Ways to exercise without hurting your feet!

Tips from AOFAS surgeons to keep your
feet injury free while enjoying outdoor sports

Rosemont, IL – May 1, 2009 – Warm spring days have arrived inviting us to jump into our favorite outdoor sports after hibernating all winter. However, a quick move into high physical activity when your feet are not quite ready can cause major injuries to the feet ruining those plans for a summer of fun. Injuries related to plantar fasciitis, arch pain or flat feet, bunions, and arthritis to name a few can be avoided with proper planning.

Tips from the American Orthopaedic Foot & Ankle Society (AOFAS) can be invaluable in developing an exercise program that will be sure to keep your feet healthy. One of the most important ways to obtain good foot health is to maintain a healthy, active lifestyle throughout the year so extra weight does not suddenly adversely impact your feet. If you feel any discomfort with your feet, have them evaluated by your orthopaedic foot and ankle surgeon before beginning an active exercise program. Remember, the feet are the body’s shock absorbers.

What are some of the tips for keeping your feet pain-free?

Warm up exercises such as a short period of walking and stretching.

Stretch again after exercising.

Be sure to wear footwear that is specific to the sport. This may include being evaluated by someone who is knowledgeable in shoe wear and biomechanics, such as an orthopaedic surgeon, pedorthist, or physical therapist.

Appropriate training for the specific sport. Impact sports such as running will place greater stress on your feet. Without proper training that builds up your tolerance to impact activities, stress fractures can occur.

Cross-training with “feet-friendly” non-impact activities, such as swimming, biking, elliptical trainers, and steppers.
If maintaining your fitness goals remains difficult, adding an orthotic device in your shoes may offer you what you need to remain active. Before doing this, always have your feet checked by an orthopaedic foot and ankle surgeon.

AOFAS member, Stephen J. Pinney, MD, of San Francisco, CA, says, “Walking puts more stress on your feet than you might think! Every time you take a step 2-3 times your body weight goes through your feet, more if you are running. It is not uncommon for an active person to take 10,000-15,000 steps per day. That is a lot of cumulative force going through the sole of the foot and the various tendons that control the movement of the foot. This repetitive loading can predispose to many common "chronic" foot conditions such as metatarsalgia, tendinitis, and plantar fasciitis.

Metatarsalgia is a painful condition involving the forefoot. It occurs when the tissue in the sole of the forefoot gets irritated and painful from the repetitive loading especially if the force is concentrated in a localized area in the forefoot. It is treated by trying to disperse the force away from the painful area by using appropriate shoe wear and orthotic inserts.”

He continues, “Tendinitis occurs when a tendon gets excessively overloaded just like a rope that starts to fray after it is subject to wear and tear. The body responds to this type of tendon injury by sending inflammatory mediators to the area and this is what leads to the pain and swelling associated with tendinitis. Depending on which tendons in the foot are excessively loaded will determine which part of the foot will develop tendinitis. Not all of the tendons in the foot are loaded equally in every foot. For example, people with flatfeet will tend to excessively load the tendons on the inside of the ankle and may develop symptoms in this area whereas people with higher arched feet are more likely to develop tendinitis symptoms in the outside part of their ankle. Treatment of tendinitis may include: modifying activities to rest the painful area; using shoes and orthotics that help to smoothly spread the force of running or walking up the leg; gently strengthening and stretching the involved tendons; and possibly bracing the ankle.”

Plantar fasciitis is the most common cause of chronic heel pain. It develops as a result of repetitive microtrauma to the heel region. As Dr. Pinney says, “The plantar fascia is a dense tissue that is found in the sole of the foot beginning at the heel bone. With each step a person takes this tissue is loaded. If someone increases the amount of walking they do, walks on hard surfaces, or gains extra weight they may suffer repetitive microtearing of the plantar fascia insertion. This will lead to heel pain, particularly first thing in the morning which is a characteristic sign of plantar fasciitis.

Like other types of chronic foot pain plantar fasciitis can usually be successfully treated by decreasing the overall loading to the foot. Dr. Pinney recommends, “Wearing appropriate shoes, walking or standing less and on softer surfaces, stretching your calf muscles, or losing extra body weight will all be helpful in decreasing or eliminating the symptoms associated with chronic foot conditions, such as plantar fasciitis.”

To keep those feet healthy, always remember:

Proper shoe wear that is appropriate to the specific sport

Proper evaluation by an orthopaedic foot and ankle surgeon

Adequate training

Stretch before and after exercising

Mix activities through cross training
To find an AOFAS orthopaedic surgeon in your area, go to www.aofas.org.