Throughout life, whether we are athletes or not, we are trapped in a painful, disabling, limiting process that we call injury.
After more than 20 years suffering them firsthand as a professional athlete and now treating them as a podiatrist, I have been able to classify into four the keys that we must take into account to combat an injury with all the possible weapons at our disposal.
In this case I am going to focus on lower limb injuries, which is my specialty, but this synthesis can be applied to any part of the body.
If we look at the diagram, we can consider that each point is equivalent to a 25% possible improvement in the pathology, as long as each of the sections is carried out correctly and we are effective in its analysis.
I always explain to my patients that the more percentage we cover, the greater the percentage of success will be when it comes to combating the injury, therefore, let’s begin to unravel the mystery of “why does it hurt?”, a mystery that frustrates so many people every time. day.
Point 1 of the scheme tries to understand what is happening to us, have an Accurate Diagnosis and understand why the injury occurred. But deciphering what pathology we have is not enough to complete point 1, we must understand why the injury occurs, and what part of our biomechanics is responsible for the problem arising. To do this, we must observe the movements of each of the joints, comparing them with the healthy limb and studying them meticulously. We must observe these movements, in slow motion if possible, to be able to appreciate small details, which added together can become one of the key points of our daily pain.
Being able to give a differential diagnosis is important, by this I mean correctly ruling out other possible pathologies that have the same signs and symptoms as our injury, this is crucial to get the diagnosis right and get off to a good start, never better said.
Once we know what pathology we have developed, we must ask ourselves “why does it occur?”
We have to explain to the patient with didactic tools, for example; with a bone foot, with a sheet, with a drawing… what Biomechanical movement of our body causes the pain, whether due to impact, continuous repetitions, inappropriate footwear, etc…. in this way we will be able to help ourselves correct that movement, even if it is a defect in one of these joints or even a deformity.
Observing oneself has a very positive impact when it comes to recovery, which is why the explanation to the patient of why their problem occurs must be clear, with a direct message that anyone who does not have training or experience can understand. anatomy of the human body, neither sports nor rehabilitation.
It is very important to be clear to give an accurate diagnosis, a radiological report will not be enough, we can resolve the pathology, but not the cause, we can reduce the pain, but not what causes it, and in the majority of patients these injuries are repetitive. since we do not decipher the cause that causes them.
Second. Workouts and habits
To analyze and take advantage of this part, the professional must have advanced training knowledge and be trained in different sports, to be able to offer the patient solutions, technical corrections, detect errors in the training phases, advise on the most recommended type of terrain for perform daily exercise, discipline, nutrition, technique, at what time of the season the patient is, even if he is not an athlete, what daily habits the patient has, how many kilometers a day he walks, knowing what extra efforts the patient has made. patient in recent weeks, (for example the Camino de Santiago without having been carrying out an adaptation before), all these points are important, so we must treat them with a very good critical eye, to be able to carry out a complete anamnesis.
Third point. Footwear.
Like the previous point, footwear is one of the four keys, which, in my opinion, accounts for 25% of the solution to our injuries.
On many occasions, just by changing the type of footwear we are successful in the treatment. At this point we must keep in mind that the more sports we do or the more hours of training we do, the more value the footwear we use has.
What type of footwear is the patient wearing? soccer boot, athletic spikes, hiking boots, moccasin shoes, high heels, is it suitable or not? Observing the wear and tear of the shoe or sneaker is important. What materials does our patient’s footwear have? , it has a buttress, it is laced, what is its drop… Is this shoe suitable for the weight of our patient? And is it suitable for the discipline you are doing?
We must ask ourselves all these questions and look for every detail that can help us detect the problem.
Advising the patient on appropriate footwear, whether technical or not, is a task that the professional has to carry out, informing himself of the different brands and models of sneakers that exist and even gutting some to know the inside of them and their materials. The most dedicated professionals even invest in trying different types of footwear from various brands to have their own sensations and be able to transfer them to the patient.
What tools do we have to solve the injury?
In this section, which some consider provides a value of more than 25%, we have:
bandages, rehabilitation by the physiotherapist jointly in a multidisciplinary team, strengthening of the intrinsic and extrinsic muscles of the foot, leg and hip, plantar orthoses (insoles) and of course infiltrations and surgeries in cases where those for which there are no solutions through non-invasive treatments.
I always tell my patients that there is a part of point four that is mandatory, and it is about strengthening. We are going to be halfway to recovering the injury if, after buying a good shoe, we attach a personalized insole to improve the footprint always after knowing the diagnosis, and if only if necessary, perform an infiltration if appropriate… we do not strengthen that weakness that is causing a decompensation that ends up causing our injury.
I hope that this summary of how to treat an injury helps you resolve your doubts, and above all to request that whoever treats you, diagnoses and helps you with your injury gives 100% of their abilities without forgetting the small details.
Hipólito Montesinos Verdú, Podiatrist and High Level Athlete