Keys To Treating Common Triathlon Injuries

Marybeth Crane, DPM, MS, FACFAS

   No one wants to rupture an Achilles tendon so most athletes will listen if you tell them that injury can be the outcome of non-adherence.

Addressing Plantar Fasciitis In Triathletes

Every podiatrist in the United States knows the causes, diagnosis and treatment options for plantar fasciitis. Triathletes are no different.

   One should emphasize aggressive conservative treatments plans with liberal use of physical therapy. The only word of advice is to be very specific on the running restrictions and the need for shoe gear modifications and/or functional foot orthotics. Avoid injection therapy in those triathletes who are still running. This is the group that would rupture their plantar fascia. The return to running should be gradual after successful treatment of this common problem.

Recognizing And Treating Metatarsalgia/Morton’s Neuroma

Again, metatarsalgia/Morton’s neuroma is a common problem we treat in podiatry offices today. Bike shoes and transitioning to very flexible or “barefoot feel” running shoes are often contributing factors. Early signs are usually numbness in the toes after riding for some distance. Patients may not have pinpoint interspace pain at first. Always rule out a stress fracture. It is often very helpful to add metatarsal padding to the cycling shoe and getting wider shoes.

   The remainder of the top ten injury list (iliotibial band syndrome, patellar tendonitis/chondromalacia patella, medial tibial stress syndrome and sacroiliac joint dysfunction) are beyond the scope of podiatry in some states. However, remember that one can address most of these injuries with better bike fit, changes in shoe gear and/or functional foot orthotics, and physical therapy.

In Conclusion

As you can see, the injuries that occur in triathlons are not unique to the sport but one should understand the psychology of these patients for successful treatment and return to sport in a better condition than when the patient walked in your office. A demand for adherence and upfront vocalization of the risks associated with non-adherence are essential keys. I hope this article has helped you have an understanding of these complex athletes and the need for comprehensive treatment plans.

   Dr. Crane is the managing partner of Foot and Ankle Associates of North Texas in Grapevine and Keller, Texas. She is a lifetime distance runner and has finished multiple Ironman triathlons. Her practice focuses on foot and ankle surgery, biomechanics and sports medicine. For more information about running and triathlon injuries, visit or .



Allow sufficient "float of the shoe cleat" check on the pedaling down stroke, not too much "dropping the heel."

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