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The Importance of Foot and Ankle Health for Runners

Runners all over the world understand the importance of foot and ankle health after experiencing a foot and/or ankle injury. Injuries like

  • plantar fasciitis,
  • achilles tendonitis,
  • bone spur,
  • ankle sprain,
  • turf toe,
  • shin splints,
  • posterior tibial tendonitis,
  • morton’s neuroma,
  • peroneal nerve entrapment,
  • high ankle sprain,

strike fear into the hearts of runner’s everywhere.

One study summarizes the prevalence of foot and ankle injuries stating: Forty to 50% of all running injuries occur below the knee. Between 10% and 20% of all running injuries are foot injuries, foot problems being the most common injuries reported by long distance and marathon runners (1). The study goes on to state that the reason foot and ankle injuries are so prevalent in runners is twofold: First, incidences of foot problems are as high as 80% in the general population. If many people already have foot problems, then foot and ankle injuries in runners are likely to be high. Second, there are great biomechanical stresses that are placed on the foot during running (1).

Injuries are NOT Inevitable for Runners

It sounds like foot and ankle injuries are inevitable for runners, right? Wrong! When you put lots of stress through an area of the body that is prone to injury, injuries like plantar fasciitis, shin splints, IT Band Syndrome and others happen. However, there are many things a runner can do to better prepare their feet and ankles for the stresses of running and greatly reduce the risk of injury. Incidentally, many of these things will also make runners faster, stronger, better runners. Let’s dive into how a runner can “bullet proof” their feet and ankles.

We now understand the stresses a runner places on the foot and ankle can contribute to injuries when the stresses are greater than what the body structure is able to withstand. Understanding the kind of stresses being put through the body while running is therefore vital to better understand how to prepare it for this demanding activity. It has been reported that forces of about two times an individual’s body weight are transferred through the body with distance running (2). Our feet and ankles are the first line of defense. We could easily write a five thousand word article on how the foot and ankle accept this load, but for the sake of brevity the basic principle is this: The force of the body landing on the foot is transferred from the foot to the rest of the body as the foot moves from supination to pronation. As the foot pronates, the ankle moves down and inward toward the ground rotating the tibia (lower leg bone) inward. This process continues up to the knee (which bends) and the femur (which flexes and rotates inward). The forces are even transmitted up further through the spine.

The 3 Different Types of Demands on the Runner’s Foot and Ankle

As each of these biomechanics happen, the body must store and absorb the kinetic energy created during running. At each joint, ligament, muscle, tendon and bone, the body must withstand different types of demand. I am breaking these demands into three important categories.

  • Mobility/Flexibility Demands
  • Stability Demands
  • Strength Demands

If any of the stresses created during these biomechanical movements exceeds the mobility, stability, or strength demands at any body structure, injury can occur. Sometimes these stresses are sudden and powerful resulting in traumatic injury (an ankle sprain, an achilles tear, ect). More often for runners, it is an accumulation of forces over time (repetitive stresses slightly above the body structures tolerance) that result in injury.

These repetitive overuse injuries often sneak up on us. Suddenly, our achilles tenon starts to burn and twinge at the end of our run, our arch starts to hurt during our first steps out of bed in the morning, or our shin starts to ache running downhill. We think “What happened?! I didn’t do anything different.” We are left to puzzle: “How did I suddenly get injured at the end of my run, or stepping out of bed, or running slowly downhill”.

What we do not realize is these small forces are not the cause of our injury, just the straw that broke the achilles, plantar fascia, or shin’s back. It was actually the hundred thousand steps before, many of which just slightly exceeded our body’s mobility, stability, or strength demands over and over and over again that caused this repetitive overuse injury.

How do you make your feet and ankles injury resistant?

So the answer to our long winded question of “How do I make my feet and ankles injury resistant?” is this:

Runners need to prepare their feet and ankles for running by exposing them to various mobility, stability, and strength demands, repetitively, over time, and with continually increasing stresses that replicate the stresses of running in a safe and controlled but aggressive way. The mobility, stability, and strength demands must also stress the foot and ankle through their full spectrum of motion, stability, and strength so the full body structure adapts. This will help eliminate weak points in the body structure, in order to prepare the structures for the forces they will experience over a typical training cycle.

Some of you might ask: “Why doesn’t my body just naturally adapt to the forces of running as I slowly add more miles and increase speed?” And the answer is: It does! This is why not all runners get injured during a training cycle. It is why smart running is one of your most important protectors against injury. However, over time, most runners will experience some sort of injury because eventually the repetitive stresses of running catch up to us. Running is an effective way to build injury resistance, but it also creates repetitive stress on the body in very similar ways every time you run.

McMillan Fantastic Feet and Amazing Ankles Program

One way to simulate the stress of running is through mobility, stability, and strength training like in the Fantastic Feet program. These targeted exercises stress the body in a similar way to running when a program is designed specifically for runners. With the right program, the right kind of stress can be applied throughout the full range of motion, full spectrum of stability, and full length of muscles contractile ability which is key to the health of your foot and ankle joints, bones, muscles, ligaments, tendons, etc.

So what are the keys to “bullet proofing” your feet and ankles as a runner? The basics like smart running (not over training, cross training, gradually building etc), appropriate rest days, and good nutrition are absolutely vital. But what most runners miss is just as vital. A well developed program of mobility, stability, and strength training that is designed specifically to challenge the feet and ankles biomechanically in the same way they experience stress when you run is key. A program like this that goes above and beyond to challenge the feet and ankles through their full spectrum of movement, stability and strength demands will push the runner to great things and is worthy of being called a “bullet proofing” program.

START THE FANTASTIC FEET PROGRAM TODAY

Cited Resources:

  1. Barr, K. P., & Harrast, M. A. (2005). Evidence-based treatment of foot and ankle injuries in runners. Physical Medicine and Rehabilitation Clinics, 16(3), 779-799.

  2. Logan, S., Hunter, I., Hopkins, J. T., Feland, J. B., & Parcell, A. C. (2010). Ground reaction force differences between running shoes, racing flats, and distance spikes in runners. Journal of sports science & medicine, 9(1), 147.

Written By Greg McMillan
Called “one of the best and smartest distance running coaches in America” by Runner’s World’s Amby Burfoot, Greg McMillan is renowned for his ability to combine the science of endurance performance with the art of real-world coaching. While getting his graduate degree in Exercise Science he created the ever-popular McMillan Running Calculator – called “The Best Running Calculator” by Outside Magazine.  A National Champion runner himself, Greg coaches runners from beginners to Boston Qualifiers (15,000+ and counting!) to Olympians.

Read Greg’s Bio

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