sports injuries

One of the keys to a killer golf game is strong ankles. As your ankles and feet are the only body parts in contact with the ground when you swing your clubs, keeping them in peak condition is essential.

golf swing strong anklesEvery golfer knows that their game depends on their swing and their swing depends on balance. If you have poor mechanics or tend to shift your weight, your balance will suffer and your swing will go off the rails. Strong ankles are key to maintaining your balance and hence your swing, so you'll spend less time in the sand trap. Or complaining of back pain.

The exercises below are meant to strengthen ankles and calf muscles, including ankle inverters and everters, responsible for the side-to-side movement of your feet. Strengthening these groups of muscles is extremely important for stability through your golf swing, especially on uneven surfaces.

1. Raise yourself on your toes. This is pretty self-explanatory. It's simple and very effective at strengthening the muscles in your calf, foot and toes.

While lightly holding on to the back of a chair to mainatin balance, slowly raise yourself on the toes of both feet. Repeat 10 times. For a challenge, try raising one foot off the ground, shift all of your weight to the opposite foot, and raise yourself on the toes of just one foot.

If you're in decent shape and would like a bigger challenge, hold on to light free weights while doing this. Don't go too heavy on the weights or you'll place undue stress on the muscles and do more harm than good. For balance training, alter your stance by pointing your toes in or out, or place one foot in front of the other.

2. Balance yourself on one leg. Not much explanation needed here. Pick one foot off the ground and hold for 20 seconds. Repeat with the other foot. If you're just starting, make sure you have a table or chair close by to hold onto until you maintain your balance. For "advanced users", stand on a pillow, which will simulate an uneven surface.

ankle exercises for golf

3. Stretch your heels and calf. Runners will be familiar with this one, as it's excellent at stretching out your heel cords. Stand facing a wall, keeping your back straight. Place your hands on the wall. One leg should be slightly forward and bent and the other leg extended behind you with the heel flat and the toes pointed in slightly. Keep both heels flat on the ground and press your hips toward the wall. Hold for 30 seconds and repeat. Then switch legs and repeat. To add an ankle stretch,  perform the stretch from this position again, but bend both knees slightly. Keep your hips centered over both feet.

4. Sitting calf and ankle stretch: Sit on the floor with both legs extended straight. Loop a hand towel around the ball of your left foot and grasp the ends of the towel. Gently pull the towel towards you while keeping your leg straight. You'll feel the stretch in your calf and ankle. Hold for 30 seconds and repeat with the right foot.

5. Increase your ankle's range of motion. Sit in a chair of sufficient height so your feet do not touch the floor. Leading with your big toe, write each letter of the alphabet with your foot. Keep the movement small, using just your foot and ankle only, not your leg.

6. Strengthen your ankle's dorsiflexion and plantar flexion. You'll feel the muscles going to work in your calf, shin, the back of your heel, and the top of your foot. With your legs straight our in front of you and your heel on the floor, anchor an elastic band on a chair or table leg, and then wrap it around your midfoot. Pull your toes toward you and push your heel forward. Repeat 10 times. This strengthens dorsiflexion. To strengthen plantar flexion, loop the elastic band around the ball of your foot and hold the ends in your hand. Without pulling on the band, point your toes forward and then slowly return to the starting position. Repeat 10 times.

Keep your ankles in tip-top shape and you'll have a much better time on the greens.

Wednesday, 28 January 2015 13:57

Foot Fractures in Adults

If you're an adult, there's a very good chance that you've fractured or broken a bone in your foot at some point. After all, there are 26 bones in each foot, and they have to take the impact of everything from walking to skydiving. That means there's a high percentage that at least one of them is going to fracture under the stress, which can range from a small crack in the bone known as a stress fracture, to a complete break which penetrates through the skin.

broken foot fractured footThe adult foot is divided into three sections: the forefoot, made up of the toes (phalanges) and the longer bones which connect to them (metatarsals); the midfoot, which contains a collection of bones that form your arches (navicular bone, cuboid bone, and cuneiform bones); and the hindfoot, which contains 2 bones that form part of your ankle and all of your heel (talas bone and calcaneus). Additionally, in most people there are very small bones called sesamoids at the base of the big toe. That's a lot of moving parts, and a fracture can occur in any of them.

Symptoms of a foot fracture

  • Tenderness, bruising, or swelling
  • Breaks in the skin of the injured area
  • Pain when you try to stand or walk
  • Inability or decreased ability to move your foot
  • "Cracking" sounds when you move your foot
  • Foot is misshapen

It's essential to have a foot fracture treated as soon as possible by a podiatrist, so that the bone and tissue injury heals correctly. Without treatment, you run the risk of developing arthritis in the fractured area, blood clots, deformity, persistent pain, infection, weakness, reduced movement, loss of feeling in your foot or damage to blood vessels, tissues and nerves.

Types of fractures in the foot

  • Stress Fracture: A bone is subjected to repeated stress, usually the result of athletic activities, walking or marching.  When the bone can no longer absorb the stress, it cracks. This is known as a "stress injury".
  • Hairline fracture: A minor crack in the bone which is difficult to see on x-rays.
  • Open Fracture: The skin and soft tissue covering the bone are torn, and the bone may be seen coming out of the skin. This kind of fracture can easily lead to infection.
  • Closed Fracture: The skin is not torn.
  • Comminuted: Bone is broken in multiple spots, usually due to trauma or osteoporosis.
  • Avulsion Fracture: Small fragments of bone detach from where tendons or ligaments attach to the bones.
  • Joint fracture (intraarticular): Affects the surface of one of the joints. May lead to a loss of motion and osteoarthritis.
  • Simple Transverse: A clean break across the bone.
  • Displaced: The bone breaks in two pieces and must be realigned.
  • Nondisplaced: Even though the bone is completely cracked, normal shape and alignment are intact.
  • Angulated: The broken ends of the bones are at an angle.

There are a number of options your podiatrist may choose to treat your foot fracture. The treatment depends on what kind of fracture you have, where it's located in the foot, and how much discomfort it's causing you. Your podiatrist may choose one or more of the following treatments:

  • Air boot (walking boot), cast, or splint. Immobilizing your foot is key to healing the bone correctly, reducing your pain, and preventing additional fractures or other damage.
  • Prescription or over the counter medicine to reduce pain
  • Antibiotics if the fracture might lead to an infection.
  • Surgery if the fracture is severe. Your podiatric surgeon may need to remove damaged and infected tissue to prevent infection and speed healing. They may also realign the bones and fix them in place with screws, wires, pins, metal plates, or external fixation devices.

After initial treatment, your podiatrist will order you to rest and elevate the foot whenever possible, and ice the foot if it's swollen or painful. When the bone has healed, they may order physical therapy to help improve range of motion and strength in the bone and help to decrease any residual pain.

 

Very few adults are strangers to heel pain. At some point in our lives, we've run too hard, hiked too far, gained too much weight, played basketball in past-their-prime sneakers, or didn't rest when we should have. Sometimes it even appears for no reason we can pinpoint. But without a doubt, we never forget that pinching and excruciating pain in our heel.

heel pain causes and treatment

Heel pain occurs in the underside or the back of your heel. When it appears on the underside, it's usually a result of damage or irritation to the plantar fascia, the tendon which runs from your heel to the base of your toes. This type of heel pain is called plantar fasciitis. If heel pain occurs at the back of your heel, the cause is usually damage to the Achilles tendon, such as achilles tendinitis. But heel pain can also be caused by arthritis, a bruise, heel spurs, gout, pinched nerve, bursitis ("pump bump"), peripheral neuropathy, a fracture, bone infection, or other conditions. For this reason, any heel pain should always be evaluated by a podiatrist to determine the best course of treatment to get you back on your feet as soon as possible.

Schedule an appointment with a podiatrist if:

  • You have severe pain and swelling near your heel
  • Severe heel pain after an injury
  • Inability to bend your foot downward without pain
  • Inability to rise on your toes without heel pain
  • Inability to walk without heel pain
  • Heel pain that continues when at rest
  • Heel pain that lasts more than 1 week

How to treat heel pain at home

Rest, Ice, and Elevation. Ice packs on the heel reduce inflammation, especially when paired with over the counter anti inflammatory medicine like advil or aleve. Rest and elevate the sore foot whenever possible.

Change your routine. If heel pain is the result of an athletic injury, change your routine. Training the same way, on the same surface, with the same shoes, will only make things worse.

Stretch before working out. Stretching your feet, raising yourself on your toes, even walking, will help warm up the plantar fascia and achilles tendon, reducing the risk of injury. When muscles, tendons, bones, and joints are gently warmed up before a workout, they're much better at handling the load you demand of them.

Are you wearing a quality pair of shoes? Whether athletic shoes or dress shoes, your footwear must fit your feet correctly and give ample support and padding. You may save money with cheap shoes, but the pain will be expensive.

How a podiatrist may treat your heel pain

  • Custom orthotics to support your feet and relieve pressure on the heel
  • Shoe modifications
  • Prescription medications
  • Steroid injections to relieve pain and inflammation
  • Immobilization in a walking boot
  • Physical therapy
  • If conservative measures are unsuccessful, surgery may be recommended

Read more: Does your child have heel pain?

Skiing is a high speed sport involving quick turns at high speed down a sloped terrain, making huge demands of your feet and ankles. When you make those turns, your foot flattens, your ankle bones lower, and your leg rotates toward the opposing leg. That puts massive stress on everything below your waist. But even with all of that stress, you should never experience pain in your feet or ankles after a day on the slopes, assuming it was accident-free. If your ankles or feet are throbbing, sore, or icy cold when you end up in the lodge, your boots may need adjustment or refitting, or may need to be replaced. But your skiing technique may also contribute.
ski boots feet hurt
Do your ski boots fit correctly? Are they the right boots for your skill level?

In skiing, your boots are your most essential gear, because movement is initiated in the feet and ankles. They should offer plenty of support, but still be flexible enough to allow forward and lateral flexing ankle movements. Ski boots that are too soft or too stiff for your ankle strength and skill cause dysfunctional ankle movement, resulting in pain.

If your ski boots don't fit correctly, your foot may literally bounce around inside your boot, referred to as ankle and heel slop. Boots which are too large - even slightly - cause the ankle to sit too low in relation to the boot's intended ankle pocket area, and this impacts ski turning biomechanics. The result is again, dysfunctional movement patterns which may cause ankle pain.

Contributing to your discomfort can be irregularities in your foot or ankle, such as former sports injuries which become aggravated, or new conditions, such as bunions.

Experienced skiers arrange for foot beds and boot alignment. Professional boot fitters correct your actual ski stance to a neutral position, called canting. The stance of some skiers may need to be moved forward, some more upright. A boot fitter will also mold the boot's inner lining to your foot's unique shape.  If you're experiencing ankle pain, tell the boot fitter about it, and they'll make the appropriate adjustments. But canting and alignment are not magic bullets - you should also select boots appropriate for your skill level.

You may want to consider asking a podiatrist to mold custom orthotics for your ski boots to stabilize your foot.

Do your feet ache? Do they cramp after a day on the slopes?

If your feet ache or are cramping after skiing, it's usually due to the overexertion of the muscles on the bottom of your foot - they're working too hard to maintain control of your skis. This is also a problem with the fit of your boots.

Do your feet turn icy cold?

If your feet become icy cold after a day on the slopes, you either need to wear thicker socks, or you may be overtightening your boots in an effort to control your balance and foot movement. It's never recommended to overtighten your boots for balance, as it creates a false sense of confidence, which could get you in big trouble. Tightening your ski boots also cuts off circulation and causes cramping, which may in turn cause ankle pain.

Is your skiing technique hurting your feet?

Your turning technique may also be to blame for your foot or ankle pain. A smooth turn initiation helps skiers carve clean, controlled arcs. Abrupt turn initiations are jerky, which causes the skier to bang their ankles against the inside of the boot, causing pain. Begin a ski turn by gently and gradually tipping your skis on to their edges.

 

It all comes down to one weak muscle, tendon or ligament. One second you're a young LeBron. The next, crumpled on the court, writhing in pain, out for the season.

[caption id="attachment_4812" align="alignleft" width="400"]UCSB BASKETBALL UC Santa Barbara player Zalmico Harmon. Note how his right foot is flat on the court and his leg is bent outwards as he's pivoting. Your ankles and feet had better be in excellent condition to do that every day.[/caption]

Basketball demands a lot of your ankles and feet - they're subjected to sudden, explosive movements, quick turns, and a relentless pounding on a hard surface. If your lower extremities aren't in perfect condition, a lot can go wrong very quickly. The best way to avoid a missed game or worse, a lost season, is to keep your feet and ankles (and the rest of you) in peak condition. These exercises will work muscles, tendons, and ligaments in your toes, feet, and ankles which are often neglected, at the athlete's risk.

But before we get into that, we'd like to mention that a basketball player should use braces and tape as little as possible during training. They're very useful when recovering from an injury, but for training purposes, they'll work against you. If the muscles in your feet and ankles are immobilized and artificially supported by tape or other means, they don't get worked. And a muscle that doesn't get worked is a weak muscle.

Occasionally you should train in bare feet. We know this isn't a practical suggestion in a public space, but when you're working out solo at home, ditch the basketball shoes whenever possible. The foot is the base of the ankle - build it naturally, without restraint, for better balance, mobility, and strength.

1. Loosen your plantar fascia and foot muscles

While sitting, roll a tennis ball around with the bottom of your foot, applying light pressure. Work it under the arch, the toes, and your heel for 5 minutes on each foot.

2. Develop your Dorsiflexion and Plantar Flexion

When your feet flex upward toward your body, it's dorsiflexion, as when you land on the court after a jump. When the foot flexes down or away, it's plantar flexion, as when you make a jump, sprint, or cut. To condition your muscles to endure this full range of motion, perform a unilateral stretch:

  • Stand on one leg, bend forward, and place your hands on a wall for balance.
  • Stretch your calf muscle and achilles tendon by pushing down on your knee and keeping your foot flat.
  • Raise yourself on your toes to stretch your calf.

3. Develop Ankle Strength

  • Wrap a band around the ball of your foot. Pull back, creating tension on the band, but just enough so you can still move your foot. Push your foot against the band and hold for one second. This strengthens the muscles used for plantar flexion.
  • Wrap the band around the ball of your foot and pull to create tension. Then push on the foot with the other foot. Pull your toes back toward you, hold for one second, and release. This strengthens the muscles used for dorsiflexion.
  • Start in the same position as above. But this time, keep your foot straight and rotate it outward. Hold for one second. This increases the strength of the muscles that control eversion and inversion, the movements that tilt the sole of the foot towards (inversion) or away from (eversion) the midline of your body.

Take the time to do the proper conditioning, and chances are you'll stay safe on the basketball court. If you experience any pain at all, take a break and get the advice of your trainer before continuing. Then follow up with a podiatrist who is expert in sports medicine for a full evaluation.

 

Tuesday, 09 December 2014 17:01

Tips For Winter Foot Care

You may have looked at the title of this post and said, "put on thick socks!"  And you'd be right - that's one tip to protect your feet from the cold this winter. But depending on your health, your lifestyle, and the condition of your feet, you might want to consider a few other tips for winter foot care as well.

[caption id="attachment_4769" align="alignleft" width="600"]winter foot careA good pair of insulated boots and thermal socks are your feet's best defense against winter weather.[/caption]

Cold weather tips for diabetics

If you have type 1 or type 2 diabetes, you're at greater risk of foot injury during the winter months than you are at any other time of year. A side effect of diabetes called Diabetic Peripheral Neuropathy causes a loss of sensation in your feet, the result of persistently high blood sugar which damages blood vessels and nerves. DPN doesn't typically appear overnight - one experiences a slow loss of sensation over a period of years as the damage occurs. This makes a diabetic patient especially vulnerable to frostbite or frostnip, potentially damaging skin and other cells.

Diabetics - and everyone - should use common sense if they're going to be outdoors for a prolonged period. Keep moving to stimulate circulation, take breaks to warm up whenever possible, wear an excellent pair of waterproof boots, and wear 2 pair of thermal socks. Take an extra pair of socks with you in case your feet get wet. If your feet are icy cold to the touch, but you don't feel the appropriate sensation, you may have already developed DPN. Please make an appointment with your podiatrist immediately for an examination and treatment plan.

Cold weather tips for runners, hikers, skiiers, snowboarders, and all athletes

Just because you're moving, it doesn't mean you're invulnerable to freezing weather. In fact, splashing through wet streets, icy slopes, and getting your boots, socks, or sneakers wet, not only opens the door to a wicked wipeout, but also to frostbite or frostnip. Anyone who's spent significant time outdoors hiking, camping, sledding, or skiing is usually acutely aware of this from personal experience. But did you know that once you get frostbite or frostnip, you risk a more severe injury if it happens a second time?

[su_column][su_note note_color="#fff2f6" text_color="#ffffff" radius="3"]Learn to recognize the signs of frostbite (Mayo Clinic)[/su_note][/su_column]

Athletes should avoid training on wet surfaces, or at least splashing through puddles or snow. Hikers, campers, hunters, skiiers and snowboarders should have quality boots and appropriate socks to keep their feet warm and dry. If you notice a loss of sensation in your feet to any degree, get indoors immediately (or somewhere warm), take off your shoes and socks, dry your feet if wet, and allow your feet to slowly warm. If pain accompanies the warming, you may have frostnip. See a podiatrist for an evaluation.

Winter foot care for everyone

  • Use common sense and keep your feet warm and dry.
  • Wear comfortable, insulated boots that leave room for 2 pair of thermal socks. Your winter boots should also have a good sole to give you plenty of traction on wet surfaces.
  • Wear thermal socks. If your feet are cold, wear 2 pair. Pass on cotton - choose synthetic fabrics that wick moisture away from your skin.
  • If your feet tend to dry out in winter, moisturize them on a regular basis. But don't moisturize in between your toes - too much moisture in that area may lead to a fungal infection.
  • Stay well hydrated to avoid chafing. This helps to prevent dry, cracked skin and blisters.
  • Use talcum powder on your feet to keep them dry - good advice for any time of year.

 

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Podiatric Procedures & Services in the Allentown PA 18104, Easton PA 18042, and Northampton PA 18067 area