You don’t have to be runner to consider yourself an athlete. You don’t have to be competing either. Anyone who takes part in regular activity is putting a greater strain on their body than the average person.

During walking, the force taken through each leg can be up to two and a half times your body weight, so it is no great surprise that, as activity becomes more strenuous, there is a greater risk of problems developing. The causes of most activity related problems are

• Abnormal biomechanics.
• Improper stretching prior to, during and after exercise.
• Increasing activity levels too quickly.

 

Many athletes could be spared the problems associated with high activity levels and impact sports by following some simple guidelines.

 

 

 

• Increase activity levels gradually when starting a new sport or returning to training after a break.
  
  
• Stretch appropriately before, during and after exercise (Get advice from your physiotherapist for the best stretching routine).
  
  
• Wear the correct equipment. Good foot position and stability of the ankles is crucial to most sports so make sure you have the right footwear.

If you are still experiencing specific problems, an orthotic solution may help you. Many top level athletes wear orthotic devices to optimise the performance of their muscles during exercise. The orthotics will also prevent problems from developing by correcting abnormal alignment.

 

SPORTING INJURIES

Certain sports predispose you to certain injuries. Runners are highly likely to suffer from lower leg injuries caused by lack of shock absorption. Golfers likely to suffer from back problems. Cyclists are at risk of suffering from knee pain. The conditions described below are typical of the types of injuries which many athletes experience.

 

RUNNERS

Track athletes are the most likely of all athletes to suffer with foot and knee problems. This is related to the impact forces experienced throughout running. Common problems:

• Ilio Tibial Band Syndrome
• Plantar Fasciitis
• Tib Post Tendonitis
• Shin splints

 

 

SHIN SPLINTS (Medial Tibial Stress Syndrome or MTSS)

Symptoms

MTSS is characterised by pain along the inner side of the shin bone. The pain may be enough to stop exercise but gradually goes away when activity is ceased.

Sometimes some mild swelling occurs around the area.

 

 

 

Causes

The main cause of MTSS is overuse. Athletes running many miles a day with very high impact forces are much more likely to suffer from MTSS. It is important to note that shin splints are not splintering pieces of bone. Commonly, the pain is arising from inflammation of the sheath surrounding the bone or the musculature which supports it.

Common risk factors for MTSS are:

• Abnormal biomechanics of the foot (excessive pronation)
• Running on cambered surfaces
• Running in worn out footwear
• Running downhill
• Rapid increase in training levels

Treatments

As with most inflammation based injuries, rest, ice and anti inflammatory medication can be very effective (See your physio for more advice – link to physio). For preventing recurrence of the MTSS, athletes should have their foot biomechanics assessed for abnormal function (this may not be obvious to the untrained eye). In addition, footwear should be replaced every 350 miles. Your practitioner should be able to give you some guidance as to a make and style of trainer which is suitable for your problem. There are also some links on our specialist footwear page which may be of use to you.

Thereafter, gradual resumption of your training should prevent recurrence

 

CYCLISTS

Being a non impact sport, cyclists tend to have different kinds of injuries. Many cyclists suffer from knee and back pain, brought on by improper biomechanics.

Leg length discrepancy

A difference in leg lengths may not seem like a problem in a non impact activity. However, if the leg lengths are different, the length from the saddle to the pedal will only be correct for one leg.

This means that the body must find some way to compensate for the discrepancy. The manifestation is normally to pronate the foot which can cause knee pain or to move the centre of gravity to the side creating an obliquity at the pelvis. This obliquity causes muscles to work harder and create greater potential for pain.

In order to maximize power output when pedaling, the recommended saddle height is between 105 and 109% of leg length. A 1% deviation, in either direction, from optimum saddle height leads to a 1% reduction in power output.

Pronated foot

The effect of a pronated foot can be seen in this picture (to the side).

The pronation of the foot causes internal rotation at the lower leg. This forces the knee to have excessive movement from side to side instead of straight up and down. The effect of corrected foot position is also shown on the figure. This corrected foot position can easily be achieved with an in shoe device which can be transferred from shoe to shoe.

 

 

GOLF

Despite being a relatively sedate sport, the golf swing produces extremely high torsional forces which affect the feet knees, hips and back. The American Golf Academy cites back pain as the most common golfing injury. However, for many people, the problem is not the golf swing itself but the miles of walking round the golf course.

 

 

Many of the knee and back problems associated with the golf swing are a result of poor foot biomechanics. Common risk factors are:

• Pronated feet
• Leg length discrepancy
• Arthritic changes in the ankle (abnormal movements performed by the feet to reduce ankle pain can affect the rotation and positioning of the knee)

There are many complex movements taking place at the foot during the golf swing. Unlike walking, certain side to side movements are required to produce a good golf swing. However, the movements must be in a controlled fashion. The primary job of the foot in the golf swing is to maintain good balance. A subjective study of golfers in America looked into the effects of foot orthoses on balance during the golf swing. 71% of the golfers reported an increase in balance and stability with a high percentage also reporting an improvement in their average score.

For many golfers who wear orthoses when playing golf, it is not the effect on the golf swing but the effect on their ability to walk round the golf course which keeps them religiously using their insoles. The improvement of the foot biomechanics mean that tired, aching legs and many painful foot problems stay at bay and you can just keep playing golf!

 

 

 

 

 

 

 

For more information on sports injuries or to discuss a specific complaint, please contact us.