Foot Injuries
mvpboxing  |   May 04, 2017, 12:05PM

Plantar Fascitis
  1. Definition and Occurrence
    1. The plantar fascia is a connective tissue that extends from the heel bone to the base of the toes and serves to support the arch of the foot during walking and running
    2. Certain factors can make athletes susceptible to overstretching of the plantar fascia leading to microtears and inflammation.
    3. Fourth most common running injury
    4. Commonly occurs in athletes with very high or very low arches
  2. Signs and Symptoms
    1. Pinpoint pain at the bottom and inside part of the heel
    2. Increased pain in the morning upon waking that decreases with walking or are worst after prolonged walking/running.
    3. Pain with toe raises
  3. Treatment and Prevention
    1. ICE and Rest in the initial stages with non-weight bearing cross training to maintain fitness (cycling, swimming)
    2. Soft tissue massage of the bottom and inside part of the heel
    3. Calf/Achilles stretching (consistency is key)
      1. If the calves are tight, it can cause increased foot pronation to compensate for the supination from the tight calves, this could cause the plantar fascia to become overstretched and inflamed.
    4. Plantar fascia stretching
      1. Perform stretches before walking in the morning
    5. Strengthening of the intrinsic muscles of the foot
      1. Picking up marbles with toes or scrunching up towel with toes
    6. Individualized shoe selection for the type of foot and biomechanics. Orthotics may also be helpful
    7. Gradual return to running when pain has resolved. Focus on soft running surfaces to begin with.
    8. 95% of patients report decreased symptoms within 6-12 months of onset of condition
Achilles Tendonitis
  1. Definition and Occurrence
    1. The Achilles tendon is the group of muscle tendons that join together and run down the back of the heel and help you stand on your tip toes and move your ankle inwards. Where the tendon inserts on the foot, there is a section of decreased blood supply that is susceptible to inflammation and injury
    2. The Achilles tendon serves the very important functions of controlling the rate of descent of the heel as the foot strikes the ground and helps to propel the body upward and forward as the runner pushes off.
    3. With a sudden increase in running or a change in running surfaces or inclination, the Achilles tendon can become inflamed and cause pain with running and walking.
  2. Signs and Symptoms
    1. Burning pain where the tendon inserts into the foot bones during walking and running
    2. Increased pain with rising up on toes
    3. Swelling and warmth
    4. Tenderness to pressure
    5. Calf/Achilles tendon tightness and thickening of the tendon
  3. Treatment
    1. Ice and NSAID’s
    2. Rest from aggravating activities until pain decreases
    3. Calf/Achilles tendon stretching, hamstring stretching
    4. After pain decreases, initiate calf/achilles strengthening, focusing on eccentric strengthening
    5. Heel lift in shoe to help take tension off healing tendon
    6. Heel liner in shoe to decrease hard back of shoe heel liner rubbing against inflamed tendon
    7. Orthotics/motion control shoe to correct overpronation if present
  4. Prehab (prevention)
    1. Consistent Achilles/calf stretching after exercise
    2. Varied running surface with limited sustained uphill running
    3. Eccentric Achilles strengthening