Section 3: You will hear two sports physiotherapy students, called John and Kath, preparing a joint presentation on foot injuries in sports players.

John: I’ve had a look at your draft presentation plan and compared it with mine, Kath, and we seem to have the same basic structure.

John: We’ve both included the same three main sections – that’s the anatomy of the foot, the injuries and the treatment – and we’ve organised our presentations in the same way.

John: But the types of sports we’ve chosen to illustrate the possible injuries aren’t the same.

John: I’ll deal with the anatomy bit.

John: I’ve got notes and a handout on that from Professor Gilligan’s lecture.

Kath: Oh, I was hoping to do that.

Kath: I’ve downloaded some useful stuff.

Kath: I do think we should limit this section though.

Kath: We don’t want to spend much time on anatomy when the main focus is on the treatment.

John: That’s true, but in the last section, maybe the two of us could show how some of these therapies actually work.

John: I could be the patient and you could do the treatment.

Kath: Good idea, because it’s hard to find pictures as injuries are mostly internal.

John: It would be good to hear some first-hand accounts from injured athletes too.

Kath: Yeah, but we don’t have time.

John: No.

Kath: Should we then discuss different types of heel injury?

John: It’s worth pointing out that these vary enormously in how bad they are.

John: It might be just a pulled muscle or a bone injury which needs surgery.

John: Sometimes only an expert can tell the difference.

Kath: Excellent.

Kath: I’ll do the slides on that. Leave that one to me.

John: Now, what about causes of heel injuries?

Kath: Well, it’s easy enough to list them over use in proper footwear.

John: This incorrect running style.

Kath: They’re all relevant, but for simplicity, let’s just pick one cause.

Kath: Say, stuff about changing your training habits suddenly.

John: You mean like suddenly doing a lot of mountain training?

Kath: Yes, that’s a good idea.

Kath: And there was research on that in the latest edition of Physio Journal, wasn’t there?

John: Professor Gilligan recommended it to us.

Kath: Great.

John: You can leave the bit on stretching techniques to me.

John: I really like all that stuff.

Kath: So, what’s going to be your approach there?

John: Well, I’ll summarise all the various techniques with visual support and then I’ll make the point that the stretching should be carefully managed.

John: Obviously you have to be careful not to over-stretch and to stretch only when your muscles are warmed up, otherwise you could do yourself more harm than good.

John: It’s also important that on a supervised programme stretching is later on combined with balance exercises, which stretch and also strengthen the muscles.

Kath: Okay then.

Kath: Before you hear the rest of the discussion, you have some time to look at questions 27-30 on page 5.

Kath: Now listen and answer questions 27 to 30.

Kath: It’s always useful to have some information on case studies at the end, in case we’re short of a material.

Kath: Did you manage to find anything?

John: Yes, a female runner in her thirties talking about her treatment for a swollen heel.

John: Initially she rested the injury.

John: This did help to reduce the swelling, although it was still a little bit uncomfortable.

John: Then she applied an ice pack to the injury twice a day.

Kath: Did that work?

John: Well, she persisted with this treatment for the first month but decided it wasn’t helping.

John: After this period she was shown how to use deep tissue massage techniques and was surprised at how much freedom of movement this created in her foot.

Kath: Wasn’t she having ultrasound treatment?

John: Yes, she was having sessions at the hospital but she remained unconvinced about its value.

John: She felt the same about the balancing exercises she was prescribed.

Kath: Okay, that’s interesting.

Kath: I looked at the aftercare program of a male sprinter who was allowed to do some sports activity as part of his rehabilitation.

Kath: After four months of treatment, he did some light running on grass, wearing shoes that gave plenty of support to his injured heel.

John: So it didn’t hurt.

Kath: Well, he found the heel was sore afterwards and the same happened with some jumping exercises he was asked to try.

John: Did he go to the gym and use weights?

Kath: Yes, after a few weeks, and if he used light weights, he could train without pain.

Kath: He also tried cycling and found this beneficial as his foot was not making contact with the ground.

Kath: He expected a similar result with swimming but found the repetitive kicking motion was actually aggravating the injury.

John: Well, both these case studies have value…

John: That is the end of section 3.

John: You now have half a minute to check your answers.

John: Now turn to section 4 on page 6.