Injury Prevention

Rehabilitation of Common Runners Foot Injuries

Dr Larry W. McDaniel, Callin Haar, and Matt Ihler discuss the rehabilitation of common foot injuries.

Whether you are a weekend warrior or a serious athlete, most runners fear the possibility of being injured. Feet are the primary method of participating in physical activities. For those who run, healthy feet are essential. Olympic conditioned runners spend many hours performing foot maintenance to prevent unnecessary injuries. Common foot injuries are Plantar Fasciitis, Metatarsal Stress Fractures, blisters, Metatarsalgia, Morton's Syndrome, Turf Toe, and Sesamoiditis. This paper will provide suggestions on caring for common foot injuries in runners properly.

Plantar Fasciitis

Plantar Fasciitis is characterized by pain in the inferior heel or the origin of the arch ligament when weight is placed on the foot. This inhibits the runners' ability to flex the foot because the pain is too great for the individual (Cole 2005)^[2]. However, there are various methods to rehab this injury. The most important issue for a quick recovery would involve decreasing the amount of swelling and inflammation in the joint. This may be done by reducing the amount of exercise and resting the injured foot (Cosca 2007)^[3].

While the runners reduce the quantity of exercise, recovering may be expedited by placing the foot in ice or cold water. The individual may choose to use anti-inflammatory medication to help in the reduction of swelling in the injured foot. Anti-inflammatory medication may assist in the process of preventing injuries to the other foot (Plantar Fasciitis Rehabilitation 2008)^[9]

Heel lifts should be used to prevent further damage to the foot. Since the runner developed Plantar Fasciitis in one foot, the other foot may be susceptible to injury. The injured person should stretch each foot by dorsiflexing both feet simultaneously. This process should be followed by alternating one foot at a time (Plantar Fasciitis Rehabilitation, 2008)^[9].

The rehab therapy also includes plantar flexing both feet using a towel to assist in stretching the Achilles tendon. To increase muscular strength and endurance in the injured area, swimming, running in the water, or using a stationary bike is recommended (Cole et al. 2005)^[2].

The above recommended exercises increase muscular activity in the foot and calf muscles.

Metatarsal Stress Fractures

Metatarsal Stress Fractures are caused by overuse of the foot. Since this is a fracture of one of the metatarsal bones walking or jogging will cause pain. The treatment for these injuries reduces the amount of activity and pressure on the injured foot. In some cases, crutches and wearing a protective boot will reduce stress on the metatarsals.

Biking is recommended to maintain strength and endurance in the lower body because it places less pressure on the metatarsal bones, and the increased blood flow may expedite healing. The healing process usually takes from 3-12 weeks for the individual to recover fully.

Blisters

Blisters are generated by constant friction against the skin, which causes a fluid-filled pocket to form on the affected area. Blisters are the most common injury among runners, athletes, and others who exercise. Blisters are caused by shoes that are not built just for their feet but are mass produced, and most people do not take the proper time to break in their shoes correctly (Mitnick n.d.)^[7].

In early blister formation, pain relief may occur by removing the shoe to allow the area to cool down. The runner may cover the area to help reduce the friction on the foot. Second skin, tape, and other forms of bandages may be applied to help protect the blister from becoming worse (Mitnick n.d.)^[7].

Blisters After a blister has formed, the runner should decide if it makes walking painful. If the blister does not inhibit walking, then the blister should be allowed to heal on its own, and the runner may use a form of second skin to help prevent the blister from getting worse.

If the blister has reached a point where it hurts while walking and doing daily activities, it is recommended to puncture the blister and allow the excess fluid to drain (Mitnick n.d.)^[7]. The runner should not remove the skin of the blister because by doing so, the blister may become infected.

Metatarsalgia

The shape of your foot mainly causes Metatarsalgia. The reason that the foot's shape causes Metatarsalgia is unclear, but researchers and therapists know how to reduce the incidences of Metatarsalgia. This is an easy injury to take care of as it is localized in the metatarsal joints that are inflamed and causing pain. Since this condition involves inflamed joints, the best advice would be to rest the foot, ice, and take pain medication that reduces inflammation (Cohen 2007)^[1].

Other treatments to prevent Metatarsalgia from occurring are changing running shoes and increasing padding. Shoe inserts may also be used to relieve pressure on the metatarsals (Cohen 2007)^[1].

If discomfort in the foot still exists, it may be necessary to consult their local physical therapist for other options such as ultrasound, a form of deep heat, to help fight off the pain and inflammation.

Morton's Syndrome

Morton's Syndrome is the inflammation of a nerve found between the third and fourth metatarsal, producing pain in the toes, causing an inability to move the toes. Treatment for this injury varies with the degree of severity. Rather than surgery, therapy is recommended involving experimentation with various modalities to assist in recovery. Surgery for Morton's Syndrome is the last resort.

Mortons Syndrome Techniques for therapy involve changing the type of shoe wear and increasing the padding on the injured area. The medical specialist may prescribe orthotic inserts to relieve pressure on the inflamed nerve (Morton's Neuroma 2008)^[8].

Therapy may include icing the foot and taking non-steroidal anti-inflammatory drugs. These chemicals decrease swelling of the foot.

Turf Toe

Turf toe occurs when the great toe is severely hyper-extended. Turf Toe is a sprain of the Metatarsophalangeal joint. Therapy-related to Turf Toe includes rest, ice on the injured foot, and the use of crutches to reduce pressure on the foot (Edell 2006a)^[4]

Turf Toe If the individual's goal is to increase overall strength, exercises may be performed that do not involve pressure on the injured toe. Pressure on the injured toe will cause more damage to the injury. To maintain strength and increase circulation in the injured area, many experts recommend using an exercise bike.

To relieve pain and allow the injured athlete to begin running, the toe may be strapped with tape to decrease flexion in the range movement of the injured toe (Edell 2006b)^[5].

Sesamoiditis

Sesamoiditis is an inflammation of the Sesamoid bones and related joints, which are located near the great toe. The injured runner will experience difficulty flexing or bending the great toe. The Sesamoid bones may be fractured (Sesamoid Fracture 2008)^[10]. Surgery related to this type of injury is rare; however, surgery may be the primary method to expedite recovery in some cases.

Sesamoiditis To reduce pain and inflammation in the Great Toe, rest the foot, take over-the-counter pain medication, and apply ice to the injured area. During the recovery period, wear shoes with low heels with extra padding (Sesamoid Fracture 2008) Aucouturier.

Sesamoiditis injuries may have a significant impact on runners. Rest and ice may be the most important therapeutic modalities. Tape is often used to immobilize the Great Toe, which may decrease recovery time.

Hopefully, after reading this article, runners will recognize a typical runner's injuries and seek proper care.

Runner's Foot Injuries

Select this link to read the article where the authors discuss typical runner's foot injuries.

References

COHEN, J. (2007) Metatarsalgia - Causes, Symptoms, and Treatment Methods. In ArticleBASE Technologies, LLC
COLE, C. et al. (2005) Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy. American Family Physician, 72(11), 2237-2243
COSCA, D. (2007) Common Problems in Endurance Athletes. American Family Physician, 76(2), 237-246
EDELL, D. (2006a, April 6) Turf Toe, The Athletic Advisor
EDELL, D. (2006b, June 4) Turf Toe Taping, The Athletic Advisor
Metatarsal Stress Fracture. (2005, November), Merck & Co., Inc.
MITNICK, M. (n.d.) How to Treat a Foot Blister. In WikiHow - The How-to Manual
Morton's Neuroma. (2008) In Healthy Feet for an Active Life - FootPhysicians.com
Plantar Fasciitis Rehabilitation. (2008) In UPMC Sports Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA USA
Sesamoid Fracture and Sesamoiditis. (2008) In IHealthSpot
Relief to Sesamoiditis [Photograph found in Aetrex Worldwide, Inc.]
Second Skin [Photograph found in Relags]
Plantar Fasciitis [Photograph found in U.S. National Library of Medicine, Bethseda, MD]
Aids for Metarsalgia [Photograph found in Try Care]

Page Reference

If you quote information from this page in your work, then the reference for this page is:

McDANIEL, L. et al. (2009) Rehabilitation of Common Runners Foot Injuries [WWW] Available from: https://www.brianmac.co.uk/articles/article049.htm [Accessed

About the Authors

Dr Larry McDaniel is an associate professor and advisor for the Exercise Science program at Dakota State University, Madison, SD USA. He is a former All-American in football and Hall of Fame athlete & coach.

Matt Ihler and Callin Haar are students enrolled in Exercise Science at Dakota State University. Both are interested in careers related to Sports Medicine.


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McDaniel, Callin Haar, and Matt Ihler discuss the rehabilitation of common foot injuries. Whether you are a weekend warrior or a serious athlete, most runners fear the possibility of being injured. Feet are the primary method of participating in physical activities. For those who run, healthy feet are essential. Olympic conditioned runners spend many hours performing foot maintenance to prevent unnecessary injuries. Common foot injuries are Plantar Fasciitis, Metatarsal Stress Fractures, blisters, Metatarsalgia, Morton's Syndrome, Turf Toe, and Sesamoiditis. This paper will provide suggestions on caring for common foot injuries in runners properly. Plantar Fasciitis Plantar Fasciitis is characterized by pain in the inferior heel or the origin of the arch ligament when weight is placed on the foot. This inhibits the runners' ability to flex the foot because the pain is too great for the individual (Cole 2005)^[2]. However, there are various methods to rehab this injury. The most important issue for a quick recovery would involve decreasing the amount of swelling and inflammation in the joint. This may be done by reducing the amount of exercise and resting the injured foot (Cosca 2007)^[3]. While the runners reduce the quantity of exercise, recovering may be expedited by placing the foot in ice or cold water. The individual may choose to use anti-inflammatory medication to help in the reduction of swelling in the injured foot. Anti-inflammatory medication may assist in the process of preventing injuries to the other foot (Plantar Fasciitis Rehabilitation 2008)^[9] Heel lifts should be used to prevent further damage to the foot. Since the runner developed Plantar Fasciitis in one foot, the other foot may be susceptible to injury. The injured person should stretch each foot by dorsiflexing both feet simultaneously. This process should be followed by alternating one foot at a time (Plantar Fasciitis Rehabilitation, 2008)^[9]. The rehab therapy also includes plantar flexing both feet using a towel to assist in stretching the Achilles tendon. To increase muscular strength and endurance in the injured area, swimming, running in the water, or using a stationary bike is recommended (Cole et al. 2005)^[2]. The above recommended exercises increase muscular activity in the foot and calf muscles. Metatarsal Stress Fractures Metatarsal Stress Fractures are caused by overuse of the foot. Since this is a fracture of one of the metatarsal bones walking or jogging will cause pain. The treatment for these injuries reduces the amount of activity and pressure on the injured foot. In some cases, crutches and wearing a protective boot will reduce stress on the metatarsals. Biking is recommended to maintain strength and endurance in the lower body because it places less pressure on the metatarsal bones, and the increased blood flow may expedite healing. The healing process usually takes from 3-12 weeks for the individual to recover fully. Blisters Blisters are generated by constant friction against the skin, which causes a fluid-filled pocket to form on the affected area. Blisters are the most common injury among runners, athletes, and others who exercise. Blisters are caused by shoes that are not built just for their feet but are mass produced, and most people do not take the proper time to break in their shoes correctly (Mitnick n.d.)^[7]. In early blister formation, pain relief may occur by removing the shoe to allow the area to cool down. The runner may cover the area to help reduce the friction on the foot. Second skin, tape, and other forms of bandages may be applied to help protect the blister from becoming worse (Mitnick n.d.)^[7]. After a blister has formed, the runner should decide if it makes walking painful. If the blister does not inhibit walking, then the blister should be allowed to heal on its own, and the runner may use a form of second skin to help prevent the blister from getting worse. If the blister has reached a point where it hurts while walking and doing daily activities, it is recommended to puncture the blister and allow the excess fluid to drain (Mitnick n.d.)^[7]. The runner should not remove the skin of the blister because by doing so, the blister may become infected. Metatarsalgia The shape of your foot mainly causes Metatarsalgia. The reason that the foot's shape causes Metatarsalgia is unclear, but researchers and therapists know how to reduce the incidences of Metatarsalgia. This is an easy injury to take care of as it is localized in the metatarsal joints that are inflamed and causing pain. Since this condition involves inflamed joints, the best advice would be to rest the foot, ice, and take pain medication that reduces inflammation (Cohen 2007)^[1]. Other treatments to prevent Metatarsalgia from occurring are changing running shoes and increasing padding. Shoe inserts may also be used to relieve pressure on the metatarsals (Cohen 2007)^[1]. If discomfort in the foot still exists, it may be necessary to consult their local physical therapist for other options such as ultrasound, a form of deep heat, to help fight off the pain and inflammation. Morton's Syndrome Morton's Syndrome is the inflammation of a nerve found between the third and fourth metatarsal, producing pain in the toes, causing an inability to move the toes. Treatment for this injury varies with the degree of severity. Rather than surgery, therapy is recommended involving experimentation with various modalities to assist in recovery. Surgery for Morton's Syndrome is the last resort. Techniques for therapy involve changing the type of shoe wear and increasing the padding on the injured area. The medical specialist may prescribe orthotic inserts to relieve pressure on the inflamed nerve (Morton's Neuroma 2008)^[8]. Therapy may include icing the foot and taking non-steroidal anti-inflammatory drugs. These chemicals decrease swelling of the foot. Turf Toe Turf toe occurs when the great toe is severely hyper-extended. Turf Toe is a sprain of the Metatarsophalangeal joint. Therapy-related to Turf Toe includes rest, ice on the injured foot, and the use of crutches to reduce pressure on the foot (Edell 2006a)^[4] If the individual's goal is to increase overall strength, exercises may be performed that do not involve pressure on the injured toe. Pressure on the injured toe will cause more damage to the injury. To maintain strength and increase circulation in the injured area, many experts recommend using an exercise bike. To relieve pain and allow the injured athlete to begin running, the toe may be strapped with tape to decrease flexion in the range movement of the injured toe (Edell 2006b)^[5]. Sesamoiditis Sesamoiditis is an inflammation of the Sesamoid bones and related joints, which are located near the great toe. The injured runner will experience difficulty flexing or bending the great toe. The Sesamoid bones may be fractured (Sesamoid Fracture 2008)^[10]. Surgery related to this type of injury is rare; however, surgery may be the primary method to expedite recovery in some cases. To reduce pain and inflammation in the Great Toe, rest the foot, take over-the-counter pain medication, and apply ice to the injured area. During the recovery period, wear shoes with low heels with extra padding (Sesamoid Fracture 2008) Aucouturier. Sesamoiditis injuries may have a significant impact on runners. Rest and ice may be the most important therapeutic modalities. Tape is often used to immobilize the Great Toe, which may decrease recovery time. Hopefully, after reading this article, runners will recognize a typical runner's injuries and seek proper care. Runner's Foot Injuries Select this link to read the article where the authors discuss typical runner's foot injuries. References COHEN, J. (2007) Metatarsalgia - Causes, Symptoms, and Treatment Methods. In ArticleBASE Technologies, LLC COLE, C. et al. (2005) Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy. American Family Physician, 72(11), 2237-2243 COSCA, D. (2007) Common Problems in Endurance Athletes. American Family Physician, 76(2), 237-246 EDELL, D. (2006a, April 6) Turf Toe, The Athletic Advisor EDELL, D. (2006b, June 4) Turf Toe Taping, The Athletic Advisor Metatarsal Stress Fracture. (2005, November), Merck & Co., Inc. MITNICK, M. (n.d.) How to Treat a Foot Blister. In WikiHow - The How-to Manual Morton's Neuroma. (2008) In Healthy Feet for an Active Life - FootPhysicians.com Plantar Fasciitis Rehabilitation. (2008) In UPMC Sports Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA USA Sesamoid Fracture and Sesamoiditis. (2008) In IHealthSpot Relief to Sesamoiditis [Photograph found in Aetrex Worldwide, Inc.] Second Skin [Photograph found in Relags] Plantar Fasciitis [Photograph found in U.S. National Library of Medicine, Bethseda, MD] Aids for Metarsalgia [Photograph found in Try Care] Page Reference If you quote information from this page in your work, then the reference for this page is: McDANIEL, L. et al. (2009) Rehabilitation of Common Runners Foot Injuries [WWW] Available from: https://www.brianmac.co.uk/articles/article049.htm [Accessed About the Authors Dr Larry McDaniel is an associate professor and advisor for the Exercise Science program at Dakota State University, Madison, SD USA. He is a former All-American in football and Hall of Fame athlete & coach. Matt Ihler and Callin Haar are students enrolled in Exercise Science at Dakota State University. Both are interested in careers related to Sports Medicine.