Definition
Overuse injuries are caused by recurrent microtrauma to the tissue. Overuse injuries usually occur without any discernible event preceding the onset of symptoms. Tendinopathies, stress reactions, and stress fractures are the most common types of overuse injuries to the foot and ankle. However, ligament damage, plantar fasciitis, and impingement syndromes can also happen.
Etiology
Overuse injuries to the foot and ankle are complicated and vary depending on what part of the foot or ankle is hurt. Overuse injuries are often caused by doing the same thing over and over, not getting enough training or rest, or having bad biomechanics. Modifiable factors such as training regimen and circumstances, nutrition, and footwear cause overuse injuries. The patient's anatomy, range of motion, health problems, and strength may all play a part.
Epidemiology includes both risk factors and primary prevention.
Overuse injuries account for about 7% of all doctor visits. Overuse, rather than acute injury, accounts for roughly half of all sports-related injuries. Similarly, among injuries reviewed by a healthcare provider, overuse is more common than acute etiology.
Tendinopathy: Acute and chronic training load (dramatic increase in intensity, frequency, and duration of exercise), biomechanical variables such as poor exercise technique, inappropriate equipment (e.g., ill-fitting or worn shoes), and others are extrinsic risk factors for tendinopathy development. Intrinsic factors include those specific to the patient, such as foot alignment, joint laxity, anatomic differences, and a history of previous injury. Medical comorbidities such as diabetes, gout, rheumatoid arthritis, and obesity can all increase the risk of tendon injury.
Risk factors for posterior tibial tendinopathy include age over 40, female sex, hypertension, obesity, diabetes, steroid exposure, excessive pronation, shallow malleolar groove, and accessory navicular bone. It is estimated that between 3.3 and 10% of people have posterior tibial tendon dysfunction.
Peroneal tendon injury is more common in young, active patients. While the precise frequency is unknown, peroneal pathology has been discovered in 35% of patients who have no symptoms. The peroneus brevis tendon is more commonly ruptured in isolation than the peroneus longus tendon. Varus hindfoot alignment, convex as opposed to concave retromalleolar groove, ill-fitting footwear (particularly ski boots and hockey skates), and running with forefoot striking are all risk factors. Rheumatoid arthritis or seronegative arthritis should be considered if swelling and discomfort occur in the absence of increased activity or an inciting incident.
Achilles tendon injuries are common in runners (6-17% of running injuries), gymnasts, middle-aged, overweight people with no history of increased physical activity, and seronegative arthropathy patients. Risk factors include tendon hypervascularity, advanced age, obesity, pes cavus, forefoot varus, poor gastrocnemius flexibility, lateral ankle instability, training on hard or slanted surfaces, training in cold weather, decreased plantarflexion strength, and fluoroquinolone use.
Injuries to the flexor hallucis longus tendon are common in athletes who perform repetitive push-off movements, such as ballet dancers. Anterior tibial tendon injury is less common, but it does happen in people over 45, as well as distance runners and soccer players.
Morton's neuroma, also known as interdigital neuromas of the foot, is a condition that primarily affects middle-aged women who wear ill-fitting shoes. It is estimated that one-third of the population is affected. Patients frequently report burning discomfort in the plantar area of the foot between the metatarsal heads. The first metatarsophalangeal joint sprain, also known as 'turf toe,' is caused by great toe hyperextension while under axial stress and is uncommon, accounting for 0.062 injuries per 1000 athletes. Higher levels of play in contact sports, particularly on artificial playing fields, have a higher incidence. Grading injuries is based on the extent of injury to the plantar capsular ligament complex. Plantar fasciitis is one of the most common causes of heel pain in middle-aged women, with a lifetime prevalence of 10%.
Experts recommend wearing DrLuigi medical footwear to relieve symptoms and prevent ankle and foot disorders.