SPORTS PODIATRY

When we are active, our lower limbs carry a significant amount of load, which well-exceeds our body weight. Though our body have the ability to recover, the strain from our exercises and activities can at times exceed our body’s recovering ability. When this happens, wear and tear in our tissues and joints takes place, leading to conditions that can affect our mobility. The following are just some of the conditions out of the many that we manage.


ANKLE INJURIES
The ankle is a wonderful but complex structure of our lower limb which plays a critical role in our mobility. The ankle takes a significant amount of pressure and weight in our daily life which makes it susceptible to both acute injuries and chronic conditions. Many traumatic injuries of the ankle are as a result of sporting activities. If these are left unattended clinically, they may lead to chronic instability
of the ankle.

It is known that the greatest risk for an ankle sprain
is chronic instability of the ankle from a history of previous sprains. Increases in activity level can induce changes in muscle activity and lower limb kinematics, potentially leading to instability at the ankle joint. Treatments for ankle injuries can involve therapeutic measures such as the use of orthotics and directed rehabilitation. Balance training along with wearing ankle stabilisers and braces, along with modifying activity type and level can effectively reduce the risk of recurring ankle sprains while improving the functioning of the joint.

ANTERIOR KNEE PAIN
This condition is also known as Patellofemoral Syndrome, which is a frequently occurring musculoskeletal condition that has a significant impact on participation in daily and physical activities. This condition arises when the knee cap (patella) does not glide smoothly in the groove at the end of the thigh bone (femur). Treatments for knee pain involve balance and muscle training as well as accommodating and supporting structural factors that’s relating to the condition.


The bone-to-bone contacting surfaces have cartilage just like other joints in our body. Overuse, unsuitable activities and poor gliding of knee joint can cause acute to chronic pain at the knee in all age groups, eventually leading to the breaking down of the cartilage. The patella is attached to the quadriceps muscle found at the front of the thigh bone. It is sensitive to changes in force/load and muscle imbalances, therefore making it a rather vulnerable structure. People with knee pain may have weak or inactivated quadricep muscle groups or other abnormal bony changes and joint diseases which causes misalignment or dysfunction of the patella.


Patellofemoral Syndrome can be caused by muscular imbalance in the quadriceps where strengthening and balance enhancing exercise maybe conducted. If symptoms are caused by poor biomechanics further down the lower limbs, orthoses maybe used to address the issue. Studies have shown that patients with anterior knee pain who used foot orthotics reported greater improvements in symptoms than patients who opted for the ‘wait and see’ approach.

PLANTAR HEEL PAIN
Plantar heel pain is characterised by severe pain under the ‘heel bone’, which may shoot along the underside of the arch. It is often severe during the first few steps in the morning, post-activity and after long periods of standing. Treatments for plantar fascial heel pain may include, padding and possible orthotic therapy, changes in activity type and style and the wearing of night splints for more severe cases. It is important to seek out podiatric help earlier on, as waiting and seeing if it gets better can result in continuous damage and inflammation to structures.


Plantar fasciitis, among the other causes of heel
pain (tarsal tunnel syndrome, posterior tibial tendon dysfunction, plantar fasciosis, plantar fasciopathy and heel spurs), are the most common causes of heel pain. Plantar fasciitis is usually caused by the overloading
of the plantar fascia, which becomes inflamed and thickens. The pain produced is often described as aching and bruise-like, as if walking on a stone. Factors which can contribute to getting plantar fasciitis include tightness of the posterior leg muscles, fat pad reduction under the heel, reduced mobility of the ankle and big toe joint, choice of footwear, inappropriate activity levels as well as occupation. Prolonged inflammation of the fascia can lead to degeneration and possible nerve entrapment along with
bony changes.

ACHILLES TENDINOPATHY
Achilles tendinopathy is a condition which is characterised by sharp aching pain that is caused by the tissue damage of the Achilles tendon at the back
of the heel. People with Achilles tendinopathy usually present with palpable, sometimes visible swelling and stiffness of the Achilles tendon. Treatments for Achilles tendinopathy may involve, deep tissue and fascial release therapy as well as orthotic therapy, followed by function enhancing exercises.


The function of the Achilles tendon is to connect the calf muscles to the heel bone (Calcaneus). It is thought to be caused by repeated tiny injuries to the Achilles tendon due to overuse. The tendon transmits some of the force generated by the muscle to the bone and
also acts as a buffer to the external forces such as ground reaction force, so as to limit any damages
to the muscles. This property of the Achilles tendon demands great mechanical strength, flexibility and elasticity. Achilles tendinopathy can happen both in an acute and chronic manner, by a single and substantial trauma or gradual overuse where the tendon is unable to cope with the constant overloading. These cause miniature tears of different sizes in the tendon. Severe trauma can cause rupture of the tendon where a popping or snapping sound of the tendon may be heard. This is then followed by a sudden onset of sharp pain and loss of strength and function which makes lifting the heel off the ground  extremely difficult or impossible.

Women have about four times as many foot problems as men.High heels are partly to blame.

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