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High speeds attained on skis and snowboards make for exhilarating sports, but expose the body to injuries.
Healthy feet and ankles act together as accelerators, steering, brakes, and shock absorbers in winter sports. Not only are they crucial to success in competition, but they 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. Properly insulated footwear is as important as coats, hats or gloves in the outdoors during the winter.

Socks are also important. Foot Health Practitioner recommend a single pair of thick socks or two pairs of thin socks made of a wool blend or acrylic blend fibres that "wick" away moisture caused by perspiration in the boot.

Feet chilled 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

In skiing, particularly at an intermediate or advanced level, high speeds and force of gravity place tremendous levels of impact trauma on the lower extremities, especially on steep and bumpy runs.

If any pre-existing foot conditions, such as corns, calluses, bunions, or hammertoes are present, see a Practitioner, a specialist of the foot and ankle, for evaluation before buckling 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 slopes 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 skiing and snowboarding.

SKI BOOTS: FINDING THE PERFECT FIT

Podiatrists specialising in sports medicine say properly fitted ski boots are the single most important factor in safe and successful skiing. Without a snug (but not too tight) and accurate fit, the pressure exerted by the constant forward motion and lateral movement of skiing will surely result in discomfort or injury.

If boots 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 extremities and cause cold feet, which both compromises performance and presents danger in the cold.

Ski boots are available in a forward-entry variety, a rear-entry style for easier entry and more comfort, or "hybrids" that incorporate both designs. Modern systems of cables and buckles make it possible to alter the boots to a near-perfect fit.

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

CROSS-COUNTRY SKIING

The motion of cross-country skiing is quite distinct from downhill, and involves the entire body.

Cross-country footwear is more like a bicycle shoe than a downhill boot. Bound to the ski only at the ball of the foot, cross-country boots should not irritate the balls of the feet.

As with running in winter, proper stretching is vital before cross-country skiing. In cross-country, the heel goes up and down constantly. Without proper loosening up first, the motion can result in painful Achilles tendinitis and plantar fasciitis, among other problems. A Practitioner can recommend proper stretching exercises.

BIOMECHANICS OF WINTER SPORTS

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

Skiers with minor biomechanical imbalances may encounter a frustrating phenomenon known as "edging," in which the ski rolls to the inside or outside edge, inhibiting control going down the slopes.

Ski boots can be "canted" internally to adjust the relationship between the boot and leg. For cases of rolling-in of the foot, or pronation, or rolling-out (supination), caused by flat feet or high arches, cants may be applied directly to the skis or within the boot. This improves edging and enhances performance and control, making the sport safer and more enjoyable.

Ski shop technicians can work in conjunction with podiatrists on specific biomechanical adjustments to improve performance and safety.

SNOWBOARDING

In recent years, skiers have shared the slopes with more snowboards - wide single skis that zigzag down the slopes. The feet are bound perpendicular to the board.
Podiatrists say large, sturdy, insulated snowboard boots flexible enough to accommodate the twisting of the lower body are best to safely control the board. Most popular with young people, snowboarding has become a bona fide alpine sport, and more snowboarders will share the slopes with skiers in the future.

PROBLEMS TO WATCH FOR

Frostbite - It's impossible to overstate the importance of understanding symptoms of frostbite. Skin-colour changes, from blue to white hues, can't be seen under a boot, 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. Wool socks are an effective way keep feet warm and dry. New battery-powered heated ski boots or 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 pair 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 shoes.

Shin splints - Pain to either side of the leg bone, caused by muscle or tendon inflammation. This may be related to a muscle imbalance between opposing muscle groups in the leg. It is commonly related to excessive foot pronation (collapsing arch). Proper stretching and corrective orthoses for pronation can help prevent shin splints.

Sprains and strains - The stress of winter running 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 of a running shoe can result in bleeding under the toenail known as a subungal hematoma or "blackened toenail." See a Foot Health Practitioner  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. Pain at these joints may indicate a need for a wider or better-fitting shoe. 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 podiatrist. 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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