Foot Conditions
Contact Sports
Description
For many sports enthusiasts, making contact is what
real competition is all about. Youth football is an integral part
of American culture, and the Super Bowl is the most watched annual
event on television.
Soccer, which fills huge stadiums the world over, is
among the most popular youth sports in the United States. Other contact
sports like lacrosse, from Native American tradition, and British
rugby have become popular as well.
All these sports require miles of running -- with quick
stops and starts -- per game. Competition is usually on grass fields,
which "give" so players may change direction quickly. It also provides
a soft landing surface on which to crash.
Injuries are inevitable in contact sports. The lower
extremities -- an athlete's steering, accelerator, and braking systems--
are particularly susceptible. But with proper conditioning, equipment,
and technique, competitors in contact sports have successful, healthy
playing seasons.
Podiatric physicicans, specialists in care of the lower
extremity, not only treat injuries athletes and get them back into
competition as soon as safely possible, but also help athletes get
into a condition that minimizes their risk of injury to the foot and
ankle.
Preventing 'Overuse' Injuries
The time a football, soccer, or lacrosse player spends
in an actual game represents only a tiny fraction of time spent in
practice, conditioning for competition. Practice involves hours of
running, repetitive drills, and scrimmages every day.
While conditioning excercises in practice will strenghthen
and improve flexibility in the lower extremity, the repeated stress
of practice may bring on chronic, or "overuse" injuries. These injuries
can nag at a player and hamper, if not end, a season of competition.
Overuse injuries also come from faulty biomechanics
of the feet -- how the lower extremity physically adjusts to the ground.
If an athlete has "flat" feet, which tend to pronate (out-toe) or
excessively high arches, which often supinate (in-toe), extensive
running and cutting can produce chronically strained ankles.
Before taking the practice field, it's wise to be examined
by a podiatric physician specializing in sports medicine, who will
identify any biomechanical abnormalities that increase the chance
of injury. The podiatrist may recommend specific excercises to strengthen
and improve flexibility of the foot and ankle, or recommend taping
or padding of the foot or ankle before practice and competition. A
podiatrist may also prescribe orthoses, customized shoe inserts that
correct biomechanical problems by redistributing the body's weight.
Podiatric physicians say proper stretching and warmup
before and after home workouts, practice, and before games go far
to prevent overuse injuries to the supporting structures of the lower
extremity. Warm-up and cool-down exercises should take 5-10 minutes
and should be conducted in a stretch/hold/relax pattern, without any
bouncing or pulling. When muscles are properly warmed up, the strain
on muscles, tendons, and joints is reduced.
Crashes, Bumps and Bruises
Football players, who today more than ever combine size
with speed, experience high-impact collision on virtually every play.
Lacrosse players "check" much like hockey players, but wear thin pads
on the arms and shoulders. Rugby players wear no padding at all. Though
technically soccer is not a contact sport, players of any age will
tell you that high speed collisions, kicks in the shin, and body contact
happens all the time.
The foot and ankle bear the brunt of the crashes, bumps,
and bruises of contacts sports. Feet get stepped on, kicked, jammed,
twisted, and cut. Quick changes in direction and hard tackling can
lead to sprains and fractures of the ankle.
Impact, or "trauma injuries are more serious than overuse
injuries, and require recovery time away from the practice and game
field. Immediate treatment should include the "RICE" formula: Rest,
Ice, Compression and Elevation.
Trauma injuries should always be treated by a medical
professional such as a podiatrist, and be fully healed before returning
to the field. Players who lie about how an injury feels, or take pain-killers
to play through a trauma injury, are not helping their team by doing
so, but rather putting themselves in danger of aggravated or permanent
injury.
Footwear
Cleats are the footwear of choice for all contacts sports
down to the youth leagues. Cleats are generally safe for young ankles,
say podiatrists. Cleats should be light and flexibile, and always
fit properly. Uppers should be supple (no hand-me-downs, please),
and there should be, and at least a finger's width should separate
the tip of the big toe and the end of the shoe. Laces should be tight.
When shopping for cleats, wear the same style of socks
you intend to wear in competition. Shop in the afternoon, when the
feet are naturally slightly swollen. Investing in proper footwear
for a young athlete is much less expensive than medical treatment
later.
Artificial Turf
Contact sports are sometimes played on artificial turf,
which presents a new set of concerns for an athlete. Some surfaces
simulate the texture of grass, and others are little more than carpet.
All forms of artificial surface are harder than grass, and make for
speeded-up competition. Cross-training shoes or sneakers are the footwear
of choice on artificial turf.
Because the surfaces do not "give" like grass, playing
on them may be more hazardous to the lower extremity. Players should
be well-familiarized with the dynamics of running and changing direction
on "turf" before competing on that surface.
Trainers and physicians frequently tape the feet and
ankles of their players for added stability, especially on artificial
turf. Proper taping can help prevent injuries from occurring, and
keep a minor injury from becoming a major one.
Injuries and Treatments
Keeping the lower extremity healthy is so important
to an athlete that most all professional football and soccer teams
have a team podiatrists, who treats minor problems like corns, calluses,
and blisters, to major injuries like fractures and dislocations. These
are the most common injuries suffered in contact sports:
Turf Toe. Turf toe is a painful jam or hyperextension
of the big toe. The condition is more common on artificial turf, but
can happen on grass as well. Immediate treatment includes the RICE
regimen, and wearing a stiffer shoe prevents aggravation of the injury.
Splinting the toe or special orthoses can also help.
Ankle Sprains. Making contact on a firmly planted
ankle can forcibly invert the joint and damage ligaments, resulting
in a sprain. Immediate treatment using the RICE formula to reduce
swelling is important to quick healing. Any sprain that doesn't show
improvement in three days should be checked by a podiatric or family
physician.
Stress Fractures. There are two distinct kinds
of fractures that require vastly different treatment. Stress fractures
are incomplete cracks in bone caused by overuse. Stress fractures
heal with complete rest. Extra padding in shoes helps prevent
Fractures. Fractures are more serious injuries
that require immediate medical attention. Casting and sometimes surgery
is required to immobilize fractures and set breaks. Requiring 10-12
weeks for rehabilitation, a fracture or a break essentially ends a
season of competition in any contact sport.
Information provided by the American Podiatric Medical Association
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