Like any other type of pain, a sharp or aching pain in the ball of the foot can be distracting when you run. Although there are many conditions that can cause pain in the ball of the foot, there are only a few that are common among runners. Stress fractures are frequent, and may be worrisome, but differ from some other conditions. Unlike stress fractures that often seem to be related to more diffuse pain, several other conditions are easier to localize.
Posterior Tibial Tendonitis and Tendinosis for Runners
By Dr. Christopher Segler
When you run, your foot hits the ground, you pronate to absorb impact and then you supinate to push off again. All of this is possible because of a muscle in your leg call the tibialis posterior. This muscle deep in the back of your leg forms a tendon call the posterior tibial tendon that attaches to your foot. It attaches to the navicular bone in the instep of your foot, right at the top of your arch.
In the very simplest of terms, this tendon helps to hold up the arch. It is really much more complex than that, but we won’t bore you with the details. All you really need to know about this is that when you get posterior tibial tendinitis it can quickly progress and become a surgical problem.
Shin splints are the most common overuse injury among runners. Either you, or someone you run with, have likely suffered from this painful malady. Like most running injuries, shin splints are largely preventable. However, if not prevented, they can derail your training program and put your dream race in jeopardy.
According to Greek mythology, when Achilles was born his mother tried to make him immortal by dipping him in the river Styx. However, when she dipped him in, she forgot the spot on the heel she held him by, which left one small area unprotected. In the end, Achilles was struck by an arrow in his vulnerable heel and was killed. Achilles shares his vulnerability with the rest of us entirely mortal runners, and that is why the tendon which connects the calf muscles to the heel bone bears his name today. The Achilles tendon is the largest tendon in the entire human body and is very strong, but it is also the tendon we rupture the most often. Anyone who is active can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.
It’s a warm afternoon and Kendra is out for a run. Not a long run, just a few miles, a moderate pace. She has been training religiously. After work she likes to run along the Marina Green. There is something serene about the sound the boats, the wind off the Bay. The prefect way to leave the stress of work behind, and think about her upcoming marathon. Visualizing the finish, picturing in her mind’s eye the finish clock; just ahead of her goal time, getting that medal, all the work paid off. Suddenly her day-dreaming is interrupted by a vague ache in her left foot. It seems in perfect cadence with the sound of that foot hitting the sidewalk. She wonders what happened. It isn’t bad though, and she finishes her run.
Pain in the bottom of the heel is common complaint in runners. Actually, heel pain is common in all people. 40% of all visits to podiatrists in the U.S. are because of heel pain. Of all of the different causes of heel pain, the vast majority is due to a condition known as plantar fasciitis. This is the most frequent cause of pain on the bottom of the heel and is an inflammation in the band of tissue (the plantar fascia) that runs from the heel to the toes. This condition is most often caused by a tight achilles tendon or poor foot structure such as overly flat feet or high arches. It can also be caused by wearing non-supportive footwear on hard surfaces, spending long hours on your feet, or obesity.
Your running biomechanics are unique to you. No one has your fingerprints, personality, or running style. Running more efficiently with custom orthotics can conserve energy and get you to the finish line faster, but… not everyone needs custom orthotics.