Winter sports’ greatest enemy…ankle sprain

Winter sports’ greatest enemy…ankle sprain

Winter sports’ greatest enemy…ankle sprain - 1

Winter sports’ greatest enemy…ankle sprain

Winter sports season means netball, footy and rugby union games galore (maybe even a spot of skiing!), but it also presents the increased risk of ankle sprains and strains…

“The chilly season means that muscles become cold. Without adequate warm-up exercises the muscles and connective tissue aren’t as flexible as they should be and this can lead to injury,” says Dr Brenden Brown, sports podiatrist and founder of A Step Ahead Foot + Ankle Care.

Dr Brenden is calling on health practitioners to “up their ankle game” beyond the simple “text book approach”.

Ankle sprains are a common winter sports injury. They 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 pains. Doing whatever you can to prevent an ankle sprain is a no-brainer.”

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Avoiding winter sports ankle injuries

Planning ahead is a great way to prevent winter sports injuries—particularly when it comes to ankle injuries. With the right preparation and precautions you can reduce the risk of an ankle sprain or strain.

“The common preventative treatment for ankle sprains is balance exercises, but while this might go some way to help reduce ankle sprains the approach really needs to be multi-factorial,” says Dr Brenden.

“To lessen the risk of injury you need to use taping, bracing and practice strength exercises.”

But be warned, Dr Brenden explains that many healthcare professionals—including, physios, chiros, sports coaches and others—at times only suggest doing calf raises. He says, “This is fine if the sport you’re doing only requires you to move the ankle up and down, but if your sport means moving your ankles side to side (for example, skiing, netball, rugby league, football and almost all sports!) then calf raises are of no use.

A textbook response to ankle sprains will often end patients in trouble. If your health professional is merely suggesting calf raises, it’s time to look further afield.

“More and more evidence suggests we need to look much further up the body, toward the gluteal muscles and alike.

“As such, your strength training needs to incorporate more than just your ankle and should be more sport specific.”

Dr Brenden says you need to functionally challenge the ankle in order to strengthen it appropriately and a special emphasis should be on preparation.

“Those participating in winter sports (or any sports for that matter!) can benefit from completing a tailored muscle strength-conditioning program. This is particularly the case if you’ve suffered a previous ankle sprain or are at high risk of injury.”

Winter sports greatest enemy... ankle sprain - 1

Points to note:

  • Ankle strengthening activities should include hoping, jumping and cutting movements if that is part of your sport
  • Strength exercises should include loading the muscles to be able to dynamically work as they would in your chosen sport
  • Loading the muscle prepares your muscles for the activity ahead. This may include using more than just weight-bearing exercises and incorporating resistance-based training.

Additional measures to help prevent ankle sprains include:

  • Warming up. Cold muscles are less flexible and more prone to injury
  • Wearing footwear appropriate to your sport
  • Making sure your footwear fits you properly (loose boots can cause falls, increasing risk of ankle injury)
  • Taking the time to cool down. Slow stretching can reduce post-sports muscle tightness and soreness and may help reduce future risk of injury
  • Knowing your limits and sticking to them

Treating your ankle sprain

The immediate treatment for an ankle sprain is the RICE approach. This incorporates: Rest, Ice, Compression and Elevation.

  • REST: “if it hurts don’t do it”. Giving your ankle a period of rest after the sprain can assist with healing
  • ICE: apply ice packs to the ankles, or area of discomfort
  • COMPRESSION: apply bandages over the injured area. Compression socks are available from your local podiatrist’s clinic
  • ELEVATION: lift the foot up above the waist or heart.

“Evidence shows that ankle sprains are unlikely to get better by themselves. Plus once you have an ankle sprain, you’re significantly more likely to have another sprain.”

“So just like the pre-sport preparation phase, it’s time to get back to strength and exercise-based rehabilitation as your next phase in rehab,” says Dr Brenden.

Related articles:

Your guide to rock-solid ankle stability

Your guide to choosing the best netball shoe

Your guide to choosing a footy boot

Think you have a heel spur, think again

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.

Your guide to choosing the right football boot

Your guide to choosing the right football boot

Your guide to choosing the right football boot - 1

Your guide to choosing the right football boot

“Numerous sports people come to see me every year and apart from problems with foot or body posture, a big issue is wearing the wrong football boots for their feet,” says sports podiatrist and founder of A Step Ahead Foot + Ankle Care Dr Brenden Brown.

Common football foot injuries and how you can avoid them

Achilles tendonitis and Sever’s disease

“Most shoes are not flat, they’re higher at the heel than at the front. Yet, the majority of football boots on the market are perfectly flat.

“A combination of tight muscles (muscles that are overworking due to sport) plus wearing completely flat shoes—which is common in most footy boots but uncommon in your regular footwear—can lead to serious foot problems in adults and kids. Foot issues include pain in the arch of the foot and heel pain.”

Quick fix: To address some of the issues associated with flat shoes, most podiatrists can give you a heel raiser to pop in the back of the shoe. You can also look for a football boot with a raised heel.

Ankle strains

“Amongst other things, one of the keys to preventing ankle strains is to avoid shoes with a highly flexible shank (midsole),” says Dr Brenden.

“When selecting a football boot —or any shoe for that matter—hold the shoe with one hand on the back heel and the other hand on the toes and try to twist in opposite directions, as if you’re wringing the shoe out. If you can wring out the shoe easily (like a cloth), it’s a no, no.

“Good football boots won’t allow you to do this; they should have strength and support in the midsole section to control and stabilise your foot. This can help to protect against ankle strains.”

Shin splints

Most football boots are designed with a flat foot bed, which can lead to many issues — one of which is shin splints. Shin splints are more common in people with flatter feet than in those with high arches and can be a result of poor choice of football boot or sudden increase in activity.”

Dr Brenden explains that the lack of cushioning puts excess pressure or force on the muscles, tendons and bone tissues surrounding the shin. This leads to inflammation and pain.

“Calf tightness is also a culprit!” he adds.

Quick fix: Stretch out those calves. Make sure to stretch both muscles. A quick internet search will throw up lots of great calf-stretching exercises.

Your guide to choosing the right football boot - 2

A guide to choosing a great footy boot

“Footy boots are often designed for and around elite footballers and while a particular football boot might be fine for Beckham—it’s often not ideal for Bradley in the Under 13s!”

General Manager of product for ASICS Mark Doherty says, “In ASICS football boots we raise the heel by 10mm and that’s quite unique to ASICS; most footy boots are flatsole boots (or zero platform as we call it).

The principle behind the 10mm heel is injury prevention; it raises the heel to take a bit of the strain of the muscles in the lower limb and hopefully it helps with some of the muscle overuse injuries that people get.”

Your guide to choosing the right football boot - 3

ASICS Lethal Ultimate has a full midsole—on the fore foot and the rear. It also still has the 10mm heel raise. The idea behind the Ultimate is that it offers comfort and cushioning, so on really hard Aussie ground it gives the added protection that you don’t normally get from a soccer boot.

“The midsole also allows for a wider fit,” adds Mark.

Your guide to choosing the right football boot - 4

The Lethal Tigreor is a speed shoe. They look like any other football boot (from other brands) but they’re unique in that they have a midsole in the rear of the shoe, which gives the shoe that 10mm raise.

Our boots are also unique in that they all have a removable sockliner. You can take the sockliner out and put an orthotic in without losing that all-important depth in the heel of the shoe.”

He says price will play a factor in determining the quality of the shoe. Shoes can vary from 100% synthetic upper to part synthetic, part leather through to full kangaroo leather (as is the case with ASICS Testimonial).

Your guide to choosing the right football boot - 5

The Tigreor Junior has a kangaroo toe box, which is unique and feels really good. Kangaroo is only 0.8 mm thick, whereas most synthetic or calf leather is 1.3mm thick. The thinner the material the better, as you get a greater feel of the ball. Kangaroo is thin but also very tough, making it ideal for football boots,” says Mark.

Key factors to consider when selecting a footy boot

  • It needs a firm heel counter
  • You shouldn’t be able to wring or twist the shoe
  • A shoe shouldn’t bend in the middle
  • It should be highly flexible in the toe area
  • Most people will also benefit from having a slight heel raise

Other articles you might like:

Your guide to rock-solid ankle stability

10 things you should know about heel pain

Think you have a heel spur? Think again

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.

Think you have a heel spur? Think again

Think you have a heel spur? Think again

Think you have a heel spur? Think again - 1

Think you have a heel spur? Think again

There’s a myriad mystery and misinformation about heel spurs. Just the thought alone of having a hard protruding growth on the bottom of the heel is more than a little alarming — but really, it needn’t be.

What is a heel spur?

“A heel spur is a small bony growth at the underside of the heel bone. People call it a spur or a calcification. We might also call it an exostosis (a benign outgrowth of cartilaginous tissue),” explains sports podiatrist and founder of A Step Ahead Foot + Ankle Care Dr Brenden Brown.

“Heel spurs are incredibly common. I see it in about 40-50% of the x-rays I perform. “However, the vast majority of people with heel spurs experience NO PAIN whatsoever.

“In all of the time I have been a podiatrist (which is 20 plus years) I have seen two symptomatic heel spurs. I’ve seen lots of heel spurs but only two that have ever presented with associated pain.

“So if we talk about the signs of symptoms of heel spurs there aren’t really any apart from having a large bony or hard nodule on the underside of the heel pad that doesn’t feel the same as the other foot and cannot be depressed (pushed or squashed).

“99% of people who come to me saying they have pain from a heel spur do not have pain as a result of a spur.

“A heel spur won’t bother you unless it’s prominent beneath your foot and the orientation of the spur is angled more towards the ground; this could cause some pain and discomfort. However, I’ve read about these types of spurs but I’ve never even seen one. Not in 20 years of practicing.”

Think you have a heel spur? Think again - 2

5 heel spur facts

  1. Your pain is most likely not caused by a heel spur

The vast array of people with heel spurs have NEVER HAD A DAY OF PAIN in their life

  1. Heel spur pain doesn’t come and go like a yo-yo

In those very rare cases where people do have a heel spur that’s causing them pain—the pain doesn’t come and go.

“If you have a friend who tells you they had a heel spur and the pain went away you have to ask yourself ‘where did that pain go?’ The pain of a heel spur isn’t like the cast of Neighbours – it doesn’t travel from Melbourne to Queensland to get a job and never return!”

  1. Silica won’t cure a heel spur

“People have told me they took silica and it miraculously dissolves their spur. I have to ask these patients ‘how on earth did the silica dissolve your bony spur but manage to leave the rest of the foot in tact. How did it not also dissolve the frontal lobe of your skull?”

  1. No operation needed

Even if you do have a heel spur, which most of the time is an incidental finding on an x-ray, you don’t need an operation to remove it.

  1. Cortisone won’t help your heel pain

For most people cortisone is useless in treating heel pain. In fact, studies have shown that after three months 56% of people who were having cortisone injections for their heel pain had zero reduction in pain.

If it’s not a heel spur — what is causing my pain?

Heel pain can be caused by a variety of other reasons including: plantar fasciitis, plantar fasciosis, abductor hallucis strain or tibialis posterior tendinosis.

If you are suffering from heel pain, be sure to visit your local podiatrist but don’t be fooled into automatically thinking that it’s a heel spur—it’s highly likely that it’s not!

Related articles:

10 things you should know about heel pain

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.

Got a question? Check out our Instagram profile #AskDrFoot 

Or, tune into our Facebook page for regular live videos and updates on the latest foot and ankle advice from the experts.

Your guide to choosing the best netball shoe

Your guide to choosing the best netball shoe

Your guide to choosing the best netball shoe - 1

Your guide to choosing the best netball shoe

“The days of calling netball a non-contact sport are well and truly over,” says sports podiatrist and founder of A Step Ahead Foot + Ankle Care Dr Brenden Brown.

He says netball is not only physically demanding, it’s a high-impact sport in which foot and ankle injuries are rife (particularly if players aren’t wearing appropriate footwear!).

Do players really need new netball shoes every season?

Short answer is, ‘Yes, they do!’

“Netball involves lots of twisting on one foot, side to side motion, jumping and running—as a consequence, many players get ankle sprains. Having a new pair of shoes at the beginning of netball season is essential. It’s an injury-prevention no-brainer!

Good quality netball shoes go a long way to assisting with injury prevention. I witness this time and time again…I’m a netball Dad and when I see a child on the sideline with an injury, it’s universally in a poor shoe,” says Dr Brenden.

Regular runners vs netball shoes: what’s the difference?

Mark Doherty, ASICS general manager of product, knows a thing or two when it comes to sports shoes. He explains that the sole of a netball shoe is a lot different to that of a running shoe.

“We tend to use solid rubber in the soles of our netball shoes, whereas in a running shoe we use blown rubber which is an air injected rubber.

“While we want netball shoes to be lighter and lighter, we also need to make sure they last and offer the wearer the protection they require.

“Solid rubber has the ability to wrap around the shoe and it also stabilises the shoe so that when you go into cross-lateral movements there’s the solid platform you need.

If you were wearing a running shoe, the shoe could potentially collapse on the lateral sides because of the movement involved in netball.

Your guide to choosing the best netball shoe - 2

What makes a great netball shoe?

“When choosing a netball shoe consider cushioning, stability, support and weight (you want it to be lightweight). A firm heel counter is important and there should be minimal twisting or ringing out of the shoe,” says Dr Brenden.

“An adequate toe box is essential too. Make sure the shoe is comfortable and roomy enough around the toes when you first try it on; these shoes are NOT designed to stretch.”

Mark says the basic principle is that a netball shoe should have a more stable base than a running shoe, but it’s also important to consider durability and performance of the shoe to last longer.

Your guide to choosing the best netball shoe - 3

Are new designs just marketing hype?

“We have a couple of top shoe models that we change every two to three years, based on the latest technology. This might allow us to make the shoe lighter, more durable or more flexible,” says Mark.

“For 2018 ASICS’s introduced the new Netburner Professional with an updated midsole foam that’s much lighter than any foam we’ve ever developed before.

“The Professional has more of a running-type feel to the shoe with the added bonus of that extra protection that’s needed in a netball shoe.”

Your guide to choosing the best netball shoe - 4

Final note: It pays to get professional advice when choosing a netball shoe.

“When you’re buying a sports-specific shoe, it’s a great idea to get professional advice.

“If you’re someone with a really high arch and you select a shoe that’s designed for someone with a low arch you are VERY likely to increase your risk of injury,” says Dr Brenden.

“Shoes differ from season to season—for example the Netburner Professional has a new, more flexible, upper material this year—which can change the feel of the shoe.

“But also, a shoe is like a fingerprint; because of the amount of manual labour involved, no two shoes are the same,” says Mark.

“Even if you pull out two size eights in the same shoe, there can be slight differences because of the tolerances you have in midsole density or the upper might be slightly different. It’s always best to try on shoes to allow for these minor differences.”

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.

Got a foot-related question? AskDrFoot

In the media: Dr Brenden Brown talking heel pain on Channel Nine’s Coach website

In the media: Dr Brenden Brown talking heel pain on Channel Nine’s Coach website

In the media: Dr Brenden Brown talking heel pain on Channel Nine’s Coach website - 1

In the media: Dr Brenden Brown talking heel pain on Channel Nine’s Coach website

It’s true there’s nothing sexy about foot pain, but nonetheless it’s a common complaint that shouldn’t be overlooked.

Dr Brenden Brown, sports podiatrist and founder of A Step Ahead Foot + Ankle Care, recently chatted to the folks over at Coach to explain the popular causes of heel pain and what can be done about it.

“Most heel pain is some form of change to the large tendon that travels in the bottom of the foot and up the back of the heel — tendons hate change,” Dr Brenden tells the team at Coach.

“The moment you massively change your activity over a short period of time, [the tendons] get really sore and angry,” Dr Brenden explains.

To read the article in full, head on over to Coach.

ABOUT DR BRENDEN BROWN

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, Dr Brenden Brown is a wealth of information when it comes to foot and ankle care.

He has appeared on Sunrise, The Today Show, Mornings with Kerri Anne and Current Affair. Dr Brenden Brown is a regular on Wendy Harmer’s Sydney’s Morning on ABC Radio and has also shared his expert know-how in the field of feet in Men’s Health, Cosmopolitan magazine, The Sydney Morning Herald, New Idea, The Australian and The Daily Telegraph.

Dr Brenden Brown is passionate about sharing his stellar knowledge of common and complex foot issues and raising awareness of the importance of foot health.