David, a recent patient at Wellness Embodied has been struggling with his trail running. He usually runs 3-4 x per week but lately was only managing one run due to waking up the next day with severe pain and swelling around his ankle. When we asked David about his training he told us that the intensity, volume or frequency hadn’t changed, and he was running the same trail he usually does. He was maintaining his normal warm up and warm down routine and he even tried cutting down distance without improvements in pain. 

With further investigating however, we found out that he had recently changed his shoes! We completed a gait assessment and inspected his running shoes, and found his new shoes allowed excessive pronation of his mid-foot causing a stress reaction to the tendons of his lower leg. The additional movement was being counteracted by increased tension in the muscles, and with the thousands of cycles that occur during a long trail run, the over-activity of the tendons was causing an inflammatory response.

 David liked his new shoes and didn’t want to have to replace them, so we decided to make some temporary adjustments and focus on improving the strength and control of the muscles controlling the ankle and foot. We taught David about the inflammatory response and the healing stages of acute injury. With a little bit of education, David now knows how much is too much, and how to recover optimally, allowing his body to adapt to the stimulus and recover before subjecting it to more stress.

We off-loaded the affected tendons using a temporary foam arch support, and began strengthening the intrinsic foot muscles, now David is building strength, capacity and resilience and is back out on the trails!