For many people they will be embarking on a training regime for the forthcoming Marathon season, whether it is their first or fiftieth? As this years London Marathon places have been allocated this article will provide a brief overview for the role of Podiatrists in the assessment of the sports patient. Here at Woodside Clinic we have experience podiatrists, Chris Nunn, Manju Mital and Luke McCarthy.
The foot is designed to provide a structural platform for the body; to absorb impact from the ground; adjust to different terrains and to become a rigid lever capable of forward propulsion.
Statistics suggest that we take on average between 5,000 – 18,000 steps per day and if there is a minor misalignment in our biomechanics then this constant repetition can cause injuries. It only requires a small level of stress repeated thousands of times per day to aggravate or create an injury.
Approximately 70% of all sporting injuries occur within the lower limb. When the potential of attaining an injury to the lower limb is this high, the role of the podiatrist becomes one of great significance in an overall combined management of the sports patient. Woodside Clinic’s podiatrists can play an important part in the prevention, diagnosis and treatment of these sports injury. Our podiatrists will assess, analyse and treat the foot, gait abnormalities and lower limb injuries that occur in the sporting and active population. Their aim is to use an orthoses, primarily simple insoles to affect the foot and its interaction with the ground during running and walking. This can help with conditions such as back, hip and knee pain, shin splints, Achilles pain, tendonitis, heel pain, forefoot pain and basic podiatric needs involving calluses, corns, blisters and nail disorders.
After taking a full medical and familial history Woodside Clinic’s podiatrists question the patient about their chief concern. As prevention becomes a focal point for all our practitioners dealing with the sports patient, it is essential that our podiatrist has an understanding of the potential risk factors associated with sporting activities.
- Sport, the demands of the sport, e.g. fractures due to trauma in contact sports that could occur from a tackle in rugby or football.
- Skill level and schedule, the demands of the training schedule dependent upon the level of competition and the aspirations of the individual.
- Shoes and socks, are these suitable for the demands of the activity and the individual?
- Surface structure, increased forces from different sporting surfaces, e.g. grass, concrete, astro turf all exert differing forces and potential dangers for sporting participants.
- Sex and age, hormones, degeneration of collagen and, or muscle mass.
- Style, each individual will possess their own style in performing their chosen sport.
- Stamina and strength, under conditioning of the cardio vascular and muscular system, often a muscle imbalance leading to fatigue and subsequent injury.
- Stretch, the importance of incorporating a stretching regime to alleviate muscle tightness.
All of the above can play a part in leading towards an injury occurring.
The assessment carried out at Woodside Clinic involves weight bearing and non weight bearing exercises to investigate whether adequate range, quality, symmetry and direction of motion are available within the hips, knee, ankle and joints of the foot. Our assessment will provide information regarding any restrictions in available movement within these joints, which will provide the basis for a treatment plan to be implemented in order to allow continued activity or a modified return to activity. Our Podiatrists aim is to alleviate discomfort at an injury site and to prevent an injury occurring by affecting the foot and the ground interaction whilst walking / running often with the use of a simple insole within the treatment plan but may involve referring to an Osteopath or Physiotherapist if needed.
Our treatment plan is all encompassing and looks to address, modify and improve poor biomechanics and footwear with the introduction of insoles and a stretching and conditioning programme.
Marathon Training Case Study
Mr N, a 35 year old electrical engineer, started training in November 2013 for his first marathon in April 2014 . Training progressed well until he started getting low back pain in February 2014. He had increased his training in both frequency and intensity from running twice a week covering 15 miles to running four times a week covering 40 miles.
During his assessment by an osteopath, we found out that he had fractured his femur when he was 20 years old after coming off a motorcycle, and that he had a significant leg length difference which was putting a strain on his sacro iliac joints. Normally the body adapts well but due to his increased training his body couldn’t cope.
He was referred to our podiatrist who used orthotics to minimise the leg length difference and with a few adjustments to his training managed to complete the marathon with minimal discomfort.
This case highlighted the fact that if you are about to embark on any significant physical challenges, it may be worth seeing you musculoskeletal therapist just to ensure potential problems can be avoided or minimised.