Even Podiatrists Get Foot Injuries

Despite my years of experience and countless hours spent advising my patients how to prevent foot problems I have incurred my first foot injury.It all began after a tough couple of weeks of running training. I am currently training for the Ironman in Melbourne with Fluid Movements next year and my training program is specifically aimed to push my body both physically and mentally whilst also allowing the appropriate recovery.The pain began in my foot after a hard run session. I noticed a pain under the arch of my foot that felt like a dull ache and was very tender to touch. I continued through another week of training which also involved repeated sprint intervals for the weekly run sessions and it started to worsen. The following week was a recovery week so I skipped the run sessions completely and continuously strapped it to try to allow it to heal by itself. It began to improve and I was able to get through another couple of hard run sessions the following week. At the end of that week was a Duathlon. It was at the Kew Boulevard and involved a very tough run on an uneven, off-road course up a steep goat track and then a hilly bike course followed by the same run but shorter. The next day the pain returned, and I felt like I was starting to limp. It felt ok when I was running but I could always notice it under the arch of my foot. The pain was brought on by running but also when I flexed my big toe back and scrunched my toes which made me think it was an injury to the flexor of my big toe – Flexor Hallucis Longis (FHL). I sent myself of for an ultrasound and it was confirmed – FHL tenosynovitis, but no tear.

How We Treat Your Injuries

The way we treat soft tissue injuries like this one at Melbourne Podiatry Clinic is with our step-by-step Return To Run program. When treating soft tissue injuries generally there are two priorities: firstly reduce the pain and inflammation and secondly to remove the stress or load on the structure. We start by biweekly sessions of gentle soft tissue massage, dry needling and active stretching. The second but very important component is to offload the tendon as much as possible. This may involve strengthening programs, shoe changes, immobilisation or orthoses. For my injury I modified an orthotic to support my arch but also allow the big toe joint to plantarflex to reduce the strain on the FHL. I will need to monitor the pain over the next few weeks in the hope that with aggressive offloading I am still able to continue training at my current intensity. Most often if we catch an issue early enough we can allow patients to continue training at their current intensity.

It is key with foot injuries to listen to what your body is telling you to avoid small problems becoming big ones. Foot injuries in general are very complex and therefore require precise diagnosis and specific treatment whilst also taking into consideration the training demands.

Andrew Maitland is a sports podiatrist at the Melbourne Podiatry Clinic. Having worked closely with many elite and amateur runners over the years he has helped many people in the prevention and treatment of running injuries.