We have been on the topic of foot care for the past two weeks so it’s only right that we hear from an expert. While training for my first half marathon, I dislocated a toe nail and initially ignored it. Then it started snagging socks and reading medical websites, and runner’s forums made me fear an infection or amputation, so I went to see my good friend Dr. Carmen April, also a podiatrist. She gently removed the toenail and put me in orthotic arch supports. Dr. April isn’t only a friend of runners who volunteers in the medical tent at several marathons, but she’s also a foodie who blogs about restaurants at Dinner With Nerds. But enough about why the bRUNcher loves her and more about you loving your feet.
Having worked with hundreds of athletes over the years, I’ve certainly treated foot and ankle injuries specific to runners. Here are a couple of tips you should know to keep your feet it tip-top running condition:
- If you have had problems with ankle sprains or lower extremity muscle strains in the past, visit a podiatrist before starting a rigorous running program. Once a person has sustained just one major ankle sprain in the past, the likelihood of a second sprain is higher than normal because ligaments rarely return to 100% tensile strength after damage from a major sprain. If you have chronic ankle instability, you may need to wear a brace to offer more stability and prevent future ankle sprains.
- Make sure that you wear appropriate socks, free of heavy creases or holes, when running. Socks that wick away excess moisture will help prevent blisters on the feet. Blisters are caused from the combination of excess moisture and friction.
- Examine your running shoes before you begin a running regimen and before each run. Check for any areas of increased pressure or irritation of the shoes against your feet. If you notice uncomfortable pressure points prior to running, it will only be made worse once you actually start running.
- If you have flat feet (hyperpronation) when you stand/walk/run or have a high arch (Cavus) foot type, you should see a podiatrist to be evaluated and possibly fitted for custom orthotics. Orthotics are special inserts that are placed into your shoes and help correct biomechanical abnormalities that result from abnormal structure of your feet. If you notice that you wear down one side of your shoe heel more than the other side, you likely have one of the above mentioned conditions and would likely benefit from orthotics.
- Many serious and long-distance runners eventually run into instances of toenail injuries such as subungual hematomas (bleeding underneath the nail) or onycholysis (toenails falling off) because of the repeated trauma caused to the nails in shoes. The repetitive micro-trauma caused by toenails hitting the tip of the shoes with each and every stride is enough to cause a contusion and subsequent collection of blood beneath the nail. A trip to the podiatrist may be needed to poke a small hole in the affected toenail(s) and express the trapped blood to relieve the pain. In the case of toenails that become detached from the nail bed, most will eventually fall off on their own. Just like a scab, don’t attempt to rip it off before it’s ready to detach. You may cause further injury, bleeding, pain and potential infection. Keeping toenails cut as short as possible will also prevent the repetitive damage to the nails.
Above all, listen to your feet. Pain alerts you that something is abnormal. A trip to a podiatrist prior to starting a running program and as injuries occur is a step in the right direction to maintaining healthy feet that will keep you running for miles and miles to come!
Dr. Carmen April is a Nashville area podiatrist and owner of her practice, The Foot And Ankle Healthcare Center, and treats runners on a regular basis. Dr. April has served on the Medical Team for many National Marathons including the Marine Corps Marathon, The Boston Marathon, The Detroit Marathon and The Music City Marathon. She also runs a Dinner With Nerds, a blog where she offers restaurant spotlights and interviews with successful people over dinner.