In Rockville and Gaithersburg Maryland, running is becoming increasingly popular. With the increase in popularity, injury rates have increased as well. Physical Therapists trained to evaluate and treat these complex injuries are often needed to address the many types of injuries. One of the most common injury is foot pain, often call plantar fasciitis, but there are a few other conditions that mimic this condition. Let’s review what happens when we run.
Running contracts and relaxes our muscles at very specific times as you strike the ground. The job of our muscles (not our joints or ligaments) is to absorb impact to allow for improved mechanics and efficiency in motion.
Your posterior tibialis muscle works in decelerating your foot as it hits the ground. Loss of strength or flexibility can reproduce pain along the outside of the calf(origin of the muscle), along the inside of your leg (muscle-tendon pathway) and inside 1/2 of your foot (insertion). Due to the origin and insertion of your posterior tibialis, pain to this muscle can mimic calf strain, “shin splints” and/ or plantar fasciitis.
One of the first questions to ask yourself is, “does it hurt when my foot hits the ground or do I have pain when my foot leaves the ground.” If your foot pain is when you hit the ground or after several miles, it’s most likely Post. Tibialis endurance or poor flexibility. As your foot is hitting the ground your posterior tib. is working hard to control the fall of the arch (pronation) before the arch is reestablished (supination), this is repeated for the duration of your run. If this is your problem, you will need to perform specific post. Tib. Stretching and specific eccentric control exercises to your post tib.
Foot pain as you “lift off the ground” during a run is more consistent with calf tightness (gastroc/soleus) or weakness rather than post tib. The Achilles tendon stores the energy from lengthening of the calf to allow you to transfer your body forward as the muscle recoils. If your calf is affected, there’s less stored energy for that recoil mechanism. This type of a pain is felt throughout your running. Carefully tailored calf raise exercise can rid you of this type of pain.
Pain on the inside 1/2 of your foot with the first few strides or resolves after a few minutes and then increases hours after your run can be associated with plantar fascia or other ligaments or joint tightness to the ankle.
Your Physical Therapist can better treat these conditions with specific manual therapies designed to improve how your ligaments and tendons function to stabilize the small bones and ankle joint. Getting to the root cause of your pain will determine how best to tackle your foot pain.
Hiza R. Mbwana, PT, DPT
Dynamic Sports & Orthopedic Physiotherapy
16220 Frederick Rd, Suite 206
Gaithersburg, MD 20877