All about the Athletic Foot

Fungal infection can lead to serious damage of the feet. This article explores ways to prevent such conditions and strategies to strengthen the foot

Many practitioners consider the foot difficult to be treated because the anatomy seems rather complex. If the foot is considered in its three distinct regions-the rear foot (calcaneus and talus), the midfoot (the cuneiforms and navicular medially, the cuboid laterally), and the forefoot (the metatarsals and phalanges)-the bony anatomy is largely simplified. Soft tissue anatomy can be superimposed on the regional division of the foot.

The most common cause of rear foot (inferior heel) pain is Plantar fasciitis. This condition occurs mainly among runners and older adults and is often associated with a biomechanical abnormality, such as excessive pronation or supination. Another common cause of heel pain is fat pad syndrome or fat pad contusion. This is also known as a “bruised heel” or a “stone bruise.” Less common causes of heel pain are stress fracture of the calcaneus and conditions that refer pain to this area such as tarsal tunnel syndrome or medial calcaneal nerve entrapment. The most common causes of mid-foot pain include navicular stress fracture, midtarsal joint sprain, and extensor tendinopathy. Forefoot problems range from corns, calluses, and nailproblems to bone and joint abnormalities such as sprains and synovitis of the MTP joints, Hallux valgus, Morton’s neuroma, and Stress fracture of the metatarsal bones. Forefoot pain is especially common in sports persons participating in kicking sports such as kickboxing, taekwondo, mixed martial arts (MMA) fighters, and ballet dancers. The Athlete’s Foot (tinea pedis) is particularly common between the little toe and the toe next to it. It is a fungal infection that can cause the skin to redden and crack. The affected areas are flaky and sometimes itchy. The skin can also turn white and thicken and is then often slightly swollen. It is commonly seen in runners (Long distance, marathon, sprinters, etc.) and swimmers. Among the non-athletic population, diabetes can be a predisposing factor as older adults of 60 years and above are mostly affected. Another condition known as Saver’s disease, or calcaneal apophysitis, is an overuse injury in young athletes that causes heel pain and is often confused with plantar fasciitis. This overuse injury is thought to be caused by traction apophysitis at the heel, correlating with the Achilles tendon insertion site. The pain classically resolves on rest or periods of inactivity. It presents in children and adolescents undergoing a rapid growth spurt or who take part in sports involving running and jumping such as volleyball, basketball, athletics (track and field, long jump, high jump), etc.

Management and foot care among athletes:

Before the management of foot-related conditions, clinicians must have a proper diagnosis of the particular condition with proper diagnostic tests and tools. Evaluation of arches (Medial Longitudinal arch, Lateral longitudinal arch, transverse arch) of the foot and strength of foot extrinsic and intrinsic muscles are some of the major domains of foot assessment and diagnosis.

Foot care tips for infections:

Keep your feet clean and dry. Wash your feet twice a day and gently towel dry between the toes.

Use an antifungal product. After washing and drying your feet, apply an antifungal product.

Change socks regularly. Change your socks at least once a day or more often if your feet get really sweaty.

Wear light, well-ventilated footwear. Avoid shoes made of synthetic material, such as vinyl or rubber. Wear sandals, when possible, to let your feet air out.

Alternate pairs of shoes. Use different shoes from day to day. This gives your shoes time to dry after each use.

Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers, and locker rooms.

Try not to scratch the rash. You can try soothing your itchy feet by soaking them in cool water.

Do not share shoes. Sharing risks of spreading a fungal infection

Foot Rehabilitation Protocol:

The movement and stability of the arches are controlled by intrinsic and extrinsic muscles.

However, the intrinsic muscles (foot core muscles) are largely ignored by clinicians and researchers. As such, these muscles are seldom addressed in the rehabilitation program.

When core muscles are weak or are not recruited appropriately, the proximal foundation becomes unstable and mal-aligned, and abnormal movement patterns of the trunk and lower extremities ensue. This can lead to a variety of overuse lower extremity injuries.

In this article, the following rehabilitation protocol is designed which focuses on intrinsic foot muscles as well as extrinsic muscles.