September 2023

Running may seem like a simple to do. However, running is actually a complex movement that puts stress on the ligaments, bones, and joints of the body.  Selecting the correct running shoe is important for increasing performance and avoiding risk of injury.  Running shoes should be selected based on your foot type.  Considerations such as trail versus road shoes are important. Your foot type dictates the degree of cushioning, stability and motion control you require.  The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes.  Professionals can measure your arch type, stride and gait and help you with your shoe needs.

The design of running shoes is created around the idea of pronation.  Pronation is the natural rolling movement of your ankle from the outside to inside when your foot strikes the ground.  If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more.  Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy.  Those considered neutral runners pronate correctly and do not need running shoes that help correct their form.  Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types.  However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation. They may require running shoes that offer additional support.

Those who overpronate experience an over-abundance of ankle rolling.  Even while standing, those who severely overpronate display ankles that are angled inward.  It is not uncommon for them to have flat feet or curved legs.  The tendency to overpronate may cause many injuries.  Areas that tend to become injured are the knees, ankles, and Achilles tendon.  If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control.  Motion-control shoes are straight and firm. Shoes of this type do not curve at the tip.  The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes the ground.

A less common problem is underpronation.  Underpronation, also called supination, is when the feet are unable to roll inward during landing.  Those who underpronate have feet that lack flexibility and high arches.  This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees.  This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact.  Those who underpronate need shoes with more cushioning and flexibility.  If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.

Obesity is a common problem in American society. Approximately one third of the U.S. population is obese. Obesity is defined as a body mass index greater than 30. Obesity has the power to affect different aspects of the body, and one of the most common problems it causes is foot pain. There have been many studies that found a connection between an increased BMI and foot problems. A simple activity such as walking up a flight of stairs can increase pressure on the ankle by four to six times.

Being overweight causes the body to compensate for the extra weight by changing the way it moves. Consequently, people who struggle with obesity commonly have arch problems in their feet. Obesity causes the arch to break by stretching the ligaments and tendons that hold the bones in the foot together. When the arch lowers, the foot may eventually fall flat. Collapsed foot arches fail to provide adequate shock absorption which eventually leads to foot pain. Other conditions that may be caused by flat feet are pronation, plantar fasciitis, weak ankles, and shin splints.

Foot problems that are caused by obesity may be treated by wearing proper footwear. Proper shoes will allow your feet to have better circulation around the arch and ankle. Additionally, those with obesity often discover that typical heel pain remedies are not effective for them.  They will find that their plantar fascia is easily injured, and it is often inflamed. The best way to treat this problem is to implement lifestyle changes. A few good ways to improve your diet are to reduce calories, fill up on fruits and veggies, and to limit sugars.

Custom foot orthotics can prevent foot problems if you’re carrying excess weight or are trying to lose weight. The purpose of orthotics is to provide shock absorption to decrease the amount of stress on the joints to prevent arthritis.

Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.

Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains. 

An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.

Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.

Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.

Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.

Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.

Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications. However, it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any more additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it. Then, tape the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery, especially when the big toe has been broken. Due to its position and the pressure the big toe endures with daily activity, future complications can occur if it is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications. Prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma. They will be able to diagnose the injury and recommend the appropriate treatment options.