Spring is here! And with warmer temperatures people find themselves outside more and enjoying their favorite sport. From hiking up the canyon to soccer in the park, we’re more active this time of year than during the previous colder months. If we’re not ready, this sudden increase in outdoor activity can lead to aches and pains.
As a physical therapist, one area I often see affected in my patients during this seasonal transition is the foot and ankle. Our feet are incredible machines that are able to support the weight of our body for hundreds of steps everyday. In fact, the average American takes around 5,000 steps per day. That equals about 1,825,000 steps per year! If you are a runner or like to be more active, then you’re looking at several million steps more than that. Our feet are very strong but the trouble comes when we haven’t been exercising as much during the winter and then we try to do too much too soon at the first hint of warm weather.
So what can you do to prepare your feet for this increase in activity and prevent getting hurt on the first run or hike?
1. Improve the capacity of your feet for activity through exercise.
One of the best things you can do is to make sure your feet and lower leg muscles are flexible and strong. I’ve listed the top five exercises below that can help strengthen your feet and prepare them to be more activity. Try to do these 2-3 times a week.
Calf Muscle Stretch
Calf Muscle Strengthening
Foot Towel Lift Exercise
Single Leg Balance
2. Choose the right footwear for the occasion.
Several years ago, I practiced in Alexandria, Virginia, right outside of Washington D.C. A common story I often heard from my patients involved them spending the day walking on the national mall in flip flops. They would decide to go tour the monuments and museums for just a little while with family or friends. This short stroll would often turn into half the day and they’d end up walking miles! Painful spots on the bottom of their feet or in the ankles soon developed and the next day when they awoke, their first steps were painful and stiff!
You wouldn’t wear flip flops to hike a mountain, and wearing hiking boots to walk on the beach wouldn’t make sense either. So choose the right footwear for the occasion. Certain types of shoes like flip flops or shoes with a higher heel will change the way your foot works and ultimately add stress that the foot isn’t used to. This increase in stress can lead to overuse syndromes like tendonopathies or plantar fasciitis.
3. Let your feet adapt by slowly increasing the load
Several years ago, there was a huge shift in the world of footwear to walk and run in a minimalistic shoe. These were shoes that offered little support and often had little to no heel. This challenged the foot to work harder in order to make up for the lack of support. The thought was that by wearing this type of footwear, the legs and feet would become stronger overall and allow the body to function more naturally.
With this sudden change in footwear, many people who had run in supportive shoes their whole lives started getting injured. Overnight the incidence of metatarsal stress fractures in the bones of the foot, shin splints, and other tendon problems was on the rise. The overall problem was not from the faulty design of the footwear, but of the short transition period for the foot to get used to the new shoes. People kept running the same amount but the bones, muscles, and tendons could not adapt fast enough to these new demands. In physical therapy, we call this a training error, meaning, the amount of stress applied through exercise was too much, too soon. The body can’t adapt quickly enough to the sudden changes and will begin to break down.
As you choose to be more active, start out gradually and let the tissues of your body get stronger overtime. If you do choose to wear footwear that your foot isn’t used to then make sure to minimize the time spent wearing them. Gradually increase how far and how fast you go. If you find yourself on harder surfaces such as rock, concrete, and asphalt, then make sure your shoes have some type of cushioning to help absorb shock from the hard ground.
4. Get into the grass.
Allowing the foot to spend some time without any type of shoe is healthy and can increase its strength and stability. There are millions of sensors in your feet that relay information to your brain based on the position and movement of your joints and muscles (proprioception). These “proprioceptors” help protect your body and make it function more efficiently. Those who always wear thick shoes lose part of this ability to sense and control their feet. Occasionally spend a few minutes in your barefeet walking around in the grass, on a sandy beach, or on soft carpet. Let your toes feel and explore something other than the cramped inside of your thick shoes!
Here is a quick test to check out the proprioception and coordination of your feet and toes. Stand with your feet pointing straight ahead and try to keep the outer four toes grounded while you lift just the big toe in the air. Next, Press the big toe into the ground and keep it there as you raise the other four toes. How did you do?
Last of all, if you’ve had a previous foot injury, talk to your physical therapist and they can perform a few tests to see if your feet are ready. Physical therapists can assess your feet for risk of re-injury, and help recommend the right footwear based on the way your feet function.
In summary, don’t be afraid to be more active but do start gradually. Choose the right footwear for the occasion, and through exercise and training your feet will be flexible and strong. You’ll be ready to enjoy the beautiful outdoors without pain or injury.
Matthew Randall PT, DPT, OCS, SCS, MTC, CSCS
Fast Track Physical Therapy and Sports Medicine