Your feet shouldn't hurt
Sacramento, CA (PRWEB) February 04, 2014
From the downhill rush of alpine snow skiing, to the gravity defying acrobatics of snowboarding, to the grace and power of figure skating, winter sports can be a perpetual challenge when it comes to proper foot care. Any problems with the foot or ankle could have serious repercussions for winter sports participants.
Podiatric physicians agree that one of the most important elements for staying injury-free and enhancing performance during winter sports activities is properly fitted boots, and nowhere is this truer than in figure skating, where the skater’s boot is the only thing between him or her and the ice.
Arguably the premier event of the ice rink, figure or ice skating involves grace, speed, balance, flexibility, strength (the male in a skating duo often lifts and holds the female skater above his head), quick stops and turns, explosive power when launching into a jump, and the jarring impact of touchdown from a jump on solid ice. Compared to other sports, ice is the hardest landing surface, and it has virtually no shock absorption. Therefore, the joints in the foot, ankle, knee, hip, and back must do all the work to absorb the shock upon impact.
Foot and ankle injuries are an ever-present part of figure skating. A skater's feet and ankles are tightly secured in a leather or leather-synthetic composite boot, and so bear the brunt of the forces generated while performing the crowd pleasing, more technically dazzling, double, triple, and now even quadruple jumps and spins on the ice.
In addition to foot and ankle injuries, deformities of the foot also tend to be common in figure skaters, and include bunions, or angulated big toe, the enlargement of the navicular bone in the arch of the foot, hammer toes (gnarled and calloused on the top), and pump bumps, or lumps on the back of the heels.
Since figure skaters only use one piece of equipment - boots, a proper fit is critical in helping to prevent injuries and deformities while improving performance in the quest for Olympic gold.
“The most common foot problem I see are young skaters outgrowing their boots,” says Dan Altchuler, DPM, a podiatric physician in Santa Monica, California who treats many junior national figure skaters ranging in age from 8-16. “If their boots are too small, it causes foot pain.”
Boots that are too large also cause problems. “If boots are too big, skaters lace them up tightly, which cuts off circulation and leads to numbness and tingling,” adds Dr. Altchuler. Skaters tend to compensate for the extra room by clenching their toes, causing foot cramps and creating an imbalance of weight distribution over the blade. “Overly tight boots can also put pressure on the tendon that runs from the front of the lower leg to the base of the big toe, which is painful and compromises performance.”
Achilles tendon problems and plantar fasciitis, or heel pain, are also common complaints, as are ulcers and bursitis. Bursitis is the inflammation of a bursa, which functions as a smooth, slippery surface at the points where muscles and tendons glide over bones. Normally, the bursa provides a slippery surface that creates almost no friction. Movement of an inflamed bursa is irritating and painful.
“We all have bumps, small cysts, and irritations on our feet,” says Dr. Altchuler. These cause irritation when pressing against the skate. The most common is “malleolar bursitis” in which the bone that protrudes from the middle of the ankle swells and causes pain. “The best remedy is to put a donut pad on it so there is padding all around the bump but not directly on it.” Dr. Altchuler also recommends using protective padding inserted into the skate lining, or having the skate punched out. Wearing gel-lined socks for extra cushioning can also help.
“Another common figure skating injury is stress fracture, usually resulting from overuse, improperly fitting boots, and/or not enough proper conditioning. If a stress fracture of the foot or ankle is suspected, stop the activity and rest. Ignoring the pain can have serious consequences. The bone may break completely,” says Dr. Altchuler. “Apply an ice pack and elevate your foot above the level of your heart. Non-steroidal anti-inflammatory medicines like ibuprofen or naproxen may help relieve pain and swelling, but may inhibit bone healing. Try not to put weight on the foot until after you see a podiatric physician (foot and ankle specialist).”
“Treatment of a stress fracture will vary depending on the location of the stress fracture and its severity.
“The goal of any treatment is to help the athlete to return to practice and competition. Following the doctor’s treatment plan will restore abilities faster and help prevent further problems in the future. Some non-surgical treatment approaches include:
“Rest; take a break from the activity that caused the stress fracture. It typically takes 6 to 8 weeks for a stress fracture to heal. During that time, switch to aerobic activities that place less stress on foot and ankle. Swimming and cycling are good alternative activities. Remember, however, not to do any physical activity on the involved foot or ankle until after consulting a doctor.
“Wearing protective footwear to reduce stress on the foot and ankle might be recommended by the patient’s doctor. This may be a stiff-soled shoe, a wooden-soled sandal, or a removable short-leg fracture brace shoe.
“Stress fractures in the fifth metatarsal bone (on the outer side of the foot) or in the navicular or talus bones take longer to heal. The doctor might apply a cast to the foot to keep the bones in a fixed position and to remove the stress on foot or ankle involved. Casts are a type of external fixation. To keep weight off the foot and ankle, crutches might be recommended until the bone heals.
“Some stress fractures require surgery to heal properly. In most cases, this involves supporting the bones by inserting a type of fastener. This is called internal fixation. Pins, screws, and/or plates are most often used to hold the small bones of the foot and ankle together during the healing process.”
Many skaters who have foot, ankle or knee problems wear custom shoe inserts or orthotics, which help align their skates properly. Figure skating boots are often narrow and high heeled so Dr. Altchuler advises getting orthotics designed specifically for ice skates. “If you skate a lot, your everyday shoe orthotics are not sufficient.”
The good news is that most winter sports foot injuries - and the resulting damage to the feet and ankles - are preventable, and proper foot health can enhance performance. Follow these simple tips for a healthy and high performance winter workout:
- Wear the appropriate shoes for each sport or activity. Wear proper fitting boots because tight ones restrict blood flow and nerve sensation to your feet. Figure skaters who are still growing should replace their boots frequently to ensure they aren’t too tight or too loose.
- Wear winter weather socks inside of footwear. Podiatric physicians recommend a single pair of thick socks made of smart wool, polypropylene or acrylic fibers that wick away moisture caused by perspiration or melting ice inside the boot.
- Keep feet warm by keeping the rest of the body warm, especially the upper body and head. Feet soaked in snow should get back indoors quickly to avoid the danger of frostbite. Wear a hat and waterproof gloves and dress in layers to prevent getting cold.
- Warm up legs and feet prior to activity. Gently stretch the hamstrings, calves and Achilles tendons.
- Begin any activity gradually. Hit the ice slowly.
- If there is any swelling or discomfort following an activity, elevate and apply ice to the affected area for 20 minutes.
- Pre-existing foot conditions, such as corns, calluses, bunions, or hammertoes should be evaluated by a podiatric physician before buckling or lacing up. Additionally, should conditions develop during skating, a podiatric physician should be consulted. A medical examination is also important for any pre-existing circulatory problems, such as Raynaud’s Disease (a circulatory disease) or diabetes.
To find a local licensed podiatric physician, or for more information on foot care visit http://www.CalPMA.org.
Founded in 1912, the California Podiatric Medical Association (CPMA) is the leading and recognized professional organization for California’s doctors of podiatric medicine (DPMs). DPMs are podiatric physicians and surgeons, also known as podiatrists, qualified by their long and rigorous education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg.
CPMA - Keeping Californians on their Feet – Healthy, Active and Productive.