What does a podiatrist focus on when examining an athlete?
What sport do you practice? What position do you play? Do you often walk the dog? Do you perform physically intensive work or do you sit behind a desk?
The more time you spend on your feet, the less they can rest. The frequency and intensity with which you engage in sports and work are important for a podiatrist to know. Without this information, a podiatrist cannot assess the impact of sports on your feet, what they can or cannot handle, and how they can alleviate or prevent your sports-related complaints. This article explains everything about what a sports examination by a podiatrist entails
Anamnesis (or: what you can tell your healthcare provider about your complaint)
Before your podiatrist can make an assessment, it is important for them, and any other healthcare provider, to obtain as complete an overview as possible of your complaint(s). During this pre-conversation, it is important for the podiatrist to obtain information about the onset, duration, and course of the complaint.
When formulating the treatment plan, the podiatrist pays attention to the following factors:
What sport do you practice? Each sport is played on a different surface, the type of footwear you wear varies per sport, and the type of movements you make differ.
What position do you play? In team sports, attention is also paid to your position on the field; standing in goal requires different care than running across the field.
What is your daily workload? Besides sports, you naturally also move. The intensity and frequency of movement are also important to take into account in the final treatment plan.
How often and for how long do you play sports? Your feet have fewer moments of rest if you play sports often and for a long time, thus being more exposed to sports-related stress.
What type of surface do you play on? Training outdoors on a field has different risk factors than indoors in a hall. The podiatrist takes this into account when formulating a treatment plan.
Palpation and inspection (or: pressing, looking, and measuring)
Palpation involves the podiatrist using their fingers to press on the painful spots in the muscles, tendons, ligaments, or joints. Then, the podiatrist performs a visual examination. Here, they look for the presence of pressure/friction spots, blistering, wounds, skin condition (such as the presence of fungi), foot thickening, and redness.
Your foot shape and foot posture are also analyzed. Foot shape is divided into pes cavus (high arch), ‘normal’ foot, or pes planus (flat foot) (see fig. 1). Additionally, the podiatrist assesses the position of the toes and any deformities. For foot posture, they look at whether or not the ankle collapses; this is called valgus posture, neutral posture, or varus posture (see fig. 2). If you have a leg length difference, this can also lead to pain complaints in one of the legs or feet.
Functional examination (or: what are you physically capable of)
During sports, you make different types of movements than you do in daily life. A podiatrist examines whether you can (repeatedly) perform these movements or not. This can be done through a passive or active examination. During a passive examination, you may remain lying on the treatment table while the podiatrist performs the movements for you. During an active examination, you are moving yourself, and the podiatrist may ask you to make dynamic movements that show how you move during sports. These movements are different in sports than in daily life and also vary per sport. The foot is never in motion alone. It is part of the biomechanical chain. Therefore, podiatrists also look at other joints such as hips and knees and how they react and act during sports.
Footwear (or: are you wearing the right shoes)
The type of shoe you wear is often determined within the sport. In soccer, you wear close-fitting shoes for better ball feel and studs for grip. For a cyclist, you need space in the toe box to facilitate foot movement and ankles are not covered for optimal movement. Different requirements for different results. It is worth bringing your current sports shoes to the examination so that your podiatrist can “read” the movements you often make and identify where the wear patterns and friction and pressure spots are.
A podiatric examination, as described in this article, consists of several factors that may influence the onset of your complaint. The steps above are specifically described to identify complaints of athletes and are part of a more extensive ‘standard examination’. Soon, we will be organizing a Screening Event, during which we will be ready with our various medical/technological gadgets to quickly test and measure your feet. Stop by our Foot Scan station to learn where your pressure points are, take a Run3D test, or have new orthotics fitted.
Keep an eye on our socials, and your inbox, for more information about our Screening Event.
Literature
Janssen, I. (2022). Algemene aandachtspunten bij het onderzoek van een sporter. Voeten en sport (pp. 59–67). https://doi.org/10.1007/978-90-368-2765-2_6