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logoHappy Feet, Happy Life!
Kessa Mauras, D.P.M.
Board Certified, American Board of Podiatric Medicine
1100 E. Marina Way, Ste. 223
Hood River, OR 97031
541-386-1006


Happy Feet, Happy Life Blog

Basketball Injury Awareness and Prevention

Few workouts are more intense and exciting than basketball. And with all those jumps, twists, and rapid changes in speed, few workouts put more stress on the feet and ankles. When preparing for a game of basketball, there are some safety tips every player should be aware of to prevent the kinds of injuries described below.

Stretching is always important before engaging in physical activity, but it is very important that stretches be done as part of or following a warm-up. Stretching “cold” actually increases the risk of straining muscles and connective tissue. It is also advisable to do dynamic stretches (like running with high knees or butt-kicks) during warm-ups, and static stretches (holding an extended pose) during cool-downs. Another important preventive measure is to frequently replace or rotate basketball shoes. If the soles have become smooth or the top no longer fits snuggly, the shoes have become a liability.

Doctors and sports medicine practitioners distinguish between acute injuries, which in basketball are usually the result of an unfortunate landing, and chronic injuries, which result from overuse. The most common acute injuries are lateral inversion ankle sprains, in which the ligaments on the outside of the ankle tear because the foot rolled underneath the foot. These can be accompanied by broken bones. Another common acute injury is tearing of the peroneal tendons, which run behind the ankle bone and attach to the outside bottom and underneath the foot. Players who suffer acute injuries should leave the game immediately and get first aid.

Breaks and strains can also result from chronic stress. This can affect the peroneal tendons as well as any other part of the foot. Plantar fasciitis is the inflammation of the connective tissue under the arch of the foot which is usually felt in the heel. The Achilles tendon, which connects the calf to the heel, is also a common victim of inflammation resulting from overuse. Stress fractures, which are hair-like cracks in bones, are another slowly-developing ailment common in basketball players’ feet. These often occur in the metatarsals, which are the bones connecting the toes to the anterior region of the foot. The fifth metatarsal, which attaches to the pinky toe, is the most frequently affected. A Jones fracture is a fracture in the base of the fifth metatarsal; an avulsion fracture is when a chip of the metatarsal breaks off.

In the immediate aftermath of an acute injury or a chronic injury which has become too dangerous to ignore, a player should be treated with RICE: rest, ice, compression, elevation. First-aid kits in gyms may be equipped with compression bandages, but people hosting basketball games in their driveways or organizing pickup games would do well to keep them and cold packs on-hand. Seek a doctor’s opinion if the pain lasts for longer than three days, and don’t be satisfied with a diagnosis without undergoing through imaging tests. Podiatrists know that different kinds of foot injuries often feel very similar to the patient but require different treatments. A specialist’s attention is often needed to determine the best course of action, and the sooner, the better.

Problems in Childrens Gait

As children return to school, perhaps with new shoes and anticipating the start of PE class, now is a good time for parents to familiarize themselves with childhood gait abnormalities. Toddlers have a very different way of walking than adults. As children grow, their legs and feet adjust naturally, but often with some temporary oddities. Although most gait abnormalities are harmless and resolve on their own, it is reasonable for parents to seek a podiatrist’s opinion on whether their child’s manner of walking indicates a more serious problem.



Certainly, children should be assessed and provided with treatment if they complain of pain. However, children will not attain a normal adult gait until they are between the ages of eight and ten, when they achieve sufficient musculoskeletal and neurological development. As toddlers, children have a wide stance and take short, rapid steps. They commonly limp, are flat-footed, and walk on their toes or with their toes pointed inward. Outtoeing and bowed legs are also common. Besides pain, the other signs of a problem are if the abnormalities are asymmetrical and if they get worse over time instead of better.



The arch of a child’s foot does not develop until around the age of five, so corrections for flat feet on children below the age aren’t useful. On the other hand, toe-walking should not persist after the age of three. When children do experience problems walking, the cause may be anything from neurological to stomach pain (which could result in a hunched over gait) or muscular. Podiatrists check the muscles and tendons of children’s legs for tightness, which could cause intoeing. Interventions for tight muscles are usually non-surgical and could include bracing and therapeutic exercise.



While assessing gait problems, doctors use imaging tests to search for issues with twisted or fractured bones. Orthopedic devices are used to treat torsion of the leg bones, along with changes in sitting habits and posture. Cerebral palsy and other neurological disorders must be considered when children have difficulty swinging their legs and balancing. Inflammation is also commonly associated with joint pain, so recent infections may be relevant to foot and hip dysfunction that has developed suddenly. Juvenile Idiopathic Arthritis is a term used to describe joint inflammation without a clear cause. It is commonly managed with exercise, steroids, and anti-inflammatories. To help rule out as many causes for gait problems as possible, podiatrists will often order blood tests, in addition to testing the child’s balance and range of motion. One other cause of limping to be aware of is ingrown toenails, which is why it is important for children’s shoes to be replaced as they grow.

Mt. Hood Podiatry September blog: Heel Pain

The plantar fascia is the largest ligament in the human body, so it’s bound to endure pain at least once in our lifetime. Under ordinary circumstances, the plantar fascia acts as a shock-absorber that supports the arch of the foot. If too much tension and stress are put on the ligament, this can result in small tears in the fascia and cause plantar fasciitis.

The sole of the foot is known as the plantar area. Plantar fasciitis is a medical term for when this area becomes inflamed. Plantar fasciitis is usually diagnosed after a physical or foot examination. Plantar Fasciitis can develop alone or it may be a symptom of an underlying condition. Excess weight puts a person at risk for plantar fasciitis. Plantar fasciitis is also common in people between the ages of 40 and 60. Activities that put a lot of pressure on the heel such as running, dancing, or jumping, can also put a patient at risk for plantar fasciitis.

Symptoms

  • Pain in the foot arch and/or heel
  • Stiffness in the plantar area
  • Tenderness in the sole of the foot
  • Nonsurgical Treatment Options

If you are suffering from heel pain, you should try resting and icing the area first. If possible, reduce or cease activities that make the pain worse. Changing the type of shoes you wear may also alleviate pain. Your shoes should always have a strong arch support and well-cushioned soles. If you don’t wish to purchase a new pair of shoes, you may want to purchase over-the-counter orthotics or request custom orthotics from a podiatrist.

When to Visit the Podiatrist

Ignoring plantar fasciitis can result in arch, heel, or overall foot pain that may damper your daily activities. You should call a podiatrist if you are not able to bear weight on your heel when you stand, or if you’ve sustained an injury to the foot that has caused heel pain. If you’ve been diagnosed with plantar fasciitis and at-home remedies such as over-the-counter pain medicine, or ice aren’t working, call a podiatrist to discuss your treatment options.


Diabetic Foot Care in Warm Weather

As the weather gets warmer, the needs and risk factors for diabetic patients will change. In some ways, the measures people with diabetes should take to protect their feet are not very different from what everyone else should be doing. However, the consequences of poor foot care for this population could be far worse, so it is important for them to know what to avoid.

There are two primary factors which put diabetic patients at increased risk for foot wounds. One is that people with diabetes commonly suffer from neuropathy—a problem with the nervous system which makes them less likely to notice if they are being injured. The other is that people with high blood sugar levels have a more difficult time fighting off infections. In warm weather, people often go barefoot or wear shoes such as sandals and flip-flops which offer minimal protection. As a result, they are much more likely to suffer scratches and burns which, if they are neuropathic, they may not be aware of until infection sets in, and if they have high blood sugar, may be severe enough to result in hospitalization or amputation.

A third seasonal risk, which affects people in general, is that open-toed shoes allow feet to dry out faster. This is a problem because dry skin breaks more easily. To reduce their chances of injury, people with diabetes should avoid ever going barefoot and stick to close-toed shoes as much as possible. Patients who haven’t recently been tested for neuropathy should never assume that they would be able to feel if sand or pavement is too hot to walk on Because some people with diabetes experience increased swelling in high temperatures, it is important for them to wear compression socks, all other risks of going barefoot aside. Though these socks may cause their feet to sweat a lot and need to be changed frequently, they are necessary to ensure healthy blood flow.

On a more positive note, warm weather often encourages people to exercise, which is crucial to controlling glucose. It is important to remember that swimming in opaque water in natural settings poses a risk of cuts from unseen objects. Running shoes should be selected for the patient’s arch shape and replaced when they are worn down. And, like everyone else, patients with diabetes should put sunscreen on their feet (including their toes) when they do go barefoot and regularly check their feet for injuries. But with the proper precautions, there’s no reason why patients with diabetes can’t have fun in the sun.




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