By: John Fiore, PT

As runners, our feet take a beating.  The human foot is designed with locomotion in mind. Healthy foot function hinges on a balance of mobility, strength, and support. When one of these three necessary components is compromised, injury risk increases. 

Foot Anatomy

The foot is complex!

Understanding the foot and how to avoid a few common foot injuries will enable runners to run with confidence.  The human foot contains 26 bones and nearly 100 joint surfaces.  In addition, our feet absorb 2.5 to 5.0 times our body weight with each foot strike. The bones of the foot form three distinct structural and functional units.  The rear foot is made up of the large calcaneus and talus.  The rear foot is designed for weight bearing and articulates with the lower leg bones (tibia, fibula).  The mid foot is made up of the navicular, talus, and cuneiform bones.  The mid foot has a dual role.  It absorbs shock during weight bearing and forms the stability we rely on (the arch) when pushing off to initiate the next step.  The fore foot is made up of the five metatarsal bones and 14 bones in our toes (phalanges) and plays a role in terrain adaptation and balance. 

Foot Mobility

Foot mobility creates shock absorption and terrain adaptation. During the walking and running stride, foot function changes from one of shock absorption to one of propulsion which means the foot must stiffen to lift our body weight against gravity for the next step or stride. Foot stiffness during all phases walking or running greatly increases the impact through the joints of the foot. Mobilizing the foot by rolling over a small ball or self -massage is a simple way to insure foot mobility.

Foot Strength

A calf strengthening program. Photo: physiosteps.co.nz

The bottom of our feet has four layers of muscles (called intrinsic foot muscles) which support the arch and provide dexterity to our toes. The lower leg muscles control the function and support of our ankle and feet collectively. 

The calf muscle group (gastric-soleus), for example, is crucial for propulsion and Achilles tendon health. 

A progressive calf loading program tailored to your abilities and goals is a great place to start. A 31% reduction in calf muscle strength naturally occurs between the ages of 20 and 60 (DeVita, et al 2016), making lower leg, Achilles, and foot injuries more prevalent in runners over the age of 40. Strengthening the medial and lateral ankle (tibialis posterior, fibularis musculature) is important as well to improve ankle stability. It is important to have a physical therapist evaluate your unique foot and ankle function (strength, range of motion, joint mobility, tissue tension) in order to create a strengthening-loading program which is right for you.

Foot Support

Strong, mobile feet equal healthy feet with adequate support for running. Many of us, however, have feet which are less than ideal either due to genetics (thanks for the bunions Grandma), prior injury, or surgery history.

In some cases, therefore, the use of an insole or custom orthotic may be needed to support the foot and ankle. A custom orthotic is a medical device with the goal of placing the foot and ankle in a neutral position. Activity goals, prior injury and medical history is factored into the design of each pair of custom orthotics. Sapphire Physical Therapy makes custom orthotics on-site using the Amfit system which allows for an accurate, custom fit. Orthotic materials (based on activity, medical history, foot type) range from soft to semi-rigid carbon fiber and everything in between. Watch for our October orthotic special (20% off all orthotics) or contact John Fiore (john@sapphirept.com) or see our website to find out more about custom orthotic options or to discuss a foot-ankle strengthening program to keep you running strong. 

References

DeVita P, Fellin RE, Seay JF. The relationship between age and running biomechanics. Med & Sci Sports & Exerc. 2016; 48 (1): 98-196.

McKean KA, Manson NA, Stanish WD. Musculoskeletal injury in the masters runners. Clin J Sport Med. 2006; 16 (2): 149–54.

If you have ever trained for a sport or participated in a regular exercise routine, you have likely heard of plyometrics. Plyometric training is a useful tool not only for athletes but also is an important component in physical therapy as way to help patients return to sport and activity. Though plyometrics are typically thought of as an exercise for more explosive sports, runners should be adding in this to their normal routine as well. 

What Are Plyometrics?

Plyometrics are a form of training that utilizes our body’s stretch-shortening cycle to produce powerful, explosive movements. Both speed(time) and strength(force) are functions of power and can be manipulated to achieve varying outcomes.  This stretch-shortening cycle in our muscles can be thought of as a spring being compressed and released (1).

Benefits of plyometrics

The primary goal when performing plyometric training is to increase our body’s power output to improve our performance during athletic maneuvers. For runners, this means increasing our running economy or improve the efficiency at which we run. Plyometrics have been shown to improve running economy as well as increase tendon stiffness and bone density (1, 2). This is especially important considering how prevalent tendon and bone injuries are in the sport of distance running.  

How to perform plyometrics

Plyometrics require an ‘explosive’ movement. Near maximal effort should be used when doing plyometrics to maximize the potential benefits, which is part of what makes plyometric training so great. Because of the level of demand placed on the body, individuals do not need to perform countless repetitions to achieve their goal. Depending on the amount of running you are doing, it is best to start with one set of ten repetitions for each type of jump, two to three times a week and then add additional sets from there.  

While plyometrics can be beneficial, we suggest consulting with your local physical therapist regarding any questions or concerns about your ability to implement plyometric training. 

Examples of Plyometrics for Runners:

1. Double leg hop for distance
2. Single leg hop for distance
3. Counter movement jump (step off box and quickly follow with jump)

For more information on plyometrics, visit the Sapphire PT blog here: https://www.sapphirephysicaltherapy.com/blog/plyometric-training

By: Andrew Traver, Student of Physical Therapy/Sapphire Physical Therapy Clinical Intern

References:

1 Voight, Michael L., and Steven R. Tippett. “Plyometric Exercise in Rehabilitation.” Musculoskeletal Interventions: Techniques for Therapeutic Exercise, Third Edition Eds. Barbara J. Hoogenboom, et al. McGraw Hill, 2013, https://accessphysiotherapy.mhmedical.com/content.aspx?bookid=960&sectionid=53549678.

2 Davies, George et al. “CURRENT CONCEPTS OF PLYOMETRIC EXERCISE.” International journal of sports physical therapy vol. 10,6 (2015): 760-86.