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Health Issues

Foot Pain

Foot Pain

Foot pain in the young athlete is a common problem encountered in all sports. Many injuries are unique to certain sports, whereas others are seen in all types of activity, especially those involving running. Injuries may involve the bones, ligaments, tendons, or other soft tissue structures in the foot.

Foot Injuries

Injuries to the foot can occur suddenly (acute) or gradually develop over time (chronic). Examples of acute injuries are fractures, sprains, and bruises (contusions). These injuries result in immediate pain and loss of function. Examples of injuries that develop over time are stress fractures and tendonitis. They are often described as nagging injuries that worsen over time and no clear cause can be recalled.

What to Do When an Athlete Has a Foot Injury

For severe acute injuries where fracture is suspected, the athlete should be evaluated by medical personnel immediately. It is also important to be seen if there are any signs of altered movement, sensation, or blood flow to areas distant to the injury. For most other injuries, try rest, ice, compression (ACE wrap, etc), and elevation. If no improvement is seen within 2 to 3 days and the athlete has a limp, swelling, or difficulties doing normal activities, he or she should be evaluated to rule out a more serious injury.

What Will My Doctor Do to Diagnose and Treat My Foot Injury?

Your doctor will ask several questions about how the foot pain began, where it is located, and what makes it worse. Your doctor will examine your foot to identify the injury that has occurred. X-rays are often needed to help with diagnosis, and other tests are occasionally used as well (bone scans, MRI, etc).

Treatment and Return to Play

Every type of foot injury has a specific treatment, and your doctor will begin this once the diagnosis is made. Your doctor may need to refer you to a sports medicine specialist or orthopedic surgeon for further evaluation and treatment. In general, athletes can safely return to their activities when they are able to pass the “5-step test,” which can be done quickly and easily in the  pediatrician’s office. The athlete must be able to (1) walk/run with full range of motion, (2) walk on “tiptoes” without pain, (3) hop on both feet without pain, (4) hop on the affected foot without pain, and (5) show satisfactory balance while performing a single-leg stance on affected side. Although the athlete may not be fully recovered at this point, passing these simple tests usually indicates that the athlete can safely and effectively return to play.

Prevention of Foot Injuries

Many types of injuries can be prevented from returning in the future. Some things that help prevent injury in general are stretching before activity, wearing properly fitting footwear, good nutrition, etc. Other measures may include taping or bracing, shoe inserts, etc. Your doctor can advise you as to the best way to prevent recurrence of your particular injury. In addition, the following shoe buying tips will help you find the best shoe for you:

  1. The best way to get the right running shoe is to spend time in a running specialty store and ask for help from a salesperson who understands running. They should watch you walk without shoes or socks and ask questions about where and how much you run. 
  2. Try on running shoes late in the afternoon or evening when your feet are swollen and stretched from the day. Runner’s feet swell and expand with running. Don’t be surprised if your running shoes are a half to full size larger than your street shoes. 
  3. Try on a variety of different brands of shoes that are appropriate for your foot type and running style. Bringing in your old pair of running shoes will also help.
  4. Bring the socks you most often use for running and orthotics (custom shoe inserts), if you wear them. 
  5. Make sure the shoe fits correctly. Running shoes should feel comfortable immediately after you put them on. The heel should fit snugly, without sliding. The uppers should be snug but not constricting and you should have at least a thumbnails space at the tip of your longest toe. This allows for foot expansion.
  6. Take the shoes for a test run in the store before you buy them. 
  7. Once you find a pair of shoes that works for you, stick with them. It helps to buy 2 pairs of shoes and alternate them running. The risk of injury increases with breaking in new shoes or running in worn-out shoes. 
  8. Replace shoes every 300 to 400 miles. Even though they may look in good condition, the midsole will have lost its support and cushion.
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Sports Shorts (Copyright © 2005 American Academy of Pediatrics) Conceptual design by the Ohio Chapter, American Academy of Pediatrics
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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