The Podiatrist s Role as Team Physician

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Maud Foster
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1 The Podiatrist s Role as Team Physician

2 Faculty Tyson Green, DPM Professor McNeese State University Department Chair, Residency Director Imperial Health / Center for Orthopaedics Lake Charles, Louisiana

3 Faculty Disclosures Dr. Green has disclosed no relevant financial relationships with any commercial interests.

4 Learning Objectives Explain the role that the podiatrist serves in the team of physicians on the sideline at athletic events Realize the need for advancement of knowledge and technology in this niche Recognize the differences in movements/stresses and injury potential between different sports and between different positions within the same sport

5 Goals and Objectives Need? Current standard of care? What injuries are we looking to prevent? Performance enhancement?

6 Golf/Baseball Need? No real established need from an injury prevention standpoint Performance improvement?

7 Golf/Baseball Current standard of care? Shoe industry No established aftermarket insert, etc: Sport-specific

8 Golf/Baseball Performance improvement? Transfer of weight? Evaluate swing phases and determine where more stability and/or strength can be derived from?

$Not really for injury prevention in golf Metatarsalgia/stress fracture prevention in$

9 Golf/Baseball Injury prevention? Not really for injury prevention in golf Metatarsalgia/stress fracture prevention in baseball Mainly cleat issues usually sub second metatarsal

10 Basketball Need? Lower extremity injuries account for vast majority of injuries in basketball More glam than function in shoes

11 Basketball Standard of care? Shoe/insert balance between dynamic and stable

12 Basketball Injury prevention? Ankle stability a must Careful of transfer to knee Shock absorption

13 Basketball Performance improvement? Sadly, cannot make that assumption

14 Football Need? More than any other sport!

15 Most Common Injuries in Football Knees Ankles Everything else!

16 Research University of Pennsylvania 332 elite players in 2005 NFL Draft Combine > 50% had a history of significant knee injury 86 had already had knee surgery 25% of all college football players have had knee surgery! Bradley J, et al. Am J Orthop. 2008;37(6):

17 Injuries QB/DB Accounted for the vast majority of ankle injuries RB/LB Accounted for the most knee injuries Ankle sprain most common ankle injury ACL tear most common knee injury QB = quarterback; DB = defensive back; RB = running back; LB = linebacker; ACL = anterior cruciate ligament.

18 Equipment Tons of money spent on design of cleats Very little to none spent on insole

20 Football With the vast differences in types of movement required to play each position, are more specific orthotics needed?

21 Subtitle Quarterback

22 QB-Specific Movements Push off Orthotics must take into account hand dominance Pocket passer? Or are most throws made on the run? Release point? Orthotics will allow for maximum push off at release point

24 Running Back Subtitle

25 Must be dynamic and withstand the stresses of quick changes in direction

26 Subtitle Linebacker

27 Side-to-side movement Start/Stop Lunging movement

28 Lots of stress on forefoot Must allow for maximum push off

29 Kicker & Punter Subtitle

30 Soccer cleats Thin Light Propulsion

31 Wide Receiver & Tight End Subtitle

32 Very similar to running back Quick out of routes

33 Defensive Back & Safety Subtitle

34 Backpedaling Start/Stop Forefoot

35 Subtitle Lineman

36 Stance and stability Forefoot slow release Maximum balance

37 What Advanced Protocols Are Out There? Subtitle

38 UCLA and Stanford Prefabricated Position-specific One size fits all

39 UCLA and Stanford Spenco Superfeet Cheaper Physician consulted for orthotics on an as-needed basis Mainly reactive with their custom orthotics, rather than using as preventive Cost- and time-consuming

40 McNeese Study 90 players per year Position-based Custom orthotics Evaluate decrease in injuries Evaluate performance hardest part

41 Study Results after 2 Years of Use Season-ending lower extremity injuries Decreased by 75% Missed more than one game Decreased by 90% All lineman started every game Only school in FCS to do so

Use of Muscles? = Less Cramping/Fatigue?

42 Other Possible Benefits Noticed Game Speed/Quickness Hard/impossible to measure Sport science Efficient Use of Muscles? = Less Cramping/Fatigue? 2011, 2012: Averaged one IV per game 2013, 2014: One IV used all season

43 Key Points Not every person/foot type is the same Not every sport requires the same types of movement Not every position within a sport has the same movement requirements A one-size-fits-all approach to different sports/positions has not worked and needs to change Injury reduction/performance enhancement with proper equipment is common sense. Our thoughts on this shouldn t change when it comes to footwear!

44 Thank You

45 Subtitle Q & A

As a former college football player, I can remember the

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