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Don't Run from Foot Faults

Pain doesn't equal gain when it comes to your feet

SUNDAY, Sept. 2, 2001 (HealthDayNews) -- It's part of the serious runner's psyche to use the mind to push the body on. But experts say those who will themselves past foot pain may wind up hobbling to their destination.

"For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down, if not treated promptly," says Dr. Marybeth Crane, a spokeswoman for the American College of Foot and Ankle Surgeons.

Among the most common foot problems experienced by runners is heel pain caused by inflammation of the ligament that holds up the arch, a condition known as plantar fasciitis.

The main causes for the condition include uneven mechanics, in which the body's weight is unequally applied to the inside of the foot, and running shoes that are too soft or worn out.

Crane, a Dallas podiatric surgeon who is also an avid runner, says preventing the condition can be as simple as doing appropriate stretching exercises and wearing sturdier shoes.

"The exercises you want to do include standing up against the wall and stretching the back of your calf, or sitting down, taking a towel or something and hooking it around your toes and pulling back," she says.

"In addition, it's important to have a stabilizing shoe with a decent heel," she adds.

Keep in mind that the more you weigh, the more supportive the shoe has to be, Crane says.

"I'll see someone who's about 15 pounds overweight and is wearing a very light training shoe that's meant for someone who weighs 100 pounds, not 180 pounds. But you need to know that the more you weigh, the more your foot has to propel you forward and the more stress it's taking," she says.

"And the more stress your foot is taking, the more likely it is that you can start to have plantar fasciitis."

In some cases, the use of ice packs and anti-inflammatory drugs such as ibuprofen can also be helpful in alleviating pain.

Overly flexible shoes can also contribute to two other common runner foot problems -- neuromas and tendonitis. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot.

Again, getting into a more stable pair of shoes can make all the difference.

Tendonitis, as its name implies, affects the tendons and can manifest itself in various ways, explains Crane.

"There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy," Crane says. "Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon."

Surgery is sometimes used to treat neuroma if the pain between the toes lasts for more than six months, and surgery can also treat heel pain that lasts for more than a year.

Runners can run themselves into more serious problems if they ignore the signs of a foot bone that may be fractured, which can occur due to a common myth among athletes that if you can walk on it, it's not broken.

"People come in my office with a stress fracture and they'll say, 'It can't be broken because I can walk on it,' " explains Crane.

"Most people think they have to have excruciating pain with a fracture. They'll still run for three or four weeks and will run through the pain, but they would have done much better had they gotten help sooner."

So if you can walk on it, how do you know it's broken?

"There's pain, and then there's real pain," says Crane. "It's one thing if you wake up after a hard run and you're stiff or maybe have some minor pain, that's normal. But continuous discomfort day after day with no varying pattern would be a tip-off that something bigger is going wrong."

If a fracture or sprain is suspected, Crane advises runners to think "RICE" -- the abbreviation for Rest-Ice-Compression-Elevation. "Should pain and swelling continue after following this procedure for three or four days, you should see a podiatric foot and ankle surgeon for an X-ray and proper diagnosis."

Key to preventing all running foot problems, Crane adds, is simply making sure to warm up -- and down -- properly.

"I usually recommend that people walk for about five minutes to warm up and then stretch and then about 15 minutes after you've warmed down, same thing," she says.

What To Do

Crane offers the following advice for other common runner's foot problems:

  • Athlete's Foot: This fungal skin disorder causes dry, cracking skin between the toes, itching, inflammation and blisters. It can be prevented and controlled by washing the feet regularly and carefully drying between the toes; switching running shoes every other day to allow them to dry; wearing socks made with synthetic material instead of cotton; and applying over-the-counter ointments.
  • Toenail Problems: Ingrown nails can cause inflammation and possible infection and usually are treated by cutting the corner of the nail with sterile clippers. Black toenails happen when a blood blister forms under the nail from trauma, and it's best to let the nail fall off by itself. Fungal toenails are yellow, brown or black and sometimes are irregularly shaped and thick. They are best treated with oral anti-fungal medications.
  • Blisters, corns and calluses: Never pop blisters unless they are larger than a quarter or are painful or swollen. Use a sterile instrument to lance the corner, leave the top as a biological dressing, wash, apply antibiotic ointment, and cover with a Band-aid. Corns and calluses are caused by repeated friction, and should be treated by trimming the dead skin and eliminating the underlying cause.

You can visit the American College of Foot and Ankle Surgeons for more information.

SOURCES: Interviews with Marybeth Crane, D.P.M., spokeswoman, the American College of Foot and Ankle Surgeons, and a Dallas, Tex., podiatric foot and ankle surgeon; ACFAS press release
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