COMMON FOOT PROBLEMS IN SPORT Universidad de Alicante GCAFD ALBA BELTRÁ ESCOLANO

Foot & Ankle Injuries Athens 2004 Badekas et al, JFAR 2009

¿ METATARSAL FRACTURE? A metatarsal fracture is a break to one of the five long metatarsal bones in the foot and is usually caused by a direct impact or trauma.

METATARSAL FRACTURE REHABILITATION 1. Before returning to sporting activities, ensure that full mobility, strength and balance are regained via a thorough rehabilitation program. 2. Rehabilitation of a metatarsal fracture may begin at different stages, depending on whether it is an acute fracture or a stress fracture and also the extent and location of the injury. Acute metatarsal fractures which require complete immobilization in a plaster cast will not begin rehabilitation until after the cast is removed.

REHABILITATION Ankle range of motion Start by moving the ankle through its full range of motion, you can do this using ankle circles or by writing the alphabet with your toes! Try to practice doing this on a regular basis to help reduce stiffness and also to ease swelling and increase blood flow to the injury.

REHABILITATION Calf stretches  It is common for the calf muscles to tighten up after any injury, especially if a period of immobilisation or reduced weight bearing is required. Stretch both calf muscles regularly every day:  To stretch the Gastrocnemius, stand with a wide stance, with the leg to be stretched at the back. Keep the heel on the floor and the knee straight as you lean forwards. When you feel a stretch in the calf, hold this position for seconds. If the stretch fades in this time, then lean a little further forwards until you can feel it again,Gastrocnemius

REHABILITATION  To stretch the Soleus muscle, Stand with a narrower stance, still with the leg to be stretched at the back and the heel down. This time, bend both knees as if trying to squat down, you should feel a stretch lower down the calf, around the achilles tendon. Again hold for seconds and maintain that stretching feeling.Soleus muscle  Repeat both stretches 2-3 times and several times a day.

REHABILITATION Toe range of motion Point your toes up and then down as far as possible. Hold each position for a few seconds and then reverse. Try to spread your toes apart as far as possible and then to scrunch them up as well. Hold for a few seconds, before reversing the movement.

STRENGTHENING EXERCISES Strengthening exercises should focus on building the strength of the intrinsic muscles of the foot, which attach to the metatarsal bones. Other activities which can strengthen these muscle include walking on sand or other uneven surfaces.

EXERCISES Towel pull  Place a small, lightweight towel on the floor, laid out in front of you. Sit on a chair with the feet flat on the towel making sure there is plenty of towel in front of you to pull. Use the toes to pull the towel towards you, bit by bit. Keep the heel on the floor. Once you find this easy, it can be progressed by using a heavier towel or even adding a small weight to the end of the towel. Pencil pick-up  In a seated position, place a pencil on the floor just in front of you. Pick the pencil up using your toes. Hold it for a few seconds and repeat this 10 times. Walking on tip toes  Rise up on to your tip toe. Walk forwards slowly, always controlling your balance before you take your next step. Start off walking steps and gradually increase the distance.

BALANCE EXERCISES Single leg balance  Start off by trying to balance on the injured leg only. Make sure you have something to hold on to in case you lose balance. Once you can master 30 seconds unaided, move on. Wobble board balance  Use a wobble board to initially practice balancing on both feet. Once you find this easy, move on to the injured leg alone. You can further challenge your balance by adding in other movements such as rotating the upper body, raising the arms up and down or even closing your eyes!