Caring for Your Feet and Ankles

 

Dr. Jonathan Key discusses common foot and ankle ailments associated with golf.

 

Most people think of back and arm injuries when they think of sports-related injuries that occur as a result of playing golf. However, just as common — and just as painful — are foot and ankle injuries. Some injuries are more common, such as plantar fasciitis, and other injuries are less common, such as hallux subungual hematoma. The good news is that golf injuries are typically overuse injuries — not traumatic injuries, says Dr. Jonathan Key, a Middlesex Health podiatrist, explaining that most overuse injuries respond extremely well to conservative management.

Common foot and ankle injuries

According to Dr. Key, the most common golf-related overuse injuries are:

• Heel pain
• Metatarsalgia
• Morton's neuroma
• Lateral ankle pain, or tendinitis
• Hallux (big toe) subungual hematoma

When you experience heel pain, the majority of the time it is plantar fasciitis, which is inflammation of the ligament, or band of tissue, that attaches to the heel bone. However, sometimes, heel pain can also be attributed to a stress fracture or bone contusions.

The presentation of plantar fasciitis is usually very clear, but an X-ray is typically taken to be sure, Dr. Key says. People usually wake up in the morning and their heel hurts immediately. As they start to walk, the pain begins to dissipate. It’s better when they are at rest, but then comes back. It is essentially on and off heel pain, he says.

For plantar fasciitis, conversative treatment options include rest, stretching, strengthening, wearing night splints, taking anti-inflammatory medicine and ensuring your shoes offer proper support. “We’ve had positive results treating plantar fasciitis with physical therapy, including manual therapy and taping techniques, to decrease the stresses on the plantar fascia,” says Brian Taber, a physical therapist and director of Middlesex Health Physical Rehabilitation. “Another trick we tell patients is to fill a small plastic bottle with water and freeze it. Once frozen, roll your injured heel back and forth over the water bottle. It not only helps to break up the scarring tissue, but it helps with the pain too!”

Metatarsalgia is when you experience pain across the ball of your foot. When the ball of your foot becomes painful and inflamed, it can be caused by tendonitis or a corn or callus. This can be treated with orthotics or more comfortable shoes.

Morton’s neuroma is essentially a pinched nerve leading to the toes, and it can be caused by wearing narrow shoes or overuse. It’s felt mainly when you are on the ball of your foot. Anti-inflammatory medicine, cortisone injections and inserts in your shoes can help.

Lateral ankle pain, or tendinitis, is the inflammation or irritation of a tendon. Tendons stabilize the foot and ankle in a golf swing, and it can hurt when there is inflammation. Lateral ankle pain occurs due to the excessive motion of the rearfoot during the golf swing follow through. On longer shots, such as a drive, this force can strain the ankle ligaments and peroneal tendons to the point where they cause pain.

A hallux (big toe) subungual hematoma happens when the golfer applies excessive pressure to the big toe during the golf swing. Typically, it will occur at the end of the follow through and will only happen on the back foot. Jamming the toe into the toebox of your shoe over and over again can cause the surrounding tissue to become inflamed and cause pain and blood to pool under the nail bed. Treatment options may include draining the blood underneath the nail and padding. 

Tips for golfers

It is important for any athlete, golfers included, to listen to their body and adjust accordingly. If something is causing pain or discomfort, make adjustments and avoid that something, Dr. Key says.

For golfers, Dr. Key recommends paying attention to your swing mechanics, which can have an impact on your feet and ankles. Also, make sure that your shoes fit properly, and be careful of your surroundings. Pay attention to terrain (specifically uneven terrain), prominent objects like roots or rocks and slippery conditions like moist grass.

When to get help

Dr. Key says the longer an overuse injury is present, the longer it typically takes to respond to conservative management, such as medication or cortisone injections. Because of this, it is important to seek treatment early.

“The sooner someone seeks treatment, the sooner they will be on their way to recovery,” he says.

 

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