Injury screening for runners part 1: the foot and ankle / Go Go Physio

Go Go Physio has been talking to the lovely Can-Tooers again about injury prevention in runners. This week it was the ultra marathon runners in Randwick's turn, who are 5 weeks into their training. I have discussed previously in this blog, the warning signs of the main running injuries. Last week I discussed a few simple injury screening tests a runner can do to highlight an area that may be more susceptible to injury. This blog will exclusively look at screening the ankle/foot. Calf tightness is one of the earliest signs that something may need looked at. Common causes can be introducing hill or speed work, increasing weekly mileage and increasing training intensity. Another factor is exercise you do in addition to running – if you’ve started to introduce gym sessions and running on the same day, or the following day, the calf may already be somewhat fatigued before you start. There are 3 simple tests a runner can do, firstly assessing for calf tightness, then secondly calf strength and finally assessing the plantar fascia.

1. Assess calf tightness:





Keeping the bent leg's knee against the wall take the back leg back keeping it straight and make sure both heels remain flat on the floor. Compare left and right. You can measure the length from the wall to the back leg's big toe. We are looking for an asymmetry indicating a tighter calf muscle on that side.


Treatment - dry needling, massage, foam roller massage


2. Assess calf strength:





The easiest way to do this is a single calf raise. Stand on 1 leg with your finger tips on a wall/ table for balance (not to push up from). Push up onto your toes and slowly down again. Do as many as you can, lifting up as high as you can. Count the repetitions and compared left and right side.

As a runner achieving 40+ reps on each leg seems to indicate a strong calf. Below 30 might suggest a lack of endurance. It's not a good idea to do this test, or strengthen the calfs when they are tight.


Treatment - 2/3 sets x 25 reps of single calf raises as an exercise


3. Assess the Plantar fascia:


PF length


Sit on a chair with your knees and hips flexed to 90 degree. Get someone to lift your toe on the left and right side. This tightens the plantar fascia giving us a simple measure to work from. Again we are looking for an asymmetry. About 70 degrees seems to be the normal but as always everyone differs.


Treatment - Stretching on a wall, rolling a ball on the bottom of the foot


So get checking for subtle differences, prevention is always better than managing injuries in the long term.