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Dr. Marian Wymore

Q: My gym has been closed for the last year because of the coronavirus pandemic. I decided to stay in shape by hiking the trails every day instead of my usual workouts of weight lifting, stationary biking or rowing. I starting having a little pain in my right mid-foot while hiking but it’s progressed to a painful, tender spot on that foot that even hurts at rest. 

A: Welcome to the world of the “COVID warrior!" The infamous “weekend warrior” that was responsible for so many athletic injuries in the past has been elevated to a new level. Many people were so eager to get outdoors that they dove headfirst into a new sport and tried to exercise their way through months and months of the pandemic blues.

Unfortunately, diving into a new sport full speed and overdoing it can result in overuse injuries.

Overuse injuries can develop when you suddenly start a new activity and don’t properly condition yourself, or suddenly increase the duration, frequency or intensity of a sport you were already doing. Suddenly doubling your mileage and increasing your pace may seem like a good idea, but you are taking a big risk by not gradually working up to it. It is not advised to increase an activity by more than 10% per week. It is also important to wear proper footwear and have good biomechanical technique. 

Sports like running, walking and hiking became very popular during the pandemic.

People who were working from home had more flexibility in their schedules and many started doing these activities every day. It is much safer to cross-train as you were before when you alternated weight lifting with stationary biking or rowing.

Can you see that you switched from three different exercises that used different body parts on alternating days to hiking every day? Plus, hiking is a weight bearing exercise so your feet, ankles, knees and hips didn’t get a rest.

Overuse on weight bearing bones puts you at risk for stress fractures in the foot, as well as in the leg. The shaft of the second metatarsal is the bone most commonly afflicted with stress fractures in the foot.   

Other common overuse injuries of the foot caused by hiking, walking and running  are plantar fasciitis, metatarsalgia (painful ball of the foot), sesamoiditis (pain is usually behind the big toe), bursitis, posterior tibial tendonitis, tarsal tunnel syndrome, or Morton’s neuroma. 

Walking, running or hiking can also cause overuse injuries from the ankle to the hip: Achilles tendonitis, shin splints, compartment syndromes, ankle sprains or strains, stress fractures of the tibia, fibula, or femur. ITB (iliotibial band syndrome), patellar tendonitis (below the kneecap), patella-femoral pain syndrome (behind the kneecap), hamstring strains or tears. Overuse syndromes of the hip include acute or chronic tendonitis of the hip abductors and trochanteric bursitis.  

The entire body is a kinetic chain starting at the feet.

Wherever the body is out of alignment, it will affect the kinetic chain above the spot of the injury or anomaly. Just picture how this might work in a golfer (another sport that has taken off in popularity during the pandemic).   

The mechanics of a golf swing are complex and it takes years to get to the point where a player can consistently swing the club in a predictable swing path. So you are essentially creating a set-up for overuse since the intention is to use the same muscles to swing nearly the exact same way every time.

If you don’t adequately stretch and warm up, even the best golfers are at risk for overuse injuries. If poor swing mechanics (we know who we are), we may be practicing an injury in the making.

Players who have less well coordinated nor predictable swings are more prone to overuse injuries because our bodies are trying to compensate for the poor swing mechanics. Overuse injuries in golf can be anywhere from the feet to the neck. The most common injuries in golf are back pain and tendonitis of the elbow (medial or lateral).  

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