Podiatry for sports injuries
- Cause: inflammation of the arch fascia due to over-stretching.
- Treatment: customised orthotics to support the arches.
- Prevention: gait and biomechanic analysis from a podiatrist who will fit the patient with customised orthotics.
- Injury common with: running and sprinting (and any sport involving running).
- Cause: sudden movements when swerving, twisting or spinning that cause the ligaments supporting the ankle joint to stretch and overextend, sometimes to the point of tearing.
- Treatment: immediate return to play may be possible if NSAIDs are administered to reduce inflammation and the ankle joint is carefully strapped and stabilised. Following that, rest, ice, compression, elevation and stablisation.
- Prevention: strapping to help stabilise and support the joint, and complete rehabilitation of any existing ankle sprain as most of these injuries occur on already injured ankles.
- Injury common with: gymnastics, running, soccer, basketball, (sports involving a high frequency of sudden movements or uneven terrain).
Chondromalacia Patella (runner’s knee)
- Cause: misalignment of the patella when running or jumping, causing the cartilage around the knee to wear down. This misalignment is often brought on by gait problems.
- Treatment: NSAIDs to reduce inflammation, rest, ice, compression, elevation and stabilisation. Surgery may be required.
- Prevention: gait analysis to ensure undue pressure isn’t placed on the patella through biomechanics of the feet; customised orthotics; leg strengthening exercises to support the patella.Injury common with: running, football, basketball, hockey (any sport involving large amounts of running).
- Cause: inflammation of the Achilles tendon due to overuse and/or excessive pronation of the foot, which forces the tendon out of alignment.
- Treatment: NSAIDs to reduce inflammation, rest, ice, strengthening exercises. If the Achilles actually tears as a result of trauma, surgery is required immediately.
- Prevention: strengthening exercises can significantly reduce the risk of damage to the Achilles tendon.Injury common with: running, volleyball, basketball, tennis (sports that require a lot of jumping).
- Cause: pain running down the length of the shin caused by running on hard surfaces, such as pavements, and overuse. The muscle that lifts the arch of the foot connects behind the shin, and it’s the stretching of this tendon that causes pain.
- Treatment: rest and ice will relieve immediate discomfort. Customised orthotics should be fitted for long-term treatment.
- Prevention: customised orthotics to support the arches should eliminate shin splints. Injury common with: running, basketball, netball (sports involving running on hard surfaces).
Treating Elite Athletes
Elite athletes have a high risk of injury while participating in sport and the most common sports injuries can all be attributed to podiatric complications. Professional and elite athletes push their bodies to the limit and will often risk injury for a better performance. That being the case, as a group, elite athletes will often mask the symptoms of injury and can make difficult patients by playing down symptoms in an effort to get back on the playing field sooner.
Podiatric treatment is recommended for elite athletes for the prevention and treatment of sports-related injuries and a podiatrist should be a key player in any medical team. It is important for any elite sports physician to recognise the patient’s desire to continue with the competition and, with this in mind, to work closely with the athlete to help prevent injury in the first place; to provide immediate return to play (RTP) treatment if the nature of the injury allows immediate RTP; and to provide more comprehensive treatment for serious injury. RTP readiness should be tested and only granted if the patient has regained full range of motion, strength, and if functional motor skills such as running and jumping have returned to normal.
Treatment will most often fit with the PRICES acronym: protect, rest, ice, compression, elevate, stablise, with compression and stabilisation techniques used to prevent injury as well as to treat it. Compression stockings and braces have been proven to be effective in providing sufficient support to reduce the risk of injury during sport and can be important aids in injury prevention, as can the right sports shoes and the fitting of orthotics.