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Foot Health for Outdoor Enthusiasts
By C. Schurman
Outdoor athletes depend heavily on their feet during training and competition – whether they play basketball, football or soccer; sprint or participate in track and field events; run, hike, or climb; row, bike, or just about anything else. If you’re experiencing any sort of recurring foot pain, it’s important to know what to do in order to return to your activities pain-free and injury-free. Below, we introduce a few common foot ailments, some causes, and suggested treatments. One of the most common ailments for runners and hikers, plantar fasciitis, has already been covered at great length at www.bodyresults.com/e2plantarf.asp. If you think you are suffering from any of the issues below, we suggest you visit a podiatrist or your primary care physician to start investigating an appropriate course of action. It might be worthwhile to have your gait analyzed to see if the foot issues have changed your stride significantly enough that other areas of your body are over-compensating leading to referring pain; you may benefit from having custom-made orthotics or over-the-counter Superfeet inserts; and you may be advised to switch activities temporarily to allow your feet time to heal.
Flat Feet – If you have flat feet, fallen arches, or pronation issues (i.e. when you run, you end up rolling inward or running on the inside of your feet – see www.bodyresults.com/e2runningshoes.asp to determine whether your feet are “normal”, pronators, or supinators) you may actually end up experiencing problems in the lower extremities due to gait change – i.e. Patellofemoral pain (see www.bodyresults.com/e2patellofemoral.asp) at the kneecap, bursitis in the hip, or compartment syndrome (see www.bodyresults.com/E2Shinsplints.asp) in the lower leg. Properly fitting shoe inserts or orthotics might be on solution, as they help support the inside of the foot so the lower leg does not alter position during activity.
High Arches – If you suffer from high arches, your foot may feel inflexible or rigid, and this rigidity may leave you somewhat more susceptible to overuse injuries such as stress fractures (see www.bodyresults.com/e2stressfractures.asp), heel spurs, Achilles tendinitis and plantar fasciitis. While orthotics usually do not help in the case of high arches, stretching may – for ideas, see www.bodyresults.com/s2calves.asp for tips on stretching calves and feet.
Black Toe – Also sometimes referred to as “jogger’s toe”, this condition results from “crush injuries” to the toenail in which the pressure of expanding blood in a confined space becomes very painful. Such hematomas can be properly decompressed by a professional who will safely relieve the pressure (with a sterilized needle or paper clip) while preserving the nail bed at all times. Black toe may result from hyperextension of the toes, in which case you can try inserting a metatarsal pad into the shoe. It can also result from improper shoe fit, which allows the foot to slide in the shoe with repeated starts and stops; if that is the case, try tightening your shoelaces, wearing thicker socks, adding shoe vamps, or protecting the toe with corn/callus pads to prevent the foot from sliding. If you suffer from this condition, avoid running downhill (such as trail running) and wear padding over the nail to prevent it from being pried upward.
Morton’s Neuroma – This condition occurs where two nerves intersect as they lead to the space between the third and fourth toes. If the nerves get inflamed or swollen, they can get pinched between the bones of the foot, leading to pain, numbness, or a feeling like a mild electric shock whenever the athlete wears very tight shoes or high heels. Athletes with a neuroma may experience pain at the ball of the foot while wearing shoes, and may find that it’s more comfortable going barefoot. Up to 90% of patients with this issue are women (Schenck p. 513). Try buying wider footwear or wearing loose, flat, comfortable shoes, sneakers or sandals. If you feel discomfort in hiking or climbing boots, you may want to custom-order your boots or see someone who specializes in boot adjustment and fitting. Try adding a thin foam rubber pad in the shoes below the bottom of the foot and ice massage the top of the foot if pain recurs.
Bunions – This is a deformity of the big toe that causes it to angle outward by more than 10-15 degrees, causing the tip of the toe to point inward toward the smaller toes. Friction from tennis shoes can cause a growth of cartilage and bone on the outer part of the big toe that can lead to bursitis and result in extreme pain. Avoid wearing tight shoes or high heels if you sense you’re developing bunions. People with flat feet are more likely to develop this condition. If the pain continues, wear wider shoes for exercise and softer shoes for daily activities. Apply RICE: ice, compression and elevation after any exercise that exacerbates the condition. Try using a toe spacer to help straighten the big toe, and apply a corn or doughnut pad over the outside of the big toe to try to help relieve some of the discomfort from friction. Usually the bunion will not disappear on its own without surgery, but it IS possible to alleviate the discomfort and live with it.
Metatarsalgia – This is a distinguished sounding word for generalized forefoot pain commonly resulting from faulty weight distribution. It is an inflammatory condition of the metatarsal heads of the foot that may feel like bruising on the ball of the foot. Pain is often worse while walking barefoot, especially on hard surfaces like concrete or ceramic tile. The pain can force a person to compensate and walk on the outside of the foot in an effort to avoid stepping on the ball of the foot. Pain is often less in good running shoes, especially those with forefoot cushioning. Try icing the ball of the foot to alleviate any inflammation. Wear good support shoes and consider creating a forefoot pad from moleskin or a corn pad to protect the metatarsals.
Blisters – See www.bodyresults.com/qaskbr.asp?id=223&cat=13 for our favorite tips.
Micheli, Lyle J. MD. The Sports Medicine Bible: 1995, pp. 70-91.
Schenck, Robert C. (Ed). Athletic Training and Sports Medicine. AAOS: 1999, p. 509-514.
Steckel, M. “Metatarsalgia and Morton’s Neuroma”, 2001 online.