Summer: Taking a toll on your soles?

It’s August—the height of summer—and many of us are taking advantage of the longer days to cram in more outdoor activities. For many, it just seems easier, and definitely more enjoyable, to go for an early morning run when it’s already light outside versus the dark days of winter.

But that increased activity also increases the risk of foot and ankle injuries, particularly among weekend warriors.

Aching Ankles

Sprains, which can vary widely in severity, are among the most common foot and ankle injuries. For minor problems, time-honored home remedies like icing, elevating, resting the foot and over-the-counter (OTC) anti-inflammatories are often all that’s needed. But if you don’t notice much relief after a few days of self-care, you should seek a professional opinion from a podiatrist, a doctor who specializes in foot and ankle care.

It may be that you need an ankle brace to support and protect the ligaments that were stretched or torn during the injury. More severe sprains may require a device called a CAM boot—basically a walking cast that relieves the ankle from bearing weight while it heals.

The good news is that most sprained ankles will getter better in a month or two.

Sometimes, however, what first seems like a badly sprained ankle may actually be a broken metatarsal—one of the long bones in the middle of the foot. Because the symptoms of a break, especially a Jones’ Fracture, and a sprain can be so similar, some fractures don’t get the early medical attention they may need, including surgery.

Individuals with chronic lateral ankle instability may also benefit from surgery to repair the damaged ligaments and return to a more active lifestyle. The condition is the result of cumulative injuries to the ligaments from frequent sprains, mostly due to overuse. That leaves the ankle more susceptible to chronic swelling, pain, tenderness and weakness, leading to even more sprains in the future.

Healing Sore Heels

Another quite common injury is plantar fasciitis, which occurs when you strain the ligament that connects the heel bone to the metatarsals. In 95 to 99 percent of people, it goes away with simple, conservative treatment like stretching, OTC inserts and physical therapy. If such steps don’t provide relief, however, I’m a big proponent of a promising new treatment called PRP.

PRP, or platelet-rich plasma injections, can often decrease or completely eliminate the pain of plantar fasciitis and other conditions, contributing to a speedier recovery. In the 30-minute procedure, some blood is withdrawn from the patient and then placed in a centrifuge to separate out the platelets, the component that helps with clotting, healing and tissue growth. Then the platelet-rich plasma—now containing three to five times more growth factors than normal— is injected into the affected area.

Most patients can get back on their feet within a few days and can resume regular activity within a month.

If the Shoe Fits…

Feet are the foundation of your fitness. If they’re in pain or stressed, you can’t do much of anything. But properly supported, your feet can conquer miles in comfort.

That’s where the right shoes come in to play. And it’s tricky. Some lucky people are born with a perfectly normal foot; however most of us need some sort of assistance to help achieve the right mechanical balance. For instance, a bunion, flat foot or a really high arch can put extra strain on different tendons and ligaments, leading to arthritis, pain and degeneration.

But finding that sweet spot is a matter of trial and error. Sneakers that I regularly recommend to my patients don’t work at all for my wide, highly-arched feet. You need to take time to find that brand and style that is going to be the best fit for your foot’s particular structure.

Orthotics can also help. I typically recommend that patients first try out an OTC support with a rigid sole, something like a piece of plastic, to see if that helps. In some cases, that may be all the arch support they need, while others may benefit more from a custom-made orthotic. Just be sure to avoid inserts that you can bend in half, which provide cushioning versus support.

The bottom line: Enjoy your summer activities, but don’t beat up your feet in the process. And always see a doctor in the event of any significant swelling, bruising or pain.

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Caitlin Garwood, DPM

Caitlin Zarick, DPM, is a board-qualified reconstructive foot and ankle surgeon and an associate professor in the Department of Plastic Surgery at Georgetown University.

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