In the heat of the summer comes band practice. We’re especially proud of our Lawrence North and Lawrence Central High School marching bands. Receiving multiple awards, we’re so proud of the fact that our schools are receiving NATIONAL attention. So we want to do our part to keep them marching!
If you add up all the steps the kids do in practice and performing they are up there with cross country. It is so common to see the same overuse injuries. We should pay attention to flat feet. First, flat feet is usually an inherited condition meaning it runs in the family. Second, flat feet have a harder time supporting the body. You can read more about the variety of conditions marching in marching band can cause by checking out the latest post on our blog!
What is the Cause?
The Pes Planus or flat foot is usually the bad guy. There is a very strong family trait for this deformity. This is why I like to see the parents and the grandparents when evaluating pediatric foot problems. Click HERE to see what this foot issue looks like.
The foot bones are growing and developing until the age of 12/13 for girls and 14/16 for guys. By the time the student is in high school, the bones have pretty much reached skeletal maturity. They now have an adult foot with adult problems. If this foot type was treated during the early developmental years, many adult foot and ankle problems could have been reduced or avoided.
What I Do for Treatment
I do not have an immediate influence on body mass or activity level. I can rapidly influence foot and ankle mechanics though. The last thing I want to do for my active kids is stop their activity.
Typically the first thing we try is to control the pronation. The rearfoot can be controlled with athletic taping, shoes, and stretching. This is a great test. The taping mimics an orthotic. Depending on the improvement, we may consider a pre-fab or custom. The custom devices take time to make and are pricey. It is nice to know if they may help before investing in them.
So, What are the Problems?
Posterior tibial tendonitis is one of the top problems. Tenderness is located from the inside of the ankle to the arch.
If the pain is on the bottom of the heel it is plantar fasciitis. If the discomfort is around the sides of the heel it may be the juvenile form of plantar fasciitis called Severs disease. This is a growth plate injury.
If the pain is at the back of the heel or slightly higher, it can be Achilles tendinitis.
Shin splints come in two flavors. Discomfort will be on the inside or outside of the shin bone. They are two different problems with two different treatments.
Houston We Have More Problems
General forefoot pain with swelling can be from a stress fracture. Typically there is a gradual buildup of pain that eventually stops the student from walking. The later the stress fracture is diagnosed, the longer the recovery. Delayed treatment could mean 4-8 weeks off the foot. Early diagnosis could mean a shorter recovery (2-4 weeks).
Ankle injuries are prevalent but usually do not occur while marching. Practice is usually in a parking lot or on the practice fields. These are very flat surfaces so there are few uneven surprises for the ankle. They usually occur before/after practice with “goofing off” antics. Some instruments prevent a forward line of sight, so stepping off a curb near the field could be the cause.
Other non-graceful injuries include dropping an instrument on the foot or tripping over an instrument case.
There are some teenager-specific problems that are not band related. They include ingrown nails and nail infections, fungal skin infection – Tinea Pedis. Warts are also very prominent in this age group. What they all have in common is an excessive amount of sweat (hyperhidrosis). This can be associated with a god-awful odor (bromhidrosis) that makes the family dog run away when shoes are removed. Most kids outgrow this but there is no since torturing the family until they leave for college. The treatment is pretty simple.
So enjoy the marching band season and the rarity of a large group of teenagers working together seamlessly…in a uniform and snap spats that would normally be cruel and unusual punishment if the parent made them do it. You can never hear Sweet Caroline, Bohemian Rhapsody, or Uptown Funk too often.
If you or your child is experiencing foot or ankle pain, contact us today!