Is Foot Pain Ruining Your Golf Swing?

As you head to your favorite golf course this spring, make sure your feet are in shape before approaching the tee box. Your big toe, heel and ball of your foot are the spots most likely to cause pain that can ruin your golf swing.

Behind these pain-prone spots can lie stiff joints, stretched-out tissues and even nerve damage. But pain relief is possible and frequently does not require surgery.
Three conditions

The three most common foot conditions that can be the barrier to a perfect golf swing are neuromas, arthritis and heel pain.

• Neuromas are nerves that become thickened, enlarged and painful because they’ve been compressed or irritated. A neuroma in the ball of your foot can cause significant pain as your body transfers its weight from one foot to the other while swinging the club.
• Arthritis can cause pain in the joint of your big toe that makes it difficult to follow-through.
• Heel pain typically results from an inflammation of the band of tissue that extends from your heel to the ball of your foot. People with this condition compare the pain to someone jabbing a knife in their heel. Heel pain can make it uncomfortable for golfers to maintain a solid stance during crucial portions of the swing.

Other painful conditions

Several other painful conditions can also make the perfect swing difficult. Ankle arthritis or ankle instability can affect the proper weight shift during the golf swing. Some athletes and former athletes develop chronic ankle instability from previous ankle sprains that failed to heal properly. Achilles tendonitis can also contribute to balance-threatening instability during your golf swing. Ill-fitting golf shoes may cause corns and calluses that make standing uncomfortable.

Foot pain is not normal. With the treatment options available to your foot and ankle surgeon, a pain-free golf swing is clearly in view. When your feet aren’t in top condition, your golf swing won’t be either.

www.foothealthfacts.org

Back to school, back to sports! Make sure to protect your children’s feet.

Sever’s Disease, also known as calcaneal apophysitis, is a disease of the growth plate of the bone and is characterized by pain in the heel of a child’s foot, typically brought on by some form of injury or trauma. This condition is most common in children and is frequently seen in active soccer, football, or baseball players. Sport shoes with cleats are also known to aggravate the condition. The disease mimics Achilles tendonitis, an inflammation of the tendon attached to the back of the heel. A tight Achilles tendon contributes to Sever’s Disease by pulling excessively on the growth plate of the heel bone (calcaneus).

Treatment includes cutting back on sports activities, calf muscle stretching exercises, orthotics, heel cushions in the shoes, icing, and/or anti-inflammatory medications. Note: Please consult your physician before taking any medications.

Baseball Shoes and Cleats

As with most athletic shoes, comfort is the most important element in choosing the right baseball shoe for you. Look for shoes with a roomy toe box that give your toes enough room to wiggle. The widest part of your foot should fit comfortably into the shoe without stretching the upper. Look for a snug heel to help keep your foot stable. Most importantly, remember to replace your baseball shoes after 70 to 75 hours of active wear.

For league play, cleats may be recommended to give you the traction needed for the surface in the diamond. Baseball cleats come in a variety of materials ranging from leather and synthetic materials (plastics) to rubber and metal. Be sure to follow the regulations of your league regarding the material allowed; many leagues no longer permit the use of metal spikes or cleats, particularly on artificial turf. Be sure to give yourself time to adjust to cleats by wearing them on the designated surface.

Basketball Shoes

Foot and ankle stability, shock absorption, and traction are the most important qualities for basketball shoes. If you are susceptible to ankle injuries, consider a high-top or three-quarter shoe that provides added support to key foot structures during play. Look for shoes that offer the following:

● A wide toe box with plenty of room for your toes to move around. Not enough room can lead to blisters, corns, and calluses.
● Lightweight, breathable material for uppers; generally, leather is recommended.
● Dense, abrasion-resistant soles that are low to the ground for better traction and support.
● A well-cushioned midsole for a shock-absorbing layer. An EVA or EVA-compressed layer is lightweight but not as durable or stable. A polyurethane layer has greater stability, but it is often heavier, too.
● Bend in the forefoot of the shoe, which is at the ball of the foot near the toes. Be sure there is less bend in the arch where you need the added support to keep the foot stable.
● A firm heel counter that fits snugly.
● Laces as the form of closure give you the ability to adjust for the support you need throughout the foot.

When buying basketball shoes, be sure to take the socks you plan to wear with them to ensure a proper fit. Have your feet measured standing up and fit the shoes to your larger foot. Walk around, turn, twist, and jump in each pair on a hard surface to see how your foot feels during each of these movements. Most importantly, make your choice based on comfort.

Soccer / Running Shoes

Our practice recommends sturdy, properly fitted athletic shoes of proper width with leather or canvas uppers, soles that are flexible (but only at the ball of the foot), cushioning, arch supports, and room for your toes. Try a well-cushioned sock for reinforcement, preferably one with acrylic fiber content so that some perspiration moisture is “wicked” away.

A running shoe is built to take impact, while a tennis shoe is made to give relatively more support, and permit sudden stops and turns. Cross training shoes are fine for a general athletic shoe, such as for physical education classes because they provide more lateral support and less flexibility than running shoes.

Football Shoes

When you are shopping for youth football shoes, the most important variable to take into consideration is the playing surface that you will be on most frequently. Before investing in a pair of shoes, review the schedule for the season and take note of the various playing surfaces that the child will be exposed to. Although most fields now are made of fieldturf, there are still those out there with Astroturf or real grass.

For fieldturf and real grass, a traditional style cleat is recommended. For young players, a shoe with molded cleats should suffice, while shoes with removable cleats are advisable for older kids who play at a faster speed and may need to customize their level of traction. If you will only be playing a few games on Astroturf, there is no need to buy a separate pair of turf shoes, especially for young children. In a pinch, regular athletic shoes will suffice for a game or two on turf.

Tennis Shoes

Tennis shoes need lots of cushioning and shock absorption to deal with all the forces placed on your feet during play and to keep your foot and ankle stable. Be sure to choose shoes specifically for racquet sports; running shoes, for example, don’t have the support needed for the side-to-side movements common to tennis. Look for a tennis shoes that have a reinforced toe, wiggle room in the toe box, padding at the ball of the foot, sturdy sides, a low, well-cushioned heel that is not flared, and a firm heel counter for support.

When shopping for tennis shoes, follow these tips:

● Try on shoes with the socks you normally wear to make sure the fit is right.
● Go shopping at the end of the day when your feet are larger and fit your shoes to the larger of your two feet.
● Let your feet be your guide to fit. Choose only shoes that are comfortable in the store — don’t expect a wear-in period. The shoes should feel supportive, cushioned. and flexible, with some resistance in the heel for greater stability.
● Walk around the store in each pair you try on. Be sure to walk on a hard-surface, not just a carpeted floor. Emulate tennis play by jumping up and down in the shoes and making some fast turns to see how the shoes will really perform.

Subungal Exostosis (bone spur under toenail)

Subungal exostosis is more commonly referred to as a bone spur under the toenail. This condition is generally caused by toe trauma, which results in the formation of a bony irregularity or prominence. The normal treatment for subungal exostosis is surgical removal. Other small tumors, called osteochondromas and enchondromas, can also form in the bone beneath the toenail.

Overlapping, Underlapping Toes

Overlapping toes are characterized by one toe lying on top of an adjacent toe. The fifth toe is the most commonly affected. Overlapping toes may develop in the unborn fetus. Passive stretching and adhesive taping is most commonly used to correct overlapping toes in infants, but the deformity usually recurs. Sometimes they can be surgically corrected by releasing the tendon and soft tissues about the joint at the base of the fifth toe. In some extreme cases, a pin may be surgically inserted to hold the toe in a straighten position. The pin, which exits the tip of the toe, may be left in place for up to three weeks.

Underlapping toes usually involve the fourth and fifth toes. (A special form of underlapping toes is called congenital curly toes). The cause of underlapping toes is unknown. It is speculated that they may be caused by an imbalance in muscle strength of the small muscles of the foot.  If deformed toes are flexible, a simple release of the tendon in the bottom of the toe will allow for them to straighten. If the deformity is rigid, surgery may be needed to remove a small portion of the bone in the toe.

In-toeing

In-toeing and out-toeing occur when the feet are positioned too far inward or outward when walking. Both conditions may be observed in young children as they are learning to walk. By the age of two, most children outgrow these problems on their own. Beyond this age, verbal reminders and reassurance may be advised to make the child aware of the proper position of the foot. In persistent cases, children may be required to wear special shoes or foot supports to help train them to place their feet in the right position. These interventions are designed to reduce abnormal pressures on the foot structure and function while still in their formative development.

Hammertoes

Hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, causing it to resemble a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.

Causes of hammertoe include improperly fitting shoes and muscle imbalance.

Treatment for the condition typically involves wearing shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions, or nonmedicated corn pads may also relieve symptoms.

In severe cases, hammertoe surgery may be recommended to correct the deformity.

Hallux Varus

Hallux Varus is a condition in which the big toe points away from the second toe. It is a possible complication from bunion surgery. The condition has been linked to a number of other causes, including congenital deformity, tight or short abductor hallucis tendons, trauma, injury, or an absence or surgical removal of a fibular sesamoid.

Treatment may focus on stretching the abductor hallucis tendon through specific exercises or toe splints. In severe cases, surgery may be recommended. During the surgery, a small incision is made on the side of the toe and the toe is splinted in a neutral or straight position.

Hallux Rigidus (rigid big toe)

An unmovable big toe, known as Hallux Rigidus, is the most common form of arthritis in your foot.

Hallux Rigidus occurs as a result of wear-and-tear injuries, which wear down the articular cartilage, causing raw bone ends to rub together. A bone spur, or overgrowth, may develop on the top of the bone. This overgrowth can prevent the toe from bending as much as it needs to when you walk. The resulting stiff big toe can make walking painful and difficult.

Symptoms include:

• A bump, like a bunion or callus, that develops on the top of the foot.
• Pain in the joint when active, especially as you push-off on the toes when you walk.
• Stiffness in the big toe and an inability to bend it up or down.
• Swelling around the joint.

Pain relievers and anti-inflammatory medications are often prescribed to reduce swelling and ease the pain. Note: Please consult your physician before taking any medications. Applying ice packs or soaking the foot in contrast baths (alternating cold and hot water) may also help reduce inflammation and control symptoms for a short period of time.

A stiff-soled shoe with a rocker or roller bottom design and possibly a steel shank or metal brace in the sole can help alleviate the symptoms. These types of shoes add greater support when walking and reduce the amount of bend in the big toe.

When damage is more severe, a surgical procedure may be performed to remove the bone spurs, as well as a portion of the foot bone, and allow the toe more room to bend.

Hallux Limitus (stiff big toe joint)

Hallux Limitus is a condition that results in stiffness of the big toe joint.  It is normally caused by an abnormal alignment of the long bone behind the big toe joint, called the first metatarsal bone. Left untreated, Hallux Limitus can cause other joint problems, calluses, and/or diabetic foot ulcers. Painful bone spurs also can develop on the top of the big toe joint.

Anti-inflammatory medications, cortisone injections, and/or functional orthotics are some of the common treatments for stiff big toe. Note: Please consult your physician before taking any medications. Surgery may be required if spurring around the joint becomes severe.

Digital Deformity

Many disorders can affect the joints of the toes, causing pain and preventing the foot from functioning as it should. People of all ages can have toe problems, from inherited to acquired.

Toe deformities in adults result mainly from an imbalance of the tendons, causing them to stretch or tighten abnormally. People with abnormally long toes, flat feet, or high arches have a greater tendency to develop toe deformities. Arthritis is another major cause of discomfort and deformity. Toe deformities also can be aggravated by poorly fitting footwear, or if a fractured toe heals in a poor position.

The most common digital deformities are hammertoes, claw toes, mallet toes, bone spurs, and overlapping and underlapping toes.