I Think I Have an Itis in My Foot

Posted by Dr. Podesta on March 17, 2011 with 155 Comments

Drummers rely on there feet to play effectively. Various genres of music are more demanding on the feet than others placing that drummer at risk for developing a variety of repetitive stress injuries to the supporting muscles and tendons. Tendon injuries can develop in any of the tendons that run across the ankle and foot. Most commonly injuries that develop are inflammation or partial tearing of the Achilles tendon (Achilles tendonitis) or from an inflammation of the plantar fascia (plantar fascitis). Both can be quite painful and debilitating to a drummer.

The Achilles tendon is the large tendon at the back of the ankle that connects the large calf muscles (Gastrocnemius and Soleus) to the heal bone (calcaneus), providing the power in the push off phase of the gait cycle or to push down on the kick pedal. Whether you play heel up or heel down, the Achilles tendon is active and/or stretched. The Achilles tendon shortens or contracts to push the foot down while playing heel up. The Achilles tendon stretches when the foot lifts off the pedal in the heel down position.

The Achilles tendon can become inflamed most commonly from overuse as well as from a number of other contributory factors. The Achilles tendon has a poor blood supply, making it vulnerable to injury and slow to heal. Achilles tendonitis can be acute or chronic. Acute Achilles tendonitis may be the result of overuse, practicing or training too much, too quickly.

Symptoms of Achilles tendonitis include pain in the back of the ankle during activity or exercise. Achilles pain will gradually develop with prolonged exercise but will go away with rest. Swelling over the Achilles tendon is a common finding and may be associated with redness over the skin.

Chronic Achilles tendonitis may often develop from acute Achilles tendonitis if the acute tendon injury is not treated properly or allowed to heal. Chronic Achilles tendonitis is a difficult condition to treat and can lead to tearing. The pains experienced during the acute phase of the injury tend to disappear after a warm up but return when activity has stopped. Eventually the injury and pain become so severe that it is difficult to walk and difficult to point the foot up or downward.

Plantar fasciitis is an inflammation of the arch of the foot between the heel and the ball of the foot. There a several possible causes of plantar fasciitis including wearing higher heeled shoes, weight gain and increased repetitive use of the foot. You are also more susceptible to developing plantar fasciitis if your arches are abnormally too high or low.

Plantar fasciitis will typically cause pain in the arch of the foot or close to the heel when you first get out of bed in the morning or after you get up from a seated position and take your first few steps. Pain occurs from stretching out the tight plantar fascia when the foot is placed on the floor and lessens after walking.

Treatment for Achilles tendonitis and plantar fasciitis can be difficult. Rest from the activity causing the injury is the first line of treatment. Strecthing the plantar fascia at night while sleeping in addition to while awake will help diminish the tightness experienced after rest. The application of cold therapy or ice for fifteen minutes every 2 to three hours can be extremely helpful. This is easily accomplished with an ice cup applied to the painful achilles tendon or by rolling the painful arch over a frozen water bottle. Wearing a felt heel pad to raise the heel and relieve strain off the Achilles tendon or the use of orthotics to support the arch can also provide relief. Stretching exercises for the Achilles tendon complex and plantar fascia are very important. Physical therapy is utilized in those cases that do not respond to early treatments. The judicial use of non-steroidal anti-inflammatory medications can also be beneficial.

The goal of early treatment of these itisis is to limit the duration of the acute stages of tendonitis and plantar fasciitis and to prevent Achilles tendon or plantar fascia rupture from occurring which will stop an active drummer in his tracks.

Filed Under: Articles, Drum Magazine

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