Run Well Juliet McGrattan (microsoft ebook reader TXT) 📖

are multiple other causes, including obesity, high-heeled shoes and arthritis.

• Morton’s Neuroma Another cause of metatarsalgia. This is common in runners (see here).

• Nerve pain A compressed nerve can cause pain, tingling and numbness. Nerves can be trapped, irritated or over-stretched at any point along their journey from the spine to the foot, so even if the pain is felt in the foot, the problem could be in the back. This is often painful at rest.

• Stress fracture An over-use injury, stress fractures are more likely in those who have osteoporosis (low bone density). They tend to occur in the metatarsal or calcaneus bones of the feet. They require prolonged periods of rest and a gradual return to running (see here).

• Arthritis A ‘wear and tear’ arthritis or a more aggressive arthritis such as rheumatoid arthritis can affect foot bones. Pain, stiffness and swelling result from loss of cushioning cartilage. It’s still important to exercise as much as you are able to (see here).

Clearly, differentiating between all of these can be tricky and foot pain can take time to diagnose. If you’re unsure, then try a brief period of rest and a gentle return to activity. If your pain persists, seek a diagnosis from a health care professional.

TRY THIS

AT HOME

Foot-strengthening exercises

Often you don’t need support in your running shoes, you just need stronger feet! Here are four simple things you can do to improve your foot strength:

1 Walk barefoot whenever you get the chance.

2 While sitting on a chair, put both feet on the floor (barefoot is best). Raise your heels, keeping the ball of both feet on the ground. Hold for five seconds. Then raise the ball off so your weight is just on the tips of your toes. Hold for five seconds. Slowly lower your foot, working back through the toes and the ball of the foot on the way down. Repeat ten times.

3 While sitting at your desk, place both feet on the ground and scrunch your feet up, drawing your toes in and foot arch off the floor. Hold for five seconds then relax. Repeat ten times.

4 Sitting or standing, put a large piece of paper or tissue on the floor. Place your bare foot on it, and try to grip the paper and lift it off the ground. Place it back down again. Repeat ten times.

Q I’ve been told I have plantar fasciitis. What exactly is it and do I have to stop running?

A Under the skin on the sole of your feet there’s a tough connective tissue, extending from the heel bones right up to near the base of the toes, called the plantar fascia. When you add ‘itis’ on to anything in medicine it means inflammation, but we no longer think that much inflammation is involved in plantar fasciitis (PF) beyond the early stages of the condition. The plantar fascia helps to support the arch of the foot and absorbs some of the force when the foot strikes the ground. Acting almost like an elastic tissue, the fascia turns strain into propulsive energy, pushing you forwards as the tension is released when the foot leaves the ground.

We don’t understand why PF happens. It has been thought to be due to the force of landing, but that doesn’t explain why people with sedentary lifestyles suffer from it too. Studies looking at the relationship between PF and the Achilles tendon show that when PF is present, the Achilles is often thickened and the muscles at the back of the leg are often tight. This is a bit of a chicken and egg situation, because we don’t know which came first. It seems to happen in runners who increase their distance or intensity of training rapidly, so beginners often get it. It’s almost certainly linked to running biomechanics, possibly the strength of your foot arch, how your foot hits the ground, your shoes and a host of other factors that are very individual.

When you get PF it becomes painful to put your foot on the ground – or you might be unlucky and have both feet affected at the same time. Pain is usually felt around the heel, especially when you first get out of bed in the morning and when walking barefoot. Initially the pain eases up with gentle walking, but sometimes PF progresses until it’s felt continuously.

So, what can you do about it? PF usually goes away eventually, but it can take six months to a year. It’s best to rest initially and let any inflammation settle down. Avoid doing anything that aggravates the pain. You’ll probably have to stop running but if running isn’t making it hurt then there’s no real reason not to carry on. You can use ice packs and anti-inflammatories such as ibuprofen in a gel or tablet form. Heel pads can take the pressure off the fascia and choose whichever shoes feel most comfortable.

Stretch out the fascia by doing exercises such as sitting with your legs outstretched in front of you and using a scarf looped around the ball of your foot to bring your foot towards you. Rolling a frozen water bottle or a golf ball under your foot can give relief too. Because of the link with the calves and Achilles, it’s a good idea to do stretches that lengthen your calf muscles. An assessment by a physiotherapist will help identify any specific triggers from your own biomechanics. Other possible treatments include steroid injections, night splints such as the Strassburg Sock, which keeps your foot flexed and stretched while you sleep, and Extracorporeal Shock Wave Therapy, where low-energy sound waves are passed through the skin to the injured area of the foot in order to increase blood flow and speed up the healing process. However, results can be very varied. Go back to running gradually, when you’re pain free, and continue with the stretches to help keep it at bay.

Real-life runners

Without over-exaggerating, I felt plantar fasciitis was the end of my running