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General Prevention for Foot, Ankle & Leg Injuries

July 10, 2006 Print This ArticleShare

Author: HyperStrike Certified Athletic Trainers

Overview

The foot, ankle, and lower leg are key anatomical structures used for a variety of activities that include keeping the body upright, balancing the body in various positions, propelling the body forward, backward, side to side, and/or up in to the air. The foot, ankle and lower leg are also interrelated as they work together to disperse and transfer forces, and serve as sites of attachments for numerous muscles, ligaments and other connective tissues in the lower extremity. Due to the purposes and functions of the foot, ankle, and lower leg, these structures are highly susceptible to acute and repetitive stress injuries.

General injury prevention topics covered in this article are:
• Selecting appropriate footwear
• Correcting biomechanics (i.e. body mechanics)
• Foot hygiene
• Achieving and/or maintaining flexibility
• Strengthening key muscle groups
• Improving neuromuscular control

Selecting appropriate footwear

Selecting appropriate footwear is extremely important in preventing foot, ankle, and lower leg injuries. Shoes are not all designed the same. Some shoes are designed and constructed based on the specific demands of a sport or physical activity, offering varying degress of flexibility, rigidity, support and/or stability to both the foot and the shoe.

The size and fitting of a shoe is very important. A shoe should be comfortable and not allow for excess foot movement. An inappropriate fitting shoe can alter one’s biomechanics predisposing her/him to either acute and/or repetitive stress injuries (i.e. Heel Contusion, Turf Toe, Tibia/Fibular Stress Fracture, Shin Splints).

Ask an allied health care professional such as your family physician, orthopedist, podiatrist, or athletic trainer to help you either: a) find the right shoe for you, b) help you determine your needs in finding the right shoe, or c) refer you to a reputable shoe store that will properly fit you for a shoe specific to your individual needs.

Correcting biomechanics (i.e. body mechanics)

Correct biomechanics is extremely important in sport and physical activity. Incorrect or faulty biomechanics due to structural abnormalities or gait/weight bearing anomalies are precipitating factors for overuse injuries. Faulty biomechanics of the foot can be addressed with orthotics.

There are a variety of orthotics (i.e. rigid, semirigid, and soft)1 used to treat or prevent foot conditions. Some orthotics are used to control foot motion while others are used to help alleviate stress points due to impact, improve balance, and absorb weight bearing stresses. 1 A qualified medical health care professional can assist you by analyzing your foot and ankle biomechanics to determine if you can benefit from orthotics.

Foot hygiene

 Proper foot hygiene is a habitual practice that can help prevent the development of tinea pedis (i.e. athlete’s foot), blisters, calluses, corns, ingrown toenails, and many other conditions. Keeping the toe nails properly trimmed, keeping the feet dry, wearing clean and appropriate fitting socks that do not compress the toes together, and keeping the calluses shaved down are all habitual preventative tasks that can keep a person from missing practice/training or competition.

Achieving and/or maintaining flexibility

Achieving and/or maintaining flexibility of the musculotendinous structures in and around the foot, ankle, and lower leg can help prevent both acute and repetitive stress injuries. For example, tight calf muscles (i.e. gastrocnemius, soleus and plantaris) and a tight Achilles tendon (i.e. the tendinous structure of the calf muscles) can alter the biomechanics of the foot and ankle, predisposing these structures to injury.

A tight soleus can also be a contributing factor for lower leg pain as it “pulls” on the tibia; this condition is known as periosteitis (i.e. inflammation of the periosteum, a thin fibrous membrane that covers and surrounds bone) or “Shin Splints.” 1

To achieve and/or maintain the flexibility of the Achilles tendon and soleus, these musculotendinous structures must be habitually stretched. Stretching should be performed before and after physical activity with both a fully extended (i.e. straight) knee and a slightly flexed (i.e. bent) knee. To read more about the Achilles tendon and Shin Splints, see “Achilles Tendinitis” and “Shin Splints” under the “Ankle & Lower Leg Injuries & Conditions” section of the injury library.

Strengthening key muscle groups

 Strength and neuromuscular control are two elements of sport and physical activity that are paramount to preventing injuries. Strength training helps to develop strength, but it also helps to promote joint stability. By improving the strength of the muscles surrounding a joint, the joint becomes more secure and potentially less susceptible to ligamentous and/or other structural injury.

Improving neuromuscular control

 Improving neuromuscular control involves improving the coordinated movements between muscles and joints as messages are sent from the central nervous system with regard to proprioception (i.e. balance, posture, bodily movement and changes in equilibrium 2) and kinesthetic awareness (i.e. ability to perceive where the body is in space, or the ability to sense joint movement and joint position)1.

By improving one’s neuromuscular control, one is also improving her/his reflex, or response and adaptation time, to external stimuli or body positioning and balance. Inevitably, improving strength and neuromuscular control of the foot, ankle, and lower leg helps to prevent injuries by preparing the body to respond to the physical challenges and environmental stimuli experienced during sport and physical activity.

References:

1. Anderson MK, Hall SJ, Martin M. Foundations of Athletic Training: Prevention, assessment and management. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005:62, 210, 578-579.
2. Thomas CL, ed. Taber’s Cyclopedic Medical Dictionary. 17th ed. Philadelphia, PA: F.A Davis Co; 1993: 1608.
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