This is the time of year when the worst feet turn up in clinic and their owners say “Help! I’ve got a marathon to do in 6 weeks”. I recently treated a patient who is in training for London 2012 (Marathon – not Olympics) who was struggling with Achilles tendonopathy, and knee pain.
He had played as a professional footballer when young but had always had problems with very bad ankle sprains. After his assessment I advised him on the most suitable trainer for his run and that he would need orthotics with a ‘forefoot post’ to stop him spraining his ankle.
He went very quiet for a while, so I said “Whats the matter?” and he said, “Let me get this straight: you’re telling me my ankles are so bad you are going to have to attach ‘four foot posts’ to them to stop them going over?”
I thought he was joking but he was serious and it was at the end of a busy day so needless to say I was struggling to keep a straight face. Anyway, I had positive feedback that his training is going well and both his knee pain and Achilles have resolved through wearing orthotics, and he is not spraining his ankles.
Other commonly seen and treated running conditions are shin splints, anterior and lateral compartment syndrome and peroneal strain. All can be successfully managed with podiatry, often in conjunction with other health professionals.