Friday, September 12, 2014

A Low Blow

The greatest volume of injuries for athletes and active people is from the waist down. Whether you're a weekend warrior or a trained athlete, avoiding injury is more time for enjoying competition, staying healthy and having fun. Below are the top injuries that happen below the belt described by Jodai Saremi, DPM in conjunction with the Aerobics & Fitness Association of America.

Toe Space
Long-distance runners and anyone who engages in a sport that applies a lot of pressure or repetitive pressure to the toes is familiar with the black-and-blue toenail. Bleeding under the nail, is caused by trauma to the nail bed.  The best way to avoid a black toenail is to prevent toes from hitting the end of the shoes. Some athletes prefer to buy their shoes a half size bigger or they wear thicker socks. The best guarantee to lose a nail is to wear shoes that are too tight and run downhill.

Foot Fracture
The most commonly fractured bone in the foot is the fifth metatarsal, on the lateral part of the foot. When the foot is plantar-flexed and the person is trying to pivot or forcefully invert the foot, the fifth metatarsal can experience an avulsion fracture - where a piece of bone is torn off by the tendon that attaches there) or the bone breaks. Preventive measures are difficult to take, since these fractures mainly occur with quick, high-energy movement during athletic activity. Some studies have shown that weak ankles and overuse/overtraining may predispose one to injuries. Ankle support and shoes with good lateral support, or shoes and orthotics designed for supinated feet are therefore recommended.

Achilles Heel
The typical Achilles rupture feels like someone hit the back of the leg or the calf with a baseball bat. There is often an accompanying "pop" sound, pain and gradual—but definite—inability to plantar-flex the foot at the ankle. In athletes, this is a debilitating injury that may take up to a year from which to recover.  Prevention of tendo Achilles rupture (and tendinitis) lies in avoiding overuse injuries that weaken the tendon and making sure the ankle joint does not overpronate. Also, in sports that require repetitive jumping or quick acceleration, strengthening the accessory plantar flexion muscles may help take some of the load off of the Achilles. Proper warm ups, stretching and icing routines are also good preventative measures.

Shin Splints
Pain in the lower leg, specifically on the tibia (shin) bone, is a problem commonly seen in runners that can sideline the athlete. Opinions differ on whether shin splints are caused by microstress fractures in the bone, inflammation of the periosteum (the skin-like covering that provides circulation and sensation to bone) or are a result of compartment syndrome from swollen muscles or tendinitis on the leg (both posteriorly and anteriorly).  Although treatment of shin splints varies depending on the cause, there is agreement that ice and rest are useful. Additionally, the forces traveling down the tibia that caused the fractures should be addressed with a thorough biomechanical exam,


Chris is a Certified Personal Trainer, USA Triathlon Level 1 Coach, Group Exercise Instructor, exercise and endurance enthusiast.  He competes yearly in numerous running races, marathons, ultra marathons, triathlons and other endurance events.