Embarking on the journey to conquer a marathon is a commendable endeavor, but it's not without its challenges. As runners log countless miles in preparation, their feet, bearing the brunt of the load, are susceptible to injury. Understanding these common foot injuries and knowing how to treat them can make the training, and ultimately the race, more successful. 

Plantar Fasciitis:

One of the most prevalent issues in distance running is plantar fasciitis. This condition involves inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot. Overuse, poorly fitting footwear, or improper running mechanics can contribute to its development. In addition to rest and ice, stretching exercises for the Achilles tendon and plantar fascia coupled with intrinsic muscle strengthening will aid treatment and prevention. In some cases, orthotic inserts can provide added stability and relief.

Achilles Tendonitis:

The Achilles tendon, connecting the calf muscles to the heel bone, is prone to inflammation during marathon training. Overtraining or a sudden increase in mileage can trigger the condition. A change in footwear can also be to blame, particularly if you’ve shifted from a shoe with a higher heel position to a flatter, “lower drop” sneaker that puts your achilles in a more lengthened position. Rest is crucial for recovery, and a gradual return to running is advised. Calf strengthening exercises, achilles strengthening and lengthening exercises, and a footwear assessment can speed rehabilitation and prevent recurrence. 

Stress Fractures:

Stress fractures typically start with bone edema (fluid build up and inflammation) caused by repetitive impact, which leads to hairline cracks or fractures. Long-distance runners can be prone to stress fractures due to frequent repetitive pounding on hard surfaces, particularly if training shoes are worn past their lifespan. Treatment involves rest and sometimes immobilization. Cross-training activities that don't involve impact on the feet, such as swimming or cycling, can maintain cardiovascular fitness during recovery. Good nutrition, including adequate calcium and vitamin D, can help ensure the bone heals properly.

Blisters and Calluses:

While not as severe as fractures or tendonitis, blisters and calluses are common nuisances for runners. Friction from ill-fitting shoes or excessive moisture can cause blisters, while repeated rubbing against shoes or socks can lead to calluses. Prevention is key, with good footwear selection and proper lacing, moisture-wicking socks and the use of emollients or anti-chafing products. Our Cracked Heel Repair can be used proactively before training runs on heels, soles and toes that are prone to blisters. If blisters do form, they should be cleaned, protected, and allowed to heal. Calluses can be softened and managed with an epsom salt soak followed by gentle pumicing and daily moisturizing.

Neuromas:

Neuromas are benign growths of nerve tissue, often between the third and fourth toes. Marathon training can exacerbate this condition due to compression and heavy use of the feet. Choosing footwear with a wider toe box, using foot pads to alleviate pressure under the affected toes, and orthotic inserts can alleviate symptoms. In severe cases, medical intervention may be necessary.

While pushing physical limits is inherent in marathon training, understanding and addressing common foot injuries as you train will ensure a smoother and more enjoyable journey to race day. Good luck! 

Reviewed by a board certified podiatrist