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   Surgery of the Foot & Ankle  •  Sports Related Injuries of the Foot & Ankle  •    Foot Diseases and Foot Pain of Any Kind 

Dr. Mark H. Tompkins  4402 Vance Jackson, Suite #146 ● San Antonio, Texas 78230
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Running Injuries

by Mark H. Tompkins

C O P Y R I G H T   I N F O R M A T I O N
To copy , to republish, to post on servers, or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from the author, Dr. Mark H. Tompkins , by using our contact form. Copyright © 2001-2005 Dr. Mark H. Tompkins. All rights reserved.

Dr.Tompkins has an extensive background and experience in reconstructive foot and ankle surgery and is board certified by the American Board of Podiatric Surgery. He is also a Diplomat of the American College of Foot and Ankle Surgeons (ACFAS), and previous Division XII, ACFAS Vice President in Pittsburgh , PA.

Dr. Tompkins also specializes in sports related injuries, and preventative biomechanics. He is a team physician for Incarnate Word University and Churchill High School . In addition, he has worked extensively with area high school, college, and professional athletes.




Common Foot and Lower Extremity Running Injuries

For ease of presentation, conditions will be separated into seven distinct categories representing individual organ systems. Subsequently, abbreviations regarding the treatment and prevention of each condition will be listed. Abbreviations are listed at the end with limited explanations.

The treatments and preventions given are intended for general medical background knowledge for the beginner or active runner. They are in no way considered thorough and complete and should be utilized only to help the individual runner better recognize various ailments, and their treatment and preventative measures. Persistent or moderate to severe problems should be addressed by a medical specialist.

 

 

Muscles

Condition
Treatment
Prevention
Overuse rest/ice-heat/stretching stretching/training
*Myositis rest/ice/stretching/straping stretching/terrain/support/shoe
Strains/mild pulls rest/ice/nsaids/pt stretching/training/support/shoe
Severe pulls/tears rest/ice/nsaids/immob/doctor stretching/training/support/shoe

 

Ligaments

Condition
Treatment
Prevention
*Sprain/partial tears rest/ice/brace/ROM exercises stretch/strengthen (SS)/training/shoe
*Complete tears/ruptures rest/ice/immob./doctor SS/support/shoe/doctor
*Plantar fasciitis rest/ice/massage/support/doctor stretching/support/shoe/doctor

 

Tendons

Condition
Treatment
Prevention
Tendonitis(mild) rest/ice-heat/nsaids/ROM stretching/training/terrain/support/shoe
*Tendonitis (severe) rest/immob./nsaids/doctor stretching/training/terrain/support/shoe
Partial ruptures rest/immob/nsaids/doctor stretching/training/support/shoe
Complete ruptures rest/immob/doctor stretching/training/support/shoe
*ITB Syndrome (runners knee) rest/ice-heat/support/SS/doctor SS/support/shoe/terrain/doctor

 

Bones

Condition
Treatment
Prevention
*Periostitis (bone bruise) rest/ice-heat/massage stretching/terrain/support/shoe
*Heel Spurs rest/ice-heat/nsaids/support/doctor stretching/support/shoe/doctor
*Bone Spurs-other rest/padding/support/doctor stretching/support/shoe/doctor
*Stress fractures immob/doctor stretching/training/support/shoe
Overt fractures immob/doctor stretching/training/support/shoe

 

Nerves

Condition
Treatment
Prevention
*Neuritis rest/nsaids/massage/pt/doctor stretching/training/support/shoe
*Neuroma rest/nsaids/support/doctor stretching/training/support/shoe
*Nerve entrapment rest/nsaids/support/doctor stretching/training/support/shoe
*Neuropraxia rest/massage/remove source shoes/ padding/support/shoe

 

Integument - (skin and related structures)

Condition
Treatment
Prevention
Blisters puncture/gentian violet/cover socks(Thorlo®)/shoe/ training
Callous/corns pumice stone/Carmol HC®/ doctor Thorlo®/shoes/pads/doctor
Ulcers antisepsis/ATB cream/cover/doctor Thorlo®/support/shoes/doctor
*Hematomas puncture/ATB/cover/doctor Thorlo®/support/shoes/doctor
Nail conditions nail care/ATB/cover/doctor Thorlo®/nail care/doctor
Athletes foot antisepsis/AF med./air/doctor Thorlo®-clean/air/med./doctor
*Dermatoses antisepsis/ATB/doctor Thorlo®-clean/air/med./doctor
Xerosis/excoriations skin care/Carmol HC®/pads Thorlo®/air/skin care/pads

 

Other

Condition
Treatment
Prevention
*Chrondromalacia Patella rest/ice-heat/stretching/support/doctor stretching/strengthening/support
*Trochanteric Bursitis rest/ice-heat/stretching/nsaids/doctor SS/terrain/support



    Treatment/Prevention abbreviations

  • Rest - from reduced activity to no activity; may also come in the form of modifying a specific activity.
  • Ice-heat - cold (ice) therapy after activity/heat prior (use of heating pads, soaks, linaments, etc.)
  • Stretching - vigorous-consistent-and thorough before and after activity; multiple repetitions for each muscle group
  • Training - appropriate and progressive/be flexible dependent on physical response; progression is the key
  • Straping - various supportive uses of tape and pads
  • Terrain - appropriate and progressive/be flexible dependent on physical response; alter according to physical response
  • Support - use of various 'orthotic' devices; more rigid devices should be prescribed by a medical specialist
  • Shoes - appropriate shoe gear; I personally refer patients to Roger Solers Sports ( www.rogersoler.com )
  • NSAIDS - non-steroid inflammation meds-aspirin and its derivatives; both over the counter and prescription
  • PT - physical therapy; warm-moist heat is most common home treatment; most effective is by registered physical therapist
  • Immob(ilization) - complete limitation of motion or pressure; most commonly performed in a medical specialists office
  • Brace - support devices that partially limit motion, rest area, and provide stability; both over the counter and doctor prescribed
  • ROM exercises - passive and active movements that improve circulation, reduce swelling and promote healing
  • SS - combination of vigorous stretching to increase ROM and strengthening exercises to increase stability and stamina
  • Doctor - should seek treatment from a sports medicine specialist
  • Massage - deep friction massage/preferably from a certified massage therapist
  • Gentian Violet - over the counter (OTC) medication that desiccates the blister and promotes healing
  • Socks - my preference are Thorlo® running socks
  • Carmol HC - OTC medication that softens and mildly debrides calluses or hyperkeratoses
  • ATB cream - OTC antibiotic medication (triple antibiotic or associated brand)
  • Antisepsis - use of proper soaps and/or products such as phisohex® or alcohol to cleanse skin
  • AF medication - OTC antifungal medications (creams, lotions, sprays, powders)



Descriptions

  • Myositis - differs from overuse (sore muscles) in that it is not transient. More chronic-deep quality type pain in the muscles of the arch or anterior/posterior/lateral leg.
  • Sprain/paritial ligamentous tear - characterized by mild to moderate acute pain, swelling, and stiffness which resides with limited rest/ice/compression/elevation (RICE). Mild can be treated by self.
  • Complete ligamentous tear/rupture - characterized by severe pain, swelling, and stiffness which does NOT reside with intial rest/ice/compression/elevation (RICE). Should be treated by a doctor.
  • Plantar fasciitis - Not a true ligamentous injury, but a fascial strain characterized by inside mid-arch pain. Usually more uncomfortable after periods of rest and after increased activity. Different than heel spur syndrome (see below).
  • Tendonitis (severe)- characterized by moderate to severe pain, swelling, difficulty walking. Not relieved with limited rest, ice/heat, immobilization. Needs to be treated by a doctor; usually a cast. Otherwise, may lead to a partial/complete rupture.
  • ITB Syndrome - characterized by pain on the outside of the knee-usually at the middle/end of activity.
  • Periostitis - characterized by deep pain, which is exacerbated by activity and relieved with rest. Most commonly affects the back portion of the heel. Different than heel spur type pain (see heel spurs).
  • Heel Spur Syndrome - characterized by pain at the bottom of the heel after periods of rest (especially in the am and after increased activity). Usually improves after some initial activity/stretching, then reoccurs.
  • Bone spurs - characterized by chronic pain over bony protuberances exacerbated with activity.
  • Stress fractures - characterized by persistent pain and swelling, which gets progressively worse. Constant pain with no improvement. Commonly occurs in the forefoot region, but can also affect the heel or bones of the leg.
  • Neuritis - characterized by burning sensation, or 'shooting' type pain exacerbated by activity and relieved with rest, ice, and massage.
  • Neuroma - characterized by burning sensation, or 'shooting' type pain which progresses to intense pain and sometimes numbness. Most commonly between the 3rd and 4th toes (Morton's neuroma).
  • Nerve entrapement - characterized by chronic 'shooting' type pain distal to the affected nerve. Most common is Tarsal Tunnel Syndrome which affects the arch mid-foot.
  • Hematoma - characterized by bleeding into tissues, which turns a blue-brown color. Most common under nails or plantar blisters.
  • Dermatoses - characterized by varying degrees of skin irritaion, itching, burning, exfoliation, and sometimes infection.
  • Chondrmalacia Patella - known as Runners Knee/characterized by pain under the knee cap, more commonly on the medial (or inside) aspect of the knee and below. This occurs with activity and often after periods of sitting or running downhill.
  • Trochanteric Bursitis - characterized by pain in the outer hip joint which occurs with increased running and extensive uphill/downhill training.




    1. These are the most common lower extremity injuries that occur with beginning, recreational, and advanced levels of running. The most common causes of these injuries are:

    2. The beginning runner-due to lack of preparation, knowledge, and training.
    3. The recreational runner who is attempting to advance to higher levels- due to inappropriate stretching/strengthening (S/S), lack of appropriate support, inappropriate training, or physical limitations.
    4. The advanced runner-due to inadequate stretching/strengthening, inappropriate training, lack of appropriate support, or physical limitations.
     

    The best advice to prevent these injuries: Proper knowledge, preparation, training, stretching and strengthening, shoes ( www.rogersoler.com ), inserts/orthotics, and recognizing physical limitations.

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    COMMON FOOT PROBLEMS

    Athletes Foot Bio-Mechanical Pain BunionsCalluses Corns Cracked Heels Diabetic Foot Flat FeetHallux Limitus/RigidushalluxHammer Toes Heel Pain/Heel Spur Ingrown Nails Mortons Neuroma Mortons Toe Neuropathy Plantar FasciitisPost Tib Tendonitis Sesamoiditis Shin Splints Sweaty Feet/Odor Toenail Fungus



     
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    Dr. Mark H. Tompkins
     ●
    Park North Professional Building ●
    4402 Vance Jackson, Suite #146 ● San Antonio, Texas 78230

    Copyright © 2001-2005 Dr. Mark H. Tompkins. All rights reserved.
    E m a i l :    office@drtompkins.com

    Copyright © 2001-2005 Dr. Mark H. Tompkins. All rights reserved.