The Center for Podiatric Care and Sports Medicine

The Consequences of Intense Weekend Workouts: Common Weekend Warrior Injuries of the Foot and Ankle

Posted by on Friday, November 27th, 2015

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Are you over 35 years of age? Do you thrive on physically demanding recreational activities? Does the bulk of your 150 minutes of weekly exercise typically happen on the weekends when you’re not so busy with work? Do you feel like you don’t get in a “good workout” if you’re not busting a gut, panting, and pushing yourself 110%? If so, then you may be classified as a “Weekend Warrior!” Being a weekend warrior is better than being a Couch Potato, but experts warn that you are also placing yourself at higher risk for injury.1http://www.theatlantic.com/health/archive/2014/10/in-defense-of-the-weekend-warrior-lifestyle/381299/2http://www.aaos.org/AAOSNow/2014/May/clinical/clinical2/?ssopc=1 In addition to Achilles tendon ruptures, which we’ve already covered in some detail, here are three other common “Weekend Warrior” injuries in the foot and ankle to look out for.

weekend warrior injuries
Weekend warriors are at increased risk for Achilles strains, plantar fasciitis, ankle sprains and stress fractures than the average active individual. Image Source: Flickr CC user Parker Knight

3 Common Weekend Warrior Injuries of the Foot and Ankle

1. Plantar Fasciitis: Heel pain is responsible for an estimated 1 million podiatrist office visits per year and affects up to 10% of the U.S. population. The pain is often worst with the first few steps in the morning and subsides with walking, but returns after periods of prolonged sitting or intense exercise. To diagnose, your doctor may recommend an MRI, which may reveal a thickened plantar fascia with inflammation. About 80% of patients will get better within four years even without treatment. However, if the pain is severe and efforts like icing, anti-inflammatory medication, padded shoe inserts, night splints, stretches, and rest do not help, then you can visit a sports medicine center for physical therapy, extracorporeal shockwave therapy, and pain-relieving injections.

2. Ankle Sprains: By far the most common ankle injury seen in US emergency rooms, there are 23,000 ankle sprains occurring daily!3http://reference.medscape.com/features/slideshow/weekend-warrior-injuries Most accidents occur when the foot twists or rolls beyond its normal range of motion, causing excessive stretching and tearing of ligaments. Sometimes there is a “popping” sound, accompanied by swelling, pain, and bruising. Symptoms (particularly with grade 3 sprains) can be very similar to a fracture, so it’s good to have diagnostic images taken to be sure your course of treatment is appropriate. Grade 1 strains can be treated with a simple regimen of rest, ice, compression, and elevation. Grade 2 sprains are treated much the same way, but you’ll need a walking boot or splint for 2-3 weeks to stabilitize the joint as it heals and physical therapy to recover full range of motion. Grade 3 sprains accompanied by chronic ankle instability may necessitate surgical ligament repair.

3. Stress Fractures: Small cracks in the bone especially affect runners and dancers. It’s estimated that 15-20% of overuse injuries are stress fractures.4http://www.physio-pedia.com/Leg_and_Foot_Stress_Fractures#Epidemiology.2FEtiology Unlike traditional fractures that are caused by sudden force, stress fractures occur slowly over time as weakened bones are subjected to repeated impact. Weakness in the bones can occur due to dietary deficiencies, carrying excessive weight, hormone imbalance, prescription drug use, bone density changes like osteoporosis, muscle weakness, or sleep deprivation. Stress fractures usually don’t appear on x-rays for two to six weeks post-injury, so bone scans done within 2-3 days are considered the gold standard for diagnosis. Treatments include complete cessation of the problematic activity for 4-6 weeks, the use of a walking boot to reduce weight-bearing, and muscle-strengthening exercises when appropriate.5http://www.acfaom.org/information-for-patients/common-conditions/stress-fractures In rare cases, medial fixation is necessary to prevent further damage.6http://www.physio-pedia.com/Leg_and_Foot_Stress_Fractures#Epidemiology.2FEtiology

Why Are Weekend Warriors More Susceptible to Injury?

Most injuries are caused by sudden abnormal movements or increases in activity before the body is warmed up and conditioned. When it comes to exercise, “slow and steady wins the race.” It’s better to increase duration, speed, and intensity by no more than 10 percent from week to week. However, there are other (less obvious) reasons for weekend warrior injuries that have to do with aging.

According to the American Academy of Orthopaedic Surgeons, age-related changes that make us more susceptible to injury include:7http://www.aaos.org/AAOSNow/2014/May/clinical/clinical2/?ssopc=1

  • Declining athletic performance after age 35 related to dietary deficiencies and lack of regular exercise
  • A 1.5% decline in maximum oxygen consumption and pulmonary function each year, resulting in decreased blood flow to the brain, reaction time, balance, and muscle mass
  • Increases in pro-inflammatory cytokines that predisposes a person to systemic inflammation like tendinopathy
  • Hypovascularity and decreased biomechanical integrity leading to tendon degradation
  • Age-related comorbidities like variation in testosterone, estrogen, insulin, and corticosteroids that make foot and ankle tendons more susceptible to degradation
  • Bad falls or stumbles that cause posttraumatic arthritis to develop in the ankle joints particularly

So what is a person to do to stay safe while working out well into old age when time is restricted?

NYC Weekend Warrior Injury Treatment and Prevention

The Center for Podiatric Care and Sports Medicine in NYC is a valuable resource for local residents to learn more about injury prevention and assess individual changes that may be taking place within your own body. We encourage you to stop by our gait analysis center — particularly if you are an avid runner — to assess your form and find out what you can do to prevent common sports injuries. We are also fully equipped to diagnose and treat any weekend warrior injury to the foot or ankle. We offer the latest minimally invasive treatments from platelet rich plasma injections to shockwave therapy, and generally use surgery as a last resort, although our board-certified surgeons are among New York’s best.

 

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1. http://www.theatlantic.com/health/archive/2014/10/in-defense-of-the-weekend-warrior-lifestyle/381299/
2. http://www.aaos.org/AAOSNow/2014/May/clinical/clinical2/?ssopc=1
3. http://reference.medscape.com/features/slideshow/weekend-warrior-injuries
4. http://www.physio-pedia.com/Leg_and_Foot_Stress_Fractures#Epidemiology.2FEtiology
5. http://www.acfaom.org/information-for-patients/common-conditions/stress-fractures
6. http://www.physio-pedia.com/Leg_and_Foot_Stress_Fractures#Epidemiology.2FEtiology
7. http://www.aaos.org/AAOSNow/2014/May/clinical/clinical2/?ssopc=1

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.