Run smart: Tips to avoid common overuse injuries

Running-Barnes-Jewish-hospitalIf you enjoy running, but put it off during what was a very long and cold winter, you’re not alone. As warmer temperatures have arrived to our area, it’s important to resume physical activity gradually, to avoid common foot and ankle overuse injuries like plantar fasciitis or stress fractures.

Plantar fasciitis is an inflammation of the thick ligament in the bottom part of the foot. This irritation can occur when someone becomes active after a long period of rest. Symptoms include heel pain, usually with the first few steps in the morning, which then improves as the fascia ‘warms up’ and stretches out.

Stress fractures are weak spots or small cracks in the bone caused by continuous overuse. For runners, the bones in the forefoot can be especially vulnerable to stress fractures. Symptoms may include tenderness over a specific spot in the bone, swelling of affected area, or increased pain with activity.

“When our bones are not ready to respond to the stress of intense physical activity, abruptly resuming a workout regimen can increase the chance for injury,” said Jeremy McCormick, MD, a Washington University orthopedic surgeon at Barnes-Jewish Hospital, who specializes in foot and ankle problems.  “While the inclination can be to go hard when resuming exercise, it can do much more harm than good if your foot and ankle aren’t ready for it.”

In order to prevent potential injury, it’s recommended to start with low-impact activities, such as biking, and build up to more high-impact activity as your body allows. It’s equally important to gradually increase endurance and intensity, regardless of the type of exercise you prefer. Proper stretching before and after a run is also important to injury prevention.

“Before you start running, make sure you have supportive, properly-fitting shoes. Shoes are your ‘equipment’ when you run,” said McCormick. “You wouldn’t play basketball with a ball that doesn’t bounce, so don’t run with old, unsupportive shoes.”

Treatment for these injuries can vary, but many don’t require surgery. Patients generally can overcome these injuries with a walking boot, physical therapy, stretching exercises, splints or other treatments, depending on the type of injury. Surgery is sometimes required for stress fractures that don’t heal, so it’s important to seek an examination if you believe you’ve sustained a stress fracture.

One of the more innovative treatments Dr. McCormick and other Barnes-Jewish Hospital orthopedic surgeons use is shockwave therapy, a noninvasive method for treating chronic heel pain caused by plantar fasciitis. This therapy involves a delivery of high-energy impulses to the area of maximal tenderness on the heel. The body’s natural inflammatory and healing response then heals the tissue and allows recovery. It has proven to be a very promising technology that is extremely safe and does not require downtime from day-to-day activities.

“Listening to your body, and respecting its limits is the best advice I can give,” said McCormick. “It’s always easier to treat something before it becomes a chronic issue, so don’t ignore pain if it doesn’t go away after a few days.”

The Washington University and Barnes-Jewish Orthopedic Center treats both teen and adult patients.  To schedule an appointment with Dr. McCormick or another specialist, call (314) TOP-DOCS or visit

Patients who experience a sprain, strain, or fracture can be seen without an appointment at our Injury Clinic in Chesterfield which is open later during the week, and until noon on Saturdays. These extended hours benefit kids in sports, working adults and weekend warriors.

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Category: Orthopedics

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Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and the largest private employer in the St. Louis region. An affiliated teaching hospital of Washington University School of Medicine, Barnes-Jewish Hospital has a 1,800 member medical staff with many who are recognized as "Best Doctors in America." They are supported by residents, interns and fellows, in addition to nurses, technicians and other health-care professionals.

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