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American Orthopaedic Foot & Ankle Society

Running (Getting those feet in shape)

AOFAS offers some prevention tips for a pain-free summer

(Rosemont, IL – July 7, 2009) Injury-free running is the goal of any runner, whether a serious competitor or a weekend warrior out for a pleasure run. The American Orthopaedic Foot & Ankle Society also wants people to enjoy physical activities, such as running, without doing any harm to their foot or ankle.  By taking a few careful steps, both before, during and after running, injuries may be avoided or certainly kept to a minimum.

AOFAS offers runners a few preventative tips when getting started:

  • Use footwear that offers good shock absorption and excellent support. Make sure your toes do not rub in the toe box of the shoe.  Shoes wear out after 400 miles of use; it’s time to replace that footwear.

  • Since our feet are unique, be sure to choose a pair of running shoes that are comfortable. A well-supported, comfortable shoe is the best one for your foot. A stiffer heel counter of a running shoe gives more rear foot control protecting the foot and ankle from rolling. 

  • Warm up and stretch both before and after running. Be sure to stretch the gastrocnemius (calf) and quadriceps (thigh) muscles, otherwise known as a “runners stretch.” Stretching the hamstrings is also important.  Core strengthening exercises should also be included to improve balance and potentially prevent injuries.

  • Run on a shock absorbing surface, such as a running track, that decreases the pounding to your feet and legs.  When just starting running or returning to it after a long while, the smooth track surface will allow you to avoid “surprise” irregular roots, rocks or inclines that can cause sprains when the ankle isn’t prepared for that type of strain.  The treadmill is often used by beginners.  This machine can cause overuse injuries since the same stride and step is used over and over again.  It is best to begin on a track rather than a machine.

  • Start slowly, working your way up in both distance and intensity.

  • Begin your sessions with a slow walk progressing to a slow jog before picking up speed, especially in the early stages of training.

  • In the beginning stages of running, it’s important to allow your body a day off between runs to rest, especially if you’re feeling sore.

  • Start running on a flat terrain and progress to running hills.  The up hills tend to apply added stress to the Achilles tendon, a commonly-injured structure in runners.  Additionally the down hills create more pounding on the knees, hips and back.  Work up to the hills!

The AOFAS also offers some excellent Technique Tips for runners since an important part of prevention includes proper running technique.

  • Avoid trying to over stride, or taking too wide a stride, by having your feet land just beneath your hips.

  • Keep your shoulders back and your hands comfortable and lightly cupped.  Avoid clenching your fists to avoid creating tension in your shoulders and arms.

  • Maintain your elbows at 90˚ and close to your body. If your elbows flare out, it will make your upper body less efficient.

AOFAS member Judith F. Baumhauer, MD, of the University of Rochester School of Medicine states that, “Symptoms are a great guide in running. Common sense is a good barometer of when something is wrong and professional help is needed. A running shoe often comes with a well- cushioned arch support.  If you have the need for extra cushioning, an over-the-counter insert can be used. In this day and age, the materials used in the over- the-counter inserts are excellent for cushioning or for applying extra pads (such as a metatarsal pad) for toe joint pain or a neuroma.  I call this “Mcgivering” the insert to customize it to you.  There are some differences among over-the-counter supports that affect their usefulness.  There are rigid ones that are not very cushioning and can be awkward to run in; therefore I would recommend a softer, cushioned insert.  The length of the insert can be either three-quarter or full-length.  I recommend full-length for running as I think the ledge on the three-quarter length ones can be uncomfortable.” 

She continued, “Another important, and commonly unknown factor for people living in geographic areas where there is not enough sunlight, such as the northeast, is to have an adequate dosage of Vitamin D and calcium for both men and women.  A deficit in these areas can increase your risks for stress fractures due to the increased load on the foot with running.  This re-emphasizes the need for cushioning and shock absorption in the shoes.”

For additional information or to find an AOFAS orthopaedic surgeon in your area, go to



The AOFAS promotes quality, ethical and cost-effective patient care through education, research and training of orthopaedic surgeons and other health care providers. It creates public awareness for the prevention and treatment of foot and ankle disorders, provides leadership, and serves as a resource for government, industry and the national and international health care community.

About Orthopaedic Foot and Ankle Surgeons

Orthopaedic foot and ankle surgeons are medical doctors (MD and DO) who specialize in the diagnosis, care, and treatment of patients with disorders of the musculoskeletal system of the foot and ankle. This includes the bones, joints, ligaments, muscles tendons, nerves, and skin. Orthopaedic foot and ankle surgeons use medical, physical, and rehabilitative methods as well as surgery to treat patients of all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle.

Orthopaedic foot and ankle surgeons work with physicians of many other specialties, including internal medicine, pediatrics, vascular surgery, endocrinology, radiology, anesthesiology, and others. Medical school curriculum and post-graduate training provides the solid clinical background necessary to recognize medical problems, admit patients to a hospital when necessary, and contribute significantly to the coordination of care appropriate for each patient.


AOFAS members have the following credentials:

  • Completed four years of medical school. The curriculum covers basic and clinical sciences, surgery, internal medicine, pediatrics, family medicine and all other medical specialties.
  • Completed five years of accredited graduate medical education (residency training) in orthopaedic surgery.
  • Many orthopaedic foot and ankle surgeons also complete advanced fellowship training in foot and ankle surgery.
  • Satisfactory completion of the national medical licensing examination.
  • Continuing medical education credits over a specific time period.
  • Board certification: Certified by or eligible for examination and certification by the American Board of Orthopaedic Surgery or the American Osteopathic Board of Orthopedic Surgery.
  • Each member must hold membership in the American Academy of Orthopaedic Surgeons (AAOS).

When selecting a medical provider to care for your feet and ankles, be sure to ask him/her about:

  • Medical school education
  • Accredited residency training
  • Areas of practice specialization
  • Experience in your prescribed treatment (surgical and/or non-surgical)



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