Following a marathon, many runners celebrate an incredible achievement after months of training and dedication. While some soreness and stiffness are a normal part of recovery, persistent foot and ankle pain, swelling or instability long after race day could be a sign that further assessment is needed.
Consultant Orthopaedic Surgeon, Mr Charlie Jowett answers the common question patients ask.
At what point should foot or ankle pain become a cause for concern?
It's perfectly normal to experience some soreness and stiffness in the days following a marathon, particularly if you've pushed yourself harder than usual. However, pain that continues to worsen, doesn't improve after a week or two, or prevents you from walking comfortably should be assessed by a specialist.
Other warning signs include:
- significant swelling
- bruising
- pain that's concentrated in one specific area
- discomfort that persists even when you're resting
These symptoms can sometimes indicate a more serious injury, such as a stress fracture, tendon injury or ligament damage, which is unlikely to resolve without appropriate treatment.
What are the most common foot and ankle injuries or conditions you see in runners?
Some of the most common problems we see include achilles tendinopathy, plantar fasciitis, ankle sprains, stress fractures and tendon injuries around the ankle and foot. These injuries can develop gradually through overuse or suddenly as a result of a twist or awkward landing.
What warning signs should runners avoid ignoring?
Symptoms runners shouldn't ignore include persistent swelling, pain that alters your running gait, tenderness over a bone, instability in the ankle, numbness or tingling, or pain that continues despite reducing activity levels. The earlier these issues are identified, the easier they are often to treat.
If someone's foot or ankle pain isn't improving, how can Ramsay Health Care UK help diagnose the problem and support their recovery?
The first step is a thorough assessment to understand the person's symptoms, activity levels and medical history. This is followed by a detailed examination of the foot and ankle to identify potential sources of pain or dysfunction.
Where appropriate, we can arrange diagnostic imaging such as X-rays, ultrasound scans or MRI scans to provide a clearer picture of what's causing the problem. Once we've established a diagnosis, we can develop an individual treatment plan aimed at reducing pain, restoring mobility and helping patients return safely to running, sport or everyday activities as quickly as possible.
Does foot or ankle pain always require surgery, or can it be treated without an operation?
In reality, most foot and ankle conditions can be successfully managed without surgery. The vast majority of patients improve with conservative treatments, particularly when problems are identified early.
Non surgical treatment options include:
- physiotherapy
- activity modification
- strength and flexibility programmes
- orthotics or insoles
- footwear advice
- anti-inflammatory treatments
- in some cases, injection therapies.
Foot and ankle surgery is generally considered only when symptoms persist despite appropriate non-surgical treatment or when there is a structural problem that is unlikely to improve on its own.
The key message is that surgery is rarely the first option and there are often several effective alternatives available.
What advice would you give to someone whose foot or ankle pain is preventing them from returning to running, exercising, or even enjoying everyday activities?
My advice would be not to simply try to push through the pain. While maintaining activity is important, continuing to exercise on an injury can sometimes make the problem worse and prolong recovery.
If pain is stopping you from doing the activities you enjoy, it's worth seeking professional advice. An accurate diagnosis is crucial because different conditions require different treatments. The sooner we understand what's causing the pain, the sooner we can put a treatment plan in place and help you regain confidence in your movement.
Most importantly, don't assume you have to live with ongoing pain. Many foot and ankle conditions are highly treatable, and with the right support, most people can return to the activities they enjoy and maintain an active lifestyle.
Are there any simple steps runners can take to reduce their risk of foot and ankle injuries when training?
Absolutely. One of the biggest mistakes runners make is increasing their mileage or intensity too quickly when training for events such as marathons or half marathons. Gradual progression allows the muscles, tendons and bones to adapt to the demands of training.
It's also important to wear appropriate running shoes, incorporate strength and flexibility work into your routine, allow adequate recovery between sessions and pay attention to early warning signs from your body. Minor niggles that are addressed early are much less likely to develop into injuries that disrupt training for weeks or months. A balanced training programme, combined with good recovery habits, goes a long way towards keeping runners healthy and injury-free.
Foot and Ankle Support at Ramsay Health Care UK
Whether you're training for your next marathon, preparing for a local parkrun or simply want to walk comfortably without pain, persistent foot and ankle problems shouldn't be ignored.
Ramsay offers access to experienced orthopaedic specialists, diagnostic imaging, physiotherapy and personalised treatment pathways designed to support recovery and restore mobility. From sports injuries and tendon problems to arthritis and complex foot and ankle conditions, our team is here to help patients get back to the activities that matter most.
Contact us to find out more.