Sport Medicine

What is podiatric sports medicine?

Sports medicine is dedicated to helping athletes of all fitness levels succeed at their chosen activity. Whether you’re a professional athlete or just beginning an exercise routine, chances are that you will benefit from the advice or medical attention from a podiatrist sometime in your athletic pursuits. Sports medicine isn’t just about surgery and repairing sports-related injuries, it is also about injury prevention.

What types of injuries are treated in sports medicine?

Many athletes suffer from similar sports medicine complaints, but whether your injury is common or more obscure, a podiatrist will be able to get you back to your sport as soon as is safely possible. In every sport, from aerobics to cycling to basketball, athletes are subject to overuse and stress injuries. Following is a list of some common sports injuries.

Ankle Sprains and Other Injuries
Athletes who participate in sports that require side-to-side motions, are played in a confined area or on uneven surfaces may be at risk for various ankle injuries. Commonly, ligaments around the ankle are over-stretched or torn, resulting in ankle sprains.

For many ankle injuries, rest, rehabilitation and strengthening exercises will be sufficient treatment, though more severe injuries may require surgery. For more information on ankle sprains, please see the related brochure on the Foot & Ankle Specialists of West Michigan’s web site.

Blisters on the foot are a common complaint for many athletes, and occur due to repeated friction, such as the foot rubbing against a certain place in athletic socks or shoes. While blisters will usually heal within several days after the source of friction is eliminated, they may become infected, requiring medical attention.

Heel Pain
Heel pain may be caused by many different conditions resulting from overuse, unaccustomed stress, or injury. For more information on heel pain, please see the related brochure on the Foot & Ankle Specialists of West Michigan’s web site.

Often caused by poorly-fitted athletic shoes, neuromas are pinched nerves in the foot that may cause severe pain and numbness of the inner toes. For more information on neuromas, please see the related brochure on the Foot & Ankle Specialists of West Michigan’s web site.

Plantar Fasciitis
The plantar fascia is a thick band of tissue on the bottom of the foot that is vulnerable to injury and inflammation, leading to plantar fasciitis. Runners and other athletes are vulnerable to this condition, also known as “heel-spur syndrome.” For more information on plantar fasciitis, please see the related brochure on the Foot & Ankle Specialists of West Michigan’s web site.

Sinus Tarsi Syndrome
Sinus tarsi syndrome is characterized by pain and a feeling of instability in the area on the outside of the foot between the heel and the ankle bone, and is often caused by an ankle sprain. With sinus tarsi syndrome, uneven surfaces may be difficult to walk on. A podiatrist may diagnose sinus tarsi syndrome with x-rays, a bone scan, computed tomography (CT) scan or a magnetic resonance imaging (MRI) evaluation, and may treat this condition with anti-inflammatory medication, stable shoes, a period of immobilization, ankle sleeve or corrective shoe inserts.

Stress Fractures
Probably the most common injury for aerobics instructors, stress fractures are caused by poor shoe selection, hard surfaces, and overuse. As compared with men, women are more likely to develop stress fractures—usually in the lesser metatarsal bones. When swelling and pain occur, seeing a podiatrist for x-ray evaluation and early treatment can prevent a disabling injury.

Weekend or brand-new athletes may be prone to tendonitis, or swelling of the tendon, in the ankle, foot, or the Achilles tendon. Since this potentially painful condition may be difficult to treat, it is important to get medical attention at the first sign of pain. For more information on tendonitis, please see the related brochure on the Foot & Ankle Specialists of West Michigan’s web site.

Treating sports injuries

As discussed above, treatment for sports injuries may vary depending of specific injury, severity, and personal medical history. Your podiatrist will be able to prescribe a course of treatment best suited to your needs.

Selecting Athletic Shoes

Good for you! You're either starting or continuing on the road to improved fitness and health through physical activity. While you're working out, don't forget that for many athletic activities, your feet are working hard. Treat them right by selecting the correct athletic shoe for your chosen activity, and you'll enjoy better performance and a decreased risk of foot problems. Athletic shoes that are made well and fit well are as important to your pursuits as shin guards for soccer or a helmet for pro football. 

For nearly any sport you choose, there is a shoe designed to meet the specific physical demands you'll be placing on your feet. Following is a list of seven popular sports and the types of shoes recommended for maximum foot and ankle protection. 

  • Running: Running demands one essential piece of equipment: a good pair of running shoes. Factors like your body weight, foot structure, the way you run and how far you run should all be considered when shopping for running shoes. A knowledgeable salesperson should be able to help you make a selection based on these factors. Your old shoes may give you clues as to what type of support or cushioning you may need; bring them with you when you go shopping for a professional opinion. 
  • Walking: Shock absorption under the heel and the ball of the foot is important for walking shoes. Walking shoes are lighter, more rigid, and less bulky than running shoes, although running shoes may also be worn for walking. Make sure your shoes are comfortable and allow you to stride easily. 
  • Cycling: There are different cycling shoes for racing and mountain biking, so choose the one that best suits your needs. In general, cycling shoes should provide support across the arch and the instep, and lift in the heel. If you are a casual rider, cross training shoes may be worn. 
  • Golf: golf shoes are light and strong, and may be equipped with special cleats for added traction on the green or in the rough. 
  • Tennis, volleyball & basketball: Shoes for these sports must allow for sudden stops, side-to-side sliding, and running. Look for good traction and a stiffer sole; the padded toe box in tennis shoes will help prevent injuries. 

For any sport and footwear you choose, it is important to wear the shoes properly and replace them promptly when they are worn. When shopping for athletic shoes, make sure you find the proper fit by following these tips: 

  • Stand up when having your feet measured to allow for expansion. 
  • As feet are often different sizes, have both feet measured, try on both shoes, and by the size of the larger foot. 
  • Walk around in the shoes: they should be comfortable right away! 
  • Go shopping in the afternoon or evening, when feet tend to swell and are at their largest. 
  • Wear the type of sock you plan to wear with the shoe. 

Follow these simple guidelines and you'll be well on your way to success, from the feet up. 

Pressure Ulcers

What are pressure ulcers?

Pressure ulcers are sores that occur when pressure cuts off the blood supply to the skin. Stress caused by the body’s weight and the impact of striking the ground place the ball of the foot, the big toe, and the heel at the greatest risk. Left untreated, an ulcer may allow infection to enter your body. If infection reaches the bloodstream or bone, your life or limb may be at risk. But with your doctor’s help, your health can be protected. Pressure ulcers can be controlled and even prevented.

How do pressure ulcers form?

Force or friction against the bottom of your foot causes the skin to thicken, forming a callus. If the skin keeps thickening, the callus presses up into the foot. This kills healthy tissue and causes pain. Unfortunately, you may not notice the pain if you have neuropathy, a health problem that limits how much feeling you have in your feet. As healthy skin dies, an ulcer forms. Ulcers may progress from hot spots to infected wounds very quickly. A callus pressing into the foot may kill healthy tissue and cause an ulcer.

Hot Spots
Red “hot” spots on the skin are signs of pressure or friction. They are a warning that you need to take care of your feet. If pressure is not relieved, a hot spot is likely to blister. Left untreated, a blister can turn into an open wound or a corn (thickened skin on top of the foot) or callus.

If a corn or callus presses into the foot, it destroys inner layers of skin and fat. Cracks and sores may form. These open wounds are ulcers. They provide a way for infection to enter the body. In some cases, dead skin (such as a corn or callus) may cover an open wound, making it harder to see.

Infected Ulcers
If bacteria enter the ulcer, infection sets in. This causes more healthy tissue to die. The infected ulcer may begin to drain. The discharge may be white, yellow, or greenish. Some infected ulcers bleed or have a bad odor. If you develop an infected ulcer, call your doctor right away.

Your physical exam

During your foot exam, your doctor will ask about your health. Do you have poor circulation, diabetes, or kidney problems? Your doctor will check your feet for hot spots and thickened skin. He or she may also look for any bone or joint problems. Your ability to feel sensation in your feet also may be checked.

Blood flow and nerve sensation in your feet may be tested if you have a chronic health problem, such as diabetes. If you have a deep pressure ulcer, an x-ray or bone scan may be done to check for signs of bone infection.

A doctor's treatment

With your doctor’s care, hot spots, small cracks, or sores can be treated before they get infected. If infection is already present, medications will probably be prescribed. Surgery may also be needed if the infection has spread.

Cleaning the Ulcer
To assist healing, thickened skin around the ulcer may be cleaned away. Medicated ointment or cream may be applied to prevent infection. Sometimes a special dressing isused to help keep the wound dry.

Reducing Force
To take pressure off hot spots and ulcers, your doctor may prescribe orthoses. These custom-made shoe inserts absorb or divert pressure from problem areas. Special shoes or temporary casts may also be used.

Using Antibiotics
To control or prevent infection, your doctor may prescribe antibiotics. Take them all, and take them as directed. If you stop using an antibiotic too soon, the infection may come back.

If Surgery Is Needed
Surgery may be needed if infection enters deep tissues or bone. In such cases, your doctor cleans away the infection while removing as little tissue or bone as possible. You may also be given intravenous (IV) antibiotics to fight the infection.

Preventing ulcers

By taking care of yourself, you may be able to prevent pressure ulcers. At the very least, you can reduce your risk of getting one. Try to check your feet daily and improve your overall health. Also, protect your feet by wearing shoes and socks that don’t rub.

Checking Your Feet
Use a mirror to look at the bottom of your feet each day. By doing so, you can catch small skin changes before they turn into ulcers. Call your doctor if you notice any hot spots, red streaks, swelling, or any cracks or sores. Also, check the soles and insides of your shoes before putting them on. Remove any objects, such as pebbles.

Improving Your Overall Health
Do your best to control health problems that may affect your feet, such as diabetes and kidney disease. Eat right and exercise. If you are given medications, take them as directed. If you smoke, stop. Smoking reduces blood flow and slows healing. Limiting alcohol intake may also be helpful.