COMMON RUNNING-RELATED FOOT PROBLEMS AND SOLUTIONS

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Running is a sport that requires very little investment for equipment other than shoes and socks. But just because we don’t need a lot, doesn’t mean we don’t spend our money on fancy watches, trackers and accessories. Two things worth your money? Shoes and socks. Afterall, we only get one pair of feet. As a podiatrist – that’s a foot doctor – I’d like to share some common running problems and my recommended solutions:

Blisters

It is well worth it to make an investment in a moisture wicking sock. The most commonly known fabric is Coolmax. When the feet sweat, the moisture creates increased friction leading to blisters. In a longer race, blisters can affect your performance. If your feet sweat excessively, then I often recommend spraying an antiperspirant spray on the bottom of the feet twice a day. Your typical underarm spray can work well as a first option. In extreme cases, there are prescription remedies to cut down on the sweating. If the antiperspirant is not enough to prevent the blisters, then try adding a small amount of Vaseline or a product like Body Glide to the spot where the blister is forming. Lastly, runners may need to switch to a different shoe model to eliminate any pressure spots caused by the shape of the running shoe. Altra is one great brand that is built with a very wide toe box, more in line with the shape of people’s feet.

Black Toenails

Most commonly occur in longer races, but runners must make sure that their running shoes are properly fitted. I always recommend that my athletic patients go to a running specialty store for the right fit and model of shoe. A good general rule is to have a thumbnail’s length between the end of your longest toe and the end of the shoe. Treatment for black toenails can sometimes be performed at home. Check to see if the end of the nail is lifted away from the underlying nail bed. Use a sterile needle to drain the blister for immediate relief and apply antibiotic ointment the next week. If the black nail does not extend to the edge, then a visit to a podiatrist might be necessary. If one notices any redness or pain extending beyond the area of the nail, then an infection may be starting and require immediate attention.

Heel Pain

Not all heel pain is plantar fasciitis, but that is the most common heel injury. One of the hallmarks of plantar fasciitis is pain with the first steps after sleeping or even sitting. This condition is called post-static dyskinesia. If the pain gets worse as your activity progresses and is not worse with first steps, then it might be an injury other than plantar fasciitis. In that case, a visit to your local sports podiatrist is in order (check out AAPSM.org for a sports podiatrist in your area).  Two very effective home remedies for plantar fasciitis include icing with a frozen water bottle for at least 15 minutes several times a day and calf stretching. I recommend that people perform a simple wall stretch: Place one foot in front of the other, keep the back heel on the ground and hold the stretch for 30 seconds. Repeat five times and do it three different times during the day. If you are limping or compensating when you are running, then rest or cross training might be necessary.

Achilles Tendonitis

Rest and ice are the two best initial treatments, but if there is visible swelling, then a visit to the sports podiatrist should be done sooner rather than later. One does not want this injury to become chronic — that makes it more difficult to treat. Stretching is not as important as strengthening to cure this injury. In my practice, shockwave therapy has proven to be extremely effective, and I offer it as a first-line treatment. An excellent paper was published by Dr. Amol Saxena. He treated 60 athletes in a prospective study using only shockwave and found that 78 percent of the athletes were completely pain free at one year. A direct link to the article can be found here. Eccentric strengthening has also been found to greatly improve Achilles tendinopathy. Look for more on this injury and other injuries in future columns.

The medical information and notes above are the opinion and insight of the author. RunHaven recommends that you consult with a certified medical professional if you experience pain.

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