Tag Archives: PatelloFemoral Pain

Elite PT Newsletter April 2018 – Running Injuries Part I – Foot/Ankle

Running Injuries – a Spring time tradition

Like the rest of you I’m done with the cold and snow and ready for some nicer weather. It’s that time of year to start thinking about summer which usually means being more active.

For you runners out there it will mean getting outside more and probably increasing your mileage.

For you athletes, it’s time to start thinking about what you’re going to do this summer to make you a better athlete for next year.

Luckily, we’ve got something this month for both of you!

Common Running Injuries
1. Patello-Femoral Pain Syndrome (anterior knee pain)
2. Achilles Tendinitis
3. Plantar Fascitis
4. Hamstring Tendinitis
5. Shin Splints
6. IT Band Syndrome (pain at the hip or lateral knee)
7. Stress Fractures
8. Patellar Tendinitis
9. Lower Back Pain

These are the most common running injuries I found searching running sites and this order is fairly consistent from site to site. We see our fair share of each of them here at Elite PT.

These are also known generically as ‘over use injuries’ – meaning that they are caused over time by repetitive stresses that gradually break down the various tissues involved (tendon, muscle, fascia, bone, etc).

These are also the most common injuries we see in high school sports that involves a lot of running, i.e football, soccer, basketball, track and cross country. So if you’re an athlete of any kind, at some point you are either going to be dealing with one or more of the above OR you should be working to prevent them.

Prevention starts from the ground up

How your foot and ankle function are huge for preventing the obvious conditions in that area but also those further up the chain in the knee, hip, and lower back.

The joints of your foot and ankle must move appropriately and the muscles must do their job to stabilize those joints as your foot hits the ground and then progresses to push off. This is a two pronged approach since the joints require adequate mobility and the muscles must stabilize at just the right times.

This month we’ll cover a few ankle/foot exercises you can use to prevent injury or to rehab from it. Sorry if I get a little deep in the ‘why’ sometimes but I do think its important to know ‘why’ you should perform these exercises.

Ankle Mobility

Here’s a great example of what good ankle mobility looks like. The knee should be able to travel 4″ past the big toe without the heel coming up or the arch collapsing.

Athletes need this much ankle mobility to squat deep, sprint, jump, cut, and so on. If you don’t then your body is going to find a way to compensate around that so you can still squat, sprint, jump, etc. Our compensations are usually what get us into trouble. In this case the common compensations are:

  •  arch of the foot collapses (excessive pronation)
  • foot turns out
  • heel comes up too soon
  • knee collapses inward

There are others but these are the easiest to see. Watch anyone with stiff ankles try to squat deep – its not uncommon to see all of the above.

These compensations put the tissues of our foot, knee and even higher up the chain into more stressful positions. With repetition, i.e. lots of mileage, this will eventually catch up with most athletes causing pain.

What to do about it?

There are two main reasons why your ankle joint may not move enough:

tightness through the muscles of the calf (will feel like stretching in the back of the lower leg)
limitations involving the ankle joint (will feel a pinching sensation in the front of side of the ankle when bending it all the way)

Tight muscles are something you can deal with fairly effectively yourself. Using foam rollers or massage sticks to loosen up the calf muscles followed by stretching are the easiest things to do. Working on ankle mobility in a kneeling posture as in the picture below is one of my favorites.

Kneeling Ankle Mobility

The goal is to get your knee as far past your big toe as possible without your heel coming up. Placing the stick at your 5th toe and taking your knee around the outside of the stick forces you to work the muscles of the foot and keep the arch high. I prefer shoes off so you can actually see what your foot is doing. It could also be done standing if kneeling causes knee pain.

If you experience that pinching sensation in the front or side of your ankle – that is going to be a tougher fix. That’s usually not something you can stretch out on your own. It’s actually a good reason to give us a call because you will need some manual therapy to deal with that stuck joint.

In conclusion

What is happening at your foot and ankle affects every other joint in your body so this is a great place to start. See how far your knee can go past your big toe – if it’s not 4″ (heel down and good arch) then it’s time to get to work.

If you want some other ideas, catch the video below featuring our former student Scott McKeel (who just ran the Boston Marathon this week) demonstrating some great ankle mobility drills.

And even if you don’t consider yourself a runner or an athlete, you still need a mobile ankle and stable foot to walk normal, go up and down stairs, and balance. These are for you too!

If you’re struggling to make gains or you do have that ankle pain I mentioned earlier, feel free to give us a call (231 421-5805). We can set up a free 30 minute assessment to determine if you just need more advanced exercises or you may need physical therapy to break through and get moving again.

I’ll leave this offer open through the end of April so get cracking!.

Have a great rest of April and be sure to look for the next article in our series on running injuries.

Joe Heiler PT