Dr Mark Nelson
Foot & Ankle Specialist
Winter Court Sports Can Present Problems for Feet, Ankles
Podiatric Foot and Ankle Surgeon Stresses Prevention
PARK RIDGE, IL.--With the pounding and movements that feet, ankles and the Achilles and other tendons around the ankle endure, court sports such as basketball, racquetball and tennis present unique problems for athletes, whether theyíre NBA types or weekend warriors. But from Shaq to the kid next door, preparation and common sense go a long way toward prevention.
Hard surfaces and sports calling for fast, lateral movements are two characteristics of indoor sports that can contribute to injuries, according to a sports medicine expert with the American College of Foot and Ankle Surgeons. "One of the most frequently encountered court injuries is the common ankle sprain," said Thomas E. Shonka, DPM, FACFAS, attending podiatrist at the Boulder Center for Sports Medicine. "Theyíre often due to the lateral aspect of the sports and, especially in basketball, the potential for stepping on a competitorís foot."
Other court injuries are more shock-related, such as stress fractures in the foot or tibia. "Stress fractures can be hard to detect and many times people with stress fractures will continue to play and delay the correct diagnosis," Shonka said.
"If the stress fracture is in the metatarsal bone, the most frequent site for stress fractures, there can be swelling in the forefoot. But stress fractures can occur in any of the 26 bones of the foot without many symptoms," he said. "Some are more common than others, but all of them can happen in court sports." Shonka cautioned that in the stronger, more dense area of the mid-foot, stress fractures can take a long time to diagnose, and if not properly diagnosed, can lead to devastating consequences. Whether competing in court sports on an organized level or in everyday use, the foot should not hurt. If pain persists, consult a podiatric foot and ankle surgeon.
Another common injury site is the heel. Heel pain can indicate a plantar fascia injury or bone spur. The plantar fascia is a thin, very strong tissue band that supports the arch of the foot, stretching from the heel to the ball of the foot. "As the arch falls, the band of tissue is under increasing tension and the weakest link is where the tissue attaches to the bottom of the heel," Shonka said. "Over time and with repeated shocks, micro-events can occur and cause the fascia to tear from the heel, resulting in bone spurs."
Ninety-nine percent of the time, conservative care is effective in relieving painful heels, according to Shonka. "For the few who donít respond, we consider a surgical approach." The most common surgical treatment is to release the portion of the plantar fascia where it attaches the heel through the use of an endoscope.
Shonka also noted that podiatric foot and ankle surgeons frequently see injuries to the Achilles tendon and other tendons about the ankle that often could be prevented. "It is very rare that someone will do appropriate stretching for their Achilles and calf muscle units," Shonka says. "These stretches go a long way toward prevention. A ruptured Achilles tendon requires surgery and is very common in baby boomers who arenít flexible and donít warm-up." Shonka stresses Achilles and calf stretches as crucial prior to competing in court sports.
For a gentle stretching of the lower extremities and the Achilles tendon, lean against a table or wall, placing one foot behind the other. Point the toes slightly inward and roll the ankle toward the outside. Gently lean forward and feel the stretch high up into the calf muscle. Always roll the weight to the outside border of the foot and never stretch to the point of producing pain.
Additional tips include:
"Boys and girls often go from soccer season right into basketball and the collective shock from running and the pull of the Achilles can cause growth plate damage," Shonka cautions. "Weeks and weeks of practices and games add up."
This article was provided with permission from the American College of Foot & Ankle Surgeons.
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