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High speeds attained on skates make for exhilarating sports, but expose the body to injuries. Healthy feet and ankles, which act together as accelerators, steering, brakes and shock absorbers in winter sports, are not only crucial to success in competition, but also help keep the body upright and out of the emergency room. Any problems with the foot or ankle could have serious repercussions for winter sports participants.

PREVENTING COLD FEET

Without warm, dry clothes, any wintertime outdoor activity is a potential health risk. Skates and socks are also important. While often ventilated, most ice skates are not built to allow perspiration to escape. Your Practitioner will recommend a single pair of thick socks or two thin socks made from a blend of acrylic or wool fibres that "wick" away moisture.

Feet "soaked" in snow should get back indoors quickly. In sub-freezing temperatures, soaked feet are in immediate danger of frostbite, a serious, painful condition that can result in loss of toes.

IMPACT TRAUMA

Skating puts tremendous stress on the ankle. Hockey players change direction at speeds near 30 miles per hour, and even casual figure skating requires quick turns and stops negotiated by the lower extremities.
Having enough protection in a hockey skate is also important. An errant slapshot can easily injure a foot in a less-protected skate.

If any pre-existing foot conditions, such as corns, calluses, bunions or hammertoes are present, see a Foot Heath Practitioner, a specialist of the foot and ankle, for evaluation before lacing up. A medical examination is also important if you have any pre-existing circulatory problems, such as Raynaud's Disease or diabetes.

Before taking to the ice in cold weather, it's important to loosen up the muscles by stretching. Stretching helps to prevent muscle pulls and tears, and prepares the muscles for the flexing required by the constant "forward lean" stress of skating.

SKATES: A PERFECT FIT, PLEASE

Podiatrists specialising in sports medicine say properly fitted skates are the single most important factor in safe and successful skating. Without a snug (but not too tight) and accurate fit, the quick turns of skating will surely result in discomfort or injury.

If skates are too loose, toes quickly get irritated in the toe box. If they are too tight, pressure leads to blisters and abrasions that result in a host of painful problems and keep you indoors or, worse, compromise control and lead to an accident.

Tight footwear also may inhibit circulation of the blood vessels of the lower extremity and cause cold feet, which both compromises performance and presents danger in the cold.

Do not put children in hand-me-downs unless they fit perfectly. Skates that are too large or too small will cause blisters, inflammation of the foot or nail irritation. The lack of proper ankle support in a too-large skate will leave the ankle susceptible to sprains, strains or fractures. Whatever the style, skates should be laced snugly, using all the eyelets.

If you are not sure your skates fit properly, or if an apparently proper-fitting pair still hurts, take them to a suitably qualified person , who can evaluate the fit and make recommendations to improve both comfort and performance on the ice.

BIOMECHANICS OF SKATING

Keeping the ankle perpendicular to the ground and straight up and down while skating brings out the best performance. Users of custom orthoses (shoe inserts) should transfer them to skates or buy orthoses especially made for skates to help maintain the best possible position.

Common side-to-side wobbling in the heel area can be remedied with "shims," or pads, in the heel. Shims can also be added to the counter area, or middle of the skate, for a more snug fit.

PROBLEMS TO WATCH FOR

Frostbite - It's impossible to overstate the importance of understanding symptoms of frostbite. Skin-colour changes, from blue to white, can't be seen in the skate, but if toes are extremely cold for a prolonged period, feel burning or numb, there is a danger of frostbite. People with a history of frostbite often get it again in the same place. Wools socks and new exothermic packs are also effective in keeping the extremities warm and preventing frostbite.

Blisters - Friction in winter sports footwear often causes blisters. Do not pop a small blister, but if it breaks on its own, apply an antiseptic and cover with a sterile bandage. Wearing two pairs of thin socks may help reduce friction.

Neuromas - Enlarged benign growths of nerves between the toes, called neuromas, are caused by friction in tight footwear and can result in pain, burning, tingling or numbness. Neuromas require professional treatment, including an evaluation of skates and boots.

Sprains and strains - The stress of skating can result in sprains and strains of the foot and ankle. They can be treated with rest, ice, compression and elevation (RICE). If pain persists, seek medical attention.

Subungal hematoma - Pressure in the toe box skate can cause bleeding under the toenail known as a subungal hematoma or "blackened toenail." See a Healthcare Professional at your Surgery immediately to help prevent the loss of a toenail.

Bone problems - Bunions and tailor's bunions, bony prominences at the joints on the inside or outside of the foot, often become irritated in skates. Pain at these joints may indicate a need for a wider or better-fitting boot. Other pre-existing conditions, such as hammertoes and Haglund's Deformity (a bump on the back of the heel) can be irritated by an active winter sports regimen. If pain persists, consult a Foot Health Practitioner. Fractures caused by trauma require immediate medical attention.

 

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mapTrekeek Foot Health Clinic, Trekeek Farm, Camelford, Cornwall, PL32 9UB

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