Netball-related foot & lower leg injuries—and how to avoid them

Netball-related foot & lower leg injuries—and how to avoid them

Blog, Sports Care

Netball-related foot & lower leg injuries—and how to avoid them - 1

Netball-related foot & lower leg injuries—and how to avoid them

Guess what? Netballers are three times more likely to sustain lower leg or knee injuries than people playing AFL, soccer or both codes of rugby.*
In addition, Sports Medicine Australia reveals that the rate of injury for netballers is 14 injuries per 1,000 hours played.

Common netball-related foot injuries include:

• Ankle sprains & strains
• Achilles tendinopathy
• Sever’s disease in kids
• Osgood-Schlatter disease (Knee pain) in kids
• Patellar tendinopathy (aka “Jumper’s Knee”)
• Plantar heel pain – incorporating plantar fasciitis, tibialis posterior tendonopathy or abductor hallucis pain

Preventing netball-related injuries

“Awareness of widespread netball-related injuries and knowing how to avoid them can go a long way to ensuring you see out the entire season,” says sports podiatrist and founder of A Step Ahead Foot + Ankle Care, Dr Brenden Brown.

Netball-related foot & lower leg injuries—and how to avoid them - 2

Ankle sprains & strains

“Ankle sprains typically occur as a result of involuntary sliding or twisting of the feet when you step on slippery or unstable ground. The sprain happens when the foot is forced into an unnatural position.

“The intensity at which the ligaments stretch can sometimes be so severe that it causes fracture or serious inflammation and pain.

“An ankle strain is an injury to the muscle or tendon. For example, overstretching the muscle or tendon can result in a complete or partial tear, with symptoms ranging from moderately painful to disabling.

“To reduce the risk of injury netball players need to perform strengthening movements. This refers to strength exercises that focus on the glutes along with balance and co-ordination of the lower limbs, as well as sports-specific exercises,” says Dr Brenden.

Netball-related foot & lower leg injuries—and how to avoid them - 3

Achilles tendinopathy

“We know that the most common cause of achilles tendinopathy is change in load; this refers to sudden alterations in the intensity or frequency of the sport. (It has nothing to do with weight!) Dramatic changes place abrupt pressure on the tendon to over work and this gives rise to achilles-related problems,” explains Dr Brenden.

“Prevention is about increasing the load gradually, over a period of time. Make sure you have a long lead into sports season and ensure you adequately warm up the achilles.”

He adds, “People often don’t recognise that going from wearing high heels to a flat or low heel radically changes the load on the tendon. If you’ve spent most of the year in a corporate environment, walking around in heels then you suddenly change to wearing trainers it’s not uncommon for achilles problems to arise.

“To overcome this, practice wearing flat shoes at home several afternoons a week. Start doing this well before the season begins so that you’re changing the load gradually.”

Patellar tendinopathy

It’s common for patella-related injuries and the associated symptoms to be caused by musclular imbalance. Practicing lower limb stability and strength exercises can be useful.

“It’s important to warm up appropriately and wear the correct footwear for the sport you’re playing,” adds Dr Brenden.

Sever’s disease

Sever’s disease is more of a repetitive strain injury than an actual disease—resulting in inflammation and irritation of the growth plate. There are several causes, including rapidly increasing physical activity in volume, intensity or frequency; doing activity in bare feet, poor foot posture (flat feet) and weak foot muscles.

Sever’s disease should be addressed by ensuring you warm up adequately before playing sport. “Warming up prepares the body for sport by improving blood flow to the area, increasing the muscle temperature and making muscles more pliable,” says Dr Brenden.

“And don’t forget to wear the right shoes for the sport you’re playing!”

Plantar heel pain

Plantar heel pain is often referred to as plantar fasciitis, tibialis posterior tendonopathy, abductor hallucis pain—amongst a number of other conditions that can cause plantar heel pain.

To help ward off plantar heel pain Dr Brenden advises not to change from wearing high heels to low (or flat) heels too quickly.

“Again, rapid changes in frequency, intensity or volume place significant pressure on the tendons, which can cause excessive strain and lead to injury.”

Tips to prevent netball-related lower limb injuries

  • Don’t rely on ankle braces! Strong muscles protect you from sprains far more than braces do! Your gluteal muscles – yes your butt — has a major role to play here!
  • Make sure you warm up. Cold muscles are less flexible and more prone to injury. Check our Dr Brenden’s ‘warm up to success tips’.
  • Don’t rapidly increase physical activity in volume, intensity or frequency. If you’re not all that active outside of netball season you need to allow a longer lead time.
  • Always wear the appropriate footwear for your sport. Choose Netball shoes – its hard to go past the Asics Netburner range (See Dr Brenden’s article ‘Your guide to choosing the best netball shoe’ or head over to our YouTube channel for his Netburner reviews).
  • If your pain or problems continue, visit a sports podiatrist to check your foot posture. Addressing foot posture prevents muscles from over compensating, leading to less ongoing problems.
  • Ensure your footwear fits you properly (loose netball shoes can cause falls, increasing risk of ankle injury).
  • Take the time to cool down. Slow stretching can reduce post-sports muscle tightness and soreness and may help reduce future risk of injury. An easy method is “Walk it out”. Don’t jump straight in the car and head home; allow yourself 10 minutes of moderate walking to cool your muscles down.
  • If you know you have weak foot or ankle muscles, or you have poor foot posture, seek professional advice – All the stretching in the world wont get you better if your foot posture is continually meaning your muscles are over compensating. A trip to a podiatrist can help address the underlying foot posture issue.
  • Ensure rehab is tailored to your needs. Netballers have specific groups of muscles they use – make sure your rehab is based around these muscles and your individual activity – Netball!
Next steps…

If this sounds all too familiar, we’d like to help. Perhaps this is something that a friend or relative may benefit from. If that is the case, we’d love you to share this article with them so they can find relief!

A Step Ahead Foot + Ankle Care is based in Western Sydney. We have multiple practitioners with loads of experience in this area. It’s our passion!

If you’d like more information, please contact our helpful front desk team. They are brilliant at working through what help you need, guiding you to the appointment that is right for your family, running through costings and then reserving your appointment time. Call us today on +61 2 9673 2987. We look forward to helping you.

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About us

A Step Ahead Foot + Ankle Care is one of Sydney’s leading foot and ankle clinics. Principal podiatrist and founder of A Step Ahead Dr Brenden Brown (AKA Dr Foot) has been taking care of people’s feet for more than 20 years.

With a background in sports medicine and having served as a former president of the Australasian Podiatry Council, Brenden is a wealth of information when it comes to foot and ankle care.

Sources: * Australian Institute of Health and Welfare (December 2014)
Morten’s neuroma Vs plantar plate

Morten’s neuroma Vs plantar plate

Blog, Uncategorized

Morten’s neuroma Vs plantar plate - 1

Morten’s neuroma Vs plantar plate

If you’ve ever suffered from pain in the ball of your foot you’ll know only too well how annoying and debilitating it can be. However, addressing the cause of the pain starts with the right diagnosis.

Two widespread causes of forefoot pain are Morten’s neuroma and plantar plate trauma. While plantar plate tears are less well known and identified, they are clinically prolific.

Morten’s neuroma

A Morten’s neuroma is a nerve injury. The joints around the metatarsal bones rub together causing irritation and swelling, which encroaches on the nerves. The nerves can become damaged and thickened resulting in the shooting, stabbing pain and burning sensation linked with a Morten’s neuroma.

The nerves in the intermetatarsal spaces (between the 2nd-3rd and 3rd-4th toes) are most commonly affected leading to pain in the ball of the foot.

Symptoms of Morten’s neuroma

  • A sharp, shooting pain in the ball of the foot (usually between third and fourth toe)
  • A burning pain in the ball of the foot that may spread or shoot down towards the toes
  • Toes may feel numb or tingle
  • Pain is intensified when wearing tight shoes or high heels

Morten’s neuroma Vs plantar plate - 2

Podiatrist and founder of A Step Ahead Foot + Ankle Care Dr Brenden Brown explains, “Wearing high heels or tight fashion shoes compresses the nerve and creates that electric, shooting pain.

“People with foot deformities, such as hammertoes, bunions, flat feet or high arches, are at higher risk of a Morten’s neuroma because these defects generally cause the foot to widen, making it more difficult to find shoes that aren’t tight.”

Treatment for a Morten’s neuroma

Treatment will depend on the severity of symptoms but first-line treatment options include:

  • Appropriate footwear—avoid shoes that are narrow in the forefoot or tight in general
  • Soft tissue rehabilitation — Soft tissue massage to the Morten’s region can provide some relief from the associated pain
  • Soft cushioned orthotics with a metatarsal dome may help reduce pressure on the nerve
  • Injections to reduce inflammation, such as cortisone or Prolotherapy
  • Surgical opinion is required if conservative measures are unsuccessful

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Plantar plate tear

This is the very start of clawed or hammer toes! A plantar plate injury involves the ligament and cartilage attached to the base of and between our toe bones (phalanges). Injury can involve tears, ruptures or distensions. Conservative treatment for this condition is highly effective.

Symptoms of plantar plate tear

  • Dull ache or sharp pain under the ball of the foot
  • A “V” sign where the toes separate and form a V shape
  • Toe lifts upwards (commonly the 2nd or 3rd toe) and may become swollen
  • In acute cases the toe becomes thickened or enlarged. Often described as “sausage like”
  • Feeling that you have a small stone in your shoe when walking
  • The feeling that there’s insufficient cushioning between the toe bones and the ground
  • Small amount of callous develops under the metatarsal heads
  • Surgical opinion is required if conservative measures are unsuccessful

Treatment for plantar plate tear

  • Conservative treatment for this condition is highly effective if caught within the first 6 – 12 months
  • Wearing firm, stiff-soled shoe can help alleviate pressure on the joint and reduce the pain
  • Cushioned orthotics with a metatarsal dome (often recommended by orthopaedic surgeons)
  • Soft tissue rehabilitation, deep connective tissue therapies to the joint capsules and the spaces around this area.
  • Deep connective tissue therapies to the extensor and flexor tendons and muscles of the foot
  • Serial strapping or taping to prevent the toes popping up or hold them in alignment

Dr Brenden says, “For years Morten’s neuroma has widely been the most common diagnosis for forefoot pain. Yet I find that in many cases, where there is a dull ache type of pain in the ball of the foot, the cause is a plantar plate tear rather than Morten’s neuroma.”

Radiology

Morten’s neuroma and plantar plate trauma are difficult to distinguish between on diagnostic ultrasound.

“When viewed in ultrasound the two conditions without further discovery and without an experienced radiologist can appear the same. The two conditions will often return a hypoechoic mass finding, hence the need for more detailed clinical symptoms and signs accompanying the request.

“Given that the difference in symptomatology between the two is often the key, clinical symptomatology should be included in the radiological request,” advises Dr Brenden.

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About us

A Step Ahead Foot + Ankle Care is one of Sydney’s leading foot and ankle clinics. Principal podiatrist and founder of A Step Ahead Dr Brenden Brown (AKA Dr Foot) has been taking care of people’s feet for more than 20 years.

With a background in sports medicine and having served as a former president of the Australasian Podiatry Council, Brenden is a wealth of information when it comes to foot and ankle care.