Track & Field Injury Treatment in MelbourneThe Cost of Speed
Nothing loads the foot like sprinting and jumping in spikes. A rigid plate, a forefoot strike and a big
toe bent to its limit - repeated at maximum effort, on an unyielding synthetic track. The margins are
thin, and so is the tissue’s tolerance.
Matt Scott has lived it: an 800m personal best of 1:47.19 and fourth at the 2019
Australian Championships, now a podiatrist whose clinical focus is forefoot pain and footwear. He knows
what a spike does to a foot, because his own feet have done it.
force a forefoot strike and drive the big toe into extreme extension at push-off
Bone
speed multiplies ground reaction force - the navicular is the injury that ends seasons
Volume
spike volume, not total weekly mileage, is the load that needs managing
General guidance drawn from athletics injury research and clinical experience. Individual risk varies with event, training history, spike volume, surface and energy availability.
What is track & field podiatry?
Care built around spike volume, not weekly mileage
Track and field podiatry is the prevention, diagnosis and treatment of foot, ankle and lower limb injuries
in athletics. It begins with the piece of equipment that defines the sport: the spike.
A rigid plate under the forefoot lifts the heel, holds you on the ball of the foot, and forces the big toe
into extreme extension at push-off. The calf and Achilles work at length, under maximum tension, through
every block start, hurdle and take-off. And the synthetic surface returns almost everything you give it.
Distance running is a volume problem. Track is an intensity problem.
That is why the injuries have a particular signature. Sesamoiditis
and turf toe barely exist in road runners but are routine here. Why
Achilles tendinopathy
arrives with the first weeks of speed work rather than after a big mileage block. Why
shin splints
turn up the week the athlete moves off grass and onto the track. And why the navicular, a bone most runners
never think about, is the stress fracture
that ends seasons in speed and jumping events.
So the number we want is not your weekly kilometres. It is how many sessions you have done in spikes, how
fast that has climbed, and what changed on the day the pain started. A
running assessment looks at how you
actually load and push off - not how your foot looks standing still. We treat athletes near Port Melbourne,
Elsternwick and Williamstown, from Little Athletics through to national level.
Spikes are a competition tool, not a training shoe. Most track injuries begin the week that distinction gets forgotten.
Is this you?
Recognise your symptoms
Pick the description closest to what you are feeling. These are the presentations we see week after week
in track and field athletes across our Melbourne clinics - each links to the full explanation below.
None of these quite fit?
Book an assessment
and we will work it out properly.
About our approach
We ask what changed, and we usually find it in the spikes.
Track injuries are load injuries, but the load is not the one distance runners talk about. It is
intensity: the number of maximal efforts, the sessions in spikes, the transition from off-season base
work onto a synthetic surface. Those changes tend to arrive together, and the tissue notices.
So the first thing we want is your last twelve weeks in detail. When the track opened. When the spikes
came out. Whether the volume in them climbed gradually or jumped. What your event asks of your forefoot.
Then we look at how you actually load and push off.
Matt raced 800m at national level and finished fourth at the 2019 Australian Championships. His clinical
specialty is forefoot pain and footwear, which is not a coincidence - it is the region a spike punishes.
He also has advanced orthotic manufacturing experience, which matters more here than in any other sport,
because a spike has almost no volume to work with.
A running assessment and
gait analysis examine footstrike,
joint range and strength under load. We work with athletes from Little Athletics through to national
level, across our Port Melbourne, Elsternwick and Williamstown clinics.
Spikes are a competition tool, not a training shoe
The rigid plate and raised heel that make a spike fast are the same features that load the Achilles,
forefoot and big toe joint dramatically. Most athletes train in them more than they need to, and
increase that volume far too quickly - typically in the week the track opens, when surface and footwear
change at once. Spike volume is the number to track, not your total weekly mileage, and it should climb
slowly across a season. We review your spikes, their plate stiffness, fit and sizing as part of every
assessment.
Conditions we treat
What spikes do to a foot
Sprinters, hurdlers, jumpers and middle-distance runners each stress the system differently, but the
forefoot, Achilles and bone bear the load. Here is what we see, why the sport produces it, and what we do.
Heel / Tendon
Achilles Tendinopathy
Spikes hold the heel off the ground, so the calf and Achilles work at length under maximum tension - through every start, acceleration, hurdle and take-off. That is a different demand from steady running: not volume, but intensity.
Pain and stiffness sit at the back of the heel, worst on the first steps of the day and in the first efforts of a session, easing with warm-up, then flaring afterwards. Track athletes routinely misread that warm-up effect as permission to keep sprinting. Tendons need correctly dosed load, not rest - rest deconditions the tendon and the pain returns with your first session back. See our guide to Achilles pain.
How we help
Progressive tendon loading, spike-volume management, and shockwave therapy for long-standing tendon pain.
Two small bones sit beneath the big toe joint, embedded in tendon - the sesamoids. They act as a pulley for push-off, and in track they cop everything: forefoot landing, a rigid spike plate, and a big toe forced into extension at full sprint.
The result is a deep, bruised ache directly under the big toe joint, sore to press, worse barefoot on hard floors and worse again in spikes. It is a genuinely under-diagnosed track injury, frequently dismissed as generic forefoot pain, and the sesamoids heal slowly once a stress injury develops. Forefoot pain is Matt’s clinical specialty. Read about forefoot pain and stress fractures.
How we help
Targeted offloading and sesamoid padding, custom orthotics that fit inside a spike, spike-plate stiffness advice, and imaging referral where a stress injury is suspected.
At maximum sprint the big toe joint extends further than in almost any other activity, while bearing your accelerating body weight. Force it past its range - a block start, a jumper’s take-off, a stumble - and you sprain it. That is turf toe.
Pain, swelling and an inability to push off follow, and for a sprinter that is the whole event. Repeated loading across a career can also stiffen the joint and drive arthritic change, which is why we take early big toe pain seriously rather than strapping it and moving on. Learn more about big toe arthritis and toe pain.
How we help
Joint protection and offloading, spike-plate and footwear adjustment, and foot mobilisation to restore joint movement.
Speed multiplies ground reaction force, and bone pays. In track athletes the tibia and metatarsals are common sites. The navicular, at the top of the arch, is the one that ends seasons.
It takes enormous compressive load during sprinting and jumping, has a poor blood supply, and presents deceptively - as a vague, deep midfoot ache that settles with rest and returns with the next session. Low energy availability, simply not eating enough to support the training, is a major and frequently overlooked contributor, particularly in endurance and jumping events. Learn more about stress fractures and foot pain.
How we help
Prompt assessment and imaging referral, structured load management, and gait analysis to correct the forces overloading the bone.
A diffuse ache along the inner shin, tender across several centimetres, coming on during and after sessions. In track it typically appears when an athlete moves from off-season base work onto the track and into spikes - a sharp change in both surface and footwear, usually at the same time.
It sits on a continuum with tibial stress fracture, and the difference is partly how long you ignore it. The key distinction is precision: if the pain narrows from a broad band to one point you can cover with a fingertip, treat that as bone until proven otherwise. Read our full guide to shin splints.
How we help
Load and spike-volume management, calf and hip strengthening, running assessment and technique work, plus orthoses where biomechanics contribute.
Sharp heel pain on the first steps out of bed, easing as you move, returning worse the next morning. In track athletes it is driven by forefoot loading in spikes, which places the plantar fascia under sustained tension, and by the abrupt jump in intensity when the competition season begins.
The warm-up effect is what fools people into training on it. It responds very well to treatment, and considerably less well the longer it is left. See our guides to plantar fasciitis and heel and arch pain.
Two tendons that stabilise the foot in opposite directions, both loaded hard on the track. The peroneals, behind the outside ankle bone, resist the foot rolling outward - and the constant left-hand curve of a track loads them asymmetrically, particularly on the outside leg.
The tibialis posterior, behind the inside ankle bone, is the main dynamic support of your arch, working on every footstrike to control the foot rolling inward. Both are commonly mislabelled as generic ankle pain and left to progress. Read our guides to peroneal tendinopathy, tibialis posterior tendinopathy and ankle pain.
How we help
Progressive tendon loading, ankle stability work, lane and direction load advice, custom orthotics, and functional foot strengthening.
Track’s acute ankle injuries belong mostly to the field events and the hurdles: landing awkwardly in the long jump or triple jump pit, clipping a hurdle, or coming down off the bend. The ankle rolls inward, overstretching or tearing the ligaments on the outside of the joint.
The first sprain is rarely the whole problem. It is the strength and balance lost afterwards that leaves the ankle vulnerable, and in a sport of maximal efforts an unstable ankle is a liability rather than a nuisance. Read our guides to ankle sprains and ankle pain.
How we help
Staged rehab, balance and landing retraining, taping and bracing, and a sports and biomechanics assessment before you return to full-speed work.
Spikes are built tight, minimal and unforgiving, and are often worn without socks. The friction produces blisters fast, the pressure builds corns and callouses under the ball of the foot, and toes jammed into a narrow toe-box bruise the nails.
Athletes wear these as a badge of honour, but a blister on race day is a genuinely performance-limiting problem, and it is a fit problem rather than an inevitability. Footwear is exactly Matt’s area of expertise. We treat the skin and nail, then remove the pressure causing it. Read about toe pain.
How we help
Safe nail and callus care, blister prevention and management, plus spike fit, sizing and lacing advice. Recurring nail problems? See ingrown toenail treatment.
Not every niggle needs an appointment. But bone pain is not a niggle, and the athletes who lose a season
are almost always the ones who gave it another fortnight to see how it went.
Stop training, see us urgently
Same-day or next-day assessment
Pain you can cover with a single fingertip
A vague, deep midfoot ache that returns with every session
Pain that wakes you at night, or is reproduced by hopping
A sudden snap at the back of the ankle and no push-off
Sudden big toe pain and swelling after a start or take-off
Shin pain that has narrowed from a broad ache to one point
A second or third bone stress injury in the same athlete
Book within 1 to 2 weeks
Manageable now, expensive to ignore
Achilles stiffness that warms up but aches that evening
A deep, bruised ache under the big toe joint
Heel pain that is worst on your first steps of the morning
Shin pain that arrived when you moved onto the track
Ankle pain consistently on one leg only
Blisters or callous in the same spot in every spike session
Wanting an assessment before the track season opens
Breaking down every time the spikes come out is not fragility. It is a spike volume that climbs faster than your forefoot adapts - and that is fixable.
Every plan is built around your event, your competition calendar, your spike volume and the surfaces you
train on. A sprinter and a 5000m runner do not get the same plan, because they do not have the same feet
by the end of a season.
1
Assessment of how you actually load
We look at movement under load, not a static foot on a mat. In track, that means the forefoot, the big toe joint and the calf-Achilles complex under intensity.
Video gait analysis, footstrike and push-off mechanics
Big toe joint range and sesamoid loading
Calf capacity, ankle range and hip strength testing
Spike volume, surface change and session intensity history
Spike review: plate stiffness, fit, sizing and lacing
Energy availability and fuelling where bone stress is involved
2
Evidence-based treatment
Treatment follows the diagnosis, not a package. Depending on what we find, your plan may include:
Spike-volume management rather than blanket rest
Progressive tendon loading for Achilles, peroneal and tib post
Sesamoid padding, forefoot offloading and joint protection
Safe nail and callus care, blister prevention before race day
3
Criteria-based return to speed
Rather than a date on a calendar, we give you milestones you have to hit before you add intensity, before you return to spikes, and before you race. Reintroducing spikes is the step athletes rush, and it is the step that costs them.
Staged progressions with clear pain rules at each intensity
A deliberate, gradual spike reintroduction protocol
Strength and capacity milestones before speed returns
Communication with your coach, physio or athletics club
4
Prevention and performance
Once you are back at full speed, the job changes: keeping you there through a competition season. In track, that means the forefoot tolerates what the event asks of it.
Sensible spike-volume progression across the season
Ongoing calf, foot and big toe strength work
Spike selection, plate stiffness and fit for your event
Session design and direction variation to manage bend asymmetry
What we will not do
We will not put you in orthotics because you sprint. The evidence does not support matching devices to arch
height, and where a device is genuinely indicated it has to be built for a spike - minimal, light, and
without dulling ground feel, because anything else is useless to you. We will not prescribe rest as a
treatment for tendon pain, because rest deconditions the tendon and the problem returns with your first
session back. And we will not clear a bone that hurts because you have a meet in three weeks. The navicular
and the sesamoids do not negotiate. We will tell you the truth about that meet, then get you to the start
line of the next season with a foot that lasts it.
Why Up & Running
Treated by someone who has raced at national level
Track is a small world, and it has its own vocabulary. You should not have to explain what a spike plate
is, or why you cannot simply take six weeks off in February.
A national-level middle-distance runner
Matt ran 1:47.19 over 800m and finished fourth at the 2019 Australian Championships. He has trained in spikes, raced in spikes, and been injured by them.
Forefoot pain is the clinical specialty
Sesamoiditis, turf toe and metatarsal stress injuries are the region track punishes, and they are exactly what Matt treats. Sesamoid pain is one of the most misdiagnosed injuries in athletics.
Orthotics that actually fit inside a spike
A spike is an extremely low-volume shoe. Matt’s advanced orthotic manufacturing experience means we can build minimal devices that offload a sesamoid without adding weight or dulling ground feel.
Spike volume, not weekly mileage
We start with what changed - the week the track opened, the session that doubled. Blaming your arches first is the fastest way to treat the wrong thing.
Video gait analysis
A running assessment looks at footstrike, push-off and strength under load, reviewed by Gary Johnstone, an Ironman World Championship finisher with 15+ years in sports podiatry.
HICAPS on-the-spot claims
All major health funds accepted. Claim your rebate instantly at every appointment, at every clinic, with no paperwork and no referral required.
800m PB 1:47.19 · 4th, 2019 Australian Championships
Matt has extensive experience in orthotic modification and injury prevention, drawing directly from his
background as a high-level middle-distance runner. He enjoys helping patients overcome foot and forefoot
pain, combining biomechanics expertise with practical solutions - which in track means understanding what
a rigid spike plate does to a sesamoid, and how to offload it without compromising the shoe. His passion
for whole-foot health shows in every consultation.
Gary brings 15+ years of sports podiatry and a calm, methodical approach to complex ankle and tendon
injuries - the caseload that middle-distance and endurance track events produce. He has run a 2:39
marathon and finished the Ironman World Championship in Hawaii, and his clinical focus centres on
optimising performance through strength and movement efficiency rather than reaching for a device first.
He uses orthotic therapy precisely when it is clinically indicated.
Personal achievements
Marathon 2hr 39min · 10km 33min
Ironman World Champs Hawaii, 9hr 24min
Geelong 70.3 Ironman 2017, AG 1st place
VFL Reserves Premiership, Port Melbourne FC
Professional credentials
Consulting Podiatrist, Melbourne Demons AFLW
Consulting Podiatrist, Williamstown FC (VFL)
Member, Australian Podiatry Association
Member, Sports and Exercise Podiatry Australia
AHPRA RegisteredAPA Member15+ Years ExperienceComplex Ankle & Tendon
This page was written by Matt Scott and clinically reviewed by Gary Johnstone, and is maintained by the
Up & Running Podiatry team. It is general information, not a diagnosis.
Book an assessment to get advice specific to your foot.
Explore our services
Services for track athletes
Commonly part of a track and field athlete’s treatment plan at our Melbourne clinics.
Three locations across Melbourne's inner west and south. Same-day appointments and all health funds
accepted. Choose the clinic nearest you and book online in under a minute.
The questions we are asked most often by track and field athletes at our Melbourne clinics.
Less than most athletes do, and increased far more gradually. Spikes are a competition tool, not a training shoe: the rigid plate and raised heel load the Achilles, forefoot and big toe joint dramatically.
Spike volume is the number to track, not your total weekly mileage, and it should climb slowly across the season rather than jumping the week the track opens.
That description fits sesamoiditis - irritation of the two small bones sitting beneath the big toe joint. It is tender to press, worse barefoot on hard floors, and worse again in spikes.
It is an under-diagnosed track injury, frequently written off as general forefoot pain, and the sesamoids heal slowly if a stress injury develops. Worth having assessed rather than trained through.
It can, over time. Running the bend loads your two legs differently and asks more of the outside leg’s stabilising tendons, particularly the peroneals.
It is rarely the sole cause of an injury, but in an athlete already carrying a niggle it is a contributor worth addressing - through session design, direction variation in warm-ups, and targeted strengthening.
How localised it is. Shin splints ache across a broad band of the inner shin, several centimetres long. A stress fracture is typically a point you can cover with one fingertip.
Pain that wakes you at night, or that is reproduced by hopping on the spot, points to bone. If in doubt, treat it as bone and get it assessed - being wrong in that direction costs you far less.
Yes, but they must be made for the spike, not adapted into it. A spike is an extremely low-volume shoe, so a bulky device is useless - and for a sprinter, anything that adds weight or dulls ground feel is a non-starter.
Matt’s advanced orthotic manufacturing experience means we can build minimal devices that offload a sesamoid or support an arch without compromising the shoe.
The navicular sits at the top of the arch and takes enormous compressive load during sprinting and jumping. It has a poor blood supply, so it heals slowly and unreliably, and it presents deceptively - as a vague, deep midfoot ache that settles with rest and returns with the next session.
Speed and jumping athletes are the ones at risk. It is the injury that ends seasons, and early diagnosis genuinely changes the outcome. If you have a midfoot ache you cannot explain, do not wait it out.
It is a genuine and under-recognised factor. When energy intake does not match training demand, bone health, hormonal function and recovery all suffer, and stress fractures become considerably more likely.
It affects male and female athletes alike, and it is especially worth exploring in endurance and jumping events. If you have had recurrent bone injuries, we will raise it with you and refer to a sports dietitian or physician where appropriate.
Often, with the right plan. Pain that warms up and then flares the next morning is a signal, not a stop sign - but it does mean the load needs managing rather than ignoring. Tendons respond to correctly dosed loading, not rest, which deconditions them.
We will typically keep you training while adjusting spike volume and intensity, adding shockwave therapy for cases that have dragged on.
Heel pain in growing athletes is commonly Sever’s disease, an irritation of the heel growth plate - and spikes make it worse by loading the forefoot and tightening the calf.
It is common, very manageable, and rarely requires full time off athletics when addressed early. Our kids’ feet service is built for young athletes.
No. Podiatrists are primary contact practitioners, so you can book directly without seeing your GP first. Private health rebates apply with extras cover and can be claimed on the spot through HICAPS at all three clinics.
A referral is only needed if you are accessing a Medicare Chronic Disease Management plan through your GP, which is a separate pathway and not typical for a sporting injury.
Track injuries are load injuries. Caught early, most are manageable without losing a season. Book with a
podiatrist who has raced at national level and understands spikes, sprint mechanics and the forefoot. You
will leave with a diagnosis and a plan, not a generic set of stretches.
