Dr. Berg's Foot Facts

Posts for category: sports injuries

As a parent of kids who play sports, you want to do everything possible to make sure your child has the best equipment and plays safely. While there's been a lot of news coverage about the problems kids can suffer as a result of concussions, there's scant information about the impact of foot and ankle injuries on youth athletes.

That's why I wrote this guide. I see far too many kids in my office with foot and ankle conditions and injuries that could have been avoided.

Heel Pain in Youth Athletes

While kids can develop the same type of heel pain as adults, namely plantar fasciitis, a condition called Sever's disease is much more common, particularly among youth athletes. This condition affects kids ages 8-14 who have an open growth plate on their heel bone. When this plate is still open it's susceptible to bruising and inflammation during activities like soccer.

To address the problem, I advise young athletes and their parents to ease up on their activity level, reduce their inflammation and pain through use of anti-inflammatory medications and ice, use of heel lifts to help absorb impact, use of over-the-counter inserts or custom orthotics, and go for physical therapy.

To prevent Sever's disease in your youth athlete, start by purchasing supportive shoes that are designed for their particular sport (see below for more information), stretching the Achilles tendon to reduce stress on the heel if they are prone to this condition, and avoiding play beyond your child's abilities.

Stress Fractures in Youth Athlete

Another overuse injury common in young athletes are stress fractures. When muscles are too tired to take on the additional stress of play it's absorbed by the bones. Stress fractures can occur in the lower legs, ankles, and feet.

Youth athletes most at risk are those who play sports that involve running, jumping, and repetitive movement such as gymnastics, basketball, and track and field. Ramping up sports activity too quickly, without rest in between to adequately condition the body, can also increase the chance of a stress fracture.

To prevent stress fractures in youth athletes make sure they do the following:

  • slow and proper conditioning for their sport

  • eating balanced, nutritious meals rich in calcium and Vitamin D

  • drink plenty of water throughout play

  • adequate warm-up and cool-down

  • stop playing when in pain and visit to podiatrist

  • alternating types of physical activities

  • go for a sports physical before the season starts

  • replace athletic shoes every 500 miles

Ankle Sprains in Youth Athletes

Ankle sprains are common in youth soccer, basketball, and other sports. In fact, researchers have estimated that ankle injuries account for 10 to 30% of all sports related injuries in young athletes. It's almost impossible to tell if your youth athlete has broken a bone or sprained an ankle without imaging--these include X-rays for identifying broken bones and ultrasound to find out the degree of soft tissue damage. Sometimes an MRI will be necessary.

While minor injuries can be treated with rest, protection of the site, and time away from the field, more severe ankle sprains will require immobilization and also rehabilitation through physical therapy. Sometimes surgery will be required.

Ingrown Toenails in Youth Athletes

Another common problem in kids who play sports are ingrown toenails. Tight shoes or cleats in soccer and other sports combined with repetitive actions such as kicking are the major culprits.

Ingrown toenails need to be treated by a podiatrist. To help ease your child's pain in the meantime, soak their foot in room-temperature water with Epsom's salt and gently massage the side of the nail fold to help reduce inflammation.

Nail surgery for treatment of an ingrown nail can be done in the office. Prevention of ingrown toenails includes wearing shoes that fit properly, avoiding tight socks, purchasing (soccer) cleats that aren't too tight, and proper toenail trimming (trim straight across, no rounded corners).

Shopping for Athletic Shoes

Buying proper athletic shoes for your sports minded child is one of the most important things you can do to prevent them from getting foot and ankle injuries on the field.

  • Buy new shoes-it’s important to start out the season with a brand new pair of shoes. Old shoes will not provide the support your child needs to avoid injury and be his or her best on the field.

  • Get your young athlete’s feet measured- these days many parents purchase kids shoes off the shelf or online. Although this is an easy solution it circumvents the need to get your kids feet measured properly. Getting a good fit is always a good idea but its imperative when your kid plays sports. In addition to getting their feet measured, be sure that the shoe is at least one thumb’s length between the top of the big toe and the end of the shoe. Always choose the larger size if one foot is larger than the other.

  • Buy the shoe designed for their sport-choosing the right shoe for their sport is essential. Athletic shoes are designed specifically for the sport they are intended, providing just the right stability and flexibility.

  • Check shoe stability-don’t just go by the name brand of shoe when you purchase it. Even great name brands provide a range of support and may not meet the requirements your child needs. Test the shoe by holding it by the heel and toe. Attempt to bend it in half. It should only bend at the ball of the foot, not in the middle. Then try and twist the shoe. It should not easily twist from side to side.

Checking the field

Many sports-related foot and ankle injuries can be avoided by checking the field before play. The field should be checked for dips, holes, stray objects, and too much water.  Alert coaching officials to any irregularities.

If your youth athlete is experiencing foot or ankle pain, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

If you're a runner you're probably already aware of the high rate of injury in your chosen sport. You're pretty sure you've got the right shoes, you're a fanatic when it comes to warming up and stretching your calf muscles, and you get plenty of rest and eat right.

You've had more than one bout of plantar fasciitis so you have a pair of orthotics that you wear religiously.

Even with all that you still find yourself in pain more than you think you deserve given how well you take care of yourself.

Now it's time to try some sure fire techniques to help your body withstand the forces that lead to foot and ankle pain when running.

Ramp Up Your Training Slowly

Foot and ankle injuries are common in runners who rapidly increase their training schedule by more than 10% a week. Your body needs time to recover and build strength. Be sure to ramp up your training slowly to avoid injuring yourself.

Increase Your Step Rate

Research has shown that when runners increase the number of steps they take by just 5% and keep their speed the same they can reduce the impact on their body by 20%. This translates to a shorter, quicker stride and fewer injuries for the runner. Although changing your running style can be difficult, fortunately there are some apps that make it much easier.  Try RunCadence, Cadence Trainer, or BeatRun.

Improve Your Core Strength

In addition to good posture, having a strong core will help prevent injuries to your lower extremities. For that we turn to our neighbors Therapeutic Associates. Check out a full page of videos on how to improve the strength of your core, hips, and glutes.

Change Up Your Exercise

Instead of focusing on putting in more miles, replace them with cross training to give your body a chance to recover. Weightlifting at the gym, yoga, and an aerobic activity such as swimming, cycling or light jogging will keep your body strong and flexible.

Watch Your Posture Even When You're Not Running

Poor posture can put extra stress on the body. One of the best ways to become more aware of your body is through yoga. If you know you have poor posture taking a yoga class can be a tremendous help in increasing your body awareness. But if you can't sign up for a class there are a few easy poses that work well to increase that awareness and improve posture.

In mountain pose, place your feet hip width apart with a slight bend in your knees, ground your feet into the mat, place your hips in a neutral position, and tuck your tailbone under just slightly. Roll your shoulder blades up, back, and down and reach the crown of your head toward the sky. For additional posture enhancing poses, check out this yoga journal article.

More information:

How to Buy the Best Running Shoes
5 Hacks for Preventing Blisters in Runners
The Art of Running Safely in the Rain

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

By Dr. Rion Berg
July 12, 2019
Category: sports injuries
Tags: Untagged

Seattle is one of the best places to cycle in the country. Along with the famed Burke Gilman Trail, the area boasts multiple urban and regional trails as well as a great biking network for commuting. Whether you bike to work on a daily basis or use cycling for recreation and a great workout, there are many things to keep in mind to ensure your feet remain pain-free.

Cycling is a repetitive sport. During one hour of cycling a rider can average up to 5,000 pedal revolutions. Add that to tight or narrow shoes and that can be a prescription for foot pain.

Ball of Foot Pain

One of the most common foot conditions found in cyclists is metatarsalgia or "hot foot". Symptoms can include hot, painful, burning sensations and swelling and numbness. These symptoms can be particularly problematic in the summer when your feet are more likely to swell. If you're in the middle of a ride you'll need to stop, get off your bike, and let the swelling and heat subside.

Sesamoiditis can occur when the sesamoids or small bones found underneath the first metatarsals get inflamed or rupture from too much pressure from sports such as cycling.

Morton's neuroma is caused by an enlarged bundle of nerves to the 3rd and 4th toes. Although cycling is likely not the cause of this condition it can put extra pressure on that area of the foot, worsening an existing neuroma.

Achilles tendonitis

The Achilles tendon can become inflamed and irritated due to improper pedaling and seat height, but can also occur due to ramping up your training too quickly if you're a competitive rider. Flat feet and a tight calf muscle can also be the culprits behind this common condition.

Luckily there's a lot you can do to prevent these conditions.

  • Purchase new shoes - your shoes are often one of the first things to consider changing when developing foot pain. If your feet have gotten larger (common in adults), your shoes are too tight and narrow, or if your shoes are worn out head to REI or another shoe store you trust.
     
  • Types of shoes
    • casual riders can purchase a cross-training shoe while more serious riders will benefit most from bicycle touring shoes (can still walk in these) or shoes with cleats.
    • a stiffer shoe can help redistribute pressure over the metatarsal heads.
    • a roomier toe box can help accommodate your feet when they swell to prevent ball of foot problems.
  • Purchase inserts or over-the-counter orthotics with a metatarsal pad or button - these devices can lift the metatarsals to maintain their natural arch and prevent nerve pain and numbness.
     
  • Custom orthotics made be necessary to alleviate and prevent sesamoiditis and Achilles tendonitis. Orthotics for cycling will need to be thinner to accommodate cycling shoes.
     
  • Move your cleats back. Cleats that are too far forward can cause ball of foot pain.
     
  • Wear thinner socks to make more room for your feet.
     
  • Wear socks made of man-made materials to help wick away moisture from your feet. This will help prevent blisters.

If your foot pain is keeping you from cycling, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

 

 

Lots of girls are watching in rapture as Team USA continues to dominate the Women's World Cup in France this year. Many of these girls will be ready to hit the soccer fields this summer but many more will compete against other Seattle school teams this fall. While the risk of concussions from heading the ball has been all over the news recently, less visible are concerns about the feet and ankles of teen girls.

Here are some of the most common soccer foot and ankle injuries in this population.

Ankle sprains
Ankle sprains are the most common injury in soccer due to the twisting and force put on the ankle during play. Combined these two factors can result in excessive stretching or tearing of one or more ligaments on the outside of the ankle.

Ankle fractures 
Ankle fractures can occur simultaneously with an ankle sprain. They result from the ankle rolling inward or outward. It's not usually apparent whether an ankle is sprained or broken, so a trip to your podiatrist is warranted to ensure proper treatment takes place.

Contusions and bone bruises
Contusions and bone bruises can result when players run into other players and when players get kicked during active play.

Plantar fasciitis (heel pain)
Soccer players most at risk for plantar fasciitis are those with flat feet. Teen girl soccer players at risk for plantar fasciitis can greatly benefit from wearing custom orthotics. For milder problems over-the-counter orthotics such as Powersteps or taping can be helpful.

Sever's Disease

Sever's disease is another common cause of heel pain in girl athletes. Up until the age 13 girls can have a heel plate that has not fully closed. An open heel plate can result in inflamed tissue in the heel as a result of playing soccer. Reducing activity, using over-the-counter or custom orthotics, or immobilization may be needed to stop the heel pain.

Ingrown Toenails

Ingrown toenails are common in young athletes as they return to school in the fall wearing their old shoes. Old shoes are usually short shoes with the potential to push against the big toe causing it to become ingrown. This problem is usually preventable by buying shoes with the correct fit.

Stress fractures
While stress fractures are most commonly caused by low bone density and this is uncommon in young girls, it can be a problem for those with low body weight. Low body weight and lack of a consistent or absent period are signals that an athlete is not taking in enough calories to support balanced hormones. Estrogen is needed to maintain strong bones. 

What You Can Do To Ensure Your Teen Girl Stays Safe During Soccer

  • Bring her for a pre-season physical examination with your doctor; make sure she asks whether your daughter has a regular period to rule out the potential for stress fractures.
  • Make sure her muscles are in condition for soccer; about a month before she begins to play take her out to a soccer field a few days a week to practice her soccer moves and build muscle strength and mobility.
  • Remind her to drink plenty of water even before she get thirsty.
  • Ensure she's eating a healthy snack every 3-4 hours so she gets enough calories.
  • Teach her to warm up prior to playing soccer; for example, a slow jog and then muscle stretches.
  • Choose athletic shoes made for soccer; if she buys cleats make sure they aren't too tight or short to prevent ingrown toenails and other foot problem.
  • Replace her athletic shoes every six months to ensure they're providing proper support.
  • If she has any specific foot issue such as flat feet or painful feet be sure to make an appointment with a podiatrist.
  • Teach her to pay attention to her body; she should tell you or her coach if she's have pain or discomfort.
  • Check out the soccer field ahead of time or find out if the coach does this. Ensuring there are no irregularities or divots in the field can help prevent unnecessary injuries.
  • Overuse injuries can also occur in young athletes; sometimes they may need to take a substantial break in their activity in order to allow the body to heal properly.

If your teen girl has painful feet or a foot problem that can put her at risk while playing soccer, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

 

Ball of foot pain is one of the most common types of pain I see in athletes. Whether you're a runner, soccer player, or dancer ball of foot pain can stop you from doing what you love. Your feet are a wondrous, complex system of bones, joints, tendons, and ligaments designed to work together perfectly. And they must. They have a big job to do. Your feet are small relative to the amount of weight they need to hold up and keep in alignment.

Considering the amount of pounding and abuse they take, it's amazing our feet continue to deliver for us. It's not until we feel pain that we start to examine what we might need to do differently to protect them.

When you do experience pain in the ball of your foot or in other parts of your feet, you might wonder why your running partner seems to glide through it all without a twinge. The truth is your athletic pursuits are only part of the puzzle when it comes to assessing why you have pain in the ball of your foot. In fact people who aren't athletes also get ball of foot pain.

What Do I Mean By Ball of Foot Pain?
Ball of foot pain occurs where the toe bones join the metatarsal bones. It can occur in one spot or all across the ball of the foot. Symptoms can range from sharp or shooting pain when the toes are flexed to tingling or numbness in the toes or it can even feel like you're walking on pebbles.

There are many causes of ball of foot pain. To properly diagnose and treat it, I'll ask you questions about your recent physical activity, watch you walk, determine your foot type, and check the types of shoes you're wearing.

The Role of Foot Structure in Ball of Foot Pain
A big factor in developing foot pain lies in the structure of your feet. Some of us have high arches, some have low arches, and some have no arches. High arched feet and feet with no arches can both cause instability in the foot that leads to ball of foot pain by putting extra pressure on the metatarsal bones. Also, a Morton's toe (the second or third toe longer than the big toe) can lead to this condition when weight shifts to the second or third toes.

How Tight Calf Muscles Affect Foot Position
Tight calf muscles can make faulty foot structure worse by increasing the pressure on the metatarsal bones at the front part of your foot.

How Physical Activity Affects the Foot
Our feet can take a lot of pressure, however, the high jumps during a basketball game and the constant pounding from running can be a primary cause of ball of foot pain. It's important to rest when you first feel the pain and not try to play or run through it since you can do further damage to your feet.

How Being Overweight Can Play a Role in Ball of Foot Pain
Being overweight can increase your risk for ball of foot pain. Every extra pound of body weight creates three extra pounds of force when walking and seven pounds when running. For example, a person weighing 200 pounds would place 600 pounds of force on their feet when walking and 1400 pounds of force when running.

The Role of Shoes in Ball of Foot Pain
One of the easiest things to do to decrease ball of foot pain is to change your shoes. Every sport has shoes designed specifically to prevent foot and ankle injuries most common to it. Basketball shoes worn for running will not protect you from running injuries. Likewise, old worn out shoes will not provide the support needed to prevent pain in the ball of your foot. Even when you're not taking part in your favorite sport it's important to keep in mind that high heels and shoes that are pointy and squeeze the front of your foot can also be a factor in your foot pain.

Common Ball of Foot Pain Conditions
Some of the most common ball of foot pain conditions are:

Metatarsalgia - the pain is typically felt on one or more of the five bones (metatarsals) in the mid-portion of the foot.

Neuroma - A neuroma is an enlarged, benign growth of nerves, which can occur in various parts of the body. The most common neuroma of the foot is called Morton's neuroma, It develops between the third and fourth toes of either foot. The incidence of Morton's neuroma is eight to ten times greater in women than in men.

Sesamoiditis - occurs when the tendons surrounding the sesamoids can become irritated or inflamed. Sesamoiditis is a common condition among ballet dancers, runners, and baseball catchers because of the pressures placed on their feet. A form of sesamoiditis called turf toe is also found among soccer players and kickers in football.

Treatment
Acute pain and injury should be treated with ice to decrease swelling. Additional treatment will depend primarily on your diagnosis and foot structure. Orthotics might be dispensed to improve your foot alignment or to relieve pressure on a nerve if implicated in the diagnosis. A program of stretching, often with an Achilles splint, is warranted if you have tight calf muscles. Weight loss may be suggested to relieve pressure on your feet.

New athletic shoes should be purchased annually to ensure they are providing the support you need. Avoid buying lightweight shoes with squishy soles and no solid shank from the heel to the ball of the foot as these will add to your ball of foot pain. Instead purchase a Hoka One One running shoe if running is your sport. It has great shock absorption with a good shank and a rocker sole to prevent your foot from jamming into the ball of your foot. Everyday shoes should be only one inch in height and have a toe box wide enough to accommodate your forefoot.

Finally, all activity should stop until a diagnosis is confirmed by your podiatrist.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

Photo credit: Photo by bruce mars from Pexels