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Posts for: April, 2018

This weekend I was able to attend my daughter Taekwondo tournament. I was able to witness and help treat a few minor foot injuries of the participants. I would like to take a moment to discuss common Martial arts foot injuries as well as review how to avoid and treat them.

Martial arts, such as karate and tae kwon do, have become very popular in recent years for both adults and children. Karate and tae kwon do have been promoted as excellent activities for maintaining good health and fitness. People frequently perform these activities after school or work.    Given that the foot and ankle account for at least 10 percent of the total injuries sustained in the martial arts — and may even be higher due to the lack of reporting of many digital injuries such as contusions, toenail trauma and uncomplicated fractures — most podiatrists are likely to encounter these athletes in their offices.    Students of the martial arts practice kicking and punching to improve their techniques and power. Students start with simpler kicks and work up to more difficult techniques. Attempting a more difficult kick without the appropriate training will often cause injury. Sparring too early without the proper training is also a common cause of injury.    The student becomes injured due to either a lack of balance, flexibility, strength or speed. For example, one can kick and punch while standing in one location or while moving. A lack of balance while performing this move will cause the support foot to be loaded without stability. This can produce sprains or strains of the foot and ankle

What Causes Common Types Of Martial Arts Injuries?

Blunt force trauma and sprains are the two basic categories of martial arts injuries that occur in the foot. Blunt force trauma injury is a direct result of the foot hitting another solid object. The object could be a sparring bag, a board, an opponent or other firm objects used in the practice of martial arts. Students frequently use heavy canvas sparring bags for kicking and punching in order to improve strength and technique. Boards varying from 1/2 inch to 1 inch in thickness are used as part of promotion tests as a student passes to the next level throughout the training experience. The boards are lined up (either singularly or in multiples) and students use their hands or feet to break them. If the student has not built up the power, speed or accuracy to strike the board with the correct technique, there can be resulting trauma to the foot or hand. Martial arts instructors assess each student to determine the level of breaking skill. Inappropriate execution on the part of the student can be very painful.    Misjudging the opponent’s intended next move can result in trauma. Normally, students step back from the kick and prepare to counter the kick with another kick. This cannot always be executed as trained due to the speed of the opponent. The consequences of missing a step or inappropriately positioning the foot while attacking or retreating from an opponent can be trauma to the ankle and foot, resulting in a sprain or fracture.

A Guide to Treating Fractures

   As a result of blunt force trauma, the martial arts student may suffer a fracture, a contusion or a laceration. Fractures require early diagnosis and immobilization to expedite healing. The most common foot fractures occur as spiral oblique injuries of either the digits or the metatarsals. They are usually the result of the torsion generated by the impact of the moving foot hitting a fixed object such as an opponent.    If one suspects a fracture, do not allow the athlete to continue the competition. Further trauma from competition can convert a simple non-displaced fracture into a displaced, comminuted fracture or even a compound fracture. If one suspects a fracture, immobilize the injured part or at least move the athlete without moving the injured area. Apply ice and elevate the limb after achieving initial immobilization. The marital artist should not go back to martial arts activity until the specific fracture is completely healed, which is usually eight weeks.

Addressing Common Contusions

   Contusions, which are usually less severe than fractures, are a common result of sparring or board breaking. This weekend I witness a severe contusion to the foot while two fifth degree black belts were sparring. One of the participants blocks a side kick but hit the top of his opponent’s foot in an awkward way. A severe contusion occurred with pain, bruising, and swelling to the top of the foot. While sparring, the student wears a chest protector, a helmet and a mouth guard as well as pads on the arm, hand, foot and lower leg. During sparring, one must perform each kick and punch in a fraction of a second to be effective. From a tactical standpoint, when students see an opening in the opponent’s defense, they will usually execute three to four moves sequentially to further reduce the opponent’s defenses. However, the opponent will also counter the attack. Both participants are vulnerable when each is trying to anticipate the other’s move.    Advancing opponents often cut short well-intentioned kicks, which land in an unintended area. A kick meant for the opponent’s torso might land on a non-padded upper thigh area, resulting in a thigh contusion. Any non-padded area such as the thigh or knees can now be a vulnerable target. Accordingly, the common areas to receive contusions are the top and sides of the feet as well as the toes. Contusion injuries may have symptoms for up to six weeks although one can usually recommend an early return to martial arts activities.

Key Pearls on Treating Sprains

   Ankle sprains occur most often in the martial arts during sparring when the student is changing positions rapidly. The most common type is the lateral ankle sprain. Sudden changes in direction during sparring can result in the student being caught off balance. A slow progression of training is essential to promote increased balance, flexibility and strength while reducing the risks of foot and ankle sprains. Pay careful attention to the sprain in order to rule out a fracture. It is essential that all ankle injuries be totally healed before permitting the martial arts athlete to return to rigorous activities such as performing difficult maneuvers or competitive sparring. A common sprain to the foot is a hyperextension injury to the first MPJ (Big toe joint). This sprain is usually the result of sparring and changing directions rapidly. The Great toe becomes forcibly moved up while the athlete lunges forward to attack an opponent, resulting in a sprain of the first MPJ.    While most of these injuries are mild, be aware there are severe cases in which the sesamoids may be partially or completely torn from their bed. A forced movement up of the great toe against the first metatarsal head may also result in a fleck of cartilage being shorn from the metatarsal head. A hyperextended first MPJ (Great toe joint) sprain can last up to four months or longer. During this time, one should follow initial immobilization (Walking boot) with physical therapy as this is essential for maximum recovery.

 


We hope everyone had a safe and injury free walk/run during the Cooper River Bridge Run this past weekend! We would like to get back to basics with proper running form so that you remain injury free for the spring and summer months. Here are some nice tips to help avoid injury and keep you on your feet.

Starting with the foot: Where should you contact

Some say to run on the ball of your foot, others say contact the ground with the heel. I take a middle of the road approach. Studies have shown that good long distance runners usually contact with the midfoot. Slower runners contact between the midfoot and the heel, faster runners a bit further forward. Only sprinters or short to middle distance runners should contact the ground with their forefoot or the ball of the foot. While there may be exceptions to the rule, this is a good way for most beginning and intermediate runners to start out. It allows for better shock absorption, less stress on the calf muscle and Achilles tendon, and better rolling forward onto the next stride. Your muscles will then be used in a manner that is similar to how you walk, and this is the pattern of muscle firing and contact pattern which the muscles are accustomed to.

Hips & Head

This part is hard to think about: Where are your hips when your foot hits the ground. Some people have suggested that your foot should be under the center of gravity of your body when it strikes the ground. A line from your head through your hips should end up at your foot. Keep the head fairly straight and look ahead. Turns to the side should be done carefully and usually mostly from the neck up to avoid twisting your body and making you unstable in your forward progression.

Arm Carriage

This is what you use when you haven't obtained a jogging baby stroller. Actually, it is where you allow your arms to swing. First, and most importantly, don't tense up and carry them stiffly with your hands balled up into a fist and your elbows completely bent. Relax. Carry your arms at your side somewhere between your waist and your chest. Make sure they are not too high or too low. One arm swings forward while the other one goes backwards. This occurs opposite to the foot and leg motion. Sprinters on the track move their arms in a straight forward-backward motion. Most longer distance runners use a slight arc as they swing their arms, but the better ones don't waste motion by moving too much from side-to-side. In other words, they don't swing their arms excessively in front of their body.

Knees

The knees do not have to come up very high for long distance runners. Only sprinters or those of us chugging up a hill have to left our legs high.

Stride Length

One of the biggest problems of form in long distance running is overstriding. Make sure that you don't do this, it can lead to a host of problems including Achilles tendonitis, ITB pain, and iliopsoas muscle pain.

Breathing

While some like to tell you how to count your breathing in seconds both in and out, we will just tell you to keep breathing, deep and regular. In most cases your breathing will take care of itself, as you run faster, you'll breathe faster. And yes, most runners are mouth breathers or at least nose and mouth breathers. It would be impossible to take in adequate oxygen just breathing through your nose.

Uphills and Downhills

Slow up a bit on the uphills. In general it is a bad idea to try going faster. Move your arms a bit more to help you imagine that you are cranking your way or pulling yourself up hill. Shorten your stride and chug on up. You can think of the little train that could and repeat "I think I can" on the way up a big hill.

On the downhill, be careful. Go slow. The biggest risk, is to your knees. Your quadriceps do the bulk of the braking and be overworked without you being aware of it. If you are racing, then you may lean forward a bit and fly down the hill in a short race, but certainly be more careful in training. In fact many runners who use hills as part of their training will walk down the hill while recovering to run up the hill once more. This is a good way to rest and recover while avoiding the excessive knee stress that downhill running can cause.

If you have any lingering pain in your feet after the Cooper River Bridge Run please contact us at: www.carolinafootspecialists.net