FEET COME FIRST

On a daily basis, our feet take a lot of abuse. On average our feet come into contact with the ground eighty to one hundred times per minute. Subsequently this generates a stride rate or cadence of one hundred and sixty to two hundred steps per minute. Your feet must bear the weight when you stand, run for the bus, ascend or descend stairs or run the marathon. Not only are we generating tension when we move, sitting down for long periods of time in a flexed position causes muscles to tighten round the ankles. Reasonably you may ask why very fat people do not run into more difficulty due to their weight. On the whole, they do but on a daily basis most will do far fewer steps. We can find ourselves in a bit of a vicious circle. We want to keep active but in so doing this applies greater pressures on our long-suffering feet.  In order to balance the books we need to look after these vital tools of the athletes trade. I cannot stress enough how important it is to look after ourselves on a day to day basis and give something back to our bodies.


The most common running injury I see on a weekly basis is plantar fasciitis. Plantar fasciitis is a repetitive strain injury of the connective tissue on the underside of the foot. This amongst other muscles and tissues make up your medial arch. Plantar fascia is a runner’s nightmare as it can rapidly get worse from early morning stiffness to constant pain in the foot and heel daily.

 

The plantar facia originates from the heel bone to the five toes. When the plantar fascia comes under repeated stress from running it begin to pull on the heel. As a result acute heel pain becomes a symptom. In the acute phase the tissue can adapt and warming up can reduce symptoms within a few strides. However this misconception whereby people assume it isn’t a problem leads to greater trouble. The tissue is continuously overstrained and begins to change form. Structurally the tissue type changes and becomes less elastic. Overtime the symptoms get worse and do not seem to disappear when warm.


This is the first sign that the tissue changes and condition is becoming chronic.  The rehabilitation of the chronic condition much more difficult and lengthy compared to the early management.

 

Early signs of plantar fasciitis you need to look out for:

 

  1. Inside heel pain on the bone on touch which is not symmetrical.
  2. Early morning stiffness.
  3. Tight calf muscles

 

I would advise if you are experiencing any of these symptoms take note on last month’s article. Take a week out and do the following stretches.

 

1) Stretch to be carried out on a step:

 

  • Straight knee
  • Bent knee
  • Hold for one minute to allow soft tissue to adapt

 

2) Lying on your back with a long towel in your hands and wrapped around the ankle pull towards you until you feel an uncomfortable sensation at the back of the hamstring and calf. This is stretching the hamstrings along with the nerves which run down the back of the leg and the ankle. Again hold for one minute.

 

Repeat all stretches 5 times in the morning and evening.

 

What should you do if the early morning stiffness and heel pain when running and on touch doesn’t subside?

 

This is where you must consult your GP to be referred for Physiotherapy and podiatry. From my experience do not go down the injection therapy or electrotherapy treatments before you have tried conservative physiotherapy first. A physiotherapist will diagnose whether the pain is coming from tight calf muscles, a structural change in the plantar fascia or both. The treatment will vary depending on the causation of pain. Having been treating this condition for 8 years now there is never a standard protocol for all. It does seem to be the case that if you try and run through the condition it will get worse and then there is a high incidence of it arising on the other foot.

 

What to do when the symptoms have reduced?

 

  1. Continue with all stretches.
  2. Strengthen the glutei muscles to prevent a mechanical strain on the plantar fascia. Exercises such as step ups, lunges and squats if done correctly are all helpful.
  3. Spend regular time on the foam roller keeping the calf muscles loose.
  4. Use a tennis ball on the bottom of your foot to loosen the plantar fascia
  5. Change footwear regularly.

  6. Seek Physiotherapy and podiatry input.

 

Something to think about to finish. It was once explained to me that the most resilient car is a Volvo which on average has a life span of twenty years. A Volvo is man engineered machine to provide safe travel for us all. However a car of this quality still needs to be service, have an MOT and refill its fuel and parts changed. So why do we treat our bodies differently? Do not wait for a surgical intervention to be needed and let us look after our bodies. Always try to prevent injury instead of ignoring it when it arises or waiting for it to happen.

 

Again I hope you are enjoying your training in the sun and for anyone who endured the London Marathon congrats!