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Person holding bandage lower leg in pain

How to avoid injury in your 40s

People in their 40s can be very active. The problem is, the activity usually involves doing things for other people. Shuttling kids to and from practice, finishing chores and homework in the evening, and putting in extra hours on the job leaves little time for regular exercise. That lack of physical activity can lead to pain in one of the most frustrating places of all – your feet.

As part of our continuing series on avoiding injury as you age, we talked to physical therapist Tim Varughese, manager of clinical services at OhioHealth McConnell Heart Health Center. He shared some simple steps and exercises you can use to keep your feet strong and flexible, and to recover from injury if you’re already experiencing pain.

Getting off on the wrong foot

“When you are active, particularly on your feet, your body is constantly breaking down and rebuilding muscle and tendon tissue,” says Varughese. “If activity drops with age, the rebuilding process slows. Muscle and tendon strength begins to decline and weaken. Soon, you have feet that are unable to bear the loads they once did. Then, if you suddenly ramp up activity, you can develop tendinopathy, which leads to inflammation and pain.”

One of the most common foot injuries for people in their 40s is plantar fasciitis, which causes a sharp pain under the heel. Plantar fascia are ligaments that run along the arch of your foot, from your heel to your toes, and can become tight with lack of use. Varughese says when you overuse or overload these weakened ligaments, small tears form at the attachment point on the heel bone, which causes the sharp pain of plantar fasciitis.

The pain can be at its worst after a period with no foot movement, like after sleeping, or sitting for extended periods at work. “Those first steps out of bed, or the first mile of a run, are usually the most painful, because you’re re-stretching, re-tearing and re-inflaming that injury,” says Varughese. “The pain may go away after the ligaments are loosened, but the damage is still there. If it goes unaddressed, the accumulation of injury will eventually catch up with you.”

If the shoe fits …

So how do we fix this pain, or better yet, condition and protect our feet to avoid this problem?

Varughese says to start with good footwear, “especially if you’re a runner. If your shoe causes you to overpronate, meaning that your foot is rolling in and placing excessive strain on your arch, it can lead to injury, inflammation and pain.” This is an issue with running shoes used beyond their intended duration, which various online resources will tell you is about 350-500 miles. Varughese recommends keeping a distance log for your footwear, and doing a “taco test” – if you bend and twist your footwear, and it feels too forgiving, shop for some new shoes.

For shoes outside of running shoes, like heels, flats and sandals, consider using an orthotic insert to provide some support. “You don’t need to go the expensive route. There’s no evidence to show they work any better than a $20 insert from your local running store.”

Get a leg up

Varughese says when you strengthen the muscles of your leg, you give your foot and ankle more stability and proper balance, which helps prevent injury. He suggests incorporating single-leg options into a few common exercises:

1. Forward-bend reach with row
Person performing Single leg forward-bend reach with row exercise

2. Romanian deadlift
Person performing Single leg Romanian deadlift exercise

3. Single-leg squat
Person performing Single-leg squat exercise

4. Step up with knee drive
Person performing Single leg step up with knee drive exercise

5. Hopping

6. Jumping rope

Light on your feet

Regularly stretching and exercising the plantar fascia can help alleviate pain and keep your ligaments loose enough to avoid injury. Varughese suggests these steps:

  1. Calf stretch with strap
  2. Plantar fascia massage
  3. Rolling a golf ball under your foot
  4. Crunching a towel with your toes
  5. Picking up marbles with your toes

Take it one step at a time

“Be patient with yourself and take the time you need to heal. A plantar fascia injury can take six months or longer to completely recover from,” says Varughese. “If you’re in pain, follow the steps we suggested here for about four to six weeks on your own ­– supportive footwear, stretches, massage, single-leg and foot exercises, and be careful not to overload or overwork your feet. If you do all that and feel like you aren’t making progress, it may be time for physical therapy.”

If you’re having pain, OhioHealth sports medicine physicians and physical therapists can help pinpoint your issues and get you on a plan to better health. Browse the wellness services at McConnell Heart Health Center  or talk with your primary care doctor about starting a fitness plan.