Preventing and Treating Midseason Running Injuries


With marathon training season well under way, many runners are going through those pesky midseason injuries or overuse syndromes. Some typical issues have common causes and can be successfully self-treated, but, as always, it is important to seek professional care if signs and symptoms persist.

Maintaining or increasing flexibility should be a training goal for every athlete. But with hectic summer schedules, it's easy to get lax and skip stretching before and/or after running. The resulting decrease in flexibility may well catch up to you in the form of plantar fasciitis, shin splints, Achilles tendonitis and other issues. These nagging overuse injuries can put a damper on that fall marathon if it is not addressed quickly and properly.

Plantar Fasciitis

Many runners are all too familiar with the heel pain caused by plantar fasciitis, caused by overuse or overload of the fascia that connects your heel bone to your toes across the bottom of your foot. This inflammatory, or even degenerative if chronic, condition can sideline you for the whole summer if left untreated. It won't “just go away.”

Increased miles and intensity can overload the plantar fascia, resulting in sharp heel pain that may start as just morning pain or it may grow to haunt you through an entire long run. Proper stretching before and after your run is the key to both preventing and treating plantar fasciitis. Keeping the heel cord stretched will minimize chances of incurring this injury.

Proper shoe fit, style and condition can also help prevent and ease heel pain caused by plantar fasciitis. Check are your shoes. If you see uneven wear patterns or the tread is thinning, REPLACE them. It is much easier (and typically less expensive) to do this than to rehab heel pain. Have a professional double check the style of running shoe you are wearing to make sure you are in the right category. You don’t want an anti-pronation shoe if you don’t overpronate. Nor do you want a cushioned shoe, if you do overpronate.

If you've already made these mistakes and suffer from plantar fasciitis, a night splint is a handy tool to help keep your heel cord stretched overnight. It can be found at most pharmacies. Unfortunately, if you've let it go this far, rest may be required for recovery.

Shin splints

Tibial fasciitis, or what we used to call shin splints, is another common overuse injury for runners. And, again, it can be prevented with proper calf stretching before and after your runs and proper shoe selection (hmm…seems to be a common theme here).

If you're plagued by shin pain, you may want to think twice about the surfaces you run on. Consider switching to running on a track, treadmill or grass to give your shins a break. Underwater running is a great exercise if you need a few rest days. Ice and compression (with a neoprene shin sleeve) are valuable tools, as well. Just remember to ice after your run and not before or you could do more damaged to the numbed area. Deep-tissue massage with a topical analgesic, done by yourself or a professional, can help release the tension of the fascial bone interface on the shin.

Achilles Tendon Pain

Pain in your achilles tendon, the large tendon at the back of the angle that connects your large calf muscles to your heel bone, can be caused by tight heel cord. By now, you know what that means ― yes, STRETCH! Ending your run with stretching and icing is an ideal scenario for this malady. But, don’t forget your pre-run stretchin,g especially if you are experiencing pain and/or other symptoms with your heel. Again, always ice for 10-15 minutes after a run, not before. Before running, you may numb the area too much and not feel the pain or strain you are putting on your heel. Also, make sure you are in the right shoe for you. If your shoes are too stiff it will increase the lever arm and cause more strain on the back of your heel.

Blisters

Blisters are just a pesky but simple annoyance that comes with running, right? Wrong! Pesky, yes ― especially in the summer months when increased moisture (a.k.a. sweat) causes increased friction and shearing forces. In a well-trained athlete, this is not usually felt until it's too late. To help prevent blisters, choose socks and running shoes with care. There are many technical socks out there, but whichever you choose, be sure to check the fiber that makes up the sock fabric. Synthetic fibers, such as polyester, acrylic, nylon, polypropylene, Coolmax, as well as natural wool are wicking fibers that will keep the moisture away from your skin, thus decreasing the chances of blistering. Some technical socks actually have two layers that protect your skin from friction and others place extra padding in common problem areas, such as the toes, forefoot and heel. For those of you who suffer from blistering between the toes there are even toe socks that can decrease the friction between the toes.

Like shoes, the fit of your socks is important. Too big and the sock can bunch up or wrinkle and cause blisters. Too tight and it can bind the toes and cause blisters there. If you have tried all this and still cannot shake blisters, there are products that you can apply to the skin before running, such as Body Glide or plain-old Vaseline. Just make sure you have tried them on a few runs before trying it on race day.

Once you have your socks figured out, take another look at your shoes. A good rule of thumb is to replace your shoes at 500 miles or six months, whichever comes first. Check the tread wear. If the tread is thinning or shows uneven wear patterns, it's time for a replacement pair. Look at the upper, if it's leaning in or out, it's time to say goodbye, or at least retire them to mowing the lawn. Even if your shoe looks ok, if you have a lot of miles or time in them, it may be time to move on. Running shoes have a middle, shock-absorbing layer that can wear out faster then the rest of the shoe. After a period of use, this part of the shoe may not rebound as well, decreasing shock absorption and increasing the load on your foot.

Try on new shoes with your favorite wicking, technical socks and after activity or at the end of the day when your feet are a little swollen. Check that the shoe is comfortable and that you have at least a thumb's width between your longest toe and the end of the shoe while standing. Don't postpone your shopping trip ― you'll want to make sure you have two or three weeks to break in your new shoes before the big race! Good luck!

Podiatrist specializing in sports medicine for foot and ankle injuries

Serving the Des Moines, Iowa area since 1997

© 2018 Johnston Foot & Ankle Clinic

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call 515.252.6063