The Marathon Foot Doctor

Our feet are critical to our general health, wellbeing and mobility – whatever our age – but they are one of the most neglected parts of our body.

Here Lucy Mason talks to Consultant Podiatrist Matthew Fitzpatrick about his work.

Consultant podiatrist Matthew Fitzpatrick has been the Clinical Podiatry Lead for the London Marathon for the past seven years, responsible for a team of volunteer podiatrists from across the country. He has been working clinically for over 12 years with a focus in musculoskeletal podiatry and has a great interest in the treatment of sports and dance related injuries. He says:

“The great thing about high profile events like the London Marathon, the Great North Run and the Olympics is that they help to raise the profile of podiatrists – because some people are still not aware of what we do.

“There were 34,000 runners in this year’s London Marathon and we had a team of 65 podiatrists to look after them, stationed at three key sites across the course, along with physiotherapists and first aiders from St John Ambulance.

“As well as podiatrists with many years of experience, I was delighted to include a large number of final year podiatry students and their tutors from both the University of Brighton and the University of Northampton. They were massively enthusiastic and it was a great opportunity for them to get involved and learn about what can happen to the feet of long-distance runners.

“We also had podiatrists from the NHS and private practices all over the UK, most of them with an interest in sport and musculoskeletal podiatry. What’s good to see is how many of them help at other big running events throughout the year.

“The most common injuries podiatrists see on the day are muscle strains and leg and foot cramps. Runners keep going with the rush of adrenaline they get but as soon as they stop, especially as the weather was cooler this year, the more susceptible their muscles are to seizing up.

“Massage and stretching helps and it has to be done swiftly, not only because we want to get them on their way again as soon as possible but because there are so many runners to deal with.

“Blisters on the heels, toes and feet are always a problem. One year, we treated a runner with a blister across the whole of his sole. We had to remove it quickly before it had a chance to buckle or rip.

“If you’re running for a long time and your shoes are too tight, long distance runners are susceptible to toe-nail injuries. As the toes rub, the nails can be damaged, blister and then come off.

“It’s fantastic to see podiatry in action at events such as the London Marathon. I’ve seen what marathon running can do to feet, though, so I think I’ll just stick to my nice 10K runs!”

Top tips for runners

For healthy, happy running feet follow these tips by The College of Podiatry and Matthew Fitzpatrick.

  • Use a square knot for your laces to stop it coming undone. Loose laces can cause potential injury and disrupt your pace. New research from the University of Berkeley in California has shown that if you use a ‘square knot’ where the left lace is crossed over the right and the bow crossed the opposite way, right over left, you significantly reduce the risk of this happening.
  • Choose a properly fitted running shoe. Go to a reputable sports shop and explain to the fitter that you are doing long distance running. Trainers for long distance should be half a size bigger than your normal shoe size as your feet tend to swell during long runs. Don’t hang on to running shoes if you use them regularly. They have between 250-500 miles of life as over time they become stretched and lose their shock absorbency.
  • Wear good socks. People often focus on this shoe and neglect the type of sock. But ill-fitting socks are one of the main cause of blisters, which can have a massive impact on your performance as they can be very painful. Avoid cotton socks as they absorb moisture and instead choose a specific running sock made from a material which will help wick away sweat. Make sure it fits properly so it is not bunching or too tight on your toes.
  • Know how to identify and treat athlete’s foot. This fungal infection is most likely to occur if our feet regularly experience damp, warm conditions – common if you’re running. It tends to affect between the toes but can appear on any part of the foot. Look out for persistent flaking and red skin. You can get over the counter remedies, including treatments that specify they only need to be applied once.
  • Don’t run through pain. If you experience frequent and ongoing pain in your feet, ankles and legs when you run, this could be a sign that your footwear isn’t right or you have a musculoskeletal issue in your lower limbs that needs looking at. Don’t run through pain as this can cause long-term damage. See a podiatrist who will be able to diagnose the issue and advise on treatment.
  • Fit orthotic insoles or inserts into your running shoes in order to help avoid an injury. Orthotics for plantar fasciitis are often suggested when heel pain or foot pain is experienced.