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Summer Games Can Cause Foot and Ankle Pain

American College of Foot and Ankle Surgeons Advises Prompt Treatment

PARK RIDGE, Ill., July 12, 2002 – With the summer recreation season in full swing, many weekend athletes are experiencing foot and ankle injuries for which prompt treatment is the key to avoiding long-term complications, according to experts from the American College of Foot and Ankle Surgeons.

From pick-up basketball participants to over-the-the-hill softball players at the company picnic, summer athletes are vulnerable to foot and ankle problems, which account for 27 percent of all sports injuries. Overuse and insufficient stretching and warm-ups often cause such injuries, says Robert J. Duggan, DPM, FACFAS, an Orlando-based podiatric foot and surgeon and sports medicine consultant to Walt Disney World’s Wide World of Sports.

"At one time or another most athletes suffer sprained ankles and/or heel pain," said Duggan, "and these conditions should be promptly evaluated and treated to restore strength, range of motion and balance. As a precaution, anyone who has had more than one sprain on the same ankle should brace it whenever engaging in athletic activity. Those with heel pain lasting more than a month should seek treatment," he added.

Any sport that requires side-to-side motion, involves several participants in a confined area, or is played on uneven surfaces, presents a significant risk for ankle injuries. Players who have experienced previous ankle sprains that have been inappropriately evaluated and treated may have persistent ankle pain, weakness and instability. Proper evaluation is critical to establish an accurate diagnosis and initiate the right treatment for the injury, according to Richard T. Bouché, DPM, FACFAS, a podiatric foot and ankle surgeon with the Virginia Mason Sports Medicine Clinic in Seattle.

"If symptoms persist, ankle surgery may be necessary to allow the athlete to continue to compete at the desired level. Performing ankle surgery though a conventional incision or though a small puncture incision with an arthroscope enables the podiatric foot and ankle surgeon to look inside the joint and assess the specific problem,"  Bouché explained. He added that arthroscopic surgery, though best known for repairing knee injuries, also is used to repair the ankle joint and lessen or eliminate the effects of arthritis that might be present. "It’s a viable procedure that should be considered to treat chronic ankle pain symptoms when conservative measures have failed," he said.

Tendonitis occurs from overuse and is common among weekend athletes who try to do too much too soon. "While muscle pain is the result of the body’s inability to control swelling, it isn’t normal for tendons to swell," said Duggan. "Tendonitis in the Achilles, ankle or foot, therefore, should be examined and treated without delay."

He added that pain in the Achilles tendon should be evaluated at the first sign of trouble. "If the Achilles is strained or stretched, it should be examined right away to help prevent a possible rupture that will require surgery and a lengthy rehab."

Blisters and neuromas also can be an annoying source of forefoot pain from sports activity. According to  Bouché, blisters occur from excessive moisture and friction, and athletes can be predisposed to this problem by wearing cotton socks instead of the preferred acrylic socks. Poor fitting, constricting athletic shoes also produce blisters as well as neuromas (pinched nerves of the foot), which cause severe pain and numbness of the inner toes.

Certain types of foot and ankle injuries are more common in various sports:

Tennis: Quick stops and starts and lateral movements can cause ankle joints to become unstable, and Achilles tendon pain also is common among tennis players.

Softball: Sliding on the base paths can cause serious ankle sprains and fractures.

Basketball: On hard outdoor surfaces, players are vulnerable to ankle sprains, Achilles pain, stress fractures and heel pain.

Golf: Players who fail to stretch before a round can experience muscle pain from walking up and down hills and from climbing in and out of deep sand traps. Avid golfers also are at risk for neuromas and hallux rigidus, a jamming and deterioration of the big-toe joint.

Running: Injuries occur most frequently when runners fail to stretch and warm up and over do it when training for marathon races. Common foot and ankle problems for runners are heel pain, neuromas, tendonitis and stress fractures.

This article was provided with permission by the American College of Foot and Ankle Surgeons.


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