ASK LARA: Introduction and Top-of-Foot Pain
Posted August 21st, 2007 at 8:45 PM by Lara Johnson
Section: Running & Training, Injury & Rehab, Columns, Health & Fitness, Injury & Rehab, Ask Lara
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ASK LARA is a free advice column to help you with all of your running, fitness and nutrition inquiries. To ASK LARA — simply fill out the form at the conclusion of the column.
You’ve heard of ASK FLASH…Welcome to ASK LARA, a new place to submit all of your running questions. Let’s get to it!
Q. So Lara, we have Flash for all of our running and fitness questions, why do we need another Q and A columnist?
~Maggie from Boston, MA
A. I’m glad you asked that question. Well, it’s true that I do not have a catchy nickname. And I don’t have Flash’s years of wisdom, as I am much younger. However, I can offer guidance based upon my own personal and professional experiences. On the personal side of the coin, I have had my share of injuries and triumphs and set-backs, and all of those other things that come with being a runner.
Professionally, I have a background in the sciences, including a M.S. in Health & Exercise Science (See below for my full bio), and simply a fascination with human anatomy and exercise physiology. I am a personal trainer and have worked with the old, the young, heart patients, diabetics, healthy adults, addicts, students, in the clinic, and in fitness. And all related to exercise. In order to tackle your many questions, I am teaming up with Flash so that we may best conquer your running inquiries. Two heads are better than one, right? Plus, perhaps some of you ladies have women-specific questions. Send them my way!
Q. Random question … I seem to have increasingly aching feet, especially after long runs and when I first get up in the the morning. It’s not the underside of my foot at all, but more of the top, just in front of my ankle bone. Is this a tendon? Is there any way I can strengthen it? And actually, it’s both of my feet, but more my left than my right. Also, I do tend to run on the outside edge of my feet. It doesn’t stop me from training for my 2nd marathon, but I want to work on it before it does!
~Achey from Arizona
A. This is not an uncommon problem among runners, as I myself have suffered an achey top-foot on more than one occasion. From the sound of your description, it is most likely (although you should still have it examined by your physician for an official diagnosis) the tendon from the tibialis anterior muscle that runs laterally (along the outside) of your shin bone. Inflammation in this area causes pain or “achiness” when you dorsiflex your foot.
This problem is often caused by tying your shoelaces too tight, or not having big enough shoes to begin with (when buying running shoes, remember that your feet swell as you run). This can particularly be problematic when running long distances in tight-fitting shoes. Try tying your shoes more loosely, and if this causes the heel of your shoe to slip, or other discomfort, consider straight-lacing you shoes. This will take pressure off the top of the foot. Check out Ian’s Shoelace Site for many methods of shoe tying, including straight laces.
Another good remedy is ice massage. Fill a paper cup with water and let it freeze in the freezer. Unwrap the top portion and rub the ice directly on the area for 10-15 minutes. I recommend icing not only the lower tendon that is near the ankle but also where the muscle inserts below the knee and next to the shin, particularly if you feel tenderness here as well. It also helps to stretch. The best method I have found is passive stretching in the seated position. With one leg outstretched, try to push the foot out in front of you to stretch the top of the foot, or have a friend help you.
It’s good that this pain is not keeping you from your training plan, however if you notice a bump on the top of the foot, you may have acquired a bone spur from pressure being constantly placed on the bone (see Cool Running: Pain on Top of Foot).
Let’s talk prevention. Aside from lacing your shoes loosely or differently, there are indeed ways to strengthen the anterior tibialis muscle. Try this dorsiflexion exercise. Take a resistance band and tie it to make a ring. Anchor the band under something sturdy like a chair (I like to use my coffee table) and sit with leg extended and the band around the top of your foot. Put enough distance between your foot and your anchor so that the band provides tension while your foot is relaxed and then throughout the entire movement.
Starting with a relaxed foot, draw the toes back towards your shin while the band is providing resistance. Use slow, controlled movements while you take your foot back to the starting position, and perform the exercise for 15-20 repetitions. Build up to 2-3 sets, and be sure to do the exercise on both feet. While you’re at it, I suggest strengthening the rest of those lower leg muscles (you know, the ones that hurt when you roll your foot on a rock or root).
Take the resistance band in your hands, this time with the band looped around the bottom of your foot. Plantar flex your foot this time (point your toes away from you) and then resist as you bring your foot back towards your body. There are great lateral strength exercises too, but those are for another day.
Have a great run!
Research sources and for more information: [WebMD]
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Lara Johnson holds her M.S. in Health and Exercise Science from Wake Forest University, and is a certified Exercise Specialist from the American College of Sports Medicine (ACSM). A clinical researcher and personal trainer, Lara works hard and plays harder, competing in events from the mile to the marathon as a member of the Boston Athletic Association (BAA).
Lara advocates exercise as the best prevention for disease and disability. She enjoys a training plan that focuses on running and that is complemented with speed-work, strength training, sound nutrition, cross training, and injury prevention.
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Tags: aching feet, advice, ask lara, cold therapy, discomfort, dorsiflex, dorsiflexion, feet, foot, foot pain, heel, Ians Shoelace Site, ice , ice massage, injuries, injury prevention, paper cup, plantar flex, Q&A, resistance band injury treatment, shin, shoe, shoelaces, straight lacing, tight fitting shoes, tikialis anterior muscle, top of foot, water
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