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Courting Injury

The twists and turns of court sports can be a problem for your feet and ankles

SATURDAY, May 19, 2001 (HealthDayNews) -- If you play such court sports as basketball, racquetball or tennis, the pounding and movement that your feet and ankles endure can produce specific problems and injuries.

Hard playing surfaces, fast lateral movements, confined playing areas and foot collisions between competitors can result in injuries like sprains and stress fractures.

"Court sports are lateral sports and as a result there are significant forces where the foot is pivoted and you change direction," says Dr. Thomas E. Shonka, attending podiatrist at the Boulder Center for Sports Medicine.

For example, you plant your feet and stretch and/or twist to hit or grab the ball.

"When you do that, it takes a great deal of strength and balance that we don't even think about. You repeat it hundreds of times during an event and it's just basically taken for granted until an accident occurs," Shonka says.

Sprains are at the top of the list and are often caused by the quick, lateral movements typical of court sports, he says. Then there are shock-related injuries: stress fractures in the foot or shin bone, for example.

Most stress fractures occur in the metatarsal bone, which can create swelling in the forefoot. But Shonka says stress fractures can occur in any one of the foot's 26 bones without many symptoms.

A stress fracture in the stronger, more dense area of the mid-foot can be difficult to diagnose.

The heel is another common injury site and heel pain can be a sign of a plantar fascia injury or bone spur. The plantar fascia is a thin, strong tissue band that supports the arch of the foot, stretching from the heel to the ball of the foot. With repeated shocks over time, the fascia can tear from the heel and result in a bone spur.

Injuries to the Achilles tendon and other tendons are also common in court sports.

"Ask anyone who's torn their Achilles tendon and they'll tell you it feels like someone hit them with a baseball bat in the back of the calf," Shonka says.

The majority of Achilles tendon ruptures he sees are in males older than 40 who were playing a court sport without doing proper warm-ups or stretches for their Achilles and calf muscles.

A ruptured Achilles tendon often requires surgery. To avoid that, you have to do your stretches. Shonka suggests leaning against a table or wall and placing one foot behind the other. Point your toes slightly inward and roll the ankle toward the outside.

Gently lean forward and feel the stretch high up into the calf muscle. Always roll the weight to the outside of the foot, and never stretch to the point of producing pain.

Shonka says older athletes should have a regular stretching regimen to maintain flexibility. Don't limit stretching to just before you exercise or play a sport.

"The older we get, the less flexible we become. And unless we continue to work on maintaining that flexibility, we're going to lose it as the years go by," Shonka says.

The shoes you wear while playing court sports can help prevent injury, adds Dr. Richard Bouche, a podiatric foot and ankle surgeon who is director of the Sports Medicine Clinic at The Virginia Mason Sports Medicine Center in Seattle.

"When you're moving from side to side, you have to have a stable platform to work from," and the shoe is critical in that regard, Bouche says.

That means selecting the proper shoe to fit the activity. For example, if you wear a jogging shoe, which has no lateral support, while playing basketball or racquetball, you're asking for an injury.

Pay attention to the soles of shoes. Bouche says some racquetball shoes have sticky, rubber soles that grab the court surface, basically locking your feet to the floor. This can lead to numerous injuries. It's better to wear hard rubber soles that provide grip but don't glue your feet to the floor.

What To Do

Here are some tips from the American College of Foot and Ankle Surgeons:

  • Buy new, quality athletic shoes and replace them frequently.
  • Seek appropriate support for arches. People with flat or high arches may require custom-made arch supports in shoes.
  • Stretch, stretch, stretch.

For more HealthScout stories on feet, click here.

For more information about foot care, go to the American College of Foot and Ankle Surgeons, or the American Orthopaedic Foot and Ankle Society.

SOURCES: Interviews with Thomas E. Shonka, D.P.M., Boulder Center for Sports Medicine; Richard Bouche, D.P.M., director, Sports Medicine Clinic, The Virginia Mason Sports Medicine Center, Seattle
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