Kickboxing and Foot Injuries

English: girls kickboxing in pe (Photo credit: Wikipedia)

For many people, kickboxing is not just a great workout, it's a way to learn self-defense and empower yourself. Martial arts has a lower risk of injury to the foot compared to other contact sports, but foot injuries still occur. Repeated ankle sprains or trauma in kickboxing can damage the peroneal tendon, a common injury.
According to a June 2005 article in Podiatry Today, foot and ankle injuries account for 10% of all martial arts injuries. This is because martial arts involves some form of kicking, which can lead to sprains or blunt force trauma. Sprains are the primary cause of tendon damage, and these injuries happen when the student has done a move incorrectly. Martial arts requires flexibility and balance and performing a kick without the proper balance can cause instability in the supporting foot.
The two peroneal tendons run side-by-side behind the outer ankle bone. One peroneal tendon attaches to the outer part of the midfoot and the other attaches under the foot near the inside of the arch. The main function of the peroneal tendon is to stabilize the foot and ankle and protect them from sprains.
Peroneal tendon injuries may be acute (occurring suddenly), or chronic (developing over a period of time). People with high arches are at risk for developing peroneal tendon injuries. Types of peroneal tendon injuries include: tendonitis, tears, and subluxation.
Tendonitis is an inflammation of one or both tendons. The inflammation is caused by activities involving repetitive use of the tendon, overuse of the tendon, or trauma (such as an ankle sprain). Symptoms of tendonitis include:

• Pain
• Swelling
• Warm to the touch

Acute tears are caused by repetitive activity or trauma. Immediate symptoms of acute tears include:

• Pain
• Swelling
• Weakness or instability of the foot or ankle.

As time goes on, these tears may lead to a change in the shape of the foot, in which the arch may become higher.
Degenerative tears are usually due to overuse and occur over long periods of time- often years. In degenerative tears, the tendon is like taffy that has become overstretched until it becomes thin and eventually frays. Having high arches also puts you at risk for developing a degenerative tear. The symptoms of a degenerative tear may include:

• Sporadic pain (occurring from time to time) on the outside of the ankle
• Weakness or instability in the ankle
• An increase in the height of the arch

Subluxation- one or both tendons have slipped out of their normal positions. In some cases, subluxation is due to a condition in which a person is born with a variation in the shape of the bone or muscle. In other cases, subluxation occurs following trauma, such as an ankle sprain. Damage or injury to the tissues that stabilize the tendons (retinaculum) can lead to chronic tendon subluxation. The symptoms of subluxation may include:

• A snapping feeling of the tendon around the ankle bone
• Sporadic pain behind the outside ankle bone
• Ankle instability or weakness

Early treatment of a subluxation is critical, since a tendon that continues to sublux (move out of position) is likely to tear or rupture. Therefore, if you feel the characteristic snapping, see a podiatrist immediately.
Because peroneal tendon injuries are sometimes misdiagnosed and may worsen with proper treatment, prompt evaluation by a foot and ankle surgeon is advised. To diagnose a peroneal tendon injury, the surgeon will examine the foot and look for pain, instability, swelling, warmth, and weakness on the outer side of the ankle. In addition, an x-ray or other advanced imaging studies may be needed to fully evaluate the injury. The podiatrist will also look for signs of an ankle sprain and other related injuries that sometimes accompany a peroneal tendon injury. Proper diagnosis is important because prolonged discomfort after a simple strain may be a sign of additional problems.
Treatment depends on the type of peroneal tendon injury. Options include:

• Immobilization. A cast or splint may be used to keep the foot and ankle from moving and allow the injury to heal. 
• Medications. Oral or injected anti-inflammatory drugs may help relieve the pain and inflammation.
• Physical therapy. Ice, heat, or ultrasound therapy may be used to reduce swelling and pain. As symptoms improve, exercises can be added to strengthen the muscles and improve range of motion and balance.
• Bracing. The surgeon may provide a brace to use for a short while or during activities requiring repetitive ankle motion. Bracing may also be an option when a patient is not a candidate for surgery.

Surgery may be needed to repair the tendon or tendons and perhaps the supporting structures of the foot. The podiatrist will determine the most appropriate procedure for the patient's condition and lifestyle. After surgery, physical therapy is an important part of rehabilitation.

While no contact sport is ever without injury, you can take several precautions. Talk with you or your child's doctor before beginning any kickboxing or martial arts exercise regimen to identify any risk factors you may have. Make sure to stretch out before and after class- most tendon injuries occur because of a lack of flexibility. Finally, if you or your child is injured, stop immediately and seek medical attention.
If you are an athlete and are experiencing foot pain, call our Newington, Kensington, or Middletown office to make an appointment.
Craig M. Kaufman, DPM
Connecticut Foot Care Centers
Sports Medicine Podiatrist in CT
Podiatrist in Newington
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