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Athletic Foot Injuries Follow-up

  • Author: Timothy J Rupp, MD, MBA, FACEP, FAAEM; Chief Editor: Craig C Young, MD  more...
 
Updated: Oct 07, 2015
 

Return to Play

As with all athletic injuries, the athlete's whole being must be considered before he or she returns to action. Athletes should practice before they play and essentially be pain free with all activity. Strength should be at least 90% of the unaffected limb, and proprioception should be restored so that the athlete can avoid recurrence. Mentally, the athlete must feel confident that the foot injury has healed; athletes should be able to compete without conscious awareness of the injury. The mental aspects of the injury are most accurately assessed in practice situations.

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Prevention

Barefoot and minimalist shoe running

Lieberman et al first observed that barefoot endurance runners landed on the forefoot or midfoot with a more plantar-flexed ankle, whereas shod runners landed on the hind foot with significantly higher collision forces. Increased proprioception, coordinative strategy, and improved intrinsic foot muscle strength have supportive evidence to suggest a benefit from barefoot running as well.[20]

Lieberman further explains that barefoot running, from an evolutionary perspective, may be hypothesized to avoid injury, as evidenced by the fact that humans have been running long distances barefoot for millions of years.[21] In an effort to reproduce the biomechanics of barefoot running with the protection afforded by running shoes, the use of minimalist running footwear has gained popularity among members of the running community. Biomechanical evidence suggests minimalist footwear favors forefoot or midfoot strike and allows for dispersion of impact forces more efficiently. Minimalist runners, moreover, generate smaller collision forces when compared with shod runners.[22] Proponents of modern running shoes believe that the cushioning and stabilization features are needed to protect the runner from injury.[23]

Future considerations include research to determine the benefits or barefoot and minimalist running include the appropriate manner with which to transition from shod running to barefoot or minimalist running and the long-term effects of barefoot and minimalist running on foot structure, muscle physiology, and bone and joint health.

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Contributor Information and Disclosures
Author

Timothy J Rupp, MD, MBA, FACEP, FAAEM Staff Physician, Emergency Medicine Consultants; Staff Physician, Innovative Emergency Medicine; Staff Physician, Emergency Service Partners

Timothy J Rupp, MD, MBA, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Texas Medical Association, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Steven J Karageanes, DO, FAOASM Director of Sports Medicine, St Mary Mercy Hospital Livonia; Regional Assistant Dean, Kansas City University of Medicine and Biosciences; Clinical Assistant Professor, Michigan State University College of Osteopathic Medicine

Steven J Karageanes, DO, FAOASM is a member of the following medical societies: American Medical Association, American Osteopathic Academy of Sports Medicine, American Osteopathic Association, Michigan State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Russell D White, MD Clinical Professor of Medicine, Clinical Professor of Orthopedic Surgery, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center-Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

David T Bernhardt, MD Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics/Ortho and Rehab, Division of Sports Medicine, University of Wisconsin School of Medicine and Public Health

David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

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The hindfoot is composed of the talus and the calcaneus.
Select tendons of the foot.
Select bones of the foot (dorsal and plantar views).
Select bones of the foot (medial and lateral views).
Select bones of the foot (superolateral view).
 
 
 
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