Return to activity without injury

I was prompted to write this blog after seeing 7 primary school age children come thought the clinic doors in the past 2 weeks with foot and ankle pain. And as we head towards the resumption of kids sport training and competition, as well as adults non-contact sport from November 8, we are anticipating we will see a lot more patients with foot and ankle pain. What we all need to remember is that we are coming off a long period of reduced activity, and if you just try to pick up where you left off, you are likely to end up with an injury or at least very sore while your body adjusts the new increased demands and loads of your chosen exercise. So how do we manage our bodies over this transition period? Here are our tips:


TRAINING LOADS

The American College of Sports Medicine recommends the following return to training program. This is based on what your normal activity was PRE COVID. It is a 4 week plan based on gradually increasing the load or intensity so the body has time to adjust


Week 1: reduce your load to 50% of normal / max 3 sessions

Week 2: increase your load so it is 70% of normal / max 3 sessions

Week 3: increase your load so it is 80% of normal / max 4 sessions

Week 4: increase your load so it is 90% normal / max 4 sessions

Week 5: Back to PRE COVID training levels


Load can be:

- intensity (effort or how hard you are working)

- time

- weight

- kilometres


For example:

If you normally complete 2 high intensity 60 minute spin classes a week, 50% reduction would look like:

- 1 at high intensity or 2 at medium intensity / or 2 x high intensity for 30 minutes


If you normally complete 4 weight sessions (2 lower body, 2 upper body) with 3 sets of each exercise, a 50% reduction would look like:

- 4 sessions at regular sets with 50% reduction in weight

- 3 sessions: 1 upper ( normal set, half the weight) , 1 lower (normal set half the weight) , 1 both but half the exercises (normal set, half weight)


If you normally place 3 rounds of 18 holes a week a 50% reduction would look like

- 3 x 9 holes with a day in between

- 1 x 18 holes plus one session at the driving range where you hit 50 balls or less with no more than 10 full 'drives'



Just remember that your kids are probably running around like crazy people at school at lunchtime. If you suddenly add a whole lot of sport specific training, they are likely to end up with pain. They need time to adjust, just like adults. If they are adamant they want to join in as normal then we would strongly advise a biomechanical assessment so we can check for any areas of weakness and advise accordingly.


AT HOME EXERCISES


STRENGTHEING


Spending a little time each day activity strengthening your foot and ankle muscles is a great way to recondition the body for activity. These are simple of complete and require little equipment. Aim for 10 reps 3 times over if you can. Great things to do while watching Netflix!


  1. Arch strengthening

  2. Calf strengthening





2. Front of leg / Ankle strengthening



  1. Toe strengthening





STRETCHING / MOBILITY


Spend some time after activity to stretch out the muscles of your feet and lower leg. Aim for 30-60 seconds but if you have the time, 4 minutes, particularly for the calf muscles is highly beneficial!

  1. Ankle

  2. Whole Foot

  3. Plantar Fascia stretching




4 Top of foot / shin stretching:




5. Calf stretching



6. Self massage: if you have any tight spots, use foam roller or your own fingers to massage in Tiger balm or Fisiocream and work out those tight sports. Try to work from the further down the leg in an upwards direction


FOOTWEAR


- Check the fit. This is especially important for your kids.

  1. You need to check the length . There should be about 1 thumb width from the longest toe (not necessarily the big toe) to the end of the shoe.

  2. You need to check the width. You should not see toes against the sides of the shoes, nor should you feel pressure

  3. You need check the depth across the toes. You shouldn't see toes pressing up against the fabric

  4. Check the lacing. Changing the lacing can completely change the way a shoe fits. You can check out another blog here https://www.balwynpodiatry.com.au/post/shoelaces

  5. Check the wear patterns. Are there obvious areas of increased wear? If you so, we advised a biomechanical assessment

  6. Have you done more than 600km in them? If so, they are likely to need replacing. If you don't want to go into a store yet, check out Active Feet. They are offering free virtual fitting appointments www.activefeet.com.au



- Consider the type of shoes you are wearing. You may want to increase the support your runners provide for the first month or two


- Consider wearing an over the counter insole to give your a little more support. The main arch supporting muscle in the foot, the Posterior Tibialis is easily irritated. A soft insole can help to provide support to this muscles while you work on the strength. This its particularly important for golfers who will suddenly walk long distances


If you experience any discomfort or pain that last more than 48 hours, we recommend coming in for an assessment or seeing your trusted health professional. Small issues become big ones and the last thing anyone wants at the moment is to have to spend more time sitting!!!