Is It Normal For Feet To Hurt When Learning Cross Country Skiing

Review of the medical research on cross-state skiing related overuse injuries reveals a "Take hold of-22":

60% of overuse injuries in competitive cross-state skiers are acquired by preseason fitness preparation.
Experts suggest that cross-land skiers engage in preseason fitness training to forbid injuries.

This paradox bedevils elite athletes of all sports and raises high-level contest to an fine art form with countless debate concerning optimal training regimens. But, for the recreational skier it is fairly easy to resolve the conflict.

In spite of the potential for overuse injuries, cross-country skiing is one of the safest and about efficient fettle enhancing sports in the world. However, for a recreational skier contemplating embarking on a long circuit on the Catamount Trail, a weekend at a touring center, or skiing a marathon the very real potential for sustaining an overuse injury can be minimized by sensibly training ahead of time, learning nearly common injuries, and knowing how to foreclose them.

There are many overuse injuries which can afflict cross-country skiers. Below are a few which are more than common to cross-country skiers in general.

Patellofemoral Syndrome (besides called chondromalacia or runner's knee joint)

This most mutual of all running injuries tin be a trouble for skiers too. It is an overuse syndrome that involves diverse degrees of degeneration of the cartilage of the patella (genu cap) or the human knee joint surface of the femur. At that place are numerous anatomical factors which can predispose 1 to this injury. These include (a) faulty tracking of the patella on the articulatio genus due to disproportionate development of the quadriceps muscles, and (b) increased angle between the femur and the lower leg, more usually seen in women. Often, patellofemoral syndrome volition be precipitated by skiing, running, or cycling likewise far, besides presently, too fast.

The symptoms of patellofemoral syndrome are:

Gradually progressive agonized or grating pain under the knee cap.
Stiffness
Giving-way sensation
Grinding, popping, or clicking sound on knee flexion
Crunchy sensation felt when holding fingers on the patella through knee joint range of motion

Provocative factors

Going up or down stairs, or down hills
Running
Squatting
Prolonged sitting with genu aptitude (Theater sign)

If there is locking or catching, a meniscal cartilage tear should be considered instead.

Management of patellofemoral syndrome:

Relative rest
- Avoid squats and lunges
- Reduce mileage to painless altitude
- Cross-train with biking, swimming, or elliptical trainer
Hurting relief
- Tylenol or ibuprofen – sparingly
- Water ice Therapy
Patellofemoral knee exercise instruction with a physical therapist
Footwear modifications
- Supervene upon when excessively worn
- Consider custom Orthotics
Avoid provocative factors
- Limit weight on a flexed knee
- Reduce mileage and footstep
- Avoid uphill and downhill running

Exercise Induced Bronchospasm (EIB)

This is a condition which, while not an injury in the usual sense, seems to be the event of repetitive exposure to cold air while vigorously exercising. EIB is the constriction of the minor airways (bronchi) in lungs making breathing difficult during exertion. Sufferers often will have a hacking coughing afterwards skiing hard in the common cold. EIB is pronounced in wintertime sports considering of the irritative effect of common cold, dry out air. It is prevalent in several winter sports affecting nearly one of every four winter Olympians. In fact, studies show that 50% of Olympic cross-country skiers take the condition. Manifestly, those with EIB can perform at a high level but they need to know how to manage the status:

Warm upwardly slowly in the cold.
Avoid exercise in very cold weather and, if you must ski, use a face mask.
Don't fume and ensure that indoor air is of high quality and smoke-complimentary.
Avoid viral upper respiratory infections such as colds and influenza by assiduously washing hands.
Consider using asthma inhalers before skiing if your doctor believes information technology is indicated.
If you have asthma, follow you physician's recommendations.

Sesamoiditis

The sesamoids are modest bones (sesame seed-shaped) associated with tendons around some joints. These bones are prone to overuse inflammation. This condition is called sesamoiditis and is common in the starting time metatarsophalangeal (MTP) joint which is located in the ball of the foot just behind the great toe. Cantankerous-state skiers using classic technique are especially prone to this. Treatment is focused on removing pressure on the sesamoids and reducing inflammation.

Sesamoiditis ranges from a balmy, occasional ache to a debilitating, intense throbbing with swelling. One of the major causes of sesamoiditis is suddenly increased activity. Speed piece of work, hill piece of work, or increased distance can cause this. Also, a loftier arched pes will put more than force per unit area on the ball of the foot.

Handling for sesamoiditis is almost always conservative; surgery is rarely necessary.

Be sure to accept properly plumbing fixtures footwear for grooming, walking, and, most importantly, for skiing.
Consider buying new ski boots if your old ones are worn and overly flexible at the ball of the foot.
Consider using Combi boots (can be used for both archetype and skating technique and have a relatively stiff sole) when classic skiing.
Cross-train past ski skating. Skating boots are much less likely to beal the condition due to their strong soles reducing flexion at the MTP joint.
Get arch supports or custom orthotics to reduce pressure on the sesamoid basic by distributing pressure level more evenly on the pes.
Use ice treatments and anti-inflammatory medications such every bit ibuprofen or naproxen to reduce pain.
Deep massage in the hands of a massage professional who understands sports medicine.
Cut down on duration of skiing or even stop skiing for a time.

Exertional Compartment Syndrome

While not every bit common as the to a higher place atmospheric condition, exertional compartment syndrome, a crusade of leg or arm pain, can be very serious if not identified and treated early. Extremity muscles are encased by compartments formed from connective tissue. If the muscles nifty due to rapid muscle growth or injury-associated inflammation, pressures in the compartment increase. This ascent in pressure can tuck fretfulness and claret vessels running through the compartment. Constriction of veins causes a vicious bicycle of increasing swelling and pain resulting in more venous constriction. This occurs most unremarkably in the lower legs and presents with exercise-induced pain and swelling relieved with rest. There is a sensation of fullness over the involved compartment. Pain begins predictably later do for a fixed fourth dimension interval or at a specific intensity level. Pain is relieved with twenty minutes of remainder and resumes on exercising again.

Blood clots, stress fractures, clogged arteries or other serious disorders can mimic this condition. Definitive diagnosis is made by having a md measure pressures within the involved compartments. Severe cases tin can involve a cold, pale, numb, or painful foot and require firsthand medical attention and surgical handling to prevent tissue damage and permanent disability.

Conservative treatment, when begun early, is often effective and involves residuum, activity alteration, rehabilitation exercises, and stretching.

Listen to Your Body

The bottom-line: be aware of signals from your trunk. Pain tin can exist your friend. When you are having persistent discomfort pay attention. Do not but treat the symptoms with pain pills and ice. Educate yourself about sports medicine and have action to prevent and care for issues. Seek help from physicians or other qualified practitioners when appropriate. Proper preparation and attention to symptoms will amend your enjoyment of the outdoors.

This article was originally printed in the Catamount Trail Newsletter and was authored by Dr. George Terwilliger, an ER md who lives in Brattleboro and is a lifelong Vermont resident. He is an avid backcountry skier and has skied many sections of the Catamount Trail.