Distance running is becoming increasingly popular. Marathons across the world are now getting some of the highest participation rates ever.
At the same time, distance running can sometimes lead to injuries. In fact, it is estimated that the incidence of injury in endurance runners is between 30-80% – and most of these are foot and ankle injuries.
Here are some examples of common injuries, and how you can lower the risk of injury, from distance running.
Common injuries in distance running sports
- Stress fractures
Stress fractures in runners most typically affect the tibia and fibula leg bones as well as bones of the foot and ankle. High-risk foot and ankle fractures include fractures of the fifth metatarsal, and of the navicular bone on the medial (inner) side of the foot.
These types of injuries sometimes arise from suboptimal training loads that can lead to an imbalance between the cells that breakdown and re-build bone tissue. This in turn can result in micro fractures and breaks.
Symptoms include localised pain during training – at first towards the end of the run, but if left untreated, then earlier in the run or even during rest.
- Ankle sprains
Ankle sprains represent about 1% of running-related injuries. Sprains to the ankles tend to be more common in sports involving stop-and-go motions, such as football and tennis.
In some cases, ankle sprains can result in persistent pain years after the injury occurred.
- Heel injuries
Heel pain in athletes can arise from plantar fasciitis. This is a condition in which the band of fibrous tissue supporting the arch of the foot becomes inflamed.
Symptoms include a stabbing pain in the heel, often first thing in the morning or after standing or sitting for long periods. The pain usually decreases with movement.
- Achilles tendon injuries
Distance running can place increased load on the Achilles tendon – the fibrous cord connecting the calf muscles to the heel bone.
There are several types of injuries that can affect the Achilles tendon. Depending on the condition, symptoms may include stiffness and pain just above where the tendon inserts onto the heel at the beginning of a run, or pain that gets worse after exercise.
How to reduce the risk of injury
Understanding factors that may increase your risk for injury can enable you to make better decisions about your running pursuits.
The risks can vary depending on the situation.
For example, stress fractures are more likely if you are female, have low bone-mineral density, your vitamin D levels are low, and/or you are a smoker. Some of the activity risks include sudden changes in training loads, changes in running surfaces, or wearing footwear that is inappropriate for you/your running mechanics.
Plantar fasciitis is associated with lower calf muscle flexibility and high arched feet. It can be exacerbated by overtraining, increased running on hills, increased distances and intensity, changes in ground surfaces and worn-down footwear. Obesity is also one of the highest risk factors for Plantar fasciitis.
Plan and manage your run
Good management of your distance runs not only reduces the risks to your feet and ankles, but to your body in general.
Good management includes:
- Take time to warm up beforehand and cool down afterwards.
- Gradually increase the intensity or distance of your runs (about 10% per week is a good general guide). While it’s good to challenge yourself, avoid pushing too far beyond your current fitness level.
- Avoid running in the hottest part of the day and always stay hydrated.
- If you plan on running on different surfaces, introduce the surface changes gradually.
- Stop if you are injured. Don’t run again until you’ve seen your doctor or podiatrist and your injury has healed.
- Take time to recover and rest between runs. If you want to exercise on your days off, consider some lower impact exercise types – e.g. swimming or cycling.
- Wear appropriate clothing (e.g. layers you can remove) and running shoes that will support your feet. Consider getting a specialist fitting for your footwear if you are going to be doing a lot of running.
Pay attention to your technique
Your feet (and body) can take quite a pounding from running, especially on hard surfaces.
It is always a good idea to ask a health professional or running coach to check your running technique and work with you on strategies you can try to improve your running biomechanics to improve your performance and reduce the risk of injury.
Wearing the right footwear can also help protect your feet, ankles and legs from running injuries. Your running shoes should be able to absorb shocks, cushion your feet and be made of durable and breathable materials.
If you are experiencing foot or ankle pain, it is a good idea to speak to your podiatrist about whether or not custom-made orthotics would be of benefit to you.
If you are serious about distance running, make sure to educate yourself about the risks and how injuries could impact your progress.
And if you have any major concerns about your feet, ankles or lower legs, contact us to book an appointment with one of our podiatrists.
References
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529586/
[2] https://www.betterhealth.vic.gov.au/health/healthyliving/running-and-jogging-preventing-injury