From our decades of patching up countless joggers, athletes, and marathoners, my team and I have dubbed plantar fasciitis, stress fractures, Achilles tendinitis, and sesamoiditis the “Sneaky””—the stealthy foot injuries behind most running grief. On the surface, they seem like minor bumps on the road, but these sneaky injuries can sideline even the best runners if left unchecked. In this section, we’ll equip you with the information to recognise these injuries early, understand why they strike on the sly, and give you a simple guide to finally beat them for good. Consider it your insider’s guide to outsmarting running’s most common foot injury troublemakers!

Plantar Fasciitis 

When you experience pain on the first step, it could be your plantar fascia saying hello! We had a client, Sarah, a regular marathon runner, who woke up one morning with a searing pain in her heel, like someone had stabbed her with a tiny knife. Walking felt like stepping on broken glass, but she continued to go on her days like nothing happened. After ignoring the pain for a few days, it only worsened, forcing her to visit us at Run Ready. I told her she made a great choice by consulting the experts on foot pain! Rest, ice, stretching, and supportive shoes became her new training partners, and she learned to listen to her body’s subtle messages before they turned into full-blown ouchies.

Our plantar fascia is a shock-absorbing tissue that runs along the bottom of your foot, keeping arches taut. Repeated pounding fatigues it until inflammation strikes – AKA plantar fasciitis. While most runners associate it with normal heel pain after resting, you can experience arch and midfoot soreness if the irritation spreads. If you get suspicious of this heel pain, make your move quickly because if it’s left untreated a simple inflammation of your plantar fascia can leave you doubling in pain and get worse. The causes of plantar fasciitis can range from overusing the tissue or increasing intensity too quickly. If you have rigid arches, use worn-out shoes, run on hard terrain, and run with too much weight, it can put extra pressure on your plantar fascia. Some of the ways we can help runners with their PF are by using custom orthotics, wearing the right shoes, doing calf and foot stretches, mobilising tissue gently, and modifying training as needed.

Stress Fractures

Stress fractures can go unnoticed for a long time. If you’ve ever felt a vague and dull pain on your foot, but can’t pinpoint exactly where it hurts, a stress fracture could be the silent culprit. Continuing to dismiss this pain as an after-run pain can break your bones and end up in a complete fracture! These tiny cracks in our metatarsals result from accumulated impact over time. When you increase your running load more than you can handle and if your bone structure can’t keep up, your bones bear the increased pressure leading to miniature fractures. Carefully monitoring the intensity and training load together with resistance exercises builds stronger feet. But, if we confirm that you have a fracture, we use special boots to immobilise your feet and provide you with pain management and relief from inflammation. 

Sesamoiditis

Ever had a sharp, burning ache under the big toe joint? I experienced this once and it felt like my toe was going to fall off from the intense pain! Nestled beneath your big toe lie two pea-sized powerhouses, the sesamoid bones. They act like pulleys, guiding your big toe and absorbing the pressure of every step. But when these tiny titans get overworked or squished by tight shoes, they throw a temper tantrum – enter sesamoiditis. Runners who crank up sudden mileage increases tend to stress out these bones. Poor shoes lacking cushioning or support under the toe box also rub and squeeze. Flexible feet help share load but some biomechanics overload sesamoids. Special pads and taping ease friction while we strengthen toe flexors long-term. Activity modification takes full weight off the sesamoids initially too. Catching this big pain early prevents chronic sesamoiditis or stress fractures. So listen to any odd toe twinges!

Achilles Tendinitis

When you wake up in the morning, you can feel some swelling, stiffness, burning pain, redness or difficulty in movement throughout your heel. You ignore this and think, well, it’s because I haven’t exerted pressure on it the entire night. Wrong! That’s likely Achilles tendinitis brought on by repeated microtears to this tissue that connects your calf muscles to your heel bone. I had a client named, Steve, who specialised in short-distance running or sprints, who came into the clinic complaining that he was feeling heel pain after he pushed himself to train regardless of the lingering pain on his heel. I took a look at his heel and saw that it was swelling, red, and very warm to the touch! My suspicions were correct. He was already suffering from Achilles tendinitis which was eventually resolved with aggressive load management. Because his heel had been damaged, Steve gave up running short distances and switched to running middle distances to keep his tendon happy! 

Repeated stress or overuse from running, jumping, or even wearing improper running shoes can cause Achilles tendinitis. When you visit us, we check for tiny calcifications called microdactyls on imaging that show your tendons crying out for help. Landing too hard, quick acceleration/deceleration, uphill running, and rigid calves all overload your Achilles over time. Sports physiotherapists like myself recommend effective treatment plans that include rest, ice, exercises, heel massages,  the use of shoe inserts, and potentially orthotics. Adjusting your training load and correcting training form gradually can also allow your injured tendon to heal while you rebuild strength.