Josephine Lawson Physiotherapy Clinic - Autumn 2008 Newsletter - Issue No. 21

FITNESS AND FOOTWEAR

With the Olympic Games now over our thoughts are turning to our more traditional Autumn sports of rugby, football and hockey.

At the beginning of the season the major factors in returning to these sports are Fitness and Footwear.

FITNESS BY MARK LANGLEY

Warm-up
Warm- up varies considerably from activity to activity and is very task specific. There are a number of components to consider, depending on the demands and explosiveness of the particular activity.
5 - 10k runs are best preceded by a jogging to running warm-up to get muscles up to a working temperature with stretching or taking the muscles and joints through slightly larger ranges than the run demands. Whereas sprinting de- mands that muscles have the greater lengthening tolerance and need the warm-up to progress to greater demands with more muscle lengthening work before expecting them to handle the rigors of the sprint. Muscle length, temperature, and range of joint movement are the factors to consider when warming up as well as time and energy conservation. As physiotherapists we can show you practical solutions to the question of warm-up which are task specific. Getting the right sports shoe is extremely important and can reduce the likelihood of a sports related injury


FOOTWEAR BY ANDREW GLADSTONE CHIROPODIST

Getting the right shoe for each activity is very important . Below are the main types of shoes and their typical applications

1. Running Shoes - primarily designed for running ! They are very flexible and provide lots of cushioning – but they are not suitable for any sports that require sideway movements (tennis, squash etc) as they also have very flexible sidewalls . Injuries might occur if you use this type of shoe for anything other than running

2. Cross Trainers are generally much stiffer and so are suitable for more types of sport that involve sideways move- ments – but as they are stiffer the foot must work harder and there is a greater chance of injury

3. Tennis Shoes – primarily designed for tennis ! They have a greater degree of flexibility and sideways support The area on the heel is tender to touch.

4. Fitness shoes – generally have a greater amount of cushioning than the running shoe to allow for the higher amount of shock the foot receives when doing some gym classes (aerobics, step)

If you experience discomfort when you undertake your activity and you are sure you have the right footwear, make sure you have the right size footwear. Studies have shown that a large proportion of people do not wear the right size shoes ! Try to get your feet measured when buying new shoes/trainers . Tight footwear can lead to blisters, corns and ingrown toenails . If problems persist a visit to a podiatrist could solve the issue . Occasionally the pain is a biomechanical issue and might need a custom made insole, a podiatrist will be able to asses your needs. right sports shoe

Common injuries caused by poor or incorrect footwear
Sports generally involve lots of movements so there are many injuries that can occur . Good shoes keep the foot working efficiently, absorbing the shock of the foot hitting the ground and preventing overloading of the many structures in the foot .

Fracture of the metatarsal bones.
These are the long bones that form the main part of the foot, they are vulnerable to kicks, knocks and twists, especially if the footwear is flimsy and non supportive.

Treatment
- Immobilisation of the foot for approximately six weeks in plaster.

Sprained ankle
If the foot is not correctly supported in a shoe or boot that is designed for the sport, e.g. rugby or football, or if trainers with poor grip are worn on wet surfaces, there is a danger of slipping and going over on the ankle resulting in a sprain of the supporting ligaments of the ankle, usually on the outside aspect, or in extreme cases the ligaments can be torn.

Treatment
- RICE (rest,ice,compression,elevation)
- Taping for support. The taping needs to be done in such a way that it will prevent moving the ankle into the painful movement, but will allow other movements, thereby preventing the ankle from becoming stiff.
- Ultrasound to speed up recovery.
- Gentle exercises.

Plantar fasciitis
The condition is characterised by pain, which is worse in the mornings and after prolonged walking or running. The area on the heel is tender to touch.

Treatment
- Heel pads worn in both sports shoes and day shoes.
- Physiotherapy, ultrasound and gentle stretching of the Achilles tendon
- Pain killers
- Steroid injections in extreme cases.
- Correct footwear.