1537FIX YOU: Overcome instep pain

FIX YOU: Overcome instep pain

Kelly Robinson from Six Physio will be here each month to answer one of your injury problems. Just head to Facebook.com/mensrunningmagazineuk and tell us as much about your injury as possible. Kelly will do the rest.  


  My right instep is quite painful, just below the ankle. The pain seems to go after a mile and a bit, but it sometimes feels like it’s burning and spreads up the shins - Jon Evans  

Kelly's Answer:

Media ankle and shin pain (pain along the inside aspect of the foot or shin) is commonly related to a dysfunction of the tibialis posterior (TP) tendon due to overuse or overloading. The TP tendon can become inflamed, degenerative, torn, or, in severe cases, ruptured.    Injury to the TP tendon often occurs when a runner has poor muscle control at the pelvis and/or an overly pronated foot position, which can cause the tendon to be placed under excessive strain. Runners are most susceptible to this when increasing distance or pace too quickly, or when tackling unfamiliar and difficult terrain.   If you are suffering the symptoms of an injured TP, it is important to get your running and biomechanics assessed by a running specialist physiotherapist, as there are many factors that could be contributing to your pain.  

six-physioMy top tips to overcome TP pain:

  1. Ensure your footwear suits your individual biomechanics and running specifics. Any good specialist running shop will video you on a treadmill and assist with getting the correct footwear for your needs.
  2. Ice the tendon for 10-15 minutes at a time during the early stages of pain. This will reduce inflammation. Ensure the ice is not directly applied to the skin.
  3. Balance on your injured leg with your knee slightly bent. Tie a theraband tightly around both ankles. Move the uninjured leg around your standing leg in semi-circles, while keeping the band taught. Concentrate on not letting your standing foot roll inwards or outwards. Repeat for 2 mins.
  4. Deep calf rises
    - Stand with good posture and engage your abs
    - Bend both knees, then rise up onto the balls of your feet, maintaining posture and making sure your ankles don’t roll inwards or outwards
    - Hold for 4-6 seconds, then lower slowly and under control
    - Do 10-15 reps, rest, then do another 10-15.
    - Once this becomes easy, perform on one leg only.
  5. Calf stretch
    - Keeping your back leg straight and heel down, lunge forward onto your front leg. Don’t let your back heel lift or rotate.
    - Hold for 30 seconds and repeat on the other leg
  6.  All exercises should be pain-free
  7. Running technique – lift your chest when running to allow your pelvic muscles to work more effectively

Download Kelly's top tips here: Overcomeinsteppain.pdf (3040k)  six-physio

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