Oh, your aching feet! Feet contain a quarter of the entire body’s bones, nearly three dozen joints and more than 100 tendons, ligaments and muscles. Plus, they bear all the body’s weight—and during high-impact activity, this can create forces on them that are up to 20 times your weight. It’s no wonder, then, that the following fitness- and sports-related foot injuries are so common.
You can injure your foot in all kinds of sports—from aerobics and basketball to running, tennis, cycling and golf. According to a 2006 survey of runners, the foot was the second most common site of injury in both younger and older people. Foot injuries can occur suddenly (like when you jam a toe) or crop up over time if you wear the wrong footwear or have an underlying biomechanical problem, such as over-pronation (your foot rolls inward too much) or over-supination (rolls outward too much), flat feet, or anything else that adversely affects the way you move. Playing on hard concrete or asphalt also increases the risk of foot injuries.
Turf toe is a sprain that occurs when the big toe forcefully bends up beyond its normal range of motion. It’s common in sports played on artificial turf or grass, when your shoe grips and sticks to the surface while your body continues moving forward. But it can happen in other settings, such as in martial arts, or from wearing overly flexible shoes with poor support. The pain is worse when you try to bend the toe up. Once swelling is no longer increasing, the toe can be taped to restrict movement.
Sesamoiditis is inflammation in the tendons associated with the two little bones (the sesamoids) of the big toe. It results in a dull pain in the ball of your foot when you put weight on it, especially when you jump or push off on it. It can occur from repeated pressure on the forefoot during high-impact activities. Biomechanical problems, playing on a hard surface or wearing inadequately cushioned shoes may all contribute.
Stress fractures are hairline fractures, typically in a long bone in the foot, but sometimes in the big heel bone. They can be caused by repetitive activity, or a rapid switch to a higher-intensity training regimen. You may be more prone to them if you have an underlying biomechanical issue, wear poorly cushioned shoes, play on hard surfaces or have low bone density (which can be due to aging or issues such as long-term corticosteroid use). Don't expect swelling, but the area will be tender and may feel warm; pain often increases during activity and lessens after rest. X-rays may not reveal anything for several weeks. Stress fractures often heal on their own, but sometimes a cast or surgery is needed.
Black toe (subungual hematoma) occurs when the toe repeatedly hits against the inside of your shoe, causing blood to accumulate under the nail. It can also result from a single strike, such as kicking a ball. It’s common in hikers, runners, tennis players, even skiers, and can cause extreme tenderness and pain. If the pain is severe, a doctor or podiatrist can drain the toe for quick relief. If the nail is partly separated from the nail bed, the nail may be removed. If the injury is extensive, the nail may fall out on its own and may grow back thicker.
Plantar fasciitis is inflammation of the fascia—the thick band of tissue on the bottom of the foot—that causes heel pain, especially first thing in the morning. It’s common in runners, dancers and people who jump a lot, and is often associated with tight calf muscles. But it can be caused by factors not related to sports or exercise, too: wearing high heels or thin-soled flats, having very flat feet or high arches, being overweight or simply the loss of connective tissue that occurs with age. Regular stretching of the Achilles tendon (behind the ankle) and sole of the foot is key in treatment and prevention.
A podiatrist or orthopedist can diagnose and treat these and other foot injuries. Ice, rest and over-the-counter pain relievers are often the first line of treatment. Customized shoe inserts (orthotics) may be recommended. You may also be referred to a physical therapist, who can suggest better footwear and help you prevent recurrences.