Foot inversion treatment and observation in athletes

Foot inversion is the most common type of hypermobility injury in athletes

The average American logs approximately 75,000 miles on their feet by the age of 50 according to the American Podiatric Medical Association. Athletes and those who are regularly physically active likely log even more, making the prevention and treatment of injuries to this part of the body especially important.

Medical News Today adds that some of the most common foot issues for the population in general are athlete’s foot, bunions, diabetic neuropathy, ingrown toenails, and plantar fasciitis. But one additional foot-related problem that may impact athletes specifically is foot inversion.

Foot inversion explained

“Inversion of the foot happens when the foot rolls laterally so that the sole of the foot is facing medially,” explains Stephen B. Hill, DC, of Hill Functional Wellness in Tempe, Ariz. “In athletes, it is the most common type of hypermobility injury in the foot and the reason for the majority of ankle and foot sprains.”

Research published in the Clinical Journal of Sports Medicine indicates that treatment and rehabilitation of foot ankle injuries such as inversion are “crucial” to athletes being able to return to their sports with full function. However, “foot inversion, or more specifically, foot inversion injury, can be a tough issue to overcome,” says Hill.

Observing foot inversion in and tread patterns

Overcoming foot inversion injury in athletes involves first identifying that it is an issue.

“There are a number of ways that a professional will observe a person with foot inversion injury or adverse foot inversion movement patterns,” says Hill. One is to look at the bottom of the athlete’s shoes or, more specifically, the tread-wear patterns.

“If the lateral side of the tread appears to be more worn than the medial side, that usually means that more pressure is being exerted on the outside of the foot when that person is walking and/or running,” says Hill. “This is a pretty clear indicator that foot inversion patterns are an issue.”

Another visual assessment recommended by Hill is to have the patient stand barefooted and facing away from you. “Look at the amount of arch the individual has in their medial longitudinal arch (main foot arch),” suggests Hill. “Oftentimes, people with structurally-higher arches will be more prone to standing and walking with more foot inversion.” 

Hill adds that, in addition to visual observations, there are also a few orthopedic and radiological tests that patients can undergo that can help ascertain whether there are structural integrity issues related to the bones, tendons, ligaments, and muscles in the athlete’s foot. These may be necessary based on findings of the physical exam.

Treating foot inversion injuries

If foot inversion is suspected, treatment begins with strengthening of the foot eversion and inversion muscles says Hill because, the stronger these muscles, the more they are able to help stabilize the foot during dynamic movements. Use of a resistance band can help with this.

A few of the ankle-strengthening exercises recommended by the Orthopaedic Specialists of North Carolina include:

• Sitting with the legs extended in front, loop the band around the ball of one foot, and cross the other leg over the top at the ankle. Holding the band, have the patient turn his or her top foot in and pull against the band. (inversion)

• Keeping the legs extended in front and the loop the band around the ball of one foot, have the patient move the band to the outside of the other foot and turn that foot out, creating resistance against the band. (eversion)

Alleviating foot inversion issues between visits

There are also certain recommendations that can be made with athletes that can help them prevent or alleviate foot inversion issues between chiropractic visits. For instance, a 2014 study published in the Journal of Foot and Ankle Research found that wearing high-top shoes can provide greater ankle joint stability by inducing a delayed pre-activation timing and decreased amplitude of evertor muscle activity.

“Remember, the foot is the foundation of the body in many ways,” says Hill. “If the foundation is unstable or off balance, it can change the dynamic of the joints above it — namely, the knees, hips, and sacroiliac joints.”

Thus, protecting the foot is critical to protecting and enhancing the body as a whole.