As physical therapists, we tend to see runners only after an injury has occurred and often, we feel that many of these injuries may have been prevented. Runners often focus on building endurance, improving speed, and perfecting form through running and only running. However, one area that is sometimes overlooked but holds immense importance is the addition of strengthening exercises for the ankles and feet. These smaller yet vital components of our lower body play a crucial role in maintaining balance, absorbing shock, and propelling us forward with each stride. Incorporating specific exercises to strengthen these areas not only enhances performance but also helps prevent injuries, ensuring you can continue pounding the pavement for miles to come.
The Importance of Ankle and Foot Strength for Runners
Ankle and foot strength serve as the foundation for a runner's stability and endurance. Strong ankles and feet provide better support for the entire kinetic chain, reducing the risk of overuse injuries that commonly plague runners. By improving the strength of these muscles, you enhance your ability to maintain proper running form, even when fatigued, leading to more efficient and injury-free running.
Common Foot and Ankle Injuries in Runners
Runners often encounter various foot and ankle injuries due to the repetitive nature of the sport and the impact forces generated with each step. Some of the most common injuries include:
Plantar Fasciitis: Irritation, degeneration, and thickening of the plantar fascia, a dense, fibrous connective tissue intricately attached to the heel, toes, and many of the surrounding muscles and structures on the sole of the foot. Symptoms include sharp, localized pain at the bottom of the foot with the first few steps in the morning, as well as after periods of prolonged rest. Aggravating activities include standing, walking, and running. The fascia shares common characteristics with tendons and appears to have a correlation between mechanical load and pain.
Achilles Tendinopathy: Inflammation, degeneration, and thickening of the Achilles tendon, which connects the calf muscles to the heel bone. This may occur in the middle of the tendon or at the portion of the tendon that attaches to the heel bone. This condition generally occurs due to an increase in intensity, frequency, or volume of Achilles tendon loading activity which exceeds the capacity to recover and adapt properly. Symptoms include sharp pain around the Achilles tendon with activities such as walking, running, and jumping. Pain may improve some with activity due to the warming effect of the tendon but worsen with prolonged activity.
Ankle Sprains: Stretching or tearing of the ligaments that support the ankle joint, often resulting from rolling or twisting the ankle. These are graded on a scale from 1 to 3 with 3 being the most severe and requiring the most time to recover. Symptoms may include pain, swelling, and bruising around the injury. It may also be difficult to place pressure through the injured limb or properly balance during single leg activities.
Shin Splints: Shin splints, also known as medial tibial stress syndrome, is the most common running related injury. Although the exact nature of the condition isn’t well understood, it is believed to occur from overloading of the bone due to increased muscle contraction and impact landing which exceed the body’s capacity to recover and make positive adaptations. Symptoms include pain along the bottom 2/3 of the inside of the shin bone which is provoked during or after physical activity and is reduced with relative rest. There may also be discomfort with palpation in this area.
Key Exercises for Ankle and Foot Strength
Incorporating a strength training routine with targeted exercises a couple times each week can help prevent these injuries and improve overall performance. Here are some essential exercises to include:
Calf Raises: Should be completed in standing and sitting to target both large calf muscles. Stand with your feet hip-width apart and rise onto the balls of your feet, lifting your heels as high as possible. Slowly lower back down and repeat for multiple reps. Perform a wall sit and raise the heels high off the ground for multiple reps.
Ankle Raises: Lean your back against the wall and slowly lift the toes and foot off the floor towards your shins. Repeat for several repetitions to strengthen muscles around the shins.
Toe Yoga: Place a small towel on the floor and use your toes to scrunch it up towards you. Lift the toes in the air while maintaining 3 points of contact on the ground with the foot. Spread the toes open and squeeze the toes together. Repeat for several repetitions to strengthen the muscles on the underside of your feet and surrounding the toes.
Resistance Band Exercises: Use resistance bands to perform exercises like ankle inversion and eversion to target the muscles surrounding the ankle joint.
Balance Exercises: Stand on one leg for increasing durations of time to improve proprioception and balance, which are essential for stability while running.
Plyometric Exercises: Utilize double leg rebound jumps by starting on two legs, jump up and down as high and as quickly as possible while maintaining legs straight and push the ground away from you with ankles and toes. Incorporate variations by performing a similar exercise with lateral and forward and reverse jumps to build capacity in different planes.
Conclusion
Incorporating ankle and foot strengthening exercises into your training regimen is essential for runners of all levels. It is important to choose the exercise that challenges you the most but allows you to perform high quality reps. Gradually increasing the difficulty of your routine over time will help to build capacity in these areas. By building a strong foundation, increasing stability, and improving endurance, you not only enhance performance but also reduce the risk of common injuries such as plantar fasciitis, Achilles tendinopathy, ankle sprains, and shin splints. If you are unsure where to begin but want to make sure you can prepare your body to stay ready for race season, we invite you to check out our performance plus program. Remember, a little investment in ankle and foot strength today can pay off with many injury-free miles tomorrow.
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