CONTACT SPORTS & YOUR FEET
Making Contact
For many sports enthusiasts, making
contact is what real competition is all about. Youth football is an
integral part of American culture, and the Super Bowl is the most watched
annual event on television.
Soccer, which fills huge stadiums
the world over, is among the most popular youth sports in the United
States. Other contact sports like lacrosse, from Native American tradition,
and British rugby have become popular as well.
All these sports require miles of
running -- with quick stops and starts -- per game. Competition is usually
on grass fields, which "give" so players may change direction quickly.
It also provides a soft landing surface on which to crash.
Injuries are inevitable in contact
sports. The lower extremities -- an athlete's steering, accelerator,
and braking systems-- are particularly susceptible. But with proper
conditioning, equipment, and technique, competitors in contact sports
have successful, healthy playing seasons.
Podiatric physicicans, specialists
in care of the lower extremity, not only treat injuries athletes and
get them back into competition as soon as safely possible, but also
help athletes get into a condition that minimizes their risk of injury
to the foot and ankle.
Preventing 'Overuse' Injuries
The time a football, soccer, or
lacrosse player spends in an actual game represents only a tiny fraction
of time spent in practice, conditioning for competition. Practice involves
hours of running, repetitive drills, and scrimmages every day.
While conditioning excercises in
practice will strenghthen and improve flexibility in the lower extremity,
the repeated stress of practice may bring on chronic, or "overuse" injuries.
These injuries can nag at a player and hamper, if not end, a season
of competition.
Overuse injuries also come from
faulty biomechanics of the feet -- how the lower extremity physically
adjusts to the ground. If an athlete has "flat" feet, which tend to
pronate (out-toe) or excessively high arches, which often supinate (in-toe),
extensive running and cutting can produce chronically strained ankles.
Before taking the practice field,
it's wise to be examined by a podiatric physician specializing in sports
medicine, who will identify any biomechanical abnormalities that increase
the chance of injury. The podiatrist may recommend specific excercises
to strengthen and improve flexibility of the foot and ankle, or recommend
taping or padding of the foot or ankle before practice and competition.
A podiatrist may also prescribe orthoses, customized shoe inserts that
correct biomechanical problems by redistributing the body's weight.
Podiatric physicians say proper
stretching and warmup before and after home workouts, practice, and
before games go far to prevent overuse injuries to the supporting structures
of the lower extremity. Warm-up and cool-down exercises should take
5-10 minutes and should be conducted in a stretch/hold/relax pattern,
without any bouncing or pulling. When muscles are properly warmed up,
the strain on muscles, tendons, and joints is reduced.
Crashes, Bumps and Bruises
Football players, who today more
than ever combine size with speed, experience high-impact collision
on virtually every play. Lacrosse players "check" much like hockey players,
but wear thin pads on the arms and shoulders. Rugby players wear no
padding at all. Though technically soccer is not a contact sport, players
of any age will tell you that high speed collisions, kicks in the shin,
and body contact happens all the time.
The foot and ankle bear the brunt
of the crashes, bumps, and bruises of contacts sports. Feet get stepped
on, kicked, jammed, twisted, and cut. Quick changes in direction and
hard tackling can lead to sprains and fractures of the ankle.
Impact, or "trauma injuries are
more serious than overuse injuries, and require recovery time away from
the practice and game field. Immediate treatment should include the
"RICE" formula: Rest, Ice, Compression and Elevation.
Trauma injuries should always be
treated by a medical professional such as a podiatrist, and be fully
healed before returning to the field. Players who lie about how an injury
feels, or take pain-killers to play through a trauma injury, are not
helping their team by doing so, but rather putting themselves in danger
of aggravated or permanent injury.
Footwear
Cleats are the footwear of choice
for all contacts sports down to the youth leagues. Cleats are generally
safe for young ankles, say podiatrists. Cleats should be light and flexibile,
and always fit properly. Uppers should be supple (no hand-me-downs,
please), and there should be, and at least a finger's width should separate
the tip of the big toe and the end of the shoe. Laces should be tight.
When shopping for cleats, wear the
same style of socks you intend to wear in competition. Shop in the afternoon,
when the feet are naturally slightly swollen. Investing in proper footwear
for a young athlete is much less expensive than medical treatment later.
Artificial Turf
Contact sports are sometimes played
on artificial turf, which presents a new set of concerns for an athlete.
Some surfaces simulate the texture of grass, and others are little more
than carpet. All forms of artificial surface are harder than grass,
and make for speeded-up competition. Cross-training shoes or sneakers
are the footwear of choice on artificial turf.
Because the surfaces do not "give"
like grass, playing on them may be more hazardous to the lower extremity.
Players should be well-familiarized with the dynamics of running and
changing direction on "turf" before competing on that surface.
Trainers and physicians frequently
tape the feet and ankles of their players for added stability, especially
on artificial turf. Proper taping can help prevent injuries from occurring,
and keep a minor injury from becoming a major one.
Injuries and Treatments
Keeping the lower extremity healthy
is so important to an athlete that most all professional football and
soccer teams have a team podiatrists, who treats minor problems like
corns, calluses, and blisters, to major injuries like fractures and
dislocations. These are the most common injuries suffered in contact
sports:
Turf Toe. Turf toe is a
painful jam or hyperextension of the big toe. The condition is more
common on artificial turf, but can happen on grass as well. Immediate
treatment includes the RICE regimen, and wearing a stiffer shoe prevents
aggravation of the injury. Splinting the toe or special orthoses can
also help.
Ankle Sprains. Making contact
on a firmly planted ankle can forcibly invert the joint and damage ligaments,
resulting in a sprain. Immediate treatment using the RICE formula to
reduce swelling is important to quick healing. Any sprain that doesn't
show improvement in three days should be checked by a podiatric or family
physician.
Stress Fractures. There
are two distinct kinds of fractures that require vastly different treatment.
Stress fractures are incomplete cracks in bone caused by overuse. Stress
fractures heal with complete rest. Extra padding in shoes helps prevent
Fractures. Fractures are
more serious injuries that require immediate medical attention. Casting
and sometimes surgery is required to immobilize fractures and set breaks.
Requiring 10-12 weeks for rehabilitation, a fracture or a break essentially
ends a season of competition in any contact sport.
The American Podiatric Medical Association operates a toll-free telephone
service, 1-800-FOOTCARE (1-800-366-8227), from which consumers
can obtain informative literature on a variety of foot health topics.
The American Academy of Podiatric Sports Medicine, an affiliate of APMA,
may be reached at 1-800-438-3355.
Produced in cooperation with the American Academy of Podiatric Sports
Medicine
