Overuse injuries of the foot and ankle
It seems to be that time of year when people are becoming more active, engaging in sports and working hard to get in shape for the summer season. In our California foot and ankle clinics, we have seen a recent increase in stress and overuse injuries over the last month or so, likely attributed to this increase in exercise and activity. While we applaud the motivation to live a healthy and active lifestyle, it is important to take some preventive measures to prevent injury. I’d like to discuss some of the common injuries that we see and some preventive measures to keep you healthy and active.
Common stress and overuse injuries of the foot and ankle:
With kids between the ages of 10 and 14, we see a lot of heel pain that is due to inflammation of the growth plate at the back of the heel. The Achilles tendon, which is the largest and strongest tendon in the body, inserts into the back of the heel bone, just behind the growth plate. Kids in track, soccer, gymnastics and such who are spending several days a week in these activities will often develop this condition, know as Sever’s disease or calcaneal apophysitis.
Runners training for a marathon, or those walking on a treadmill several times a week can both develop a stress fracture. This often happens when someone abruptly increases their mileage or number of times per week they are exercising. A stress fracture is usually an overuse type of injury that produces acute bone swelling leading to a crack in the bone. It is due to either normal amounts of stress to a weakened bone (as in the cases of osteoporosis), or abnormal amounts of stress to a normal bone (such as with increased mileage). Pain is usually worsened with increased or repetitive activities. Stress fractures are usually not seen on initial x-rays, and sometimes require an MRI or a bone scan to confirm the diagnosis. They are treated with a period of non-weight bearing to the affected area, and usually require crutches and a cast or cast boot until the bone heals.
Tendinitis, similar to a stress fracture, can develop with an increase in mileage or with any repetitive activity. In the foot and ankle, we commonly see tendonitis develop in the Achilles tendon, or on the inside or outside of the ankle depending on the foot type and mechanics. If you have an area of your ankle that swells up with activity, and becomes very sore, you most likely have a case of tendonitis. Controlling foot mechanics with the proper shoes and possibly with arch supports or custom orthotics, can often prevent or be used to treat a case of tendonitis.
Prevention of overuse injuries is the smartest approach. The following are some tips to keep yourself active and exercising, and will help you avoid a period of recovery.
- foot and ankle stretching excercises are very import before and more importantly, after exercising.
- make sure you have appropriate shoes for your activity (if you don’t know what to look for, schedule an appointment with a foot doctor, or buy shoes from a specialty running shoe store).
- make sure your shoes are not too worn.
- ease into an exercise program (going from no exercise to 7 days a week all of a sudden is unwise)
- what surface are you running or walking on? (flat or angled road, concrete vs dirt or grass, treadmills, etc., can all have advantages and disadvantages.)
- if your arches flatten when standing, get some over the counter arch supports or consider custom orthotics; these can be built specifically for your activity and shoe choice.
- if you start to feel sore, ice the affected area after a work-out.
- if you have consistent pain in one area, get it checked out.
The University Foot & Ankle Institute welcomes you for consultation and treatment of whatever foot or ankle problem you may have. We are southern California’s leading foot and ankle specialists and have years of success in treating and prevention of lower extremity sports injury and other foot and ankle ailments.
Dr. Baravarian been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),
Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.
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