Foot problems in Atheletes
The foot is biomechanically the most stressed out body part. We are all aware of the 10000 steps per day which is 7 km per day and try to follow it. As per this count, it is said that by age 78 years, each person walks atleast 2,00,000 km. Foot problems are sudden (acute) or of slow-onset.
There are over 30 bones, joints and ligaments in the foot. There are four muscle groups for ankle and four more for the foot making it a complex chain for fine actions.
Acute foot problems
Ankle fractures (bimalleolar) followed by Lisfranc midfoot fractures and small toe fractures are the most common. If not displaced, they need plaster, strapping or special boots and braces. When displaced, they may need surgical fixation.
Achilles tendon followed by peroneal and tibialis anterior tendons are most commonly injured in varying grades.
Chronic long-standing problems
- Stress fractures of second metatarsal and distal tibia are most common in bones.
- Any tendon/muscle may experience chronic tendinosis, partial or complete tear depending on the sport.
- Plantar fasciitis and retrocalcaneal bursitis behind heel is also common.
- Any bone can have bone contusions or edema, cartilage lesions (especially Talus) and joints have experience instabilities.
- The Atheletes-foot is a fungal infection with itchy, stinging and burning feet. Using good steroid and antifungal creams with fresh socks and footwear helps.
- Ingrown toenail (nail grows inward) may need excision and fungal toe nails need medical management.
- Claw toes and hammer toes need stretching appropriately and surgery if needed.
- Spurs on xray are always a concern, but remember they are a reflection of other problems only.
Diagnosis
Depending on condition, clinical examination with either xray/ultrasound or mri is needed for diagnosis.
Treatment
- Footwear modification
- Use arches, wedges, MCR/MCP insoles as needed
- Gait training
- Use alternate training surfaces
- Use rest periods to incorporate healing phases appropriately
- Stretching and strengthening should be balanced
- Selective muscle conditioning and tensioning
- Routine foot inspections for corn, blister, callus etc
- Ultrasound guided steroid and PRP (platelet rich plasma) injections
- Medications for reducing swelling and helping healing
- Strapping, bracing and crepe bandage
- Plaster of paris application
- Surgery for bones/ligament reconstruction. The surgery can be done by arthroscopy (key hole surgery) or open surgery
Dr Suman CPS
Consultant orthopaedic surgeon
Sports injuries and arthritis specialist
VGM Hospital
