Dorsal tendinitis
One of the common mantras of the running world is that you should avoid running too much too soon, or farther than your body is prepared to handle. This is especially important when transitioning to barefoot or minimalist style running.
The obvious reason is that the bones, tendons, and muscles in your feet are not conditioned to handle running many miles without padded shoes right away. All of that tissue is severely underdeveloped from a lifetime of wearing shoes.
Your leg and foot tissues are not sufficiently activated while you wear shoes.
There are 20 muscles within our foot and 12 muscles from our leg that attach to our foot. According to Dr. Michael Nirenberg and Dr. Benno Nigg, while walking in shoes, only the tibialis anterior (a shin muscle) and triceps surae (calf) muscles are needed. When you start a barefoot or minimalist training regimen, all of those parts of your feet which have stayed asleep inside of your shoes are now awakened and exercised quite rigorously. If you don’t proceed slowly you are more than likely going to encounter some pain.
I haven’t worn regular shoes since I busted up my knees while running in sneakers a while back. Since then I have been working at conditioning my legs and feet for running barefoot and in Vibram Five Fingers. Part of that work was in preparation for the 2010 Garage Games CrossFit competition which was held last weekend. In order to be ready for the various endurance segments of the event, I had to ramp up my trail running at a faster pace than was probably appropriate.
A commonly used training metric for increasing one’s running distance is to add no more than 10% of your maximum distance per week.
This is generally good advice, so long as you actually follow it. Unfortunately, since my running had been curtailed for a while as my knees healed, I had to up my training pace much more quickly to ensure I had the legs for the event’s trail run.
I ended up running well and was happy with my performance, my feet however were not. The second day of the event I had to decide whether or not to continue on with an aching foot. Knowing that I would probably regret it if I pulled out early, I stuck it out and finished my last workout. That night though my right foot was pretty swollen and tender. The x-rays I had done the following morning ruled out any fractures, but I was left with a diagnosis of tendinitis in the dorsal (top) tendons of my foot.
As it turns out, pain in the top of the foot is a common reported malady from people starting out with barefoot or minimalist running. It all comes down to doing too much too soon and not giving the foot sufficient time to build up strength.
Barefoot Ken Bob recommends that you avoid pushing off while running and spend some time strengthening the foot with special exercises.
One exercise which he does uses a small 3 to 5 pound weight. With the weight up on top of the toes and your heel resting on the ground, gently lift the weight a few times with the front of the foot. I plan on doing this regularly as soon as my tendons are back to normal, and recommend everybody else who is getting into the barefoot or minimalist trend to do so as well.
I was fortunate that I hadn’t suffered anything more serious like a stress fracture. I had a fracture in my foot about 6 years ago from Jujutsu, and it took several months to fully heal. Just thinking about not being able to run for another two months again has me determined to proceed more cautiously.
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The “gently lifting weight with the foot” exercise can be replaced by gently lifting the entire foot while running. This is just a bit beyond the “don’t push off” advice. By lifting the fore-foot along with the heel (think of trying to keep the foot parallel to the ground – you won’t but that effort should be enough), we not only discourage excess push-off, but also get about a thousand fore-foot lifts for each mile we run. With that many repetitions the weight of the foot is enough.
.-= Barefoot Ken Bob´s last blog ..10 Miles Logged =-.
Thank you Ken Bob! I’m think I’m going to give that a try before I start using weights then. Luckily I do have some small hand weights with a grip that I could easily slip my toes through.
My tendons have healed up pretty well so far; hopefully I will be able to try out your suggestion next week.
Hi David. Thanks for visiting our blog!
We’re getting a lot of experience with foot injuries and PF in particular. I have a case that seems to stem from a foot injury (hard landing when jumping across a creek)- I didn’t think there was anything serious even though it was inflamed and swollen for a month (dumb!) and just kept running on it, but a couple months later, PF showed up. I have become a big believer in icing, and wish I had started much sooner. My advice is to be gentle but persistent, back down rather than fight the injury, then try again. And ice!
As for the advice not to push off on the toes, this will help by lessening the strain on the fascia, but I found a few months of that weakened my leg (calf muscle atrophy). So I’ve begun toe-offing again without any major aggravation.
I’d like to read about your stress fracture story to see how that played out. I think my foot bones are still not recovered.
Cynthia
Hi Cynthia! I agree, icing seems to help a lot. I have started doing it now even if my legs don’t hurt, just in case.. heheh!
As far as the fracture in my foot, it was from several years ago when I use to train in Ju Jutsu. I had a belt examination that night in which I had to demonstrate various techniques. The culmination of the test was to spar each member of the dojo, started with the lowest rank and ending with the sensei. Trust me, it was an exhausting experience.
Little did I know, that at some point during my sparring matches, one of my round kicks must have twisted my foot up. The doctor suspected that the tendons in my foot probably pulled the bone apart. How crazy is that? I’ve always had issues with flexibility, so I didn’t find it too hard to believe. The funny thing is, I didn’t even realize my foot was hurt for the rest of the night. I went out to celebrate with friends and never felt any pain. I guess the adrenaline and endorphins stayed in my system for a while.
The next morning though, I woke up, went to go downstairs and felt a nasty pain in my foot. That was the beginning of a boring two month recovery!
[...] shoes had affected the conditioning of my leg muscles. Not only are very few of the leg’s muscles activated while running in shoes, but the calf muscle becomes shorter in relation to the amount of [...]
It is mainly related to the surface on which you primarily run. Running on a soft surface like a beach or a garden would not cause that much damage as running on a hard surface like a concrete road.
Dr. Gauresh.
.-= Fracture Healing´s last blog ..Bone Fracture Healing =-.
question regarding this topic: (great blog btw)
i’ve picked up running again five weeks ago (with Hal Higdon’s 30 wk novice supreme plan) and in the second week, I switched to forefoot running with my asics. I’ve done this for 4 weeks now and had no real problems. My calves were letting me know that they were there, but no discomfort at all. Now, this week, I interrupted my program for my “five fingers initiation”. i did a half mile run 2 days ago and a mile yesterday, thinking to do a half mile again today (no other running involved).
but when I got up this morning, my outside of the right foot is sensitive (like, really sensitive). I limped for the first few steps out of bed. I’m thinking of not running with my five fingers tonight, but using my asics again instead.
so, would it be ok to:
“warm up” half a mile or so every other run with my five fingers and then switch to my normal shoes for my normal run, but use the forefoot approach as good as possible?
or is it advised not to combine at all and just go for mild runs with the five fingers (and let me foot “heal” before I pick up)?
thanks!
btw: I have no real goal set: so there’s no end date and I’m not planning on running a marathon this year. I was just using Hal’s schedule as it seems a good way to break into a habit.. ( no goal for this year that is )
Keep up the good work
Mr. D – If you haven’t read it already, I’d check out this post: http://naturallyengineered.com/blog/front-side-foot-pain-from-barefoot-running/
In my opinion, if your feet hurt so bad that you are limping I would not run at all. There are many other ways to increase your aerobic conditioning (besides running) that you can do as an alternative till your feet are 100% again.
Thanks so much David for the fast response!
yes, I’ve read that part as well
Maybe I should reformulate my question:
should I continue to focus on fivefingers or move back to normal shoes and gradually inject warm up sessions with fivefingers ’till I’m completely in harmony with them.
If you don’t have any races looming on the horizon (which I think you mentioned you don’t) then I would just go full minimalist, if it is your intention to go minimalist completely at some point.
If your feet hurt, then rest that day and do some other kind of exercise if you wish.
Thanks so much!
I value your opinion and will act accordingly. rest it is !!