Foot and Ankle Running Injuries for Girls and Teens
Last month’s blog introduced our readers to a great group we support called Girls on the Run of Ottawa and Allegan Counties.
To briefly recap, Girls on the Run seeks to inspire 3rd through 8th grade girls to discover their inner strength and confidence and chase their dreams through 10-week running programs that culminate in a 5K event.
If you didn’t get a chance to read it earlier, check it out and learn more about the impact it is having in the lives of girls throughout West Michigan.
We don’t need to tell you how important it is for girls, boys, and people of all ages to stay active and get plenty of exercise. Running is a great way to do it! It doesn’t cost much money or require fancy equipment; you can do it anywhere and you can do it alone or in groups. The barriers to entry are low.
But unfortunately, running can also lead to injury. In this month’s blog, we’ll take a look at some of the most common ones—with a special focus on young runners.
For most runners, the heel is the first part of the foot to make contact with the ground on every stride. As a result, it must handle significant impact forces. Heel pain is therefore a very frequent symptom.
For adolescent and teen runners, the most common heel pain condition is Sever’s disease, also known as calcaneal apophysitis. This is not actually a disease, but an inflammation of the growth plate of the heel bone.
During childhood and adolescence, the growth plate—an area of softer tissue responsible for forming new bone—is relatively exposed and vulnerable to injury. This is especially true during growth spurts, when a child’s bones (and the muscles, tendons, and other structures that attach to them) are developing rapidly.
If an older teen or adult starts feeling pain along the bottom of the heel, the cause is more likely to be plantar fasciitis. This condition is the result of irritation of the plantar fascia, a tough band of fibrous tissue that runs across the entire sole of the foot and supports the arch. If your heel pain is especially noticeable right when you get up in the morning, it’s another likely sign of plantar fasciitis.
Pain on the back of the heel, is often indicative of Achilles tendinitis (although there are a few other possibilities), a condition in which the Achilles tendon becomes inflamed. Often the pain stairs as a dull, aching stiffness, but over time pain may become sharper.
Stress fractures are thin cracks that develop in the surface of bones, usually due to overuse. Due to foot structure, improper support or changes in activity level, the bones receive an increased level of stress which can cause a crack in the bone.
Although stress fractures are possible in almost any bone, they are particularly common in the feet (especially the long metatarsal bones) and lower leg. Teen girls and young women may be especially susceptible to stress fractures for a variety of reasons, including lower bone mineral density and muscle mass when compared to male runners.
Unfortunately, stress fractures often require several weeks of rest to heal and can worsen significantly if you continue to exercise or restart too quickly. That can be difficult for kids and athletes who want to stay on the go. Surgical treatment is usually not necessary but evaluation and treatment by a podiatrist is recommended.
The term shin splints doesn’t necessarily refer to a single, specific type of injury. It could be used to describe any kind of overuse injury to the area surrounding the tibia, also known as the shinbone. This could include stress fractures to the shinbone itself, as well inflammation or irritation in the muscles, tendons, or other soft tissues surrounding it.
Shin splints are especially common in young runners. Recent evidence suggests that girls may be twice as likely to develop them as boys. Shin splints are often due to the calf muscle being too tight, causing overuse of the muscles on the front of the lower leg. Rest and stretching are often the simple answers to this problem.
Toe and Toenail Problems
Running often leads to toe trauma, usually do to poorly fitting shoes. Kids and teens in particular often struggle with toe injuries because their feet are always growing. This makes it more difficult for their parents to keep them in shoes that fit properly.
If shoes are too tight, they can pinch and put downward pressure on the nails, increasing the risk of problems such as ingrown nails. But if you try to “cheat” and get your child shoes that they can “grow into,” the results can be just as bad. Shoes that are too lose can slide around and slam into the front of toes over and over. The repetitive trauma can lead to bruising and bleeding under the nail, and in severe cases the nail may even come off.
Helping Your Young Runner Prevent and Treat Injuries
An ounce of prevention goes a long way. Here are some tips that can reduce the risk that the young runner in your family will suffer an injury:
- Start slow. If your little one is a beginner, or still working her way into shape, make sure she doesn’t try to go too hard, too soon. Make sure she starts with a distance, pace, and duration she can handle, and then slowly increase the difficulty by no more than 15 percent per week.
- Make sure she has the right shoes. A good pair of running shoes are critically important. They should fit your child’s feet just right—not too big, not too small. Go to a running store, if possible, and have the shoes fitted.
- Encourage her to try a variety of sports and activities. Running is great, but if you run every day (or even just overspecialize high-impact sports) you are more likely to develop overuse injuries. It’s especially important to cross-train in some lower impact activities, too. Go to the pool, or take a long bike ride!
- Make sure she’s eating a healthy diet—and getting a good night of sleep, too. Proper nutrition and plenty of recent are crucial for both physical and mental wellbeing. It will also help her recover faster from injuries, too.
- Always warm up and cool down. Warming up allows the muscles to get into “activity mode” safely, while cooling down helps restore a resting heart rate gradually and prevents cramping. Always be sure to stretch before and after activity.
- Don’t let them play through pain. Kids can be stubborn and not want to come off the field but ignoring pain will only make the injury worse. If your child is treated promptly, she’ll spend less time overall recovering and more time enjoying activity!
About that last point …
At Northwood Foot and Ankle Center, we provide expert care to runners and athletes of all ages, including grade schoolers and teens.
Young athletes often require a different treatment approach than their parents or grandparents do. We love working with kids and understand how to optimize our treatment protocols for their still-developing feet and legs.
Each treatment plan is customized for the individual athlete, with respect to their age, injury, and individual goals. We may recommend physical therapy, balance exercises, modified activities, custom orthotics, or other protocols based on need.
In order to achieve the fastest and best results, it’s critically important that all of our recommendations are closely followed. As a parent, you may have to keep a close eye on your young runner and help them stay focused and disciplined during their recovery. We know, it isn’t always fun—but in the long run, it means more happy and healthy running and a lot less pain!
To schedule an appointment with the pediatric sports injury experts at Northwood Foot and Ankle Center, please call our practice at (616) 393-8886. We have offices in both Holland and St. Joseph for your convenience.