Current Concepts in the Evaluation, Management, and Prevention of Common Foot and Ankle Injuries in the Runner

Abstract

Purpose of ReviewRunning-related injuries (RRIs) are a common cause of dysfunction among runners. Foot and ankle injuries are among the most common RRIs. The purpose of this review is to detail current concepts in the pathophysiology, evaluation, management, and prevention of foot and ankle RRIs.Recent FindingsRunning gait analyses are helpful in identifying biomechanical and kinematic abnormalities that can be targeted in rehabilitation. Musculoskeletal ultrasonography is now being used to both qualitatively and quantitatively assess tissue integrity to guide diagnosis, prognosis, and return to run decision-making. Recent treatment analyses have demonstrated that rehabilitation exercises are vital for restoring tissue function. The effectiveness of gait retraining and shoe modification is unclear. There is emerging evidence that training the foot core muscles is preventative against RRIs. Although injections such as orthobiologics have recently gained popularity, their long-term effectiveness in the management of foot and ankle RRIs remains inconclusive.SummaryA comprehensive review of RRI risk factors and a thorough physical examination are vital for identifying RRIs. Ultrasonography is an emerging diagnostic modality for RRIs. Treatment should center around extrinsic risk factor reduction, activity modification, rehabilitative exercise, and a gradual return to run progression. Caution should be used when considering injections, particularly orthobiologics, for the management of RRIs. Future research should be performed to investigate the effectiveness of gait modification and the effectiveness of orthobiologics in the treatment of RRIs.