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Snatching CrossFit Victory from the Jaws of Da Feet (and Ankles)!

When the music is blasting, the box is pulsating and the sweat is flowing, it’s easy to jump into a CrossFit workout with reckless abandon. In fact, that’s the whole idea. However, sometimes that “jump” can cause injuries and it’s difficult to separate minor soreness from potentially major problems. This is particularly true with injuries to the feet and ankles.

Who worries about their feet and ankles?  Right?

Sure they get sore when you’re running, jumping and lifting but every other muscle gets sore too. While this is true, it is equally true that the feet and ankles, just as the shoulders and knees, are vulnerable to stress injuries.

Have no fear! With a little knowledge, you can avoid these injuries.

An Ortho Doc Who Understands Why You Are Crazy about Your Workout

Most participants in intense CrossFit workouts have experienced the pain of a sprained ankle. While this is a very common injury, the medical explanation of this condition is somewhat more complicated.Dr. Keith Heier is an orthopedic specialist at Texas Health Orthopedic & Spine Center in Carrollton, Texas. In his practice, he has treated hundreds of CrossFit athletes and he has some insights about avoiding injuries to the feet and ankles during one of those grueling WODs.

“There are acute injuries such as sprained ankles and metatarsal fractures, which typically occur when a runner accidentally steps in a hole or off a curb and lands awkwardly, Dr. Heier said. These happen randomly and aside from careful observation, there are very few preventative measures which can be employed.

“There are also injuries which can be prevented among CrossFitters who are just getting started with their program called “overuse” injuries. Muscles can be strained, especially if there is little warm-up, and if the runner doesn’t give this strain the time necessary to heal, the pain and injury will get worse. Overuse injuries can also result from an athlete increasing the length of his/her run before his body is acclimated to the distance,” he noted.

“Genetics can also play a part in these injuries,” he said. “Some CrossFitters have flat feet, high arches, bunions or hammertoes, and these conditions can lead to stress fractures of the metatarsals, tendonitis in the Achilles or planter-fasciitis.

“CrossFit participants are so into their workout that they are more likely to get that overuse injury to their feet or ankles,” Dr. Heier said. “And because the workouts are so intense, these athletes are more likely to get the acute injury. Participating in explosive activities such as flipping tires can easily lead to a tendon tear if the correct form is not used.”

Pushing Through the Pain

Part of the essence of CrossFit training is pushing one’s body to an uncomfortable and even painful level. The standard response for hardcore CrossFitters is to push through that pain. Dr. Heirer explained how an athlete knows when the condition is more than just uncomfortable, and perhaps dangerous for the foot or ankle.

“Any pain that is directly over a bone is a potential problem,” he said. “You can push yourself hard and work through most muscle or hamstring pain, but pain over a bone is NOT something you should work through. Also, pain that is lasting over a week and particular that which is over a bone has the increased likelihood of being a stress fracture. If you notice this type of pain, it’s a good idea to stop the high-intensity workout for a few days and see if the pain subsides. If it doesn’t, it’s time to go an orthopedic doctor to check it out.

“The best way to treat this type of foot or ankle injury is to stop the high-intensity workout and use a milder, aerobic workout on a stationary bike or some very low impact workouts or mild lifting. Once you can feel less pain, you should very slowly get back into regular workout mode. It is easy to re-injure a foot or ankle by returning to a high-intensity regime too quickly. Slow and steady is better. There is a time for tearing down and a time for healing.”

Preventing Feet and Ankle Injuries

Many injuries to the feet and ankles can be avoided by simple, preventative actions. Dr. Heier explained.

“For the CrossFit athlete and serious runner, there are several stretching exercises that can help prevent minor injuries,” he said. “The classic calf stretch involves the runner leaning against the wall and stretching the back of his Achilles tendon.

“A hamstring stretch – where the athlete is bending over and touching her toes – is an easy and effective exercise to do before the workout. It is also advisable to do a planter-fasciitis stretch, which involves pulling one’s ankle back as far as possible and then grabbing the toes back toward the tibia (lower leg). With this stretch, the runner will feel the tightening in the planter-fasciitis part of the foot.

“Finally, simple balance exercises, which help to strengthen the core of the body, are advisable before the run begins. This could be in the form of planks, back extensions or jumping rope.”

Shoes for CrossFit Training

Choosing the right shoe can make huge difference in both the health and fitness success of a runner or CrossFit athlete.  According to an article “Men’s Fitness” on choosing the correct shoe for CrossFit training, “Although a regular gym shoe might be good enough for any old workout, you aren't just doing any old workout—you are doing the ultimate workout. So you need a CrossFit shoe that provides stability while lifting, comfort and cushion while sprinting, and secure support for jumps and WODs. Just like you take care of your body while working out to ensure correct form and movement, you've got to take care of your feet, too.” Click here for the MF recommendations for the six best shoes for CrossFit training.

“CrossFit shoes may look great on the outside, but when they have been used for more than 250 miles they present an injury danger to the wearer,” Dr. Heier said. “Wear and tear can cause running shoes to be too tight or too loose. The padding can be worn away and this causes problems.

“My approach to choosing the right shoes involves first examining the type of foot of the athlete. Someone with flat feet should choose a ‘motion control’ shoe with a high arch which helps prevent the flat foot. There is also the classic ‘neutral’ shoe which enhances stability or cushioning. If, for example, someone has a high arch and they choose a shoe designed for a flat foot, this will tilt the runner to the outside of the foot. This could lead to a stress fracture on the outside of the foot.”

Treatment for Foot and Ankle Injuries

As a foot and ankle expert, Dr. Heier treats many serious and casual athletes in his practice. The treatment can range from the very simple, such as rest, or complex, such as surgery.

“In most cases, stopping the running, icing, light stretching and prescribing a nonsteroidal are the first lines of treatment,” he said.  “Sometimes our treatment includes changing running shoes or placing an orthotic in the shoe.  In rare cases, the injury might require surgery.

“Conditions such as plater-fasciitis, tendonitis of the Achilles and even stress fractures will heal if we give them a chance. Surgery is always the last resort” he concluded.