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Sunday, November 05, 2006

Ankle pain in older runners

I have been running since I was a boy; I won my first school title when I was 10, and since then I have run ever since. In April this year I turned 40, so have been running for 30 years, reasonably consistently.
Whilst I've had my share of reasonably serious injuries (many self-inflicted, but a number being managed as I get older), my biggest concern is after a 1 hour plus run on hard surfaces, my feet and/or ankles just hate it, and I spend the whole run, waiting until it's over. I did a easy 75 min flat run with my mates yesterday, and I just couldn't wait until it was over. In terms of shoes, I wear Asics 2110 at home and work, so a reasonable shoe.
I am actually worried for the first time ever about how this might affect my running. Any suggestions of what I can do? Likely treatment or supplements?
Photo: sometimes, foot and ankle problems are easy to spot; more often, the trouble is not so obvious and, unfortunately, there are no single, quick-fix solutions.
Gary Moller comments:
Thanks, "B", for consenting for this going onto the web: The problem you describe is one of the most pressing faced by "ageing" runners. If not resolved, the runner may be forced into giving running away and we can't have that happening, can we?
The best approach to dealing with foot and ankle pain is to tackle the problem from several different angles and hope that one, or a combination of the following suggestions have a beneficial effect:

  • Run, step and bound barefeet weekly in sand. This is what the great coaches of old, like Percy Cerutty, always had their athletes do as part of their training. When Otago athletes of the 1970's were at their height of national prominence, coaches like Alastair McMurran had regular bounding sessions up the massive sand dunes of the Otago Peninsula (I had the dubious pleasure of doing a couple). This type of training helped develop and maintain strong, flexible feet and ankles. This type of training is all but forgotten nowadays and much to the detriment of runners. This type of training is all the more important as we get into our 40's and older. Joints, muscles and tendons thrive on being flexed and extended through their full range of movement. On the other hand, repetitive and restrictive movement, such as running on pavement is not good for feet and ankle joints.
  • Try different shoes and fit semi-orthotic inner soles. Although I prefer Asics myself, an obvious measure is to try a few different makes and models. The change can be remarkable when it comes to ankle pain. I have 4 different pairs that I rotate, including a pair of Asics designed for off-road running. The semi-orthotics I recommend are Formthotics Active which can be purchased here. A measure as simple as an inner sole change can give relief.
  • Do your ankle and foot exercises. If your feet tire as a long run progresses, the arches begin to drop, shock absorption diminishes and the outer borders of the ankle joints may be bruised which you may really feel upon getting out of bed the next morning! Here is the link to the E-Pub on the subject. Of course, these do not replace sand dune running!
  • Get your leg pulled! Yes, get a strong massage therapist to get stuck into your feet and ankles, working on mobilising all of those tight sinews and joints, including the main ankle joint. Manipulate a child's supple feet and the contrast with a typical runner's feet will shock you. So get into it and don't neglect the sand running which flexes the feet better than any masseur.
  • Take Glucosamine, Chondroitin and magnesium daily. Joint food preparations help guard against arthritis and may even help reverse the process. If the feet and calf muscles are tiring prematurely and cramping, this may be partly due to magnesium depletion which is a near universal problem with older runners. If the muscles tire, then the feet cease doing their stability and shock-absorbing work, thus throwing abnormal strain on the structures of the ankles and feet.
  • Run off-road. Buy a pair of shoes designed for trail running and do all of the long runs on trails. The soft surface and constant adjusting of foot and ankle placement is what those feet were designed for and they love it! Take care at first: your lack of flexibility and dulled reflexes from all that road running means you need to take care initially not to stumble or trip. The foot and ankle pain may be stirred up initially; but should diminish and disappear as the feet and ankles strengthen and regain flexibility with regular trail running.
  • Do cross training. Aqua-Jogging done properly and cycling are my favourites. These enable the ageing runner to continue to develop a huge cardiovascular reserve while sparing muscles and joints that have already given more than a lifetime of faithful service!
(For more about this topic, type "ankle" into the search box to the upper left of this page and search this blog.)

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