Every day, podiatrists treat cyclists who have sustained overuse injuries from pushing themselves beyond their limits. A routine that includes warming up, stretching, and cooling down can help prevent some of the common injuries mentioned below.

As with all athletic injuries, persistent pain indicates the need to seek treatment from a sports medicine specialist familiar with cycling injuries.

Knee Pain: Some intrinsic knee issues, such as swelling, clicking, or popping, should be evaluated by a sports medicine specialist immediately. A biomechanical imbalance, improper saddle height, or incorrect foot positioning on the pedals can cause cartilage irritation or deterioration, typically under the kneecap. Riding in too high a gear, cycling uphill for long distances, or standing on the pedals can exacerbate the problem. Cleated shoes or touring shoes with soles that limit side-to-side motion can also lead to knee pain if the knees, feet, and pedals are misaligned.

Shin Splints: This condition is characterized by pain along either side of the shinbone, caused by inflammation of the muscles or tendons. It is often linked to a muscle imbalance between opposing muscle groups in the leg and is commonly associated with excessive foot pronation (a collapsing arch). Proper stretching and using corrective orthotic devices can help prevent shin splints. 

Warming up increases blood flow to the muscles and raises body temperature, preparing the muscles and joints for the strain of cycling. It also gets the heart and lungs ready, which can help prevent early fatigue.

A good warm-up routine doesn't have to be lengthy or tedious; 3 to 5 minutes is sufficient (a little longer in cold weather). You can engage in any light physical activity that involves the legs and feet, such as jogging in place, walking with slow jogging, skipping rope, or performing slow jumping jacks.

Cooling down after your ride is equally important, as it allows your heart rate to decrease gradually and your body temperature to return to normal. Five to ten minutes of walking or very slow jogging is adequate for cooling down. 

After warming up, your muscles are more pliable and ready to be stretched. Flexible muscles can better withstand the strain of vigorous exercise, and stretching can help prevent muscle fatigue, spasms, sprains, and strains. Additionally, it's crucial to stretch your muscles again after the cool-down period to prevent them from tightening up. Many studies have shown that the stronger an athlete is, the less likely they are to incur injuries.

If you or someone that you care for suffers from pain in the feet, ankles, knees, hips, and/or lower back, the pain may be due to misalignment caused by faulty biomechanics, which can be treated and corrected with the help of custom orthotic insoles. To schedule your comprehensive biomechanical evaluation, visit drleecohen.com or call our Sports Medicine Podiatry Center and book an appointment at our Marlton, N.J., Sports Medicine Facility or Ridley Park, P.A. Office location with one of our podiatric sports medicine specialists today by calling (610) 522-9200.

Spring is a season when people get outside, become more active, and make their shoe selections for activities and sports like running, tennis, and baseball. In this article, we will provide tips for choosing the ideal shoes for spring sports activities. Many of these tips can be applied to selecting various types of shoes, regardless of the season. Even if you have already chosen your shoes for this spring, these suggestions will still be useful for future selections.

Choosing the right shoes for each sport is crucial. Good athletic shoes provide important cushioning and stability, which can help prevent injuries and enhance performance. In contrast, worn-out shoes with damaged soles and heels can actually cause and worsen injuries.

Today’s playing surfaces vary widely and include different types of turf fields, tennis courts, and running surfaces such as streets, trails, and grass. Each of these surfaces requires specific shoes designed for optimal performance. Since athletic shoes serve as the interface between the player and the playing surface, their importance should not be underestimated. 

FINDING THE PROPER FIT

When selecting athletic shoes, several important considerations must be addressed, even if they may seem obvious. Properly fitting shoes can enhance performance and help prevent injuries. Ill-fitting shoes can lead to various problems. That’s why it’s essential to consult with a shoe-fitting expert when choosing shoes for specific sports. Shoes that are too small can cause foot pain, while shoes that are too large can result in heel slippage, lack of stability, and blisters.

It’s important to remember that different brands often fit differently. For example, if you wear a size 9 in Adidas, you might need a size 9.5 in another brand or even a size 10 in New Balance. This is why seeking assistance from a shoe professional is crucial when trying to find the right sports shoe. Additionally, as we age, our shoe sizes can change. The time of day when you buy shoes also matters; later in the day, your feet tend to swell. If you purchase shoes in the morning and then play your sport in the afternoon, you could end up with shoes that are the wrong size, leading to foot pain.

We recommend that our patients and athletes have their feet sized every time they buy shoes, both while standing and while seated. Measurements should be taken from heel to toe, from heel to the ball of the foot, and for width. This can be accomplished using a Brannock device, which we utilize in our office for accurate foot fitting.

When purchasing new shoes, it is important to have them fitted using the actual socks that will be worn during the sport. Typically, running shoes are half a size larger than your regular sneakers. 

When purchasing shoes for children, it's important to resist the urge to choose a larger size in the hope that they will eventually fit into them. This is a common mistake that can cause instability and lead to foot injuries. A proper fit is crucial for their safety and comfort.

RUNNING SHOES

The fit of a running shoe should allow for about a thumbnail's length of space between the end of your longest toe and the end of the shoe. Your heel should be able to move slightly, but it should not slip, especially if you are wearing orthotics or a custom insole. It’s important to bring and insert your orthotic insoles when trying on new shoes. Your shoes should feel comfortable in the store, and it is recommended that you jog around the store for about 10 minutes to ensure they fit well.

BASEBALL AND SOFTBALL CLEATS

When buying baseball shoes, ensure there is enough room in the toes to move comfortably while standing straight. A snug fit with no heel movement is essential. Baseball and softball cleats are considered low to medium-impact shoes, as they experience approximately 4 to 6 times your body weight transferring to the feet. The impact can be even greater on artificial surfaces. Therefore, it's advisable to have midsole cushioning in baseball and softball cleats to help absorb this impact.

Most players prefer mid-cut or mid-height cleats for better ankle support. Metal cleats feature molded soles with several small metal spikes designed to provide maximum traction on the field, especially on extremely hard surfaces. These shoes are typically made of leather, have cushioned midsoles, and fit similarly to standard sneakers.

For younger players, molded cleats are standard because metal cleats are not allowed. These cleats have molded midsoles and cushioning, making them suitable for instructional levels of the sport. They also come in different heights and are safe for use on grass and certain types of artificial turf.

TENNIS SHOES

Tennis shoes fit similarly to running shoes, but there are important differences. When trying on tennis shoes, you should ensure there is a thumbnail's length of space between the end of your longest toe (usually on your larger foot) and the end of the shoe. Your heel should have some movement but should not slip out of the shoe. 

Tennis shoes are essential for players because the game requires quick lateral movements, stopping, starting, cutting, pivoting, and jumping. Running shoes lack the lateral stability necessary for effective play in tennis. Additionally, the traction pattern of tennis shoes varies depending on the type of court surface you're playing on. A professional tennis shoe fitter can help determine the best type of tennis shoe for you.

When selecting tennis shoes, it’s also crucial to consider court surfaces, your style of play, and foot structure. This is important for all sports, but in tennis, lateral support is vital for preventing ankle sprains and other injuries.

In conclusion, selecting the right footwear for your spring activities is essential for both performance and injury prevention. Properly fitted athletic shoes can provide the necessary support, cushioning, and stability, allowing you to enjoy your favorite sports to the fullest. Regularly assessing your shoes and keeping them in good condition will not only enhance your overall experience but also contribute to your long-term performance. Whether you're hitting the pavement for a run or gearing up for a game, remembering these tips will serve you well both this season and in the future.

To schedule your comprehensive biomechanical evaluation, visit drleecohen.com or call our Sports Medicine Podiatry Center and book an appointment at our Marlton, N.J. Sports Medicine Facility or Ridley Park, P.A. Office location with one of our podiatric sports medicine specialists today by calling (610) 522-9200.

Just like other aspects of our bodies that we inherit from our parents, we also inherit the bone structure of our feet, along with any related problems or associated issues. This means you can thank your parents not only for traits such as your hair color, eye color, and height, but also for many of the foot and lower body issues you may experience.

Some of the common hereditary causes of foot problems seen and treated in our office by our team of sports medicine podiatry experts include:

Flatfeet

A flat foot or lower-than-normal arch in the foot can cause foot pain, fatigue, and balance issues.

High Arches

A high foot arch is one that is raised more than normal. With high arches, the feet do not roll inward (pronate), resulting in less surface area making contact with the ground. This decreases the foot's ability to absorb shock and puts excessive pressure on the ball and heel of the foot.

Plantar Fasciitis

Inflammation of the plantar fascia, a thick band of tissue along the bottom of the foot, which causes pain often near the heel and on the bottom of the foot. 

Bunions 

A bony growth protruding from the joint at the base of the big toe, which can cause pain, stiffness, and difficulty walking. It may also lead to further complications such as bursitis, metatarsalgia, and hammertoes.

Hammertoe

A condition in which the middle joint of a toe is bent, often resulting in pain, stiffness, swelling, and difficulty walking. Hammertoe can also lead to corns and calluses. 

Genetics significantly influences the shape and structure of our feet. Some individuals inherit foot mechanics that increase the likelihood of certain conditions due to hereditary traits affecting how the bones, muscles, and joints in the foot are formed.

Because the feet are the foundation of the body, an imbalance, or even the slightest biomechanical shift, can affect the entire body and cause pain in multiple areas along the kinetic chain, including the ankles, legs, knees, hips, and back.

To schedule your comprehensive biomechanical evaluation, visit drleecohen.com or call our Sports Medicine Podiatry Center and book an appointment at our Marlton, N.J., Sports Medicine Facility or Ridley Park, P.A. Office location with one of our podiatric sports medicine specialists today by calling (610) 522-9200.

April is Foot Health Awareness Month and the perfect time to discuss proper body alignment and how misalignment can cause strain, resulting in pain, because proper foot health is one of the most important aspects to address when it comes to proper body alignment. The pain can appear at any level in the body whether it be the back, hips, knees, legs, ankles, or feet, it just depends on where the body’s weakest link is along the kinetic chain. Strain causes pain. And it all begins with the feet.
Woman performing squat exercise while holding hand weights

A balanced structure means a reduced chance of injury, improved stability, increased confidence, endurance, and overall athletic performance. That said, it is clear how important it is to take care of your structure - especially your feet which are the body’s foundation.

This article will discuss the feet and ankles, where most movement begins, and much like a building’s foundation it determines stability, holds up the structures (including all its weight), and connects it.

After years of standing, walking, and wearing shoes, the arches of your feet gradually weaken and cannot provide the necessary support for your body. Many problems we see in the office such as hip pain, back pain knee pain, and Achilles tendon pain are not related to any pathology in those areas but are related to poor mechanics of the foot and ankle. 

The most effective and simplest way to correct those painful conditions is with a custom orthotic. Custom orthotics are inserts that fit into your shoe that are custom-molded to correct your faulty mechanics. They help to reduce abnormal motion while you walk or run and equally disperse pressure on the bottom of your feet to realign the structures of your foot. By doing so, custom orthotics improve the foot’s structure and help prevent bone misalignment, as well as tendon and ligament fatigue. As your foot strikes the ground, orthotics within the shoe gently direct the structures into the correct position, reducing pain and stopping inflammation.
Custom orthotic being shaped by athletic trainer using grinder

Our custom orthotic inserts are known as every foot and ankle’s ”Secret Weapon”. We design the insoles individually using eight different materials. We use our extensive examination, x-ray findings, height, weight, and age; plus your activity to determine what device we should construct for you.

If you would like to learn more about ways in which Dr. Lee S. Cohen and Associates can provide some answers about pain related to the body and or our custom orthotics and how they can help you build a stronger foundation for better movement, we recommend setting up an appointment for a complete evaluation by calling the office at (610) 522-9200 or by emailing us at This email address is being protected from spambots. You need JavaScript enabled to view it.. 

Dr. Lee S. Cohen & Associates, Sports Medicine Podiatry Center provides complete foot and ankle health care for the entire family serving the South Jersey, Philadelphia and surrounding areas with two convenient office locations: 701 NJ-73 #6, Marlton, NJ 08003 and 642 E. Chester Pike Ridley Park, PA 19078.

What is shockwave therapy?

It is an FDA-approved, noninvasive, office-based procedure that is used to treat many musculoskeletal conditions.

How does it work?

It uses ballistically generated waves, which are a combination of acoustic and pressure-generated waves, to help stimulate the body’s natural healing processes and decrease pain.

Shockwave Therapy can help to:

• Stimulate the metabolism.
• Encourage the healing processes.
• Attract growth factors, platelets, and growth mediators to the area.
• Interfere with pain signals.
• Stimulate and increase local blood flow and blood vessel formation, called angiogenesis.
• Speed along the body’s natural healing process.

It’s especially helpful for those chronic overuse injuries that have been lingering for a long period of time, that need a little help to jump-start the healing process.

How is the treatment applied or given?

It is a series of between 4 and 6 treatments, each at one-week intervals. Each treatment takes less than 5 minutes.

It is completely noninvasive. There are no injections, no downtime, and no numbing medicine, which are some of the many benefits of this treatment.

What conditions can be treated with shockwave?

Many acute and chronic musculoskeletal conditions such as plantar fasciitis Achilles tendonitis, shin splints, sesamoiditis, Morton’s neuromas and historically a lot of the focus was just on treating those overuse chronic conditions however there is increasingly more evidence that it is suggesting that it is going to be very helpful for acute conditions as well and even speeding along the healing process in stress fractures.

Credit: Dr. Alicia Canzanese

Visit www.drleecohen.com/shockwave-therapy to learn more. Call our offices at (610) 522-9200 or visit www.drleecohen.com /contact to schedule your comprehensive evaluation today at our Ridley Park, PA., office location or Marlton, N.J., Sports Medicine Podiatry Center.