Both long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners.

The human foot is a biological masterpiece that can endure the stress of daily activity. For runners, the feet are more vulnerable to injury than any other part of the body. Runners should watch for signs of foot problems that can slow them down if not treated promptly.

The most common complaint from runners is heel pain. This condition, also called plantar fasciitis, is frequently caused by inflammation of the ligament that holds up the arch.

Heel pain can result from faulty mechanics and overpronation, when pressure is unequally applied to the inside of the foot. It can also be caused by wearing running shoes that are worn out or too soft.

At the first sign of heel pain, runners should do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory drugs like ibuprofen can help.

If heel pain continues, custom orthotics, injections or physical therapy might be required. Normally, surgery isn't considered unless heel pain persists for more than a year and conservative treatment fails to bring relief.

Neuromas and tendonitis are other common foot problems that affect runners.

A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot.Overly flexible shoes are often the cause; padding, orthotics or injections are usually effective. Sometimes, surgery is recommended if pain between the toes continues for more than six months.

Serious runners can also be sidelined by tendonitis, as can overzealous beginners who try too much too soon.

There are several forms of tendonitis that affect the Achilles and other areas; all are treated with rest, icing, stretching, anti-inflammatory medications, and sometimes orthotics or physical therapy.

A common myth among athletes is that it's not possible to walk or run if a bone in the foot is fractured.

I often hear surprised patients say, "It can't be broken; I can walk on it." That's dead wrong, especially with stress fractures, when pain and swelling might not occur for a few days.

If a fracture or sprain is suspected, I advise runners to remember the acronym "RICE," referring to rest, ice, compression and elevation.

If pain and swelling continues after following RICE for three or four days, see a foot and ankle surgeon for an X-ray and proper diagnosis.

Vail is with Advanced Footcare Clinic, Findlay. Questions for Blanchard Valley Health System doctors may be sent to This email address is being protected from spambots. You need JavaScript enabled to view it., or to Weekend, The Courier, P.O. Box 609, Findlay, OH 45839-0609.