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Teen Runner: Foot Pain

This is the last entry in our Teen Runner series, and we saved an interesting post for the end! We are going to discuss foot pain in young runners. Foot pain is quite prevalent with younger athletes and can come from a multitude of issues. I will try to differentiate some for you today so we can get a good idea of how to rehab!

As discussed in previous posts, we should always consider the risk of a stress fracture in teen and youth athletes. Due to growth plates, energy demands, and drastic changes in activity levels, they can be particularly susceptible. But how will we know to suspect a stress fracture? Here are some clues:

- Toothache-like pain in the foot at rest or at night

- Unrelenting pain that doesn’t get much better or go away completely

- Pain that worsens with activity and doesn’t “warm up” as you go

- Recent growth spurts or drastic changes in activity (like the beginning of a sport season)

It can be very challenging to diagnose a stress fracture without an image, so reach out to me if you are concerned and I will try to help. If we can safely rule out a stress-fracture, then we want to move on to some other common injuries.

Plantar Fasciitis

Most teen runners are not very susceptible to plantar fasciitis due to several factors that we don’t need to go into, here. However, some common characteristics will present if you are suffering from this injury:

- Pain located at the rear of the arch of the foot

- First step in the morning is very painful, but will warm up with activity and be less painful

- The end of the day typically is more painful

Treatment for plantar fasciitis can be very straightforward if you find the right PT! I have seen this many times and can help quickly should you start to suffer from this injury. Treatment consists of dry needling, strengthening, and alleviating the true cause of the pain!

Turf Toe

Most distance runners will not suffer from this injury from long-distance, but rather from playing another sport or just running around the yard.

- Characterized by significant discomfort at the base of the big toe and gets worse when the toe is pulled upward

- Typically feels much better in a rigid shoe or when at rest

It can be difficult to rehab from this injury so it is wise to get it looked at soon after it shows up. Treatment consists of shoe modification, strengthening, and stability.

Posterior Tibialis Tendonitis

That’s right, shin splints can manifest in the foot as well! Remember, the posterior tibialis tendon inserts onto the navicular of the foot. This insertion can be come inflamed and highly irritated through overuse or drastic changes in training load.

- Pain will present on the inside of the arch, directly on the bone or tendon

- Pain will worsen with activity after initially warming up and feeling somewhat better

- This injury can also feel “squeaky” if swelling is present

Posterior tibialis tendon injuries have been covered in our shin splints post, so check that one out!

Achilles Tendonitis

Ah, the Achilles. We saved perhaps the most common young athlete foot injury for last. We have written several articles on this condition and you can reference one of them here.

- Pain typically presents anywhere along the Achilles tendon, and may or many not improve with activity

- Significant tightness in the calf or heel can also be felt

Once again, this condition can be treated in a pretty straightforward manner, so reach out today if you have any issues! We will focus on strengthening using eccentrics if tolerated, and some gait analysis.

Thank you for following along with this series, and if there are any injuries I didn’t cover that you would like me to in the future, please let me know!



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