Don’t let your feet give you the boot!

Many of the problems seen commonly in derby are those involving foot disorders, such as blisters, calluses, foot pain, sore toes, and bunions. Abnormal foot structure accounts for a major percentage of these. The foot is constructed of multiple bones, ligaments, tendons, and muscles all of which function to provide shock absorption and propulsion. Since about 1.5 times your body weight bears down a foot in walking alone, it is evident that dysfunction of the foot causes damage. And you can see being overweight adds to the problems. There are major muscles in the lower leg that support the function of the foot, so you must pay attention the strength and flexibility of these as well, especially the Achilles.

There are several structural abnormalities of the foot that result in secondary problems. I’ll outline the major ones in this article. You should have your feet examined before embarking on the strenuous sport of derby to avoid being side-lined by these problems during the season.

Flat foot (or flat arch)
As mentioned, the arch provides shock absorption; it does this by flexing with weight bearing. Too much flexing or too little will cause difficulties. This section and the next describe this.

There are two varieties of flat arch: flexible and rigid. The flexible flat foot is distinguished by the ability to form an arch when not weight-bearing or by standing on the toes, even if the foot is flat when standing. The rigid arch does not form an arch in either case. An easy way to see a flat arch is to walk barefoot with wet feet. The normal C-shape footprint is not seen because the arch contacts the ground. Also, when viewing the foot from the rear, the heel appears to tilt outward as the foot rolls in on the instep.
Generally, a flexible flat arch does not cause much difficulty except for foot pain with heavy use and some wearing down on the inside of the shoe heel. The rigid flat arch does cause foot pain (in the arch), ankle pain (usually on the inside of the ankle), callus (particularly on the ball of the great toe), shin splints, and plantar fasciitis (an inflammation of the fibrous tissues on the bottom of the foot).

High arch (or cavus foot)
The high arch is usually rigid. This results in high arch even when bearing weight. The foot does not flatten or flex enough. When viewed from the rear in standing position, the heel appears to tilt outward. A high arch results in inadequate shock absorption in the foot with the heel and ball of the flat taking more of the impact than normal.

A skater with a high arch will complain of foot pain (especially in the instep), recurring callus (both on the ball of the foot and heel), and shin splints and is more likely to develop plantar fasciitis.

Toe deviations
One of the commoner abnormalities of the foot is a great toe that deviates outward towards the little toe. The cause is often tight, pointy toed shoes, wearing a high heeled shoe frequently, or a high arched foot. The toe may deviate because of bony problems. Because of the protrusion of the joint, bunions are a common complication. The pinky toe can also have a deviation towards the great toe and develop corns and bunion.

A hammer toe is one where the middle joint of the toe is bent downward and doesn’t straighten easily or at all. It occurs most often in the second toe since this is longest toe. Hammer toe results in blisters or calluses on the tops of the toe. Most often, it is caused by wearing shoes that are too short for the foot, wearing high heels frequently, or as a result of a poorly healed toe fracture.

“Claw toes” is a condition where the toes are bent up at the first joint and curl down at the other two joints. Usually, all the toes are involved. Although claw toes can occur from wearing tight shoes, they can also occur from neurological diseases and thus warrant a full evaluation by a doctor.

Blisters
The rubbing and chafing of wet skin against the hard surface of a shoe or boot is cause of most blisters. Ill-fitting skates - too tight or too loose - cause many blisters. Foot structure abnormalities can add to the likelihood of getting recurrent blisters, especially in the same spot.

There are preventive steps. Making sure that cool new skate fits well at the start is important; if you find they don’t fit well, work with your skate provider to get a good fit. Keeping the feet dry by using powder and airing the feet out from time to time helps. Some skaters find wearing two layers of thin socks works well. Socks should be a breathable material such as cotton. If an area of soreness develops on the foot, even without a blister, start covering the area right away; your medical staff can advise the best method.

The details of treating each of these conditions are too lengthy for a short article like this. In general, padding, orthotics (specially made shoe inserts), splinting, and sometimes surgery are the management.

The main point is to know you have an abnormality and have it evaluated and treated before the secondary problems occur.