From pulled muscles to fungal infected nails, chiropodist Dr. Germaine Binns sees the gamut of foot-related injuries in runners and walkers that visit his Foot and Ankle Clinic.Foot problems related to running and walking account for about 30 percent of his patients.

“This business is seasonal,” he said. “We’ll see a lot of people around now because this is New Year’s resolution time and many people will suddenly start exercising.

“International race weekend and 24th May bring in quite a few people and then what I call the weekend warrior — those people who sit around all week and hit the pavement hard on the weekends.”

Many patients are referred by physical therapists and orthopaedic doctors to Dr. Binns. “I see our job as preventative,” he said. “We have to try and prevent a re-occurrence of the injury and in order to do that, we have to figure out why it happened.”

While he said it is often easy to figure out the problem, it is extremely difficult to fix.

“People need their feet to get from place to place,” he said. “It is more difficult to treat someone when you cannot strap them up and prevent them from using that part. In order to truly recover you need them to be immobile but they need to get around,” he said.

Heel pain and arch pain are the two most common complaints of runners and walkers he sees. Most often this is caused by strain on the plantar fascia — a large muscle on the under portion of the foot which is attached at the heel on one side, and toes on the other.

“This is the main shock absorber of the foot,” Dr. Binns said. “But it isn’t good at stretching. If it is stretched it will pull at the place where the muscle attaches — the heel — causing heel pain. Overstretched plantar fascia may also become inflamed. Pain in the arch of the foot especially on waking or after sitting for a long time, is usually an indication of an inflamed plantar fascia.”

A variety of toenail problems including ingrown nails, nail loss and nail discolouration also plague runners and walkers that visit Dr. Binns. This happens largely as a result of wearing sneakers that are too tight. Dr. Binns explained that the big toe, as the main propulsion in the foot, tends to slide forward and hit the front of the shoe or sneaker.

“Remember the foot is a mobile adaptor in a rigid container,” he said.

This repetitive action in the short term can lead to blistering and pain.

He said very often a blood clot can become lodged under the nail bed and be very painful. “This usually leads to loss of the nail,” he said. In cases where people disregard the pain, the long-term effect is fungal infection.

It may be hard to believe that patients disregard pain but according to Dr. Binns most people have a low regard for feet and tend not to address pain there with the urgency of pain felt elsewhere in the body.

“Forty percent of all pain will go away, so if you do not treat it as a preventative mechanism you will injure something,” he said.

The biggest reason runners and walkers have problems with their feet is that they tend to wear sneakers as a fashion statement instead of for good health. “Often people buy by the brand name rather than for comfort, but not all shoes are right for all people,” he said.

“We find the most problems after the End-to End walk happen with people wearing Nike,” he said. “The problem is that Nike tends to be too narrow in the front not giving your toes enough room to spread out.

“We recommend Brooks and that is because they come in different widths,” he said. “You have to be careful with the sneakers that say they come in different widths but actually just have additional fabric on the top. Brooks actually increases the width of the rubber sole underneath as well.”

Dr. Binns feels Brooks do this better than New Balance and Asics which also increase the width of their soles.