Tips to prevent common foot injuries

Foot injuries are both very common and a source of deep frustration. Yet many of the most common foot injuries from running or playing sports - or just from daily life - are preventable. Here's how to keep your feet healthy and avoid injury.

While they can affect anyone, runners and other keen sportspeople are most susceptible to foot injuries as well as being the people least inclined to heed the advice to rest.

The good news is that many foot injuries are minor, and can be prevented simply by wearing the right shoes. Common injuries run the gamut from blisters and calluses (a clear sign of badly fitting footwear) to tendon ruptures (which require urgent medical attention).

"Studies have shown that most of us take between 4,000 to 18,000 steps a day. We all wear tight shoes and even high heels and so it's no wonder our poor feet are exposed to lots of wear and tear and injuries," says Andy Goldberg, consultant orthopaedic surgeon, Foot and Ankle, at the Wellington Hospital (part of HCA UK). "Aside from overuse, ill-fitting shoes and poor training habits are the commonest causes of foot injuries."

Types of foot injury

You can often get a clue as to the cause of your foot problem from the position of the pain.

In the foot

If the injury is around your heel, it might be plantar fasciitis (pain in the underside of the heel) or Achilles tendinopathy (tiny tears in the tendon that connects the back of the foot to the calf muscle). Plantar fasciitis can feel like a dull ache or a bruise, and the pain is usually worse in the morning. Achilles tendinopathy can cause pain, stiffness and sometimes swelling, making it hard to move freely. The damage can gradually worsen over time.

"These pains are often caused by exercising too much or by having calf muscles that are too tight," says Lloyd (Robert) Williams, an orthopaedic surgeon at King Edward VII's Hospital and founding partner of The London Orthopaedic Clinic. "Both are a particularly common complaint in runners and are types of repetitive strain injuries. I often see these sorts of injuries in patients who have suddenly upped their activity levels rather than increasing gradually." 

Physiotherapist Lyndsay Hurst, founder of Your Pilates Physio, says plantar fasciitis is the most common foot injury she sees. It often comes as a result of a biomechanical problem somewhere around the foot or ankle - or even around the knee, hip or pelvis.

"It can often start when someone starts walking more miles than they might normally do, causing an irritation in the fascia," she says. "I will often find some muscle imbalances, as some areas are weak and some are compensating. There also can be some stiffness in the forefoot that can contribute to the problem."

Metatarsalgia is pain in the front of your sole (behind your toes) coming from the area of the metatarsal bones. While this may be in part related to stiff ankles or short Achilles tendons, one of the most common causes is exercising, especially in shoes that don't provide adequate cushioning.

Further up

One common injury is an ankle sprain - an overstretching of the ligaments that hold your bones and joints together.

"Initially this is like stretching an elastic band, but in severe injuries the ligaments can either fray partly or tear completely in half, causing bruising and swelling," says Goldberg. "You may not be able to put any weight through your foot."

A tendon rupture (most commonly in the Achilles tendon) may occur after a slip or accident. It may sound like a pop, followed by a debilitating sharp pain, and you might struggle to walk. In some cases, this requires surgery.

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What to do if you're injured

If you suspect you have Achilles tendinopathy, the most important thing you can do is to rest the tendon, potentially applying cold packs to reduce swelling.

For suspected plantar fasciitis, rest your foot on a raised surface where possible, wear comfortable shoes with soft insoles, and place an ice pack on the affected area for up to 20 minutes every two to three hours. A variety of physiotherapist-recommended exercises can help relieve symptoms and reduce the risk of recurrence. Alternatively, you may well benefit from physiotherapy - you may be able to access this on the NHS, or you can book a face-to-face or video consultation with a certified private physiotherapist on Patient Access.

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In both cases, you should book an appointment with your GP if the pain doesn't improve within a week or two.

"If you have an underlying condition - for example, diabetes or arthritis - your GP may refer you to a specialist doctor, and if your symptoms are very bad, or have lasted longer than six weeks, you may be referred to an orthopaedic surgeon who specialises in foot and ankle surgery," says Williams.

If your injury causes a lot of bruising and swelling, or is painful to walk on, you should visit a healthcare professional as soon as possible. It's also a good idea to get checked out if your symptoms always come on after sport. This will prevent you from sustaining further damage and developing a chronic injury.

How to prevent injury

In terms of avoiding these injuries in the first place, the best place to start is by going easy on yourself: stretch and warm up before sports, don't push yourself too hard, and take time to rest and recover whenever you notice any niggles. You should also incorporate strength and conditioning exercises into your training regime, with a view to maintaining good form.

"Pushing yourself too hard and exercising too frequently can lead to overuse injuries and cause a long-lasting impact on your body," says Goldberg. "Finding yourself tired, and unable to do as much sport or exercise as you used to, could mean that you've overtrained and need some time off - exercise is good for you, but injuries are not." 

The shoes have it

It's just as important to wear the right trainers, replacing them whenever the tread starts to wear out. (A good rule of thumb for runners is to buy a new pair of trainers every 300-500 miles. That means, if you run 20 miles a week, you'll need two or three new pairs of trainers a year.)

"Don't be tempted to buy a pair of trainers based on what they look like. It is far better to select them based on your feet and the way you run," says Williams. "Having a gait analysis carried out at a reputable sports shop will help you buy the right sort of footwear. Giveaway signs you may be wearing the wrong shoes include feeling like your shoes are too tight or are rubbing and giving you blisters."

The occasional niggle is probably par for the course if you're active. However, through taking sensible measures you can prevent minor injuries from becoming major ones.

"If something just doesn't seem to be settling, seek advice. The sooner the better," says Hurst.

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