Before beginning any training plan, check in with your doctor or certified training professional to talk about what is right for you.
I noticed a burning sensation in my feet for the first time during the early days of the COVID-19 pandemic. At first, it was a faint flare, only becoming apparent after a lengthy run. Then it started to nag me, becoming a hard-to-ignore ache even on moderate training days. Before I knew it, I was struggling to run a single treadmill mile at the gym. I couldn’t ignore the pain anymore.
A trip to a specialist and an MRI revealed a plantar plate tear in my right foot. I went under the blade to repair it two months later, but surgery was just the beginning. After leaving the hospital with a hopeful mindset, I embarked on a six-month recovery as challenging to my usually tireless mind as it was to my 30-year-old body.
After my right foot healed, persistent pain in the left one eventually led my podiatrist, Colorado-based Dr. Jared Menchin, to diagnose me with osteoarthritis. Dr. Menchin told me, “Lower extremity injuries are common in long-distance runners and endurance athletes,” and the majority of those injuries were due to repetitive strain. So, I wasn’t alone in my experience, but I took little comfort in my body’s limitations. There was a high chance that I’d worsen my condition if I continued running at my current pace. Something had to change.
Previously, when my anxieties grew loud enough to make me lash out at friends and family, I went for a run. The wind sweeping through my hair calmed me down, and the repetitive movements and open-air workouts grounded me. I felt most myself with a pair of trail runners on. What’s more, people perceived me as an athlete. Labeling myself as injured seemed like the end of myself as I knew it. Who was I if I wasn’t a “runner” anymore?
1. Listening to your body is essential—and difficult
This wasn’t my first bout with foot pain, but it was the first time I had to wonder whether my body might not love endurance running as much as my mind. Unlike minor aches and pains, these issues had long-term implications that caused me to slow and eventually stop. Although my instincts were always to run farther and witness what would greet me on the other side of a ridgeline, I’m apparently more prone to foot injuries than others.
Dr. Menchin points out that the heavy load endurance sports “place on the body can be too much for some people, especially those with preexisting conditions like joint arthritis, cardiovascular problems, or biomechanical issues — like with gait or foot strike — in their feet and ankles.” Repetitive stress, particularly from running, can lead to overuse injuries in the lower limbs, including tendinitis and stress fractures. “Not everyone is built for the rigors of long-distance training, and it’s crucial for people to recognize their own limits,” says Dr. Menchin.
I’d been ignoring my limits for years, looking the other way when a new ache emerged. Most of the time the problem seemed to resolve itself, and I was back on my feet. This time, things were different. After 15 years, was I no longer cut out for running?
The answer is not so simple. Health practitioners’ views differ about what constitutes “too much,” and for whom. Colorado-based physical therapist Gabe Dorn is a lifelong athlete and specializes in endurance sports. He says that most people — barring chronic health conditions or systemic disease — should be able to participate in endurance sports in some way. “It is very rare that someone cannot participate,” he says.” Staying consistent with endurance activities like running may be more about regulating volume or intensity, or building appropriate muscular strength, for example.
2. Slow down and lift more to become a stronger runner
Amid my foot struggles, I started lifting weights more consistently. I quickly learned that a major part of building strength was time under load, or slowing down the tempo of each rep. In fact, research shows time under tension matters more than number of reps for building strength. When paired with a progressive overload — i.e. gradually increasing the weight week after week — this type of training has a significant impact on overall strength. As someone who’d always defined herself by distance and quantity, adapting to prioritize quality was a monumental task. Yet, over time, I noticed my muscles strengthening and the slow, consistent weight lifting sessions paying off.
So, I applied the same theory to running. When the burning sensation in my foot started to fade, I dared to jog again. Dr. Menchin told me I could start with a five-minute run as long as I was pain-free, then slowly increase that window of time.
One of the biggest mistakes a runner can make is running too much too soon, Menchin says. “You want to allow your body to adapt to the increased stress of longer-distance runs without risking overuse injuries. One study showed that 60% of injured male runners and 50% of injured female runners [had] increased their weekly running distance by greater than 30% in the month prior to injury.” In the past, I’d been known to go from the couch to a marathon—and took pride in my fast-tracked conditioning. Through an array of injuries, I started to realize that my body could only tolerate so much stress.
“Incorporating strength training into your routine can significantly reduce injury risk, as strengthening your core muscles and the muscles around your hips, knees and ankles helps build stability, providing better support during long runs,” Menchin says. So, in the event that I could return to a running life, strength training should still remain a part of my regimen.
3. You are not the sum of the things that your body can do
On a philosophical level, getting injured also made me realize that how I quantified myself was “flawed.” In my culture, it’s common to define oneself by a career or relationships. I’m a writer. I’m a sister. Truthfully, though, this frame of thinking is fragile. The second I relinquished my morning runs, part of my self-perception and identity crumbled. The reality is, even if I stopped all the activities and work I currently do, I’d still be somebody.
“In any given year, the majority of runners will get injured from a running-related injury, and some of that is out of their hands,” Dorn tells me. But some of this strain can be avoided by running less overall or by gradually increasing mileage, especially when training at higher intensities “where forces through the body tend to be higher.”
As I navigated a long injury cycle, learning how to adapt to my circumstances and more widely define my role in my community demonstrated to me that I create my own reality. Maybe it was enough to no longer place high-volume distance running at the center of my life, and to shift to new or adjusted hobbies.
4. Risk management can support longevity in sports
Osteoarthritis was a tragic diagnosis for me in many ways; instead of an acute injury that could be healed, I was dealing with the consequences of poor biomechanics and overuse. Managing the condition wasn’t as simple as following a rehab protocol. Instead, I had to fully grasp my body’s nuances, and honor its limitations—and I’d never been good at the latter.
“For runners, osteoarthritis in the feet can present a significant challenge, but with the right strategies, it is still possible to maintain an active lifestyle,” says Menchin. “The goal when treating osteoarthritis conservatively is to try to decrease motion in the affected joints.” There are a number of ways to accomplish this, including by wearing stiff-soled, well-cushioned footwear and orthotics, when necessary. “Moderating your activities, not overtraining, and substituting [running with] low impact activities such as biking and swimming can be helpful as well,” Menchin adds. Those who don’t find success with moderate treatments should work with a healthcare provider to determine next steps, which may include physical therapy, steroid injections and/or surgery, in more extreme cases.
Staying mindful during my runs allowed me to slowly increase the distances my body could tolerate. While I used to ignore small aches and pains after runs, I’m now much more receptive to what they might indicate—and I adjust accordingly. While running looks very different for me now than it used to, I count myself lucky to get back on the trail with a new perspective.