As you head to the gym this winter, you’re probably dreaming of toned legs, sculpted arms, a svelte midsection...but what about your feet? We don’t often count them among our finest features, but our feet make the rest of our fitness routine possible. Virtua podiatrist Gerard Collins, DPM, reminds us that they deserve a little more attention – and if you forget about them, they’re likely to ‘speak up’ for themselves in the form of pain or even injury.

If you do experience sudden, acute pain in your foot during exercise, stop. “Don’t feel like you need to power through it,” says Dr. Collins. “That’s just not a good idea. The first line of treatment for a situation like that is rest.” Take a few days off from whatever activity it was that caused the pain in the first place, and then come back to it cautiously. If it no longer hurts, it’s likely safe to continue your routine as usual. But “if you go back after a few days, or a week, and that same pain is there again, it’s possible there’s an underlying injury.” At that point, you should seek medical attention.

Common culprits of acute foot pain during exercise include:

• Tendinitis
  “If the pain keeps coming back in a specific area – say the outside of your foot, just in your inner heel – it’s possible that the tendons in that area have become inflamed,” says Dr. Collins. It’s not a serious problem, but it requires rest, stretching to restore proper range of motion, ice, and anti-inflammatory medication. “Generally this will resolve the issue.”
   
• Plantar fasciitis
  Plantar fasciitis is also an extremely common fitness foe: One out of every two people will experience some form of it at some point in their lives. With this condition, the plantar fascia, which is a band of tissue that spans from the heel to the ball of the foot, has become ‘tight’ or inflamed. Conservative treatment is similar to that for tendonitis – rest, ice, stretching, meds – but more severe cases may need a more aggressive approach. Physical therapy and even surgery are options, but you might also try one of Dr. Collins’ favorite fascia stretches: “Freeze a water bottle, and then put it sideways on the ground. Rolling your foot along its surface gives you stretching an icing in one step.” If you prefer sticking to room temperature, a tennis ball is also a good alternative.
   
• Bone spurs
  Depending on the location of a bone spur, it can seem to ‘suddenly’ crop up when beginning an exercise routine. “Especially if the bone spur is on the heel, for example,” says Dr. Collins. “All of a sudden you’re moving quickly in a pair of sneakers and it’s rubbing against the back of the shoe.” It can feel a bit uncomfortable, or it can cause real pain. Spurs also commonly occur on the top of the foot, or on the big toe joint. If a change of shoes or more cushioned socks solve the problem, it’s not necessary to have the spur removed. “But if it’s a situation where every time you put your shoes on, there’s pain, you may opt to have your doctor shave it down.”

Before Jumping in Feet First

We’ve all heard the cautionary phrase that plays on most workout videos or on the gym’s new membership paperwork: ‘Consult your doctor before beginning a new exercise routine.’ Most people (I’ve been guilty as well!) are quick to blow-off this suggestion. But Dr. Collins’ advice sounds pretty valuable in light of a possible foot injury down the line. Here are his top recommendations:

• Start Slow: You’ve probably heard it a million times – and it’s always hard to squelch the surge of motivation that tends to accompany the outset of a new fitness routine. But starting slow isn’t just important for your muscles, your lungs, your heart...the bones and muscles in your feet need time to meet the increasing demands of high-impact activities.
   
• Get the Right Footwear: You also want to make sure you get the right shoes to fit your new fitness regimen. Lacing up a five-year-old pair of beat-up sneakers you’ve been using to do yard work and suddenly going out to run five miles is a no-no. Your sneakers don’t have to be expensive, but they should be sufficiently supportive. Also be wary of jumping too quickly into the minimalistic/’barefoot’-style shoes that have recently flooded the market, says Dr. Collins. “These shoes can have their benefits, but you need to gradually build up the amount of time you wear them. Start with walking around the house for an hour, and then two, and then more. After that, try a short workout in them before going all-out. You can be very fit and still hurt yourself if you do too much too soon in these shoes.” Dr. Collins has treated an increasing number of metatarsal stress fractures in the era of this ‘barefoot’ craze.

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