1. You have increased your load too quickly

Activity load has one of the highest correlations to achilles and plantarfascia inflammation. People that run casually are more likely to get achilles pain than those who don’t run and marathon runners are more likely to experience symptoms than casual runners. Why is this?

Well when you are running you are potentially putting three times your body weight through your foot (reported by the Saucony shoe company). If you do this more often, your feet and ankles are obviously taking more force. Though you don’t need to be a runner to have pain around your foot and ankle. Pain can come from an increased activity level from sports, hobbies or work.

The British Journal of Sports Medicine reports using a ratio to help reduce the chance of injuries. You simply divide your last week’s exercise amount by your weekly average over the past month. For example if you average 30 minutes of running per week over a month, and then increase your running to 60 minutes a week your ratio is 2. It is advised that you try and keep your ratio between 0.8-1.3 to decrease the chances of injury. This same ratio can be used for standing time, sports and any other activities you do. 

2. You have large abnormalities in your foot posture

(image: medbridgeeducation.com)

Foot posture isn’t a direct correlator to foot/ankle injuries though it is something that needs to be considered. As you can see in the above image, bone alignment is likely to change the way your foot moves and therefore your knee and hip also.

You should also compare your feet on both sides, if you have large differences side to side, this may have larger impacts on injuries. Your physio can easily test how much your foot posture influences your injury by placing tape around your foot. If this helps your symptoms, you may benefit from foot posture training, orthotics or shoewear changes.

3. You lack flexibility

If you lack flexibility in your lower limb joints and muscles, you may place yourself at a greater risk of injury. Muscles to consider are your hamstrings, calf muscles and plantarfascia.

As you can imagine, if you have restrictions in your movement, you may make compensations that can lead to problems with your lower limb.

To measure your hamstring length at home check the below image. You should try and aim for a straight line between your knee and your ankle. In this image, the client lacks flexibility. Note that this isn’t a perfect test and you should only stretch gently.

(Image credit: Aspetar.com)

A great way to measure your ankle flexibility is by performing a knee to wall test. In performing this test you must keep your front heel flat and try to touch the wall with your lead knee. Put down a tape measure on the ground and take a number, the average result is 10cm. If you feel a severe stretch or pain, you may be experiencing some ankle restrictions that can lead to injury. It is important to compare both sides and ensure they are similar.

(image credit physio-pedia and The Physio Channel)

4. You are overweight

There isn’t an easy way of saying it, being overweight increases your chances of foot and ankle pain. For every extra kilogram you carry on your body, this is equivalent to four kilograms through your knees, hips and ankles according to osteoarthritis research. If you multiply this force with the number of steps you take a day, you can understand the level of load being placed through your lower limbs.

If you have also gained weight quickly, this again may increase your likelihood of experiencing symptoms. Ways of managing your weight include paying attention to your caloric intake and activity level. 

In summary, to avoid achilles and plantar fascia pain, manage your load appropriately, manage your weight, ensure you stay flexible and keep an eye on your foot posture.

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