I started running for the first time at the beginning of 2022. As my feet hit the pavement, I felt some tightness up and down my shins, but I thought it was just a part of “getting used to” running. Turns out I was wrong. After a couple of runs, I was limping and unable to put weight on my left foot. A few visits to a podiatrist, and one MRI later, I discovered that I was part of a growing population who are experiencing overuse injuries in their feet as a result of getting active again after being sedentary for so long. There’s even a term for it, according to The New York Times: pandemic foot.
“During the pandemic, early on, we were seeing potentially less [injuries],” explains Dennis Cardone, MD, a sports health expert and chief of the Division of Primary Care Sports Medicine at NYU Langone Health. “People were a little bit less active, but as they start to return to activity, there has certainly been a spike to [injury] levels that are higher than pre-pandemic.”
It only takes about two weeks to start losing muscle mass when you stop working out, so for many people who spent months staying home and reducing their physical activity, potentially “muscle weakness, a muscle imbalance, or just lack of conditioning has led to these injuries,” explains Dr. Cardone. “The other part of it is different activity–so many people were just doing one type of activity and then suddenly they changed.”
What workout shifts are most likely to lead to pandemic foot
If you’re used to running on the smooth, flat surface of a treadmill and you decide to hit the trails, the change in terrain underfoot can be a difficult adjustment for your body if you don’t progress slowly. Same goes if you’ve been sticking to mainly low-impact workouts like Pilates or yoga, but then decide to start doing higher impact activities like running or jumping rope. If you don’t allow your body the time to build up to the new level of stress you’re putting on it, this can quickly lead to overuse injuries.
After my various foot doctor visits I was diagnosed with plantar fasciitis and mild tendinosis, which in layperson terms means I used my foot too often without allowing it enough time to recover in between runs, and now it was inflamed. Once I started going to physical therapy I also learned that the root of my problem stemmed from higher up in my body–my hips and my glutes weren’t strong enough to allow my feet and ankles the stability and strength they needed for high-impact activities.
Dr. Cardone explains that this is quite common in women because “women have a wider pelvis than men,” he explains. “This leads to a sharper angle in the knee and leads to more overuse problems in the front of the knee; those can indirectly also lead to ankle injury. Women [also] tend to be more flexible than men…so it means their ligaments are just not as tight [and] their muscle tendons work a little harder to give them stability.” He says nine out of 10 women he sees present with knee joint or glute strain.
As such, Dr. Cardone recommends strengthening your hips and glutes in an effort to offload stress on your ankle.
You can start with this lower-body workout that targets your hips, hamstrings, and glutes:
When you’re most at risk of overuse injuries
After just returning to exercising or starting a new fitness routine is the period of time where there’s the most significant risk for injury, says Dr. Cardone, who suggests moving slowly and padding your workout plan with extra rest days at the beginning. If you are someone who worked out regularly prior to the pandemic, he suggests cutting your previous workload in half and committing to a gradual increase from that point rather than jumping right back in.
Recovery is also key, according to Dr. Cardone, who says proper sleep and nutrition makes a big difference in how your body bounces back. So does cross-training i.e. mixing up the types of workouts you do so there are some high- and low-impact options. “If you’re a runner, then add biking, swimming, or elliptical training,” he says, “and everybody should add strength training. We have evidence that these types of things really do help injury prevention.”
And if something feels off, the sooner you stop what you’re doing, the better. According to Dr. Cardone if you have persistent symptoms for two weeks or more or if symptoms are worsening, it’s time to reach out to a professional for guidance.
What to do if you wind up with an overuse injury
While the physical recovery may be slow and require a lot of attention, it’s true also that going from active to needing to rest can take an emotional toll, so prioritizing your mental health is key to recovery. “It’s fairly common for people to struggle with their emotions while dealing with on-going physical pain,” explains Shomari Gallagher, LCSW, and psychotherapist at Alma Therapy. “However, there are ways to shift our perspective, and care for our mental and emotional well-being that help us live more fulfilling lives.”
Gallagher encourages starting by practicing more self-compassion. Acknowledge your feelings and hear yourself out. Resist the urge to judge yourself. Try being accepting and kind to the pain instead of rejecting it. And for the moments when self-blame starts to ramp up, cutting yourself both physical and mental slack can make a difference in recovery. Here’s some examples of self-talk she says you can use to encourage self-kindness and empathy.
“I know this hurts right now. I’m here for you” “I notice you’re angry right now, what will make you feel better?”
“Remember that your unpleasant emotions are just a signal that something needs your attention and care, just like a wound to your body does,” Gallagher says. “Pay attention to your needs and respond with love.”
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