Sport Injuries Caused by Foot Instability

      
        

Running related injuries can be caused a number of lower extremity structural problems.  A study in the British Journal of Sports Medicine in 2002 published the results of a survey of 2002 patients with running injuries treated between 1998 to 2000 at the Allan McGavin Sports Medicine Centre in Vancouver. The sports medicine doctors involved in the study recorded the nature and history of the injury along with a physical examination which included a biomechanical assessment. The following structural problems were evaluated in the biomechanical examination: leg length difference, knee alignment (knock knees or bow legs), Q angle, knee cap position and foot arch height.

The survey results outline the total number of the top 7 running injuries in the first 3 columns of Table 1.  Some injuries such as patella femoral syndrome seem to occur more in women than men.  Dr Jack Taunton the lead author of the study stated "The most common overuse running injury 20 years ago was patellofemoral pain; this is still the case today. Iliotibial band friction syndrome is now the second most common injury. Overuse injuries result from a complex of training errors (including lack of specific strength and flexibility), inappropriate surface and terrain, biomechanical lower extremity malalignment, and inappropriate footwear."

The structural problems that were identified with each type of running injury are outlined in the last 7 columns of Table 1.   The  7 lower extremity  structural problems that are associated with each type running injury have been recorded by total number and by percentage.  The number of  patients with running injuries who have either flat feet (pes planus) or high arched feet (pes cavus) have been identified in bold by absolute numbers and by percentage in Table 1. 


Injury

Total number

Men

(n/%)

Women

(n/%)

Bow leg

Number (%)

Knock Knee

Number (%)

Pes planus

Number (%)

Pes  cavus

Number (%)

Patellar squinting

Number (%)

High Q angle

Number (%)

Large leg length
difference

Number(%)

Patella femoral pain syndrome

PFPS

331

124/38 207/62

106 (32)

95 (29)

58 (18)

17 (5)

62 (19)

21 (6)

13 (4)

 

Ilio tibial band friction syndrome

ITBFS

168

63/38 105/62

54 (33)

25 (15)

25 (15)

12 (7)

13 (8)

3 (2)

17 (10)

 

Plantar fasciitis

158

85/54 73/46

28 (18)

25 (16)

19 (12)

11 (7)

6 (4)

1 (0.6)

12 (8)

 

Meniscal injuries

100

69/69 31/31

28 (29)

19 (20)

8 (8)

6 (6)

2 (2)

0 (0)

2 (2)

 

Tibial stress syndrome

99

43/43 56/57

27 (29)

16 (17)

17 (18)

1 (1)

4 (4)

1 (1)

1 (1)

 

Achilles tendinopathy

96

56/58 40/42

28 (28)

11 (11)

17 (13)

6 (6)

2 (2)

0 (0)

5 (5)

 

Patellar tendinopathy

96

55/57 41/43

19 (22)

23 (27)

21 (25)

3 (4)

4 (5)

5 (6)

5 (6)

 

The pain from lower leg over use running injuries can be caused by the foot and lower leg malalignments as outlined in Table 1.  These lower leg and foot malalignments can be stabilized by the use of custom foot orthotics.  Pes planus and pes cavus were identified as biomechanical problems associated with patellofemoral syndrome, ilio tibial friction band syndrome, plantar fasciitis, shin splints and achilles tendinopathy. These injuries can be stabilized with the use of custom foot orthotics.  Custom foot orthotics (CFO) are prescription medical devices designed to stablized and control the function of the foot and its alignment with the lower leg.

The following sports injuries will usually respond to custom made foot orthotics

  1. Shin splints

  2. Ilio-tibial band syndrome

  3. Patello-femoral syndrome

  4. Chronic ankle sprains

  5. Achilles Tendonipathy

 

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