Injury prevention for the foot and ankle: what are we missing?

Injury prevention for the foot and ankle: what are we missing?

Do you wonder why you can never get past that 5km run, or why after three weeks of solid training you break down with injury, only to see this pattern happen time after time?

Whether it is injury below the knee, or a weak spot you seem to carry and have had your whole life, we believe there is always a solution to fixing this for good.

We see a common theme in the clinic, especially with people who do nothing but run. Ultimately it doesn’t matter whether you injure your Achilles tendon, calf or sustain a bone stress injury, usually the cause is the same. Tissue stress, or more specifically the tissue cannot tolerate the exercise demands you put on it.

We all want to push ourselves, whether this is running faster, harder or for longer, however success and injury are often results that are not too far from one another. Not all exercise is equal, running is effective in building bone density, cardiovascular strength and tendon strength, it is poor for building muscle strength, and a difficult form of exercise to being if you have not done it before.

Running is difficult, or, consistent progressing running is difficult. It challenges us, our tissues capacity to recover, our minds capacity to keep pushing and our brains capacity to sensibly build up our running volume.

Running comes with responsibility from the participant, as we age our bodies deteriorate, our muscular strength decreases, leading to the reduced ability to train at high intensity. We can however slow this down with strength training, we know this can help prevent injury.

So often we see people who run or walk struggling to stay on track and injury free. People often present to our clinic hoping that a small change in footwear or a tweak to an orthotic will cure their issue, sometimes this does work, however we always try and consider a broader range of factors of how a running injury has come about.

The missing link in many running, walking and sporting injuries, can be directly related to the poor planning and lack of time put towards strength and conditioning of our musculoskeletal system.

We know our ability to build strength and muscle begins to slow after the age of eighteen, resistance training or strength training is crucial for longevity and to limit the chances of developing an injury.

In this case we need to look at the function of the foot:

The foot contacts the ground and absorbs the stress of our body when landing
It then becomes a:
Rigid lever for propulsion during toe off phase of gait
The foot is:
A point of balance
Major support for our body mass
Proprioceptive epicentre

Appreciating the function of the foot allows us to see why there is such a fine line between performance and injury, if one of these functions falter, we are at risk.

Resistance strength training is one of the best forms of injury prevention.

Muscle weakness can be linked to many pathologies of the foot, we need to look holistically at the small muscle groups such as the gastrocnemius and soleus of the ankle, as well as our little foot intrinsic muscles and the further up the chain at the glutes and core control.

Poorly functioning ankle plantarflexors such as the gastrocnemius and soleus are associated with Achilles tendon injuries, weak quadriceps have been related to patellofemoral joint injury. And of course the gluteal group, when weak has an association with a number of injuries all over the body.

If we consider the typical everyday person who exercises, it is easy to see the trickle effect that having weak glutes does on the quadriceps which can overload a weak calf muscle and then the foot.

The foot is already under a massive load during exercise so sometimes it doesn’t take much to tip it over the edge and create injury.

So, what can we do to prevent or limit our risk of overuse injuries?

It’s simple, we intervene in the degeneration of our muscular strength by activating multiple muscle groups at the same time, working on high repetition endurance, or low repetition high weighted strength. Incorporating a variety of movements and exercises, concentrating on single leg movements, dynamic and explosive, high velocity and multidirectional all in the name of injury prevention, and focusing on how this actually helps the foot.

In short, we need a gym program to challenge our body before we can run. This doesn’t mean you can’t run without going to the gym, it does mean you are at higher risk of developing an injury if you do so. It doesn’t need to be complex, but it does need to be targeted towards muscles you use when running, this is done correctly is the greatest form of injury prevention.

If you need help with your strength and conditioning, then seek it, we specialise in exercise as medicine, and therefore can guide you through the best way to keep you active.

Click here to review your strengthening program with our podiatrists