite side. Rest 60 seconds between sets.
If you are struggling with foot and ankle pain and cannot get it under control. Reach out to us today! Let us help you find the root cause and build you a program to get you back to pain free running! Click HERE to set up your FREE discovery call!
