Sports Injuries & Pedorthics: Prevention & Recovery
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Sports Injuries & Pedorthics: Prevention & Recovery

Foot injuries are among the most common athletic injuries, partly because there are so many parts of the foot – 26 bones, plus ligaments, joints, tendons and muscles – that can be injured. That's why it's also extremely easy for a relatively routine injury like a sprain to mask a more serious problem.

Appropriate footwear can help athletes avoid or mitigate foot injuries. Footwear can also play a major role in rehabilitation and recovery. Because credentialed pedorthists specialize in shoes and foot orthoses, they can play a significant role on an athlete's health care team.

Pedorthics (peh-DOR-thiks) is the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.  When pedorthics is part of a medically-approved training or treatment program, shoes and orthoses help athletes avoid or compensate for foot problems that might otherwise limit or preclude their participation in sports. When foot injuries do occur, pedorthics can help athletes during the treatment and rehabilitation program that aids them in returning to their sport.

Increased Risk of Injury

Many sports subject the foot to excessive weight loads. For example, during a normal run of 10 miles, the foot strikes the ground approximately 15,000 times with a force equal to three or four times the runner's body weight. During walking, each foot alternatively receives the body's entire weight.

Speed helps determine the force with which foot and ground meet. Greater speeds mean greater pressures on the lower extremities. The foot must absorb the stress. When the sport requires sudden starts, stops or changes in direction, even more stress is placed on the foot and the foot/shoe interface, which increases the risk of foot injury.

A condition called "turn toe,” for example, is more prevalent in sports where sudden stops are routine. Contact sports like football or soccer often result in ruptures or tears. Non-contact sports like running or aerobics frequently result in overuse problems.

Most sports injuries can be broadly categorized as acute or chronic. Acute injuries are "fresh” ones with fairly obvious causes and effects. Chronic injuries usually occur from overuse, repetitive motion or stress. Because athletes sometimes play through pain – ignoring an injury, or favoring the injured spot and putting unusual pressure on other areas of the foot to compensate - they can experience additional damage without realizing it.

Foot injuries can be underdiagnosed or difficult to recognize simply because the foot has so many parts. A credentialed pedorthist, working with a medical practitioner, can be of unique assistance by focusing on the foot, orthosis and shoe as a unit.

Shoes as Sports Equipment

For amateur as well as elite athletes, the shoe is probably the most important piece of equipment, because contact between the foot and the athletic surface is fundamental to accomplishment. Most athletes recognize this by choosing sport-specific footwear – but even a sport-specific shoe cannot address such factors as amount or duration of training time; intensity of performance; the surface involved; or the athlete's physical history, weight, foot type and foot shape. A credentialed pedorthist can help with shoe selection based on these factors.

Whatever the sport, most athletic shoes are expected to perform contradictory functions – for example, to be lightweight and flexible, but at the same time provide good cushioning, support and protection. Many sports require the foot to perform contradictory maneuvers one after the other, as well: start/stop, forward/backward, side to side. Since this creates considerable stress on the foot, months or years of athletic activity can create more wear-and-tear than would otherwise occur. Through shoe modifications and foot orthoses, pedorthics helps athletes accommodate, correct or compensate for that greater-than-average wear-and-tear.

Relieving Pressures

The foot itself has a natural fatty heel pad that helps distribute weight pressures safely. Over the years, the pad wears down, lowering the heel's ability to absorb shock. A credentialed pedorthist can recommend shoes and fabricate orthoses that help the athlete deal with this natural breakdown. Most athletic shoes today are manufactured with an inlay, a removable pad that acts as a shock absorber. A credentialed pedorthist can replace the manufacturer's standard inlay with one tailored to the athlete's needs, according to a doctor's prescription.

Individual Help

Modifying the shoe, adjusting the lacing, or wearing an appropriate orthosis can help an athlete avoid or recover from injury. Although most shoe modifications for athletes fall into broad categories – like shanks, wedges, stabilizers or rocker bottoms – they must be individualized for the person and the sport. Since even a personally tailored shoe or orthosis can't assist every athlete in every situation, sport-related foot injuries will continue to occur – and pedorthics can help during the recovery process.

By modifying a shoe, a credentialed pedorthist can make it possible for an athlete to wear the appropriate bandaging, bracing or other footwear devices that a doctor may prescribe to facilitate healing. In fabricating an orthosis, the credentialed pedorthist creates a tool to compensate for a problem, which helps allow injuries to heal more quickly. As healing progresses, the orthosis or shoe may require additional changes – to the shoe itself; in the sock thickness, size or fabric; in the shape, depth or materials of the foot orthosis; or in a combination of footwear components.

Whether the need is preventive, accommodative, conservative or compensatory, pedorthics can help athletes remain active and enjoy their sport to the fullest.

Patients may be eligible through health insurance for partial or full reimbursement for footwear prescribed to accommodate or alleviate medical conditions.

This page contains generalized information. Use of specific words within this generalized framework is not intended either to reflect or to contradict technical pedorthic definitions. Nothing in this brochure should be interpreted as a substitute for professional consultation.

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