How To Evaluate Figure Skating Injuries

By Rachel A. Janowicz, DPM
Bursitis, hammertoes, Sever’s disease and plantar fasciitis (especially in skaters with tight posterior leg muscles or increased longitudinal arches) are other chronic pedal conditions that have been linked to figure skating.3 It is not currently known whether hallux valgus, limitus or rigidus are directly correlated to skating or its equipment. However, painful bursa and neuritis can form over deformities due to the rigidity of the boot. Again, heat-molding of the boot by the manufacturer and/or padding is appropriate. Why Off-Ice Conditioning Is So Important A skater uses a variety of muscle groups to execute the most difficult of triple jumps down to the placement of a finger and facial expression. Combining proper technique with adequate strength and flexibility can reduce the risk of injury. Such conditioning begins off-ice, where skaters should incorporate into their training a regimen of strengthening and stretching as well as cardiovascular work. However, any mature athlete understands the benefits of rest and one should recommend to the skater to have one day a week away from strenuous physical activity in order to allow for recuperation. A special consideration for skaters is the environment in which they train. Ice arenas are damp and cold, and elite skaters frequently train in the early morning. Properly warning up off and on the ice is important prior to and after practice. Skaters should also do this after resurfacing of the ice or breaks. Older skaters should be particularly cognizant of the need for proper stretching and warming up in order to prevent injury. What You Should Know About Skating Boots Since many acute and chronic injuries are caused by the skating boot itself, it is a good idea to have skaters bring their skates to the appointment for evaluation.1-4 A skate is not just a blade mounted to a boot. The apparatus can vary drastically in regard to the position of the blade, the fit of the boot, any modifications made and the materials used in the construct. Although boot and blade combinations are mass produced and sold cheaply in various sporting good and department stores, competitive skaters will likely obtain their boots from a reputable boot company or dealer, purchase their blades separately and have them properly mounted by a professional. A custom fitted boot with a quality set of blades can cost in excess of $1,000. Many skaters opt to purchase stock boots, which are a good alternative to the more expensive custom boots in lieu of the expense involved in replacing skates which continue to be outgrown. However, even these stock boot/blade combos can cost hundreds of dollars. For custom skate boots, the professional fitter will take various foot measurements. (One may take a plaster cast such as that for a custom molded shoe although this is not standard.) The measurements attempt to accommodate for all bony prominences like malleoli as well as other osseous considerations such as hallux abductovalgus deformities. Stock boots may or may not include accommodation for normal bony anatomy but the manufacturer can easily mold or “punch out” the leather of both custom and stock boots. It is important for podiatrists to know that custom and stock boots lack intrinsic arch support or orthoses although most professional boot companies provide foam box casting services by their personnel at additional cost. Treating Tendinitis Conditions Related To Boots Other common tendinitis conditions related to skate boots are that of the extensor hallucis, tibialis anterior and posterior tibial tendons.6 Extensor tendonitis or lace bite results from lateral slipping and compression of the tongue across the top of the foot and ankle with dorsiflexion. One can add midline lace hooks or alternate lacing, or supplement the skate tongue with porous rubber, felt or lamb’s wool in order to treat this problem in conjunction with antiinflammatory medication and ice. Skating can exacerbate or even cause posterior tibial tendinitis because the standard boot construct lacks intrinsic arch support. Custom orthoses are certainly indicated in this case. In Conclusion Educating the skater, coach or trainer and/or parents in regard to the etiology of the skater’s condition is essential to ensure compliance. Clinicians should emphasize a gradual return to the ice with off-ice conditioning and a slow increase in the difficulty of moves after returning to the ice.

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