One of the reasons you moved to Seattle is your love of skiing and snowboarding. Few places in the country offer the variety of downhill ski and snowboarding options within one day’s drive. While these are fantastic sports for your heart, they can lead to many different types of acute and chronic foot and ankle injuries.
Before I dive into the types of foot and ankle injuries to watch out for, let’s discuss the risk factors for developing those injuries.
Risk Factors for Foot and Ankle Injuries in Skiers and Snowboarders
Skiers and snowboarders are at high risk for chronic and acute injuries. Falling, collisions, irregular terrain, and fatigue can all add up and cause damage to your lower extremities.
The most common risk factors are:
- Lack of strength training and stretching
- Improper form
- Taking on more challenging terrain than your skill level
- Inattention to other skiiers and snowboarders
- Fatigue causes by inadequate breaks, lack of sleep, or skiing too many days in a row
- Old or poor equipment – this can include worn out bindings, worn out or improperly fit boots
- Going off trail or failing to heed warning signs
Foot and Ankle Injuries in Skiers and Snowboarders in Seattle
Skiers Toe or Toe Bang
Skiers Toe or toe bang can occur in both skiiers and snowboarders. This common condition happens when your boots are too short or your foot slides to the front of the boot causing your toenail to hit the top (thus the name toe bang). It usually affects the big toe but can also affect the 2nd toe if this digit is longer. This repetitive movement causes pain, the separation of your nail from the nail bed, bleeding under the nail (subungual hematoma), and eventually a black or purple toenail.
If the pain persists, you’ll probably need to have the hematoma drained by a podiatrist. Don’t try this at home as you’ll risk getting an infection.
While this condition is more common in snowboarders it can also affect downhill skiers. It occurs when the foot is bend backwards and outwards with so much force that lateral process of the talus bone fractures. Pieces of the talus bone can either stay in place or shift away from their normal position. Improper landing from a jump is the most common cause of this injury.
- Severe ankle pain
Initial treatment includes icing and taking anti-inflammatory medications. Depending on the severity and type of fracture the foot and ankle will either need to be immobilized with no weightbearing for 6 weeks or will require surgery.
Achilles Tendon Rupture
The Achilles tendon is located on the back of your ankle (it connects the heel bone to the calf muscle). It allows you to flex, bend, and push off—all critical aspects of skiing. When this tendon becomes overstretched it can rupture. It is one of the most common injuries among skiiers. Most often the Achilles tendon ruptures due to overuse, weakness, and calf tightness.
Symptoms of an Achilles Tendon Rupture
You’ll notice one or more of these symptoms from an Achilles tendon rupture:
- Sudden, sharp pain in the back of the ankle or calf – often subsiding into a dull ache
- A popping or snapping sensation
- Swelling on the back of the leg between the heel and the calf
- Difficulty walking and unable to stand on your toes.
To prevent further damage, skiiers and snowboarders should use the RICE method (rest, ice, compression, and elevation) until they can see a podiatrist. Additional treatment depends on the severity of the rupture.
Ankle and Foot Sprains and Fractures
It’s no surprise that foot and ankle sprains and fractures are common in skiers and snowboarders. With all the twisting, turning, and jumping that occur in these sports it’s no wonder. These can all cause the foot and ankle to overstretch, tear, and sometimes fracture.
One of the most common causes of these conditions are improperly fitting boots and bindings that won’t release when they should. Ski boots that are too big allow the foot to slip too much and tight bindings don’t allow the foot to release from the skis when they should.
Treatment of these injuries includes immediate application of ice and wearing a boot for 4-6 weeks depending on severity.
A common foot problem in skiers is arch pain. This is most frequently found in skiers who have flat feet or a flexible foot type. The main culprit of the pain is thought to be a weakness or dysfunction of the intrinsic muscles at the bottom of the foot. When these muscles have to work harder to increase stability (when skiing for example) microtrauma and pain can occur.
Treatment for the skier’s foot pain can include:
- Strengthening the intrinsic foot muscles
- Custom orthotics to reduce the stress on the foot
- Purchase of properly fitting boots
Fungal toenails primarily occur in snow sport athletes when boots are too short or too large. When the top of the toenail hits the boot repeatedly the nail can separate and allow fungus to get in. Fungus particularly loves warm and dark environments. Your sweaty, hot feet are the perfect place for it to thrive.
Because fungus of the toenails is hard to get rid of, they are best treated using a comprehensive approach. A combination of laser, topics, oral medications, and shoe therapy yield the highest level of successful treatment. Eighty to ninety percent of our patients are satisfied with the effectiveness of this treatment.
Morton’s neuroma is a benign growth of nerves that occurs between the 3rd and 4th toes of the foot. Skiers and snowboarders most likely to develop this condition are those who wear high heels with pointy toes when they’re off the slopes or have an abnormal foot structure such as flat feet. Pressure on the front of the foot from skiing can make this condition worse. Ski boots that are too tight in the ball of the foot can also be problematic.
Symptoms of Morton’s neuroma are progressive and include pain, tingling, numbness, burning, or feeling something is in your shoe like a bunched up sock. This condition starts out with mild symptoms and gets worse over time if not treated.
Treatment for Morton’s Neuroma
- Wearing shoes with a wider toe box and a lower heel when off the slopes
- Guided ultrasound injections of alcohol to shrink the neuroma
- MLS laser therapy to reduce pain and inflammation
- Custom orthotics
Pain and inflammation under one or more of the five bones or metatarsals of the ball of the foot is called metatarsalgia. Along with unequal weight distribution when skiing or snowboarding, athletes with flat feet or high arches are also at risk for this condition.
Symptoms of metatarsalgia
- Sharp shooting pain when the toes are flexed
- Tingling or numbness of the toes
- Calluses forming under the affected joint
- Offloading weight to the affected joint and/or use of a metatarsal pad
- Custom orthotics to foot biomechanics
- Getting properly fitted boots
Prevention of Foot and Ankle Injuries in Skiers and Snowboarders
Fortunately, many foot and ankle injuries are avoidable if you have the proper equipment and avoid unnecessary risks.
Purchase Boots With A Proper Fit
- Go to a specialty ski or sports shop you trust. Eg. Stores like REI have specially trained boot fitters. These boot fitters will recommend the best boots for your feet and can make modifications to the shell if you have existing foot problems or trouble with fit. They can also help determine how much flex you need in your boot and make suggestions accordingly.
- Ski boots should fit snugly but not too tight or you risk developing a blackened toenail or cutting off your circulation.
- Ski boots that are too loose can cause toenail problems and prevent you from feeling secure when skiing.
- Sometimes custom orthotics are needed, particularly for those who overpronate or have flat feet.
- Snowboarders’ boots should fit snugly, well-insulated, sturdy and flexible so you can easily twist your body and control your board.
- Learn more about finding the best boots for snowboarding here.
Buckle Your Ski Boots Properly
- Start by stepping into the boot and cinching the 2nd buckle down. This is the buckle that will hold your heel securely to the back of the boot.
- Kick your heel on the ground to push it back and set it into place.
- Then buckle the top buckle.
- The bottom two buckles are for side-to-side control. Be sure not to buckle them too tightly. If you do you can have too much compression on the top of your foot, causing numbness, cutting off circulation and causing pain. You should be able to close these buckles with one finger.
- The power strap on top should be secured snugly.
Wear the Right Socks
Purchase socks that wick away moisture to keep your feet dry and warm. A great brand recommended by REI and this podiatrist are socks by Smart Wool or Darn Tough. If you tend to sweat a lot regardless of the type of socks you wear, bring along an additional pair.
Get Your Bindings Checked
Worn out bindings or bindings that won’t release are an accident waiting to happen. Make sure you get your bindings checked before the season starts. Purchase new ones if they are worn out or the technology has changed.
Sking or Snowboarding with A Chronic Foot or Ankle Condition
Weak or chronic ankle problems, heel pain or Achilles tendonitis, bunions and neuromas are all pre-existing conditions that may cause you problems when skiing or snowboarding.
Wearing an ankle brace can help skiers or snowboarders who tend to sprain their ankle. Custom orthotics for ski boots may be needed to help with the other conditions. However, getting a proper fitting boot will be most essential to prevent worsening of these conditions. Off the slope it will be important to seek treatment for these conditions as well. That will help with your on-slope performance and cause you fewer problems.
If you're experiencing any of these foot problems, contact our office today at 206-368-7000 or request an appointment online.
Ski or Snowboard Using Proper Form
If you’re new to the sport or you’ve been told by others that you’re not skiing or snowboarding properly it’s important to get some training. Skiing with proper form will go a long way in preventing foot and ankle injuries.
How to Train for Skiing
Training for skiing revolves around building muscle strength and endurance, improving balance, and increasing flexibility. Learn more by reading this article by REI. While this is a really good article with important exercises it doesn’t mention the importance of improving your flexibility. For skiers with tight calf muscles and Achilles tendon stretching right before you ski and at home can make a big difference in preventing flare ups of plantar fasciitis, Achilles tendonitis, and also help prevent an Achilles tendon tear. A daily yoga practice with an emphasis on stretching can also be of help.
How to Train for Snowboarding
Snowboarders should also train for their sport by increasing muscle strength, endurance, and improving their balance. Learning how to land properly from a jump is also key to preventing injury. Check out REI for information about training for snowboarding.
Safety Tips for Skiers and Snowboarders
Many of the risk factors for foot and ankle injuries in snow athletes can be avoided. Keep in mind the following when headed for the slopes:
- Avoid off area terrain and pay attention to warning signs
- Avoid particularly icy slopes
- Ski or snowboard on slopes at your skill level
- Take lessons to improve your form and skill level
- Pay attention to other skiers-many injuries are caused by colliding with others
- Get plenty of sleep and take breaks
- Drink plenty of water (may want to use a hydration pack so you can drink while you ski or snowboard.
- Take high protein snacks with you such as nuts or protein bars.
Wear Safety Equipment and Proper Clothing
Wearing safety equipment and proper clothing will also help prevent all types of injuries.
- Helmet designed for skiing and snowboarding
- Goggles that fit over the helmet
- Wrist guards for snowboarders
- Wear layers of clothing
- Wear a warm hat or headband
- Wear reflective clothing if you ski
Is A Foot or Ankle Problem Hampering Your Skiing or Snowboarding in Seattle, Washington? Request an Appointment Now
Don't let painful foot or ankle conditions cause you to miss out on the activities you enjoy. Complete the contact form on this page or call our office at 206-368-7000 to schedule an appointment with Dr. Berg.
Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.
North Seattle Foot & Ankle Specialist Dr. Rion Berg offers compassionate podiatry care for all foot and ankle problems to those living in Seattle Washington and the surrounding areas. Call us today at 206-368-7000 for an immediate appointment or request an appointment online.