January 12, 2009

Resolutions Gone Wrong

'Tis the season for doctors to see lots of patients with foot and ankle pain. Why? In their effort to stick to New Year's resolutions...
Doctors see it happen every year.

Throngs of former couch potatoes hit the track or the treadmill with well-intentioned but unrealistic exercise goals, driven by a New Year's resolution to lose weight. And too often, it's the feet that ultimately pay the price.

Practitioners who treat sports-related foot and ankle injuries are currently bracing for the annual influx of patients with foot pain linked to New Year's resolutions gone wrong, said Marybeth Crane, DPM, managing partner of Foot & Ankle Associates of North Texas and a spokesperson for the American College of Foot and Ankle Surgeons.

Consider starting out with a walking program, which will be less stressful on the feet and ankles than running. Try to alternate hard workouts with easier ones.

"There are so many people who have made weight loss one of their resolutions, but unfortunately they go about it in a shotgun fashion," said Crane, who is herself an avid runner. "They tend to do too much, too soon, and too fast."

The foot and ankle pain that often follows can come in a variety of forms, including plantar fasciitis and other types of heel pain, Achilles tendinitis, and interdigital neuritis (pinched nerves). (See Figures below).

Figure 1
(Image courtesy of )

Women in particular are susceptible to neuritis as a result of wearing high-heeled, pointy-toed shoes; the added repetitive stress of exercise — especially in shoes that are too tight —can exacerbate the condition.

Figure 2
(Image courtesy of )

To keep foot and ankle problems from derailing your New Year's resolution, the ACFAS recommends consulting a physician or trainer before beginning any type of new exercise program. Wear the shoes that you're planning to wear during exercise so that the practitioner can make sure the shoes provide adequate support and fit properly. If buying new shoes, have your feet measured first.

"A lot of people probably haven't got the right running shoes, and they may not even have shoes in the right size if it's been a while since they exercised," Crane said. "We might weigh 100 pounds more than we did when we were 20, but we still think we wear the same size shoe. That's usually not the case."

Consider starting out with a walking program, which will be less stressful on the feet and ankles than running. Try to alternate hard workouts with easier ones.

If wintry weather has you renewing that expired gym membership, make sure you know how to properly use the exercise equipment. Too many people fail to keep their heels down while using an elliptical machine or cross country ski machine, Crane said, which puts pressure on the ball of the foot and increases the risk of neuritis.

Some minor foot and ankle pain can be self-treated. For heel pain, the ACFAS recommends icing the bottom of the foot before bed and stretching the plantar fascia (Figure 1) by flexing the feet and pulling back the toes, several times per day. RICE therapy (rest, ice, compression, elevation) can help with Achilles pain.

However, if pain persists for five days or more, you should see your doctor. Chances are, you'll be in good company.

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