My Blog

Posts for tag: Sports Medicine Charleston

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.

 

Choosing the right custom foot orthotic for overpronation

Are you a runner and have not had success with custom orthotics in the past because they were uncomfortable and too rigid?  If so please read on and learn about the best material that Sports Podiatrists can use so that your orthotic is comfortable as well as provides the correct amount of support.

Q: What materials are available for orthotics and which are the best?

A: : In order to understand why certain orthotic materials are typically recommended by podiatric physicians, it is important to understand the fundamental goals in orthotic therapy. The purpose of the functional orthotic is to accurately and precisely position the foot throughout the gait cycle so as to promote proper function. Its function is not merely to support the arch, as is often the case with commercial appliances or arch supports purchased in retail stores. The functional orthotic is prescription fitted and is very effective in alleviating symptoms and establishing proper alignment. In order to achieve the desired and expected results from the use of functional orthotics, several steps must occur. First, a detailed range of motion and muscle testing examination is performed by your podiatrist. The purpose of this is to measure and quantify the motion of all lower extremity joints, identify abnormalities such as excessive laxity or limitation of motion, and determine the weightbearing and non-weightbearing functional positions of these joints. The muscle testing portion of the examination is performed in order to determine muscle groups which may be excessively weak or tight and to determine their part in the overall cause of injury, symptoms or biomechanic problem.

Following the examination, a non-weightbearing neutral position cast or three dimenstional image of the foot is taken. The specific method of casting or imaging is critical and must be done accurately in order to achieve an accurate impression of the foot in its neutral position. The negative casts or three dimensional image (email) are then sent to an orthotic laboratory accompanied by a prescription written by your podiatrist indicating not only the specification of the foot pathology that needs to be addressed, but also the materials to be used and the dimensions and accessories to be used in the manufacture of your functional foot orthotics. The manufacture of functional foot orthotics is thus a multi-step process involving detailed and intricate cast correction, orthotic fabrication and application of additional items prescribed by your podiatrist for the treatment of your specific condition.

In order to achieve the desired results, the functional foot orthotics must be made from materials which have the ability to resist the pathologic symptom-producing forces which have ultimately produced the injury. Typically, plastics or graphite are used, both offering a range of flexibilities, designed to appropriately resist abnormal injury-producing forces while allowing comfort and compliance so as to be compatible with the sport. The plastics that are used are generally made of a family of materials called polyolefins, the most common being polypropylene. The thickness of these materials ranges from 1/8" to 1/4". These materials range from quite flexible and compliant to relatively rigid. Graphite also ranges from quite flexible to quite rigid and is generally one-half as thick and one-half as heavy as orthotics made from polyolefin materials. The flexibility, or compliance, of an orthotic is a subjective choice determined by the requirements of your sport and the degree of rigidity required to resist the abnormal forces resulting in injury. Highly flexible devices are used when the forces imposed are relatively minor or the requirement of the sport mandates a compliant device. However, these materials possess shorter life spans due to the cyclic fatigue inherent in an orthotic device that has a high degree of flexibility. More rigid orthotic devices are used when more significant forces are present or the sport of choice is compatible with the more rigid device. More rigid devices have the advantage of being quite durable and can often last for many years without modification or adjustment. Typically, stop-start complex motion and/or cutting sports (ie. soccer, basketball, aerobics, tennis) require more compliance in an orthotic device, while repetitive-motion sports such as walking or running are quite compatible with more rigid devices.

Soft materials such as Neoprene, various open- and closed-cell foams or similar cushioning materials may be used in conjunction with functional foot orthoses to provide both support and comfort. A patient should always discuss these options with their podiatrist and even entertain the possibility of having more than one pair of orthotics using materials of different flexibility and/or covers as determined by the requirements of their sport, the constraints of their shoe gear, and their overall comfort.

Successful orthotic treatment should always include an orthotic device that is effective in reducing eliminating symptoms and is comfortable to wear. By selecting the appropriate flexibility material and cover material, both of these goals can generally be achieved.

Our foot specialists at Carolina Foot Specialists are active athletes that have experienced a majority of the foot ailments that patient's present with in the office. When custom foot orthotics are dispensed a detailed plan includes the proper break in period  as well as a plan to get patient's back to their chosen sporting activity. We have a policy where orthotics can be refurbished or remade within a six month period of time if required to insure that our patient's are please with the custom orthotics  that they have received.

For more information of a variety of foot conditions please refer to our website at www.carolinafootspecialists.net