Foot pain and injuries are common in the running community. Unfortunately, some injuries are often overlooked or misdiagnosed. It is important to be receptive to pain and pay attention to your body.
Below are three common running injuries.
The first signs and symptoms are pain beneath the second to fourth metatarsals. Early on this condition can be treated with manipulation of the metatarsal heads, placement of a metatarsal pad and one to two weeks of rest from impact activity. Sometimes a walking boot is required.
Stress FractureStress fractures of the metatarsal heads are a progression of Metatarsalgia. Once the ligaments of the metatarsals are bruised, they weaken. This makes the bone susceptible to fracture.
At first the marrow inside the bone cavity swells resulting in bone marrow edema. The bone will then fracture from the inside out, resulting in stress fracture.
Once bone marrow edema or stress fracture is present, the patient needs to have complete rest from impact activity and give the injury four to six weeks to repair before returning to running.
Signs and symptoms of bone marrow edema and stress fracture are slight discomfort while running but increased pain and limping after running. X-rays or MRI may help confirm the diagnosis but are not necessary as they do not change the symptom and sometimes are not sensitive enough to find the exact site of the break.
Torn Plantar Plate/Metatarsal Ligament
Detecting a torn metatarsal ligament can be challenging. In the early stages there is no real way to tell the difference between metatarsalgia, stress fracture and a torn metatarsal ligament. It is in the later stages that it becomes obvious.
The pain for this condition may be present following six weeks of complete rest. While the bone typically heals in six weeks, ligaments can take up to a full year to completely repair. You may notice the toes splaying away from the pain. It is common is to see the second toe splay towards the big toe.
Once a diagnosis of a torn metatarsal ligament is given, the patient is placed in a walking boot and restricted from any weight bearing activity for six weeks. Custom orthotics with extra forefoot padding and metatarsal pads are prescribed.
After six weeks the runner is allowed to begin non-impact activities like stair climbing or elliptical. If there is no pain with those activities, after two weeks the patient can begin walking and hiking.
After a week if there is still no pain the patient can begin light running (1 or 2 miles) for the next two weeks. If there is still no pain, a prudent and progressive training program can be undertaken.
If you suspect that you are suffering from any of these common running injuries it is recommended that you seek out the help of a specialist.Sign up for your next race.
Dr. Runco is a US Navy Veteran, a Doctor of Chiropractic, owner of the San Diego Running Institute and the Clinical Director of the San Diego Running Institute Sports Injury Clinic. Dr. Runco has competed in 50+ mile races and various marathons. He teaches continuing education at various local colleges and specializes in running injuries, shoes, and equipment and endurance training. For more information, visit www.sdri.net or www.whateverybodyneeds.net
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